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A real itinerary from a real patient - took 10 minutes to complete:


COUNTRIES OF TRAVEL:
1. Virgin Islands (USA)
2. Antigua and Barbuda
3. Barbados
4. Trinidad and Tobago*
5. Brazil*
6. Uruguay
7. Argentina*
8. Chile
9. Peru*
10. Costa Rica
(Cert!)
11. Nicaragua (Cert!)
12. Mexico

* Risk of yellow fever transmission in this country.


Cert!: This country will require a yellow fever certificate on entry.

YELLOW FEVER REPORT
A YELLOW FEVER certificate will be required on entry into:

> 10. Costa Rica
> 11. Nicaragua

This YF certificate recommendation valid for country sequence selected.

There is a RISK of yellow fever in:

> 4. Trinidad and Tobago * - check YF areas.
> 5. Brazil * - check YF areas.
> 7. Argentina * - check YF areas.
> 9. Peru * - check YF areas.


YELLOW FEVER REQUIREMENTS ON RETURN TO AUSTRALIA:
Australia will require presentation of a valid yellow fever certificate if returning to Australia within 6 days of having stayed overnight or longer in:

> 4. Trinidad and Tobago * - check YF areas.
> 5. Brazil * - check YF areas.
> 7. Argentina * - check YF areas.
> 9. Peru * - check YF areas.

YELLOW FEVER REQUIREMENTS FOR AUSTRALIA
A yellow fever vaccination certificate is required for travellers aged 1 year or over ONLY IF arriving (within 6 days of having stayed overnight or longer) from countries with risk of yellow fever transmission EXCLUDING Galapagos Islands in Ecuador, the island of Tobago and LIMITED TO Misiones province in Argentina, and for travellers having transited more than 12 hours through the airport of a country with risk of yellow fever transmission, with the same exclusions as above.

* Risk of yellow fever transmission in this country.

PLEASE NOTE
Period of validity of yellow fever certificate: in accordance with the amendment to the IHR (2005) adopted by the World Health Assembly in resolution WHA67.13, from 11 July 2016 the period of validity for all certificates of vaccination against yellow fever changes from 10 years to the duration of the life of the person vaccinated, including for certificates already issued and new certificates. Accordingly, as of 11 July 2016, valid certificates of vaccination presented by arriving travellers cannot be rejected on the grounds that more than ten years have passed since the date vaccination became effective as stated on the certificate; boosters or revaccination cannot be required.


VACCINE REPORT

VACCINATIONS for disease protection

Hepatitis A vaccine
Hepatitis B vaccine
! Rabies vaccine
Typhoid fever vaccine
! Yellow fever vaccine
! Cholera vaccine

! CHOLERA: cholera vaccine not routinely recommended - observing safe food practices is considered more important.

! RABIES: if activities/areas of travel increase rabies risk. Rabies risk level in:
> Virgin Islands (USA) rabies risk: (D)
> Antigua and Barbuda rabies risk: (D)
> Barbados rabies risk: (D)
> Trinidad and Tobago rabies risk: (D)
> Brazil rabies risk: (B)
> Uruguay rabies risk: (D)
> Argentina rabies risk: (B)
> Chile rabies risk: (D)
> Peru rabies risk: (B)
> Costa Rica rabies risk: (C)
> Nicaragua rabies risk: (A)
> Mexico rabies risk: (B)

Rabies Risk Levels (Source: CDC):
RISK LEVEL A
Rabies is found in bats and other mammals, including in dogs.

RISK LEVEL B
Although rabies is found in bats and other mammals, including in dogs, it is not considered a major risk.

RISK LEVEL C
Rabies is found in bats and other mammals but not in dogs.

RISK LEVEL D
Rabies is only found in bats, but not other mammals or in dogs (Lyssa virus found in bats in Australia).

! YF: if travelling in yellow fever areas in:
> Trinidad and Tobago
> Brazil
> Argentina
> Peru

NOTE: ensure routine vax in date - chickenpox, diphtheria/tetanus/whooping cough, influenza, mumps/measles/rubella, polio

MALARIA REPORT

MALARIA RISK IN
(check areas of travel):

Brazil
Argentina
Peru
Costa Rica
Nicaragua
Mexico


SUITABLE MALARIA DRUG ALTERNATIVES ARE (mosquito avoidance remains important):

Brazil:
WHO:
P. vivax areas:
mosquito-bite prevention plus chloroquine, or doxycycline or atovaquone-proguanil or mefloquine chemoprophylaxis.
P.falciparum areas:
mosquito-bite prevention plus Atovaquone-proguanil, doxycycline, or mefloquine.

CDC: states of Acre, Amapá, Amazonas, Rondonia, and Roraima. States of Maranhão, Mato Grosso, and Para (but not their capital cities): Atovaquone-proguanil, doxycycline, or mefloquine. Areas with rare cases: mosquito avoidance only.


Argentina: no drug recommended

Peru:
WHO: P vivax areas:
mosquito-bite prevention plus chloroquine, or doxycycline or atovaquone-proguanil or mefloquine chemoprophylaxis.

Loero region:
mosquito bite prevention plus doxycycline, mefloquine or Malarone.

CDC: doxycycline, mefloquine or Malarone.


Costa Rica: no drug recommended

Nicaragua:
WHO:
P vivax areas:
mosquito-bite prevention plus chloroquine, or doxycycline or atovaquone-proguanil or mefloquine chemoprophylaxis.
P falciparum areas:
Malarone, chloroquine, doxycycline, or mefloquine

CDC:
Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS): Malarone, chloroquine, doxycycline, or mefloquine.
Other areas with malaria: mosquito avoidance only.


Mexico:
WHO: mosquito bite prevention only.

CDC: states of Campeche, Chiapas, Chihuahua, Nayarit, and Sinaloa: Malarone, chloroquine, doxycycline, mefloquine, or primaquine (first exclude G6PD deficiency).

States of Durango, Jalisco, Oaxaca, Sonora, Tabasco, and Orthón P. Blanco municipality of Quintana Roo: mosquito avoidance only.

WHO: World Health Organisation
CDC: Centres for Disease Control and Prevention




NOTE
Fever 7 DAYS OR LATER
after entering a known malarious area should be regarded as malaria until proven otherwise.

No antimalarial prophylactic regimen provides complete protection - mosquito avoidance measures remain important.

Unexplained fever or any ‘flu-like illness within 12 months of return from a malarious area should be investigated to exclude malaria.


PLEASE NOTE
The traveller is strongly advised to check with the relevant embassy that their yellow fever certificate will be accepted by border officials on arrival if they were vaccinated more than 10 years ago (to avoid possible vaccination at a border crossing).



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