1 Diseases transmitted through intimate contact pose a more limited risk. Most travelers are not routinely in jeopardy for hepatitis B, which is transmitted through the exchange of blood and blood products, sexual activity, or contact with open skin lesions of infected persons. Previously unvaccinated persons who will work in healthcare in areas of high hepatitis B endemicity or persons who plan to live in these areas for more than six months and anticipate intimate contact with the local population should be vaccinated. In addition, if it is likely that medical or dental treatment will be sought in local facilities, vaccination is recommended. The hepatitis B vaccine is highly effective, but doses need to be started six months before travel.
Meningococcal meningitis is transmitted through respiratory droplets.
Vaccination against meningococcal disease is not a requirement for entry into any country, but it is required for pilgrims to Mecca, Saudi Arabia, for the annual Hajji. 1 One injectable dose gives at least three years of immunity. All raw vegetables, which may be grown or washed with contaminated water, should be avoided. Instruct travelers to stay away from all sauces, especially those served at room temperature. Also, fresh cheese and spicy foods are common sources of travelers' diarrhea.