Health - Tibet - page 654

Chickenpox (Varicella) Discuss this vaccine with your doctor if you have not had chicken-
pox.
Diphtheria & Tetanus Vaccinations for these two diseases are usually combined and are
recommended for everyone. After an initial course of three injections (usually given in child-
hood), boosters are necessary every 10 years.
Hepatitis A The vaccine for Hepatitis A (eg Avaxim, Havrix 1440 or VAQTA) provides long-
term immunity (at least 20 years) after an initial injection and a booster at six to 12 months.
Hepatitis A vaccine is also available in a combined form, Twinrix, with hepatitis B vaccine.
Three injections over a six-month period are required, the first two providing substantial
protection against hepatitis A.
Hepatitis B China (although not so much Tibet) is one of the world's great reservoirs of
hepatitis B infection, a disease spread by contact with blood or by sexual activity. Vaccina-
tion involves three injections, the quickest course being over three weeks with a booster at
12 months.
Influenza The flu vaccine is recommended for anyone with chronic diseases, such as dia-
betes, lung or heart disease. Tibet has a high rate of respiratory illness, so all travellers
should consider vaccination.
Measles, mumps and rubella (MMR) All travellers should ensure they are immune to
these diseases, either through infection or vaccination. Most people born before 1966 will
be immune; those born after this date should have received two MMR vaccines in their life-
time.
Pneumonia A vaccine is recommended for anyone over 65 or those over 55 with certain
medical conditions.
Polio Everyone should keep up to date with this vaccination, which is normally given in
childhood. One adult booster is then needed (as long as the full childhood course was com-
pleted), particularly if travelling to a country with recent polio activity such as Nepal. This
should be discussed with your doctor.
Rabies Rabies is the most common cause of death by infectious disease in China. Vaccin-
ation is strongly recommended for those spending more than a month in Tibet (especially if
you are cycling, handling animals, caving or travelling in remote areas) and for children.
Pretravel vaccination means you do not need to receive Rabies Immuno Globulin (RIG)
after a bite. RIG is very unlikely to be available in Tibet. If you are prevaccinated and then
bitten, you need only get two further shots of vaccine, as soon as possible, three days
apart. If not prevaccinated, you require RIG plus five shots of vaccine over the course of 28
days. The full series of vaccination does not require any boosters unless a bite occurs.
Tuberculosis The risk of tuberculosis (TB) to travellers is usually very low, unless you'll be
living with or closely associated with local people in high-risk areas. Recommendations for