Vaccination and Travel Information for Panama

PANAMA

 Information current as at:  February 2009 by The D2 Medical centre No1 Fitzwilliam Street Upper Dublin 2 ph 6314500. The experts in travel vaccines Dublin 2.


Climate: Temperatures are high across the whole country throughout the year, though cooler at high altitudes. The rainy season lasts from May to November. Rainfall is twice as heavy on the Pacific coast as it is on the lowlands of the Caribbean coast.

The average temperatures remain fairly constant all year round and average 25-30°C in Cristobal. Humidity is 90% June until December.
Capital City: Panama City
Altitude: 20 metres above sea level
Main Cities: Colon, David
Population: 2,808,268
Land Area (sq km): 78,200
Currency: 1 balboa (B) = 100 centesimos
Languages: Spanish (official), English 14% note: many Panamanians bilingual
Religions: Roman Catholic 85%, Protestant 15%
Economy: Bananas, shrimp, sugar, coffee



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 remote or 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, particular for all long term travellers to the region.

YELLOW FEVER A yellow fever vaccination certificate is recommended for all travellers going to Chepo, Darién and San Blas. This country is in the Yellow Fever Endemic Zone. Vaccination is recommended for travel to rural areas. No cases reported since the 1940s.

* World Health Organization:
The following countries and areas are regarded as Yellow Fever infected areas:

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 (south of 15°N), Togo, Uganda, United Republic of Tanzania, Zambia.
America: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, Venezuela.




West of the Canal: There is a low malaria risk, predominantly due to P. vivax ,that occurs throughout the year in three provinces: Bocas del Toro, Chiriqui and Veraguas in the west. Chloroquine-resistant P. falciparum, has been reported in the extreme northwest, near the border with Costa Rica. Areas immediately adjacent to the Panama Canal ( Herrera, Los Santos, Cocle ) and all major urban areas are, in all likelihood, risk free though prophylaxis is recommended.

East of the Canal: Falciparum malaria accounts for 3% to 28% of all cases in the region. Travellers to Darién Province and San Blas Province in Panama (including San Blas Islands) must assume Chloroquine-resistant P. falciparum, which has been reported in areas east of the Panama Canal and in the vicinity of Gatun Lake west of the Canal.

There are five common medications for malaria prevention available in ireland. They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a D2 medical Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

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 Panama




GENERAL
Although Panama City has some very good hospitals and clinics, medical facilities outside of the capital are limited. Many medications are unavailable so travellers to Nicaragua should bring with them any prescribed medicine in its original container and in amounts commensurate with personal use. A copy of the prescription and a letter from the prescribing doctor explaining the need for prescription drugs facilitates their entry into the country. There is a severe shortage of basic medical supplies, including disposable needles, anaesthetics, and antibiotics.

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 MDICAL DIRECTOR 

Yellow Fever Map


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