The number of people visiting South Asia has gone up dramatically in the past few decades. Most travelers to this region are those visiting friends and relatives. Traveling to India carries several risks, and they vary depending upon the itinerary, duration of travel, rural versus urban travel. In addition to the recommended travel vaccines, travelers need to be updated with the routine vaccinations such as tetanus, diphtheria, measles, mumps, and rubella.
Risk of common travel-related diseases such as hepatitis A and typhoid fever and traveler’s diarrhea—is very high for travelers going to India. These diseases usually happen through ingestion of contaminated food or water and can be prevented if the travelers get appropriate vaccines before (usually 4-6 weeks) the intended travel date.
Typhoid: Risk of typhoid is very high for travelers going to India. BC had the highest number of typhoid cases in 2008. Majority of the cases were due to travelers returning from India particularly from the Punjab state. Injectable typhoid vaccine is a one-dose vaccine that can be given over the age of two years. There is an oral typhoid vaccine available as well for those 5 years of age and older, but it requires multiple (4) doses. Injectable typhoid vaccine is usually good for 2 years, and the oral vaccine is good for about 5 years.
Hepatitis A & B: Risk of hepatitis A & B is very high for travelers going to India. Hepatitis A vaccine can be given over the age of one. If you get a booster dose of hepatitis A after about 6-12 months, then the vaccine is good for a long time perhaps life. The risk of hepatitis B is increasing due to the rise in medical tourism to India. Hepatitis B is not an issue with children/adults born in Canada after 1980 as they are getting this vaccine either through school or routine childhood vaccinations. It is important to note that travelers require at least 2 doses of hepatitis B vaccine before traveling for adequate protection (preferably 3 treatments to complete the series).
Traveler’s Diarrhea: Traveller’s diarrhea (Delhi belly) is the most common cause of illness in travelers to India. The most common cause of travelers diarrhea (enterotoxigenic E.Coli.) can be prevented if the travelers get the oral vaccine (Dukoral) before their travel. Oral travelers diarrhea vaccine can be given after age two years. Travelers should still be careful about food and water precautions. The traveler should be advised regarding appropriate antibiotics for self-treatment and adjunct medications.
Malaria: Risk of disease is very high for travelers going to India. It is essential for travelers to take chemoprophylaxis anti-malarial drugs to prevent malaria infection. Malaria in India is very resistant to commonly used drugs such as chloroquine. It is equally crucial for travelers to use mosquito repellents medications to prevent the mosquito bites as there are other mosquito-related diseases common in India such as Dengue fever and Chikungunya fever.
Others: There are several other vaccines, e.g. meningococcal meningitis quadrivalent (Men A, C, W, W 135), monovalent (Men B), Japanese Encephalitis and Rabies which can be recommended for travel to India depending upon your itinerary. You should always consult a travel clinic before your intended trip.
Dr. Parmjit Sohal MD, PhD, CCFP, FCFP, CTH is a family physician and travel medicine consultant at Surrey Medical & Travel Clinic (www.surreytravelclinic.com). He is also a Clinical Professor in the Department of Family Practice at the University of British Columbia, Vancouver.