Slate's Medical Examiner: Shots for World Travelers

Does travel to exotic lands always require special vaccinations and medications? Madeleine Brand speaks with Slate contributor and Yale University medical professor Dr. Sydney Spiesel about what precautions travelers should take before setting off.

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ALEX CHADWICK, host:

This is DAY TO DAY from NPR News. I'm Alex Chadwick.

MADELEINE BRAND, host:

And I'm Madeleine Brand.

Spring is here, time to plan for your summer vacation and those plans could involve a trip to the doctor's office. Here to tell us which shots you may need for your trip is our resident medical expert, Dr. Sydney Spiesel. He writes a column for the online magazine Slate and he joins us now from Yale University where he teaches medicine. Hi, Syd.

Dr. SYDNEY SPIESEL (Yale Medical School): Hi, Madeleine.

BRAND: Now, obviously you don't need shots for every foreign country. Which ones do you need to get shots for?

Dr. SPIESEL: Well, in general it's a good idea to make sure that certain immunizations are up to date for travel in the tropics, and in particular, you know, we always focus on developing countries because our feeling is the level of sanitation may be lower and there are more medical risks in some of that travel.

BRAND: So that would include Latin America, Southeast Asia, Africa, the Caribbean?

Dr. SPIESEL: Yes, every place I'd like to go.

BRAND: So which shots should we get?

Dr. SPIESEL: Well, the first shot that should be on everybody's list for those destinations is hepatitis A. It's a wonderful, the vaccine is a wonderful vaccine, it provides a very good level of protection.

BRAND: What are the symptoms of hep A?

Dr. SPIESEL: People run fevers, they have abdominal pain, they have nausea, they have vomiting, and typically they turn yellow.

BRAND: Hmm. So hep A, you need a shot for that. What are some other diseases?

Dr. SPIESEL: Well, another disease, it's important to make sure your polio immunizations are up to date. Polio, it had almost been eliminated from the earth and now this disease is coming back, especially in Central Africa and Northern India, and if those are the destinations, it's not a bad idea to get a booster dose of the current killed polio vaccine. It's a shot and it especially might be helpful for adults who had been immunized a long time ago.

BRAND: Anything else?

Dr. SPIESEL: A couple of other sort of oddball things. In terms of intestinal diseases, typhoid vaccine is always a good idea. The old one used to be really horrible, it'd make you feel awful and had very little effectiveness. There are two new ones, one is a shot ad one is an oral vaccine which are really much more effective and don't make you feel awful; that's always a benefit in a vaccine.

If you're traveling to sub-Sahara Africa meningitis is a real risk and the meningococcal vaccine, there's quite a good meningococcal vaccine that's been released in the last couple years and that would be a good one.

BRAND: What about just protecting yourself against run of the mill Montezuma's Revenge, just the icky gut feeling that you sometimes get when you travel?

Dr. SPIESEL: The first issue is, as they used to say, don't trust the water in a developing country. Not even bottled water. The bottled water is often not safe. But the one exception, and I recently learned about this, that bottled sparking water is much, much more likely to be safe, and apparently because the seltzer, the dissolved carbon dioxide inhibits the bacteria that cause traveler's diarrhea.

It's also not a bad idea to ask your doctor before you travel for some treatment that you might want to take along in case you do develop Montezuma's Revenge.

BRAND: Dr. Sydney Spiesel is a professor at the Yale Medical School. He also writes the medical examiner column for Slate.com, and he's our regular resident medical expert.

Thank you, Syd.

Dr. SPIESEL: Thank you.

BRAND: Happy travels.

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