Vaccination and Travel Information for Iran

IRAN

 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: Iran has a variable climate. In the northwest, winters are cold with heavy snowfall and subfreezing temperatures in December and January. Spring and Autumn are relatively mild, while summers are dry and hot.
In the south, winters are mild and the summers are very hot, having average daily temperatures in July exceeding 38° C. On the Khuzestan plain, summer heat is accompanied by high humidity.
In general, Iran has an arid climate in which most of the relatively scant annual rain falls from October through April. In most of the country, yearly rain fall averages 25 centimetres or less. The major exceptions are the higher mountain valleys of the Zagros and the Caspian coastal plain, where rain fall averages at least 50 centimetres annually. In the western part of the Caspian, rain fall is greater than 100 centimetres a year.
Capital City: Tehran
Altitude: 1150 metres above sea level
Main Cities: Esfahan, Mashhad, Shiraz
Population: 65,619,636
Land Area (sq km): 1,648,000
Currency: 10 Iranian rials (IR) = 1 toman
Languages: Persian and Persian dialects 58%, Turkic and Turkic dialects 26%, Kurdish 9%, Luri 2%, Balochi 1%, Arabic 1%, other 2%
Religions: Shi'a Muslim 89%, Sunni Muslim 10%, Zoroastrian, Jewish, Christian,
Economy: Petroleum 80%, carpets, fruits, nuts, hides, iron, steel



  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 recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.

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 recommended for travellers who will be staying in rural areas for 1 month or more.


TUBERCULOSIS (TB) Immunisation is not compulsory, and is not routinely recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt, and this is recommended pre- and post- travel for those going to ‘at risk’ regions.


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 for travellers who will be living in rural areas for 1 month or more.


YELLOW FEVER No vaccination requirements for any international traveller.




Malarial risk is present in various areas. Limited risk, exclusively due to P. vivax, exists in some areas north of the Zagros mountains and in western and south-western regions during the summer months. Transmission occurs year-round in the southwest, south, and southeast, but only during the summer in the north and northeast. Falciparum malaria accounts for 25% of the cases in the southeast and 5% to 10% of the cases in the southwest and south. Vivax malaria accounts for the rest of the cases. Malaria is endemic in approximately one-third of the land area of Iran, in the southwest and south (along the Persian Gulf, south of the Zagros mountains), in the southeast (Sistan-Baluchistan), and in the north and northeast (along the Caspian Sea and south of the border with the former USSR). Malaria transmission occurs in rural areas at elevations up to 1,500 meters. 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 Iran




GENERAL
Basic modern medical care and medicines may not be available. Basic medical care and medicines are available in the principal cities of Iran, but they may not be available in outlying areas. Doctors and hospitals may expect immediate cash payment for services. Serious medical problems requiring hospitalisation, with or without medical evacuation, can be extremely expensive. Visitors are strongly recommended to carry travel insurance.

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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