Vaccination and Travel Information for India

INDIA

 Information current as at:  February 2009 by The D2 Medical centre No 1 fitzwilliam street upper dublin 2 Ph 6314500. The experts in travel vaccines Dublin 2.


Climate: Hot tropical weather with variations from region to region. Coolest weather lasts from December until February, with cool, fresh mornings and evenings and dry, sunny days. Really hot weather, ( dry, dusty and unpleasant ) is between March and May. Monsoon rains occur in most regions in summer between June and September.

Western Himalayas: Srinagar is best from March to October; July to August can be unpleasant; cold and damp in winter. Simla is higher and therefore colder in winter.

Northern Plains: Extreme climate, warm inland from April to mid-June falling to almost freezing at night in winter, between November and February. Summers are hot with monsoons between June and September.

Central India: Madhya Pradesh State escapes the very worst of the hot season, but monsoons are heavy between July and September. Temperatures fall at night in winter.

Western India: November to February is most comfortable, although evenings can be fairly cold. Summers can be extremely hot with monsoon rainfall between mid-June and mid-September.

Southwest: The most pleasant weather is from November to March. Monsoon rains fall between late April and July. Summer temperatures are not as high as Northern India, although humidity is extreme. There are cooling breezes on the coast. Inland, Mysore and Bijapur have pleasant climates with relatively low rainfall.

Southeast: Tamil Nadu experiences a northeast monsoon between October and December and temperatures and humidity are high all year. Hills can be cold in winter. Hyderabad is hot, but less humid in summer and much cooler in winter.

Northeast: March to June and September to November are the driest and most pleasant periods. The rest of the year has extremely heavy monsoon rainfall and it is recommended that the area is avoided.
Capital City: New Delhi
Altitude: 210 metres above sea level
Main Cities: Bangalore, Bombay, Calcutta, Hyderabad, Madras
Population: 1,014,003,817
Land Area (sq km): 3,287,590 sq Km
Currency: 1 Indian rupee (Re) = 100 paise
Languages: Hindi, Bengali, Teugu, Marathi, tamil, Urdu, Gujarati, Malayalam, Kannada, Oriya, Punjabi,English, Sindi, Sanskrit, Hindustani (a popular variant of Hindi/Urdu spoken widely throughout northern India)
Religions: Hindu 80%, Muslim 14%, Christian 2.4%, Sikh 2%, Buddhist 0.7%, Jains 0.5%, other 0.4%
Economy: Agriculture, farming, services, textile goods, gems and jewelry, engineering goods, chemicals, leather manufactures, tourism



 The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

HEPATITIS 'A' Immunisation is strongly recommended but not compulsory.

HEPATITIS 'B' Immunisation is strongly recommended for travellers.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.


JAP.B.ENCEPHALITIS Immunisation is recommended for travellers who will be in the rural or remote areas for 1 month or more at a time.


POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.



RABIES Immunisation is definitely recommended for travellers who will be living in rural areas for 1 month or more.


TUBERCULOSIS (TB) Immunisation is not compulsory, and is not recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt.


TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

TYPHOID FEVER Immunisation is recommended.


YELLOW FEVER Anyone (except infants up to the age of 6 months) arriving by air or sea without a certificate is detained in isolation for up to 6 days if that person (i) arrives within 6 days of departure from an infected area, or (ii) has been in such an area in transit (excepting those passengers and members of the crew who, while in transit through an airport situated in an infected area, remained within the airport premises during the period of their entire stay and the Health Officer agrees to such exemption), or (iii) has come on a ship that started from or touched at any port in a yellow fever infected area up to 30 days before its arrival in India, unless such a ship has been disinsected in accordance with the procedure laid down by WHO, or (iv) has come by an aircraft which has bee n in an infected area and has not been disinsected in accordance with the provisions laid down in the Indian Aircraft Public Health Rules, 1954, or those recommended by WHO.



The following countries and areas are regarded as endemic for Yellow Fever:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Togo, Uganda, United Republic of Tanzania, Zambia.

America: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, Venezuela.




Malaria is highly endemic at elevations less than 2,000 metres (6,500 feet). Malaria is present in all areas of India including the cities of Delhi, Mumbai, Madras excluding high altitude areas of Himachal Pradesh, Jammu and Kashmir, and Sikkim. Malaria risk in the more temperate New Delhi is seasonal, with the major risk being from July until November, with a ‘high’ in September.

The incidence of malaria has increased recently in Delhi, Tamil Nadu State, and Haryana State. The most intense malaria transmission in India occurs in the eastern and northeastern states. P. vivax malaria accounts for 60%–65% of cases countrywide, P. falciparum the remainder. Transmission is generally limited to May through November when Anopheles mosquito vectors breed in standing water. Approximately 40% of the population is infected with malaria. Chloroquine resistance is reported. P. falciparum resistant to chloroquine and sulfadoxine–pyrimethamine reported.

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.

Malaria map of India




GENERAL
Adequate to excellent medical care is available in the major population centers, but it is usually very limited or unavailable in rural areas. Medical facilities are basic in urban areas and poor to non-existent in rural areas. Some medicines are in short supply or locally unobtainable.

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 Medical recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.

                                                                                                                                 DR JOHN J RYAN MEDICAL DIRECTOR

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