Preparing for Your Trip to the Dominican Republic
Before visiting the Dominican Republic, you
may need to get the following vaccinations and medications for
vaccine-preventable diseases and other diseases you might be at risk for at your
destination: (Note: Your doctor or health-care provider will determine
what you will need, depending on factors such as your health and immunization
history, areas of the country you will be visiting, and planned activities.)
To have the most benefit, see a health-care provider at least 4–6 weeks
before your trip to allow time for your vaccines to take effect and to start
taking medicine to prevent malaria, if you need it.
Even if you have less than 4 weeks before you leave, you should still see a
health-care provider for needed vaccines, anti-malaria drugs and other
medications and information about how to protect yourself from illness and
injury while traveling.
CDC recommends that you see a health-care provider who specializes in Travel
Medicine.
Find a
travel medicine clinic near you. If you have a medical condition, you should
also share your travel plans with any doctors you are currently seeing for other
medical reasons.
If your travel plans will take you to more than one country during a single
trip, be sure to let your health-care provider know so that you can receive the
appropriate vaccinations and information for all of your destinations. Long-term
travelers, such as those who plan to work or study abroad, may also need
additional vaccinations as required by their employer or school.
Be sure your routine vaccinations are
up-to-date.
Check the
links below to see which vaccinations adults and children should get.
Routine vaccines, as they are often
called, such as for influenza, chickenpox (or varicella), polio,
measles/mumps/rubella (MMR), and diphtheria/pertussis/tetanus (DPT) are given at
all stages of life; see the
childhood
and adolescent immunization schedule and
routine
adult immunization schedule.
Routine vaccines are recommended even if you do not travel. Although
childhood diseases, such as measles, rarely occur in the United States, they are
still common in many parts of the world. A traveler who is not vaccinated would
be at risk for infection.
Vaccine-Preventable Diseases
Vaccine recommendations are based on the
best available risk information. Please note that the level of risk for
vaccine-preventable diseases can change at any time.
Vaccination or Disease |
Recommendations or Requirements for Vaccine-Preventable
Diseases |
Routine |
Recommended if you are not up-to-date with routine shots, such as
measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine,
poliovirus vaccine, etc. |
Hepatitis
A or immune globulin (IG) |
Recommended for all unvaccinated people traveling to or working in countries
with an intermediate or high level of hepatitis A virus infection (see
map) where exposure might occur through food or water. Cases of
travel-related hepatitis A can also occur in travelers to developing countries
with "standard" tourist itineraries, accommodations, and food consumption
behaviors. |
Hepatitis
B |
Recommended for all unvaccinated persons traveling to or working in countries
with intermediate to high levels of endemic HBV transmission (see
map), especially those who might be exposed to blood or body fluids, have
sexual contact with the local population, or be exposed through medical
treatment (e.g., for an accident). |
Typhoid |
Recommended for all unvaccinated people traveling to or working in the
Caribbean, especially if staying with friends or relatives or visiting smaller
cities, villages, or rural areas where exposure might occur through food or
water. |
Rabies |
Recommended for travelers spending a lot of time outdoors, especially in
rural areas, involved in activities such as bicycling, camping, or hiking. Also
recommended for travelers with significant occupational risks (such as
veterinarians), for long-term travelers and expatriates living in areas with a
significant risk of exposure, and for travelers involved in any activities that
might bring them into direct contact with bats, carnivores, and other mammals.
Children are considered at higher risk because they tend to play with animals,
may receive more severe bites, or may not report
bites. |
Malaria
Areas of the Dominican Republic with Malaria: All
areas (including resort areas), except none in the cities of Santiago and Santo
Domingo.
If you will be visiting an area of the Dominican Republic with malaria, you
will need to discuss with your doctor the best ways for you to avoid getting
sick with malaria. Ways to prevent malaria include the following:
- Taking a prescription antimalarial drug
- Using insect repellent and wearing long pants and sleeves to prevent
mosquito bites
- Sleeping in air-conditioned or well-screened rooms or using
bednets
All of the following antimalarial drugs are equal options for preventing
malaria in the Dominican Republic: Atovaquone-proguanil, chloroquine,
doxycycline, or mefloquine. For detailed information about each of these
drugs, see
Table
3-11: Drugs used in the prophylaxis of malaria. For information that can
help you and your doctor decide which of these drugs would be best for you,
please see
Choosing a
Drug to Prevent Malaria.
To find out more information on malaria throughout the world, you can use the
interactive CDC malaria
map. You can search or browse countries, cities, and place names for more
specific malaria risk information and the recommended prevention medicines for
that area.
Malaria Contact for Health-Care Providers
For
assistance with the diagnosis or management of suspected cases of malaria, call
the CDC Malaria Hotline: 770-488-7788 (M-F, 9 am-5 pm, Eastern time). For
emergency consultation after hours, call 770-488-7100 and ask to speak with a
CDC Malaria Branch clinician..
More Information About Malaria
Malaria is always a serious disease and may be a deadly
illness. Humans get malaria from the bite of a mosquito infected with the
parasite. Prevent this serious disease by seeing your health-care provider for a
prescription antimalarial drug and by protecting yourself against mosquito bites.
Travelers to malaria risk-areas in the Dominican Republic, including infants,
children, and former residents of Dominican Republic, should take one of the
antimalarial drugs listed in the box above.
Symptoms
Malaria symptoms may include
- fever
- chills
- sweats
- headache
- body aches
- nausea and vomiting
- fatigue
Malaria symptoms will occur at least 7 to 9 days after being bitten by an
infected mosquito. Fever in the first week of travel in a malaria-risk area is
unlikely to be malaria; however, you should see a doctor right away if you
develop a fever during your trip.
Malaria may cause anemia and jaundice. Malaria infections with
Plasmodium
falciparum, if not promptly treated, may cause kidney failure, coma, and
death. Despite using the protective measures outlined above, travelers may still
develop malaria up to a year after returning from a malarious area. You should
see a doctor immediately if you develop a fever anytime during the year
following your return and tell the physician of your travel.
A Special Note about Antimalarial Drugs
You should purchase your antimalarial drugs before travel. Drugs purchased
overseas may not be manufactured according to United States standards and may
not be effective. They also may be dangerous, contain counterfeit medications or
contaminants, or be combinations of drugs that are not safe to use.
Halofantrine (marketed as Halfan) is widely used overseas to treat malaria.
CDC recommends that you do
NOT use halofantrine because of
serious heart-related side effects, including deaths. You should avoid using
antimalarial drugs that are not recommended
unless you have
been diagnosed with life-threatening malaria and no other options are
immediately available.
For detailed information about these antimalarial drugs, see
Choosing a Drug to
Prevent Malaria.
Items to Bring With You
Medicines you may need:
- The prescription medicines you take every day. Make sure
you have enough to last during your trip. Keep them in their original
prescription bottles and always in your carry-on luggage. Be sure to follow
security guidelines, if the medicines are
liquids.
- Antimalarial drugs, if traveling to a malaria-risk
area in Dominican Republic and prescribed by your doctor.
- Medicine for diarrhea, usually over-the-counter.
Note: Some drugs available by prescription in the US are illegal in other
countries. Check the US Department of State
Consular Information Sheets for the country(s) you
intend to visit or the embassy or consulate for that country(s). If your
medication is not allowed in the country you will be visiting, ask your
health-care provider to write a letter on office stationery stating the
medication has been prescribed for you.
Other items you may need:
- Iodine tablets and portable water filters to purify water if bottled water
is not available. See A Guide to
Water Filters, A Guide to
Commercially-Bottled Water and Other Beverages, and Safe Food and Water for more
detailed information.
- Sunblock and sunglasses for protection from harmful effects of UV sun rays.
See Basic
Information about Skin Cancer for more information.
- Antibacterial hand wipes or alcohol-based hand sanitizer containing at least
60% alcohol.
- To prevent insect/mosquito bites, bring:
- Lightweight long-sleeved shirts, long pants, and a hat to wear outside,
whenever possible.
- Flying-insect spray to help clear rooms of mosquitoes. The product should
contain a pyrethroid insecticide; these insecticides quickly kill flying
insects, including mosquitoes.
- Bed nets treated with permethrin, if you will not be sleeping in an
air-conditioned or well-screened room and will be in malaria-risk areas. For use
and purchasing information, see Insecticide
Treated Bed Nets on the CDC malaria site. Overseas, permethrin or another
insecticide, deltamethrin, may be purchased to treat bed nets and
clothes.
See other suggested over-the-counter medications and first aid items for a
travelers' health
kit.
Note: Check the
Air Travel section of the
Transportation
Security Administration website for the latest
information about airport screening procedures and prohibited items.
Other Diseases Found in the Caribbean
The following are disease risks that might affect travelers; this is not a
complete list of diseases that can be present. Environmental conditions may also
change, and up to date information about risk by regions within a country may
also not always be available.
Dengue
epidemics have occurred on many of the Caribbean islands. Most islands are
infested with
Aedes aegypti, so these
places are at risk for introduction of dengue. Protecting yourself against
insect bites (
see below) will help to prevent this
disease.
In 2006,
malaria
(
falciparum) was confirmed in travelers
to Great Exuma, Bahamas, and Kingston, Jamaica, areas where malaria transmission
typically does not occur. An outbreak of eosinophilic meningitis caused by
Angiostrongylus cantonensis occurred in
travelers to Jamaica.
Cutaneous larval migrans is a risk for travelers with exposures on beaches
and
leptospirosis
is common in many areas and poses a risk to travelers engaged in recreational
freshwater activities. Such activities may include whitewater rafting,
kayaking, adventure racing, or hiking. Endemic leptospirosis is reported in
Jamaica. Travelers to regions in Jamaica can reduce their risk to leptospirosis
by avoiding activities which expose them to contaminated fresh surface water.
Outbreaks of
ciguatera
poisoning, which results from eating toxin-containing reef fish, have
occurred on many islands.
Endemic foci of
histoplasmosis
are found on many Caribbean islands, and outbreaks have occurred in
travelers.
Anthrax is hyperendemic in Haiti but has not been reported on most of the
other islands. Haiti also has a high incidence rate of
tuberculosis
and high
HIV
prevalence rates.
Staying Healthy During Your Trip
Prevent Insect Bites
Many diseases, like
malaria
and
dengue,
are spread through insect bites. One of the best protections is to prevent
insect bites by:
- Using insect repellent (bug spray) with 30%-50% DEET. Picaridin, available
in 7% and 15% concentrations, needs more frequent application. There is less
information available on how effective picaridin is at protecting against all of
the types of mosquitoes that transmit malaria.
- Wearing long-sleeved shirts, long pants, and a hat outdoors.
- Remaining indoors in a screened or air-conditioned area during the peak
biting period for malaria (dusk and dawn).
- Sleeping in beds covered by nets treated with permethrin, if not sleeping in
an air-conditioned or well-screened room.
- Spraying rooms with products effective against flying insects, such as those
containing pyrethroid.
For detailed information about insect repellent use, see
Insect and Arthropod
Protection.
Prevent Animal Bites and Scratches
Direct contact with animals can spread diseases like rabies or cause serious
injury or illness. It is important to prevent animal bites and scratches.
- Be sure you are up to date with tetanus vaccination.
- Do not touch or feed any animals, including dogs and cats. Even animals that
look like healthy pets can have rabies or other diseases.
- Help children stay safe by supervising them carefully around all animals.
- If you are bitten or scratched, wash the wound well with soap and water and
go to a doctor right away.
- After your trip, be sure to tell your doctor or state health department if
you were bitten or scratched during travel.
For more information about rabies and travel, see the
Rabies chapter of the
Yellow Book or
CDC's Rabies homepage. For more
information about how to protect yourself from other risks related to animals,
see
Animal-Associated
Hazards.
Be Careful about Food and Water
Diseases from food and water are the leading cause of illness in travelers.
Follow these tips for safe eating and drinking:
- Wash your hands often with soap and water, especially before eating. If
soap and water are not available, use an alcohol-based hand gel (with at least
60% alcohol).
- Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or
bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not
possible, learn how to make water
safer to drink.
- Do not eat food purchased from street vendors.
- Make sure food is fully cooked.
- Avoid dairy products, unless you know they have been pasteurized.
Diseases from food and water often cause vomiting and diarrhea. Make sure to
bring diarrhea medicine with you so that you can treat mild cases yourself.
Avoid Injuries
Car crashes are a leading cause of
injury among
travelers. Protect yourself from these injuries by:
- Not drinking and driving.
- Wearing your seat belt and using car seats or booster seats in the backseat
for children.
- Following local traffic laws.
- Wearing helmets when you ride bikes, motorcycles, and motor bikes.
- Not getting on an overloaded bus or mini-bus.
- Hiring a local driver, when possible.
- Avoiding night driving.
Other Health Tips
- To avoid infections such as HIV and viral hepatitis do not share needles for
tattoos, body piercing, or injections.
- To reduce the risk of HIV and other sexually transmitted diseases always use
latex condoms.
- To prevent fungal and parasitic infections, keep feet clean and dry, and do
not go barefoot, especially on beaches where animals may have
defecated.
After You Return Home
If you are not feeling well, you should see your doctor and mention that you
have recently traveled. Also tell your doctor if you were bitten or scratched by
an animal while traveling.
If you have visited a malaria-risk area, continue taking your chloroquine for
4 weeks after leaving the risk area.
Malaria is always a serious disease and may be a
deadly illness. If you become ill with a fever or flu-like illness either
while traveling in a malaria-risk area or after you return home (for up to 1
year), you should seek
immediate medical attention and should
tell the physician your travel history.
Important Note:
This document is not a complete medical guide for travelers to this
region. Consult with your doctor for specific information related to your needs
and your medical history; recommendations may differ for pregnant women, young
children, and persons who have chronic medical conditions.
#MSPInfectología | Para la organización Mundial de la Salud (OMS) la incidencia del virus del dengue va aumentando a pasos agigantados a nivel mundial. Según las estimaciones, cada año se reportan alrededor de 390 millones de casos.
La prevención de este virus se puede hacer mediante el manejo adecuado de los desechos sólidos, limpiar y vaciar cada semana los recipientes donde se almacena agua para el uso doméstico y fumigar las zonas estancables y los productos susceptibles de traer el mosquito.
#MSP: Lo más relevante para médicos, pacientes y profesionales de la salud. #Pioneros
LIBROS GRATIS #PDF solo dirígete al enlace de las fotos y allí tienes el enlace en donde puedes descargar de forma legal y sin trucos tu libro. Dr. Ramon Reyes, MD @DrRamonReyesMD https://lnkd.in/eVpFyzZ #DrRamonReyesMD
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