Malaria and other mosquito transmitted infections
Immigrants from countries with high malaria prevalence gradually lose their immunity and are exposed to infection when they visit their former homelands. Experience shows that people from Africa and Pakistan are most at risk. Visits during the rainy season, travel to areas with poor health services and infrastructure and prolonged stay in close contact with the local population are important factors that make this group more susceptible to infection.
It may often be appropriate for people travelling to visit their former homelands to take preventive medicine against malaria and to protect themselves against mosquito bites. In addition, protection against mosquito is important to avoid other mosquito born infections like dengue fever and Zika fever. When travelling with children it is particularly important to have good malaria protection and preventive measures.
Young children who will be travelling to tropical and subtropical areas can begin vaccination in the childhood immunisation programme earlier than scheduled and receive doses at shorter intervals in order to have two or three doses of vaccine against diphtheria, tetanus, pertussis, poliomyelitis, haemophilus influenzae (DTP-IPV-Hib-HepB vaccine) and pneumococcal vaccine before departure. The child must then receive an additional dose of vaccine (four dose programme). Children who are travelling to countries with polio should receive at least two doses of polio vaccine before departure. The first dose can be given shortly after birth. When travelling to countries with outbreaks of polio, it adults may need to be vaccinated against polio before departure.
Vaccination against measles, mumps and rubella can be accelerated by giving one dose of vaccine at 9 months at the earliest, but doses given before 12 months of age should be repeated at 15 months.
Adult immigrants will often be immune to hepatitis A and hepatitis B. The same does not apply to their children. The hepatitis B vaccine is included in the childhood immunisation programme for children born after 1.November 2016. Children with parents who come from countries with high prevalence of tuberculosis are offered BCG vaccine in the childhood immunisation programme. It is recommended that children who are aged over one year who will visit their parent’s former homelands should have the hepatitis A vaccine. This also applies for short visits, as children can be a source of infection in the community on their return. The typhoid vaccine may be recommended for adults and children over 2 years, depending on the type of trip. The cost of malaria protection, hepatitis A vaccine and typhoid vaccine will be paid by the traveller.
Since children may come in contact with animals infected with rabies without their parents’ knowledge, they may be recommended to take the rabies vaccine when travelling to an endemic area. There is no lower age limit for the rabies vaccine.