RESUMO
Several vaccinations are recommended to protect international travellers, especially to tropical countries, from diseases in other parts of the world. Firstly, the routine schedule of childhood vaccinations and booster shots according to the Swiss immunisation programme should be checked, updated or even completed. Additional vaccinations against hepatitis A and B, typhoid fever, poliomyelitis, rabies or Japanese encephalitis may be recommended. This will depend on a number of factors including the exact destination and route (developing countries, rural areas), planned activities (backpacker, family visit, business trip), duration of travel, season, age of the traveller and current health status including the current medication and previous vaccinations. Some vaccinations, such as yellow fever, may be required for travellers to certain countries and the international certificate of vaccination may even be required when entering a country from another country where yellow fever is endemic. The international certificate of vaccination (or a letter of exemption when appropriate) is considered valid only if it is administered by an approved vaccination centre. Furthermore, the meningococcal vaccination (A, C, W, Y) is required for pilgrims to Saudi Arabia. It is recommended to start the vaccinations four to six weeks before departure to ensure enough time to administer all the necessary doses for an adequate immune response. All commonly used vaccines can be administered on the same day. The basic health insurance does not usually cover travel vaccines.
Assuntos
Controle de Doenças Transmissíveis , Programas de Imunização , Viagem , Adulto , Criança , Países em Desenvolvimento , Emigrantes e Imigrantes , Humanos , Esquemas de Imunização , Profilaxia Pré-Exposição , Suíça , Clima TropicalRESUMO
QUESTION UNDER STUDY: In Switzerland, vaccination against varicella is not recommended in the basic immunisation schedule. However, for individuals aged 11-40 years who do not have a reliable varicella history the Swiss Federal Office of Public Health recommends either (i) a vaccination or (ii) a serology test and vaccination of those with a negative result. In the Travel Clinic of the University of Zurich, the second strategy is followed. In this study we retrospectively assessed the overall percentage of individuals with varicella-specific antibodies despite a negative history and we examined the influence of age, number of siblings, order of siblings, age difference to siblings and nationality on varicella seropositivity. METHODS: Between December 2008 and August 2015, the sera of 1757 individuals with a negative varicella history were tested for varicella antibodies. RESULTS: A total of 1593 individuals (91%) had a positive result. We found an increasing trend for varicella seropositivity with increasing age. Those aged less than 40 years were significantly more often seronegative (9.5%) than those aged 40 years and above (6.0%, p = 0.049). Seropositivity was associated with nationality. The percentage of seropositives increased with the number of siblings. CONCLUSIONS: Our results indicate that, despite the significant varicella seropositivity differences between those aged below and above, the age of 40 may not be an ideal threshold for performing a varicella serology in individuals with a negative or unknown varicella history. In the age groups above 40, testing for varicella antibodies may be especially reasonable in individuals with no or a small number of siblings and in those of specific nationalities.