Diseases transmitted by insects, such as mosquito-spread yellow fever and malaria, are still problematic. Some countries, particularly in Africa and South America, require proof of yellow fever vaccination. A one-dose vaccination for yellow fever, administered only at designated centers, such as local health departments, provides immunity for 10 years. Malaria is prevalent in the tropical regions. 1 Advise individuals to be vigilant for the flu-like symptoms of malaria, which may appear up to a year after exposure.
Travelers can minimize risk by avoiding infectious mosquitoes.
Warn them to stay in areas protected by screens or mosquito nets, to wear clothes that thoroughly cover the body, and to apply insect repellant to all exposed areas. An application of permethrin-containing repellents by spray or soaking to clothing and bednets will repel insects for several weeks. 1 Food and waterborne diseases, such as typhoid fever, cholera, and hepatitis A, can cause serious illnesses. Vaccination against typhoid fever is recommended for travelers to areas where there is a recognized risk of exposure to Salmonella typhi, i.e., the Indian subcontinent, Asia, Africa, and Latin America, and particularly for those visiting small cities or rural areas, or traveling for an extended period in areas with recognized risk. Three typhoid vaccines are currently available for use in the US, one oral and two parenteral preparations.