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Statens Serum Institut’s vaccination recommendations for foreign travel have been updated

Statens Serum Institut no longer recommends routine use of malaria tablets for travellers to the majority of countries/areas in Southeast Asia and Central & South America. And tuberculosis vaccination is primarily recommended for children aged up to 11-12 years of age.

Statens Serum Institut’s (the SSI) reference group for travel vaccination and malaria prophylaxis regularly revises the SSI’s travel vaccination recommendations. This year, the reference group has primarily focused on the risk of malaria when travelling to Southeast Asia and to Central & South America and on the indication for vaccination against tuberculosis.

Low malaria risk in Southeast Asia and Central & South America

The risk that Danish travellers to Southeast Asia and to Central & South America become infected with malaria is very modest. In the past 10 years, only seven cases were acquired in Southeast Asia and eight cases in Central & South America. This is equivalent to approximately 2% of all imported malaria cases.

On this basis, Statens Serum Institut no longer recommends routine use of chemoprophylaxis for travellers to the majority of the countries/areas in Southeast Asia and Central & South America where such prophylaxis was previously recommended.

For travellers to specific areas with a certain level of known risk of malaria, Stand-by emergency treatment may be used as an alternative to conventional malaria prophylaxis.

If the traveller is not given malaria tablets for continuous use during the travel, it is very important that the traveller is informed that some risk of malaria may remain, and the traveller must therefore be recommended systematic use of effective mosquito bite prophylaxis and must be instructed to be attentive to fever and other malaria symptoms both during and after the travel (particularly in the initial three months after returning from the travel).

It is important to point out that Stand-by emergency treatment is not the same as self-therapy. If the traveller runs a fever during a stay in Southeast Asia or Central & South America (or other places with a malaria risk), the traveller should always contact the emergency desk of his or her insurance company for advice on local malaria work-up and treatment.

Furthermore, it is important to be aware that some groups of travellers, e.g. immigrants who visit their families in their country of origin, travellers who go trekking and stay overnight in some jungle and swamp areas and back-packers on long-term travels with no predetermined travel route, may be at a heightened risk of becoming infected with malaria and these groups therefore require extra careful guidance.

Tuberculosis vaccination (BCG vaccination)

The BCG vaccine’s protective effect in children until adolescence (11-12 years) is well-documented and good. Unfortunately, it has never been documented that BCG has any convincing effect against tuberculosis (TB) in adults, including healthcare workers who are at risk of occupational TB exposure. Nevertheless, experience shows that the risk for such workers is currently modest.

BCG vaccination is therefore primarily recommended for children below 12 years of age of immigrants who will shortly be visiting relatives in areas with a high TB occurrence and to children below 12 years of age who will be staying for an extensive period of time (> 6 months) in such areas.

For more information, please read EPI-NEWS 27a, 2017, which also provides advice relating to the vaccination before pilgrimage to Mecca and describes a current increase in Denmark of invasive infections with group A streptococci.

 

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