Vaccination for Nicaragua
June 5, 2018

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WHO em­pha­sizes that all trav­ellers (do­mes­tic and in­ter­na­tional) should be up to date with rou­tine vac­ci­na­tions.

Trav­ellers should be ad­vised to check that they have been fully vac­ci­nated against measles, rubella, mumps, diph­the­ria, tetanus, per­tus­sis (whoop­ing cough) and po­liomyelitis be­fore start­ing their travel. Non-im­mu­nized or in­com­pletely im­mu­nized trav­ellers should be of­fered the rou­tine vac­ci­na­tions rec­om­mended in their na­tional im­mu­niza­tion sched­ules, in ad­di­tion to those needed for in­ter­na­tional travel.

Check the vac­cines and med­i­cines list and visit your doc­tor (ide­ally, 6 months) be­fore your trip to get vac­cines or med­i­cines you may need.

Pro­tec­tion against mos­quito bites

All trav­ellers should be ad­vised that per­sonal pro­tec­tion from mos­quito bites be­tween dusk and dawn is their first line of de­fence against malaria.

Trav­ellers may pro­tect them­selves from mos­qui­toes by the means out­lined in the fol­low­ing para­graphs.

In­sect re­pel­lents are sub­stances ap­plied to ex­posed skin or to cloth­ing to pre­vent hu­man/​​vec­tor con­tact. The ac­tive in­gre­di­ent in a re­pel­lent re­pels in­sects but does not kill them. Choose a re­pel­lent con­tain­ing DEET (N,N-di­ethyl-3-methyl­ben­za­mide), IR3535 (3-[N-acetyl-N-butyl]-amino­pro­pi­onic acid ethyl es­ter) or Icaridin (1-piperidinecar­boxylic acid, 2-(2-hy­drox­yethyl)-1-methyl­propy­lester). In­sect re­pel­lents should be ap­plied to pro­vide pro­tec­tion at times when in­sects are bit­ing. Care must be taken to avoid con­tact with mu­cous mem­branes; in­sect re­pel­lents should not be sprayed on the face, ap­plied to the eye­lids or lips, or ap­plied to sen­si­tive, sun­burned or dam­aged skin or deep skin folds. Al­ways wash the hands af­ter ap­ply­ing the re­pel­lent. Re­peated ap­pli­ca­tions may be re­quired every 3–4 h, es­pe­cially in hot and hu­mid cli­mates when sweat­ing may be pro­fuse. When the prod­uct is ap­plied to clothes, the re­pel­lent ef­fect lasts longer. How­ever, la­bel in­struc­tions should be fol­lowed to avoid dam­age to cer­tain fab­rics. Re­pel­lents should be used in strict ac­cor­dance with the man­u­fac­tur­ers’ in­struc­tions and the dosage must not be ex­ceeded, es­pe­cially for young chil­dren and preg­nant women.

Mos­quito nets are ex­cel­lent means of per­sonal pro­tec­tion while sleep­ing. Nets can be used ei­ther with or with­out in­sec­ti­cide treat­ment. How­ever, treated nets are much more ef­fec­tive. Pre­treated nets may be com­mer­cially avail­able. Nets should be strong and with a mesh size no larger than 1.5 mm. The net should be tucked in un­der the mat­tress, en­sur­ing first that it is not torn and that there are no mos­qui­toes in­side. Nets for ham­mocks are avail­able, as are nets for cots and small beds.

Mos­quito coils are the best known ex­am­ple of in­sec­ti­cide va­por­izer, usu­ally with a syn­thetic pyrethroid as the ac­tive in­gre­di­ent. A more so­phis­ti­cated prod­uct, which re­quires elec­tric­ity, is an in­sec­ti­cide mat that is placed on an elec­tri­cally heated grid, caus­ing the in­sec­ti­cide to va­por­ize. Bat­tery-op­er­ated va­por­iz­ers are also avail­able. Such de­vices can also be used dur­ing day­time if nec­es­sary.

Aerosol sprays in­tended to kill fly­ing in­sects are ef­fec­tive for quick knock­down and killing. In­door sleep­ing ar­eas should be sprayed be­fore bed­time. Treat­ing a room with an in­sec­ti­cide spray will help to free it from in­sects, but the ef­fect may be short-lived. Spray­ing be­fore bed­time, com­bined with the use of a va­por­izer or a mos­quito net, is rec­om­mended. Aerosol sprays in­tended for crawl­ing in­sects (e.g. cock­roaches and ants) should be sprayed on sur­faces where these in­sects walk.

Pro­tec­tive cloth­ing can help at times of the day when vec­tors are ac­tive. The thick­ness of the ma­te­r­ial is crit­i­cal. In­sect re­pel­lent ap­plied to cloth­ing is ef­fec­tive for longer than it may be on the skin. Ex­tra pro­tec­tion is pro­vided by treat­ing cloth­ing with per­me­thrin or etofen­prox, to pre­vent mos­qui­toes from bit­ing through cloth­ing. In tick- and flea-in­fested ar­eas, feet should be pro­tected by ap­pro­pri­ate footwear and by tuck­ing long trousers into the socks. Such mea­sures are fur­ther en­hanced by ap­pli­ca­tion of re­pel­lents to the cloth­ing.

Trav­ellers camp­ing in tents should use a com­bi­na­tion of mos­quito re­pel­lents and screens. The mesh size of tent screens of­ten ex­ceeds 1.5 mm, so that spe­cial mos­quito screens have to be de­ployed.

Screen­ing of win­dows, doors and eaves re­duces ex­po­sure to fly­ing in­sects.

Ac­com­mo­da­tion with these fea­tures should be sought where avail­able.

Air-con­di­tion­ing is a highly ef­fec­tive means of keep­ing mos­qui­toes and other in­sects out of a room as long as the room has no gaps around win­dows or doors. In air-con­di­tioned ho­tels, other pre­cau­tions are not nec­es­sary in­doors

Eat and drink safely

Un­clean food and wa­ter can cause trav­el­ers' di­ar­rhea and other dis­eases. Re­duce your risk by stick­ing to safe food and wa­ter habits.

Eat

  • Food that is cooked and served hot
  • Hard-cooked eggs
  • Fruits and veg­eta­bles you have washed in clean wa­ter or peeled your­self
  • Pas­teur­ized dairy prod­ucts

Don't Eat

  • Food served at room tem­per­a­ture
  • Food from street ven­dors
  • Raw or soft-cooked (runny) eggs
  • Raw or un­der­cooked (rare) meat or fish
  • Un­washed or un­peeled raw fruits and veg­eta­bles
  • Un­pas­teur­ized dairy prod­ucts
  • ”Bush­meat” (mon­keys, bats, or other wild game)

Drink

  • Bot­tled wa­ter that is sealed
  • Wa­ter that has been dis­in­fected
  • Ice made with bot­tled or dis­in­fected wa­ter
  • Car­bon­ated drinks
  • Hot cof­fee or tea
  • Pas­teur­ized milk

Don’t Drink

  • Tap or well wa­ter
  • Ice made with tap or well wa­ter
  • Drinks made with tap or well wa­ter (such as re­con­sti­tuted juice)
  • Un­pas­teur­ized milk