Caution: travel is hazardous for children who are not fully immunized. And it doesn’t matter who is doing the traveling – your child or perfect strangers.
• Example: Last month, a woman with a communicable case of measles traveled by air from London to New Mexico, stopping at airports in Baltimore, Denver, and Albuquerque. Similar scenarios occur several times a year. Measles is a serious, highly contagious viral disease. The virus is coughed into the air and remains viable for several hours; vigorous coughing is part of measles. Passengers sitting within five rows of the woman were at risk of acquiring the disease if they had never had it or were not immunized against it. Also at risk were contacts in the airports, on her way home from the airport, and in her home.
• The relationship between travel and diseases was recognized centuries ago. In fourteenth century Venice, passengers on ships coming from ports where plague was epidemic were kept aboard ship anchored far out in the harbor until local officials established that no case of the disease was present. The quarantine generally lasted forty days. “Quarantine” is derived from the Italian words for “forty days.”
• Travel makes vaccinating children imperative. Vaccination campaigns have been so successful in Western countries that vaccine-preventable diseases are now rare. Consequently, many parents believe that vaccines are no longer necessary or that vaccines are more hazardous than the disease. Not so. Vaccines are safe. And if vaccination programs were discontinued the diseases would make swift and dramatic comebacks, with travel a main conduit.
Controversies over vaccines are largely irrational. There is no known link between measles vaccine and autism, for example. The story was concocted by a British physician being paid large sums of money by lawyers who needed evidence to sue pharmaceutical companies making the vaccine. Legal charges are pending against him. See Wikipedia measles autism Wakefield.
• Vaccination practices overseas dictate practices in Western countries. In 2004, polio was close to extinction; cases were occurring in only four countries in Africa and Asia. Dates were set when the disease would likely be eradicated and when polio vaccinations would be discontinued. However, vaccinations were halted prematurely in Nigeria, a country where polio still existed. An official announced that the vaccine was a plot to sterilize Nigerian women. Vaccinations in that country decreased sharply, the number of cases increased greatly, and travelers unknowingly spread the disease to numerous countries in Africa, Asia and Eastern Europe. In 2010, cases of polio were reported in 21 countries. The date for eradication is now nowhere in sight, and vaccination of children everywhere will continue for the foreseeable future.
• People with infectious diseases travel. Many such diseases become communicable days before symptoms appear; the infected people do not know that they are ill. Moreover, because last minute cancellations are costly and cumbersome, people knowingly travel when they are ill. And public health measures – screening millions of passengers for fever or distributing questionnaires at airports, for example – are ineffective.
• Aircraft lend themselves to spreading disease. Aircraft air filtration systems generally limit the spread of disease-causing organisms to the immediate area of ill passengers. This is similar to most air filtration systems in schools, office buildings and hospitals, and better than aboard most surface mass transit systems. However, on aircraft, the exposure is continuous, often lasts for eight or more hours, and there is an increased chance of an infected passenger from overseas being aboard.
• You need not travel to have your children exposed. Classmates of your child may recently have returned from visiting friends and relatives overseas. Large U.S. theme parks attract millions of visitors from overseas. Universities in Western countries have huge numbers of overseas students. While school health officials make every effort to insure that these students are immunized, cases of vaccines-preventable diseases occur yearly.
• Inform your doctor that your family is traveling overseas when plans are finalized. Most destinations require no additional inoculations if children are fully immunized. However, some destinations may require several, sometimes multi-doses given over many weeks. In addition, there are new vaccines especially beneficial for teenagers, vaccines against pertussis (whooping cough) and meningitis, for example.
• Update your own vaccinations. Traveling with children is more likely to expose you to local children overseas – and possibly their diseases. Many childhood diseases – measles, chickenpox, rubella and whooping cough, for example – are prevalent in developing countries, and more common in Europe than in North America. And such diseases can be serious for adults.
• Closing messages:
For Doctors: ask patients if they have traveled recently.
For Patients: tell doctors that your family has traveled recently.
Failure of simple communications results in delayed diagnosis, sometimes with serious consequences. Travel-related diseases may surface weeks or months after the trip, when the trip is half forgotten. A prime example – though not vaccine-related – is malaria. In the U.S., more than a thousand people return home with malaria. Half of the cases are not diagnosed on their first visit to a doctor.
