Welcome to
Regional Medical Clinic
and Black Hills Travel Medicine. If
you will be traveling, please
call ASAP and ask for a travel medicine appointment. We specialize in
travel vaccinations, such as typhoid and yellow fever, and prevention of
malaria and other travel
diseases. Look at the page Why Travel Medicine? to
better understand how travel medicine can help you have a safe trip.

South
Dakota Yellow Fever Vaccination Site
-
Clinic Hours: 8 AM to 5 PM Monday -
Thursday
(Friday AM by special appointment)
-
Phone: 605-718-3300
-
Fax
605-718-3425
-
Address: Black Hills Travel Medicine
c/o Regional Medical Clinic
640 Flormann Street
Rapid City, SD 57701
(Located behind 8th Street Safeway Store)
Sylvia Cuka, LPN - Travel Medicine Nurse
Steven Stocks, MD -
Director profile
Notices to Travelers
updated
October 10, 2008
Airport Screening
Do you know what 3-1-1 means? See
www.tsa.gov/travelers
Aviation Notes - 1
-
Always keep prescription medicines in your carry-on
in the original labeled container.
-
Use the 3-1-1 rule for toiletries, cosmetics, lotions
etc.
-
To allow for
parking, check-in and other unforeseen
delays, travelers should plan on arriving at the
airport:
-
2 hours before domestic
flights
-
3 hours before international
flights
Travelers may be denied boarding passes at
check-in
when less
than sufficient time remains for a security check.
Aviation Notes - 2
Bird Flu
According to the
WHO, travelers to
countries experiencing bird flu (avian influenza) are not considered to be
at risk unless there is direct and unprotected contact with infected birds,
including feathers, feces, under-cooked meat or egg products. Avoid
handling surfaces contaminated by above.
In infected countries, avoid direct
contact with poultry, including well appearing, sick, or dead chickens or
ducks. Avoid places such as poultry farms, bird markets where live or
poultry are kept or raised. There is no risk in eating cooked chicken
or duck.
wwwn.cdc.gov/travel/contentAvianFluInformation.aspx
Batteries (Lithium)
DOT’s rule on lithium batteries in air travel, which
took effect on January 1, 2008, prohibits carriage of spare lithium
batteries in checked baggage... If you put a portable electronic device in
checked baggage, you may still do so with the batteries installed in the
device.
In carry-on baggage, you may still carry any number of some types of
lithium batteries, such as the ones used in cell phones and most laptop
computers, provided you take measures to protect terminals. You may also
carry up to two more powerful batteries, within the limits...
For details see http://safetravel.dot.gov
Chikungunya Fever
Chikungunya fever is a viral infection transmitted by the
bite of mosquitoes. It can cause mild to severe arthritis for six
weeks or more. Imported cases have been occurred in a number of
countries which have never previously reported chikungunya. Travelers are advised to practice daytime and
nighttime insect precautions.
http://www.cdc.gov/ncidod/dvbid/Chikungunya/index.htm
http://wwwn.cdc.gov/travel/contentChikungunyaFever.aspx
Dengue Fever & Dengue Hemorrhagic Fever (DF
& DHF)
Dengue
is the world's the most common arboviral disease (virus
transmitted by an insect) in the world. It is transmitted
by the bite of infected mosquitoes (usually Aedes aegpyti)
and the
most common cause of fever in travelers returned from the Caribbean,
Central America, South and Central Asia.
Brazil-
As of March 28, 2008, Brazilian Health
Authorities reported a national total
of 120,570 cases of dengue fever, including 647 DHF cases
and 48 deaths for 2008.
As of April 10, 2008, a total of 75,399
cases of dengue fever, including 80 confirmed deaths had
been reported in Rio de Janeiro this year.
http://wwwn.cdc.gov/travel/contentDengueTropicalSubTropical.aspx
In the August 18, 2008, ProMED-mail
report:
The coastal state of Ceara, Brazil, is recording the
2nd largest epidemic of dengue since 1986. The weekly
bulletin of the Secretariat of Health reports 37,549 cases
in 184 municipalities. Fortaleza continues to have the
greatest number of recorded cases of DHF, totaling
250, with 8 confirmed deaths and 12 under
investigation. More than 98 percent of the neighborhoods
have
confirmed [cases of] classical [dengue] disease.
Hand, Foot, and Mouth Disease
Asia-
Since March 2008, a growing number of cases of hand, foot,
and mouth disease (HFMD) has been reported in parts of Asia,
mainly affecting children. HFMD is common among infants and
children. It is very contagious and is spread through direct
contact with the nose and throat secretions, saliva, blister
fluid, or stool of an infected person.
No vaccine is available to prevent HFMD.
There is no specific treatment for people who are sick with this
disease other than treating symptoms, such as fever.
Travelers can take steps to prevent getting HFMD by practicing
good personal hygiene and following safe food and water
practices. If you are traveling to China, follow these tips to
help make healthy choices:
-
Wash your hands frequently with soap and
water for 20 seconds, especially before you eat, after you
cough or sneeze, and after you go to the bathroom. If soap
and water are not available, use an alcohol-based hand gel
(with at least 60% alcohol). Consider packing alcohol-based
hand gel in your luggage to ensure you have it when needed.
-
Eat foods that are fully cooked and
served hot.
-
Drink beverages that have been properly
bottled and sealed (water, carbonated drinks, or sports
drinks).
-
Do not put ice in drinks.
-
Eat only fruits and vegetables that you
can wash and peel yourself.
-
Do not share eating utensils, such as
forks, spoons, and cups.
http://wwwn.cdc.gov/travel/contentHandFootMouthAsia.aspx
Hepatitis A
Ethiopian-
Several cases of hepatitis A have recently been
reported in children and adults linked to adoptees from Ethiopia.
Hepatitis A is a
liver disease caused by the hepatitis A virus. Most children under the
age of 6 years do not get sick from the infection, but can spread it to
older children and adults, who often become ill.
wwwn.cdc.gov/travel/contentHepAEthiopianAdoptees.aspx
Japan & Import of Banned Medications
According to Shoreland, it is illegal to bring into Japan some over-the-counter medicines commonly
used in the United States, including inhalers and some cough, cold, allergy,
or sinus medications. Banned ingredients include those deemed to be
stimulants, such as pseudoephedrine, levmetamphetamine, and the common cough
suppressant dextromethorphan.
Some U.S. prescription medications (codeine, narcotics,
stimulants, and psychotropic drugs) cannot be imported into Japan, even when
accompanied by a customs declaration and a copy of the prescription. Japanese customs officials have detained travelers carrying prohibited
items, sometimes for several weeks.
Travelers to Japan may bring a one-month supply of a
prescription medication or a two-month supply of an over-the-counter
medication so long as they don't contain the banned substances listed above.
Larger supplies and/or prescriptions that contain narcotics require import
certification, and application should be made several months prior to
travel.
http://japan.usembassy.gov/e/acs/tacs-medimport.html
http://www.mhlw.go.jp/english/topics/import/index.html
Japanese Encephalitis Vaccine Shortage
As of May 2008, Sanofi Pasteur will be
limiting US travel clinic orders of JE-VAX®
to a total of 9 doses per month. This
means you should plan as far ahead as possible for your JE
vaccination. These ordering restrictions are expected to
last until 2009 when
Intercell's IC51 JE vaccine will be available in the US.
http://wwwn.cdc.gov/travel/contentJapaneseEncephVaccine.aspx
Malaria
Great Exuma Island, Bahamas-
The CDC has received an official report of a confirmed
malaria case in a person who traveled to Great Exuma, Bahamas,
in March 2008 and is reinstating the recommendation that
travelers to Great Exuma, Bahamas take chloroquine malaria
preventive medication (prophylaxis).
http://wwwn.cdc.gov/travel/contentMalariaBahamas07.aspx
Kingston, Jamaica-
The CDC recommendations for traveler antimalarial medication in Kingston, Jamaica
have been rescinded as of February 2008.
wwwn.cdc.gov/travel/contentMalariaJamaicaNewCase.aspx
Measles & Mumps Update
Unprotected travelers may be at risk for measles and mumps.
These diseases a generally thought of as childhood diseases.
They can be much more severe in adults, especially
immunosuppressed adults, such as, those with certain chronic
illnesses, cancer or those on immunosuppressant drugs for
diseases like rheumatoid arthritis. Measles and mumps
still circulate widely in developing countries and outbreaks
still occur in some developed countries.
http://wwwn.cdc.gov/travel/yellowBookCh4-Measles.aspx
http://wwwn.cdc.gov/travel/yellowBookCh4-Mumps.aspx
Traveling adults and
adolescents who are unsure of their immunity to measles or mumps
should have two doses of the MMR vaccine 28 days apart or have
their blood checked for antibody levels.
Measles
Israel & Switzerland-
Currently, numerous measles outbreaks are ongoing worldwide,
including outbreaks in Switzerland and Israel, which have
resulted in cases imported into the U.S.
http://wwwn.cdc.gov/travel/contentMeasles.aspx
http://wwwn.cdc.gov/travel/contentIsraelPassover.aspx
Passports-Western Hemisphere
Implemented on January 23, 2007, ALL PERSONS
traveling by air between the United States and Canada,
Mexico, Bermuda, and the Caribbean region are required to present a passport
or other valid travel document to enter or re-enter the United States.
LAND
AND SEA TRAVEL
The following
summarizes information available on the
Department of Homeland Security’s
website.
-
JANUARY 31, 2008
U.S. and Canadian citizens will need to
present either a
WHTI-compliant document, or a
government-issued photo ID, such as a
driver’s license, plus proof of citizenship,
such as a birth certificate. DHS also
proposes to begin alternative procedures for
U.S. and Canadian children at that time.
-
LATER
At a later date, to be determined, the
departments will implement the full
requirements of the land and sea phase of
WHTI. The proposed rules require most U.S.
citizens entering the United States at sea
or land ports of entry to have either a U.S.
passport; a U.S. passport card; a trusted
traveler card such as NEXUS, FAST, or SENTRI; a
valid Merchant Mariner Document (MMD) when
traveling in conjunction with official
maritime business; or a valid U.S. Military
identification card when traveling on
official orders.
Note: The passport requirement
does NOT apply to U.S. citizens
traveling to or returning directly from a
U.S. territory.
Poisons & Toxins
China-
According to the CDC,
as of September 22, 2008, contaminated milk products
in China have caused nearly 40,000 infants to be brought in
for medical care, with almost 12,900 hospitalizations, and
at least three infant deaths in China. Similar health
problems have been reported in Hong Kong and Singapore but
have not been confirmed. Specific advice for travelers
to China can be found on the following web site:
wwwn.cdc.gov/travel/contentMelamineChina.aspx
Polio Update
County specific information-
wwwn.cdc.gov/travel/contentPolioOutbreaks.aspx
Q Fever
Netherlands-
The Dutch National Institute for Public Health and the
Environment has reported an outbreak of Q fever in the
Netherlands. Between January 1 and July 24, 2008, 660 human
cases have been reported in Noord (North) Brabant Province and
southern Gelderland Province. People can become sick with
Q fever by breathing in the C. burnetii bacteria,
usually through contaminated barnyard dust and soil. People can
also get sick by drinking or eating unpasteurized (raw) milk and
dairy products.
http://wwwn.cdc.gov/travel/contentQFeverNetherlands.aspx
Rabies-Unavailability of Rabies
Pre-exposure Vaccination
As of May 20, 2008, both Sanofi Pasteur and
Novartis rabies vaccine producers have been supplying rabies
vaccine only for treatment of patients potentially exposed to
rabies. This is due to Sanofi Pasteur renovating it's
production facilities in France. Pre-exposure vaccination
must be delayed until further notice.
Novartis Vaccines is no longer be shipping
supplies of RabAvert®. To obtain IMOVAX® rabies vaccine, clinics
must first contact their
Rabies State Health Official so that a risk-assessment can
be conducted for the suspected exposure.
September 4th update:
http://www.cdc.gov/RABIES/news/RabVaxupdate.html
Tetanus & Whooping Cough
Tetanus, also known as "lockjaw," and
whooping cough (pertussis) are serious illnesses. Both
illnesses occur worldwide.
A tetanus booster is often forgotten
by travelers. This can cause difficulties when
minor injuries occur, and the traveler cannot find a clinic
for a tetanus booster or does not know his vaccination
status. Vaccinate before your trip, and ask for the new
tetanus combination booster which contains both tetanus and
acellular pertussis vaccine for
whooping cough.
Developing countries have high rates of
pertussis infectious putting the traveler at risk. In
addition, the US has experienced a study
increase in whooping cough or pertussis cases since 1980, in
adolescents and adults. Infected persons are highly
infectious and often are not aware that their irksome,
barking cough is pertussis. Previous vaccination or
infection as a child with pertussis does not give lasting
immunity. Pertussis is serious and sometimes fatal to
unvaccinated infants.
In March of 2006, the CDC published it's recommendation that
all adolescents age 11-18 years receive one dose of Tdap to prevent pertussis
infection.
All unvaccinated travelers are at risk for pertussis.
www.cdc.gov/mmwr/PDF/rr/rr5503.pdf
In December of 2006, the CDC published
it's recommendation that adults, in particular certain
groups, such as physicians, nurses, dentists and other health care workers
with direct patient contact, receive one dose of the
newly licensed Tdap vaccine to prevent pertussis infection
and outbreaks. All unvaccinated travelers are at risk for pertussis.
www.cdc.gov/mmwr/PDF/rr/rr5517.pdf
Yellow Fever
Argentina-
Yellow fever vaccination is recommended for all travelers
older than 9 months who are going to the northern and
northeastern forested areas of Argentina, including Iguaçu Falls
and all areas bordering Paraguay and Brazil.
See the
Updated CDC Yellow Fever Risk Map for Argentina.
http://wwwn.cdc.gov/travel/contentYellowFeverArgentina.aspx
Bolivia-
On December 1, 2007, the Bolivian Consulate General in the US, advised that all persons older than 12 months traveling to Bolivia must
have a valid International Certificate of Vaccination or Prophylaxis (ICVP)
to ensure protection against yellow fever.
According to the CDC:
Travelers who do not have a valid ICVP will still be allowed to enter Bolivia if they agree to sign an affidavit exempting the Bolivian state from any liability in the event the traveler gets sick with yellow fever within the Bolivian territory. This last option may cause delays at the point of entry.
According the CDC recommendation for
Bolivia:
(Yellow fever vaccination) for all travelers >9 months of age traveling to areas east of the Andes Mountains (see
Map 4-16). Does not include the cities of La Paz or Sucre. Vaccination should be given 10 days before travel and at 10 year intervals if there is on-going risk.
http://wwwn.cdc.gov/travel/destinationBolivia.aspx
Brazil-
Travelers are strongly advised to follow the
CDC yellow fever vaccination recommendations for Brazil,
with the addition of the northern part of Espiritu Santo
state and the western part of Santa Catarina state. The
Federal District of Brasilia is also an endemic area. The
Brazilian MOH has recommended vaccination of travelers >6
months of age.
wwwn.cdc.gov/travel/contentYellowFeverBrazil.aspx
Ecuador-
According to Shoreland, effective March 1, 2008 the Ecuadorian
Ministry of Health requires travelers to the Amazon region of
Ecuador to present a yellow fever vaccination certificate.
All travelers should carry their certificate with them when
entering that region.
Ivory Coast-
Since May 2008, the Côte d’Ivoire (Ivory Coast)
has experienced an outbreak of yellow fever chiefly in and
around the city of Abidjan. Nineteen cases have been
confirmed by the Côte d’Ivoire Ministry of Health.
Paraguay-
On the basis of Paraguay case reports and the
vaccination campaign taking place among the local
population, travelers are strongly advised to follow the
expanded CDC yellow fever vaccination recommendations for
Paraguay. Until further notice, yellow fever
vaccination is now recommended for all travelers older than
9 months who are going to all areas of Paraguay.
wwwn.cdc.gov/travel/contentYellowFeverParaguay.aspx
Tanzania-
According to the CDC yellow
fever vaccination requirements for Tanzania have changed.
Vaccination is now required for travelers arriving from all
countries.
wwwn.cdc.gov/travel/destinationTanzania.aspx
Yellow Fever Vaccination Certificate
Issues
This
is currently the only disease for which the World Health Organization (WHO)
officially makes vaccination requirements for international travel.
Proof of vaccination may be required for the following reasons:
-
To
obtain a visa to a country with YF.
-
Arriving in a country from one that has YF.
-
To enter national parks
or other areas in countries with YF.
-
At the discretion
of individual countries.
If proof of vaccination is required, the vaccination must be done at least 10 days before entry.
Certificates are good for 10 years.
As per the WHO, the
International Certificate of Vaccination or Prophylaxis (ICVP) for yellow
fever is a legal document. It must
be filled out and stamped at an
official yellow fever vaccination site
and must be complete in every detail to be valid.
To prevent
importation and indigenous transmission of YF, a number of
countries require a certificate of vaccination from travelers
arriving from endemic areas, even if only in transit. Such
requirements may be strictly enforced.
You may be denied entrance unless
you submit to taking the vaccine at that time or quarantine. This can put one at risk
for HIV and hepatitis B and C from contaminated needles. Also, in
some situations, the vaccine
may be ineffective due to improper handling.
According to the State of South Dakota
"yellow fever vaccination center guidelines":
-
The
International Certificate of
Vaccination for yellow fever is an official record.
-
The vaccination center is required to
assume responsibility for immunization and health education
for travelers receiving yellow fever vaccination.
Back to top
