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CIWEC Clinic Katmandu Nepal detailed info
Food and Water and Diarrhea
An Advisory Committee Statement (ACS)
Committee to Advise on Tropical Medicine and Travel (CATMAT) and National Advisory Committee on Immunization (NACI)*†
Recommended Usage: Travellers’ Diarrhea DUKORAL
Indications for the oral BS-WC vaccine are limited because of the
following:
- most episodes of travellers’ diarrhea are usually mild
and self-limited; - therapeutic options (oral rehydration, dietary
management, antimotility, and antibiotic treatment) are available
if prevention fails; - < 50% (range 25% to 50%) of travellers’
diarrhea cases are caused by ETEC bacteria; - the protection by
the vaccine against ETEC diarrhea is approximately 50%; and - vaccinated travellers may gain a false sense of security and
possibly avoid being as strict in observing food and water
precautions.
In summary, vaccination with the BS-WC (DURORAL)vaccine as a prevention strategy for travellers’ diarrhea is of limited value and cannot be routinely recommended for the majority of travellers.
BS-WC vaccine may be considered for the following selected
high-risk, short-term travellers who are
aged > 2 years:
* with chronic illnesses for whom there is an increased risk of
serious consequences from travellers’
diarrhea (e.g., chronic
renal failure, congestive heart failure, insulin-dependent diabetes
mellitus,
inflammatory bowel disease);
* with an increased risk of acquiring travellers’ diarrhea (e.g,.
gastric hypochlorhydria and young
children aged > 2 years);
* who are immunosuppressed due to HIV infection or other
immunodeficiency states;
* with a history of repeated severe travellers’ diarrhea; or
* for whom a brief illness cannot be tolerated (i.e., elite athletes
or business or political travellers).
Conduct a detailed, individual travel-related risk assessment to
determine those travellers who may benefit
most from BS-WC
vaccination as a prevention strategy for travellers’ diarrhea.
Motion sickness
Protection Against Mosquitoes CDC