Family Travel Clinic

Traveller’s diarrhea is a common medical problem for people travelling from developed to developing countries. Symptoms may include frequent loose bowel movements, stomach cramps, nausea, bloating and fever. Cholera can cause very severe watery diarrhea. Both illnesses can spread through contaminated food or water. A clinician can advise whether an oral vaccine is recommended for your trip. 

Oral traveller's diarrhea vaccine information:

• DUKORAL DIN# 02247208

Hepatitis A can spread through food or water contaminated with the virus. Raw or undercooked food, food handled by someone who has not washed their hands, and water contaminated by human waste can be sources of infection. Hepatitis A is a vaccine-preventable disease in travellers. Hepatitis A & B vaccines may be given as a combination vaccine in those who qualify for this series.  

Hep A vaccine information:

• AVAXIM DIN#02237792
• HAVRIX JR DIN# 02231056
• AVAXIM Pediatric DIN#02243741
• HAVRIX Adult DIN#02187078
• TWINRIX ADULT DIN# 02230578- Twinrix (Hep A & B combined)
• TWINRIX JR DIN#02237548- Twinrix (Hep A & B combined)

Hepatitis B can spread through sexual contact, blood, bodily fluids or objects contaminated with bodily fluids. A clinician can advise whether vaccination is recommended for your travel plans and risk level. Hepatitis A & B vaccines may be given as a combination vaccine in those who qualify for this series. 

Hep B vaccine information:

• ENGERIX B DIN#02487039
• ENGERIX B Pediatric DIN#02296454
• RECOMBIVAX B Adult/Pediatric DIN#0224367
• TWINRIX ADULT DIN# 02230578- Twinrix (Hep A & B combined)
• TWINRIX JR DIN#02237548- Twinrix (Hep A & B combined)

Japanese encephalitis is a viral disease spread by mosquitoes. Vaccination may be considered for travellers three months and older who will spend a month or more in high-prevalence areas during transmission season, especially if travel includes rural areas. 

Japanese encephalitis vaccine information:

• IXIARO DIN#02333279

There is currently no approved vaccine against malaria, but antimalarial medication is available for adults and children. Travellers should also take steps to prevent mosquito bites. 

• Activities | When possible, avoid places and times when mosquitoes are most active. Try to avoid damp, wooded areas where mosquitoes live and breed, and stay indoors or take extra precautions during dusk and dawn.
• Clothing | Wear full-coverage clothing that protects against mosquito bites, such as long-sleeve shirts and full-length pants. Wear shoes and socks to protect your ankles and feet. Try to wear light-colored clothing as dark colors attract mosquitoes.
• Netting | Sleep in screened areas or under bed nets. Tuck mosquito netting under your mattress when sleeping. Mosquito netting should also be used over children in strollers. For the best protection, mosquito netting should have mesh large enough for air circulation, but small enough to keep out mosquitoes.
• Insect repellant | Apply an insect repellent containing up to 35% DEET to skin, clothing and bed nets.

Anti-malariarial medication information:

• MALARONE DIN#02238151
• MALARONE PED DIN#02264935
• DOXYCYCLINE DIN#02158574
• MEFLOQUINE DIN#02244366
• HYDROXYQUINE DIN#02246691
• CHLOROQUINE DIN#00021261 (not currently available) 

Learn more about malaria on AboutKidsHealth.

Meningitis is an infection of the membranes that cover the brain and spinal cord. It is most common among children and people whose bodies have trouble fighting infections. Meningococcal conjugate vaccine prevents four types of meningococcal disease. 

Meningitis vaccine information:

• MENACTRA DIN#02279924
• NIMENRIX DIN#02402904
• BEXSERO (B) DIN#02417030
• TRUMENBA (B) DIN#02468751

Rabies can spread through the bite of an infected animal. Avoiding contact with animals, especially dogs and monkeys, can reduce risk. A clinician can advise whether the rabies vaccine should be considered based on your destination, itinerary and access to safe post-exposure care. Related information: Animal bites on AboutKidsHealth. 

Rabies vaccine information:

• IMOVAX RABIES DIN#01908286
• RABAVERT DIN#02267667

Typhoid fever spreads through contaminated food and water. Vaccination may be recommended for travellers who will have prolonged exposure to potentially contaminated food and water, especially in smaller cities, villages or rural areas in countries with a high incidence of typhoid. Related information: Typhoid on AboutKidsHealth. 

Typhoid vaccine information:

• TYPHIM VI DIN#02130955 
• VIVOTIF DIN#00885975

Yellow fever spreads through the bite of an infected mosquito. Yellow fever immunization may be recommended for travellers nine months and older who are visiting or living in certain countries in Africa, Central America and South America. Some countries require proof of yellow fever immunization. Recommendations depend on your itinerary and the requirements of the country you are visiting, including stopovers. 

SickKids Family Travel Clinic is a designated Yellow Fever Clinic. The clinic can help determine if you will need to be vaccinated for Yellow Fever and provide you with the necessary documentation. The Yellow Fever vaccine must be administered a minimum of 10 days before your trip and is not covered by OHIP (Ontario Health Insurance Plan). 

Is Yellow Fever vaccination required? 

If you are travelling to a country that requires a Yellow Fever vaccination, you must be immunized at a designated Yellow Fever clinic and carry an official Certificate of Vaccination with you to be inspected by border and country officials. If you are unable to prove that you have had the Yellow Fever vaccination, you may by denied entry into a country. Many countries have regulations for Yellow Fever vaccination even if you are only travelling through the country. For more information, visit: Travellers Going to Yellow Fever Areas - Canada.ca. 

Yellow fever vaccine information:

• YF-VAX DIN#00428833- Yellow Fever

Immunization during pregnancy requires careful review of the possible risks of vaccine-preventable disease and the possible risks of vaccination for the pregnant person and fetus. In general, vaccinations should be avoided during the first trimester. Live virus vaccines, such as oral typhoid, should be avoided in all trimesters. 

Some travellers have conditions or treatments that reduce immune function, such as organ transplantation, HIV infection, cancer, corticosteroids or immunosuppressive medications. Travel-related risks for immunocompromised travellers depend on their immune status. 

Living with a chronic health condition does not mean you cannot travel. Planning ahead can help you prepare for your trip. 

Before travelling outside Canada: 

• Contact the Family Travel Clinic to find out whether travel vaccines, medications or other interventions may be recommended. 
• Carry a letter from your doctor explaining your condition and any medical supplies you may need. 
• Carry a record of your medications and vaccinations. 
• Ask your doctor or pharmacist whether you need to adjust your medication schedule if you will cross time zones. 
• Bring enough extra medication in case your return is delayed. 
• Arrange health insurance before you leave.