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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Cold
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
Flexibility
Gadgets & Gizmos
Get Moving!
Get Motivated
Golf Exercises
Golf Injury Prevention
Head Injuries
Hockey Injuries
Home Gyms
Immunization
Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
Low Back Pain
Osteoporosis & Exercise
Osteoarthritis
Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Prevention of Sports Injury
Proprioception
Recreational Safety Equipment
Running
Safe Snow Shovelling
Shin Splints
Ski Conditioning
Shoes & Fit
Sore Elbow
Sore Shoulder
Spinal Cord Injuries
Staying Active
Staying Fit in the Cold
Sports Nutrition & Supplements
Strength Training
Swimming Injuries
Teen Sports Injuries
Walking
Water and Exercise
Weight Training
7 Wonders of Walking
Adolescent Health
Full Listing with story descriptions
Acne
Adolescent Behaviour Problems
Adolescent Growth & Development
Body Image
Body Piercing
Bullying
Chronic Diseases in Teens
Communications Skills
Concussion in Sport
Cosmetics & Skincare
Dangers of Artificial Tanning
Depression
Depression - Causes
Drug Use
Female Physical Exam
First Period
Internet Safety
Junior High
Mentoring to Quit Smoking
Mononucleosis
Parent-Teen Communication
Parent -Teen Interaction Patterns
Personal Care
Psychological Assessment
School Problems
Self Esteem
Self Esteem & Body Image
Sexually Transmitted Diseases
Talking About Sex
Taking Chances
Tattoos
Teaching Respect
Teens & Smoking
Teenage Blues
Teen Bedwetting
Teen Drivers
Teen Girls
Teen Health
Teen Immunization
Teen Independence
Teen Rebellion
Teens & Divorce
Teenagers and Sexual Issues
Teens & Exercise
Water and Exercise
A Woman's Physical
Your First Job
Youth Violence
Ask the Doctor
Bone Density Testing
My Doctor Says I Need a Test
Childbirth
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
Exercise in Pregnancy
Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
Infections During Pregnancy
Intrauterine Growth Restriction (IUGR)
In-Vitro Fertilization
Low Birth Weight Babies
Medication & Pregnancy
Miscarriage
Managing Your Own Labour
Monitoring Your Labour
Nausea & Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Pregnancy Weight
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Pregnancy Weight Gain
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
Full Listing with story descriptions
Asthma in Children
Attention Deficit Disorder
Babysitter
Bed Wetting
Chickenpox
Childcare Options
Children's Headaches
Childhood Obesity
Choosing A Babysitter
Circumcision
Colds & Flu
Common Childhood Skin Infections
Croup
Developmental Milestones
Diaper Rash
Daytime Wetting
Introducing Solid Foods
Developmental Co-ordination Disorder
Diarrhea
Discipline
Earache
Eczema
Feeding Your Baby
Feeding Your Toddler
Fever
Head Lice
Hearing
How Children Grow
Hearing Loss
Hearing Issues in Newborns
Heart Murmers
Hip Clicks
Influenza
Iron
Is it an Emergency?
Children and Sports Injuries
Lazy Eye (Amblyopia)
Learning Disabilities
Leg Problems
Not Just Baby Fat
Orthodontics
Preparing for Lab Tests
Recognizing Learning Disabilities
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
School
Scoliosis
Sick Toddler
Sleep Struggles
Sniffles, Fevers, Rashes & Coughs
Sore Throats
Speech Problems
Strep Throat
Toddler Safety
Thumbsucking
Tooth Injuries
Travelling with Children
Tummyache
Urinary Tract Infections
Vaccinations
Vaccination and Autism
When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
Dental Exam
Dental Care Devices
Dental Caries
Dental Care Offshore
Dental Implants
Dental X-Rays
Dentures and Healthy Jaw
Esthetic Dentistry
Fluoride
Fluoride Findings
First Dental Visit
Headaches
A Healthy Mouth
Healthy Mouth, Healthy Body
Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Mouth Protection Equipment
Oral Cancer Screening
Oral Healthcare
Oral health and long term care
Oral Health Care Products
Orthodontics
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
Full Listing with story descriptions
10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
Allergic Rhinitis
Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
Bladder Problems
Blood Transfusions
Breaast and Prostate Cancer Screening
Carpal Tunnel Syndrome
Check-Up
Colon Cancer Screening
Contact Lenses
Contraception
COPD
Cost of Doctor's Visit
Diabetes Management
Diarrhea
Diagnostic Tests
Do I Need a Bone Density Test?
Doctor Visit
Driving Vision
Dizziness
Dealing with Dry Eyes
Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
Electronic Medical Records
Epilepsy
Eye Exam
Family Doctor
Fibromyalgia
Floaters and Flashes
Food Poisoning
5 Ways to Stay Healthy
Gallbladder
Get Active!
Glare
Headaches
Healthcare Teams
Heart Health
Hemorrhoids
Hepatitis C
Human Papilloma Virus
High Blood Pressure
High Blood Pressure Risks
How to Talk to Your Doctor
Hypothyroidism
Insomnia
Irritable Bowel Syndrome
Joint Replacement Surgery
Kidney Disease
Lazy Eye Blindness (Amblyopia)
Medical Digital Technology
Migraine
Meningitis
Multiple Sclerosis
Multiple Myeloma
Obesity
Opioid Myths
Primary Healthcare Reform
Prostate Problems
Quitting Smoking
Red Eyes
Respiratory Tract Infections
Restore Your Core
Rosacea
Screening Tests
Shingles
Sinusitis
Special Diagnostic Tests
Stopping Stroke
Stroke
Superbugs
Thyroid
Ulcers
Urine Tests
Vaccination Controversies (ask the doctor)
Win by Losing
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
Burns
Choking
Cuts and Scrapes
Emergency Care Guidelines
Eye Injuries
Fainting and Convulsions
First Aid Travel Kit
Hypothermia and Frostbite
Nosebleeds
Poisoning - Household
Sunburn
Growing Older
Full Listing with story descriptions
Advance Care Plans
Age-Related Macular Degeneration
Alzheimer Disease
Avoiding Memory Loss
Building Strength
Caring for the Caregiver
Cataracts
Can I see Well Enough to Drive?
Cholesterol
Congestive Heart Failure
Coping with Dementia
Constipation
Controlling Medications
C.O.P.D.
Delirium
Dementia and Agitation
Dizziness (Vertigo)
Eating Well
Elder Abuse
Exercise Benefits
Erectile Dysfunction
Eye Care
Eyesight and Driving
Feet
Frailty
Fungal Nail Infections
Get Active!
Glaucoma
Grief
Have Health, Will Travel
Health Tips for Seniors
Hearing
Incontinence
Joint Replacement
Lab Tests
Living Longer With Diabetes
Macular Degeneration
Male Menopause (Andropause)
Maintaining Quality of Life as You Age
Memory Loss
New Corneal Treatments
Nutrition for Seniors
Osteoarthritis
Osteoporosis
Parkinson Disease
Problem Gambling
Prostate Health
Retirement
Seniors and Medications
Senior Sexuality
Sexually Transmitted Infections
Screening Tests
Seniors and Driving
Sleeplessness
Skin Structure
Skin Protection
Skin Over 50
Solving Sleep Issues
Staying Healthy
Stroke Prevention
Travel Tips for Snowbirds
Wills and Personal Directives
Modern Living
Full Listing with story descriptions
Abuse
Acupuncture
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
Antidepressants
Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
Cosmetic Pesticides
Depression
Diabetes Epidemic
Discipline
Diseases from Pets
Downsizing
Dying at Home
Erectile Dysfunction New Treatments
Exotic Travel
Fertility Issues
Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
Grief
Harassment
Healing Through Music
Healthy Computing
Humidex
Hypnotherapy
Ice Safety
Indoor Air Quality
Lymphedema
Mature Student
Melamine in Food
Middle Age Health
Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Schizophrenia
Smokeless Tobacco
Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Sunburn
Sunglasses
Time Management
Travel Health Protection
Travel Comfort Tips
Travel Immunization
Understanding Change
Unplugging
Whiplash
Wind Chill Index
Workplace Drug Testing
Workplace Health
Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
Weight Loss
Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
Insomnia
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Pain Relievers
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports & Nutrition Supplements
Sunscreen
Taking Medication
Take as Directed
Using Antibiotics Wisely
Viagra
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
Alcohol
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
Disaster Planning
Diseases from Pets
Caffeine
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
E-cigarettes
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Meningitis
Norovirus
Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
Sun Safety
Surviving Disaster
Sushi Preparation
Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
Water Smarts
Vision Damage
Water Wisdom
West Nile Disease
Whooping Cough
Workplace Alcohol Abuse
Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception
Contraception for Mature Women
Cosmetic Procedures
Cystitis
Endometriosis
Estrogen's Effect on the Brain
Fear of Fracture
Fibroids
Heart Attack
Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menopause
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Osteoporosis
Ovarian Cancer
Ovarian Cysts
Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
Sexually Transmitted Infections
Urinary Incontinence
Vaginitis
Varicose Veins
Viagra for Women
Yeast Infections
Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
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Family Health Magazine - MODERN LIVING

It’s a Small World...
for Both You and Disease
Protect yourself before travelling

Travel to faraway places is becoming more inviting, affordable, and easy to manage. You can travel to anywhere in the world within 36 hours. Unfortunately, so can disease. Parasites, viruses and bacteria can hitch a ride in your bloodstream. While travel is an adventure, be aware of the risk of acquiring exotic diseases. Without precautions, you can become ill while away or after returning home. In many cases, you can protect your own health and that of others by getting immunized.

The Three Rs of Immunization: Routine, Required and Recommended

Routine

Growing up in North America, we have access to standard childhood vaccinations. They include diphtheria, tetanus, polio, pertussis (whooping cough), measles, mumps, rubella (often referred to as German measles), Hib (Haemophilus influenza type B), varicella (chickenpox), and hepatitis B for those born after 1982.

If you plan to take your children to countries with high risks of certain diseases, have them assessed by a travel doctor or public health nurse. Additional vaccinations, or modifications, may be needed, especially if children have not finished the routine series. Be aware that diseases like tetanus, polio and measles are common in less developed countries. They can cause severe disability or death.

Required

Meningitis

This specific travel vaccine protects against four different strains of bacteria. Travelers to Saudi Arabia for the Hajj and Omrah will not be issued a visa without proof of this vaccination from a travel clinic. It must be repeated every three years.

Certain countries in Africa and South America have mosquitoes that can carry this virus. The disease attacks the liver, causing the severe jaundice (yellowing of the skin and whites of the eyes) from which the name comes. The death rate from yellow fever is very high.

Yellow Fever

Some countries require proof of vaccination (a special certificate from a certified yellow fever centre) in order to enter the country. Many countries free of yellow fever will refuse entry to an unvaccinated traveler coming from a country that has this disease. The vaccine and the official certificate are valid for ten years. After that time, the shot must be repeated and a new certificate issued.

Yellow fever vaccine can be given to adults and children over nine months of age. It is a ‘live’ vaccine, containing minute amounts of weakened virus that stimulate the blood to form protective antibodies. These antibodies will destroy any new yellow fever viruses a nasty little mosquito might inject.

The vaccine is made in cultures (or growing environments) that include egg protein. Those with a severe egg allergy cannot take it. It is not given to pregnant women, or to anyone with severe problems of the immune system. Rare but serious side effects from the vaccine have also been reported in people over the age of 60.

On occasion, people unable to take the vaccine must travel to countries that require the certificate. In this case, an exemption letter can be given by a travel clinic that is designated as a yellow fever centre. The unvaccinated traveler must be aware, however, of the risk of getting the disease. As well, officials at the country’s border may choose not to accept the exemption letter, and refuse entry.

Discuss your risks and options with a doctor or travel nurse at a yellow fever centre. Remember that to provide protection and for the certificate to be valid, this vaccine must be given at least ten days before entering the country at risk.

Recommended

Where you go, for how long, and whether you plan to backpack through the jungle or stay in a five-star resort affect your risk and the vaccinations you should consider. As no vaccines (except oral typhoid) in this category are live, they can generally all be used in pregnancy and in children over the age of one or two.

Hepatitis A

From Calgary to Timbuktu, this is an extremely common virus. Asymptomatic carriers (those who have the virus but show no symptoms of it) can pass it on by handling food, water and ice cubes others then consume. You can get Hepatitis A whether you eat street food or in an expensive restaurant. The illness can vary from mild and flu-like, to severe with prolonged symptoms due to liver inflammation. Symptoms appear two to six weeks after infection. The virus is excreted in the stools of infected people. Its spread is related to lack of adequate hand washing. Infected children often do not get ill but spread the disease through less than hygienic toilet habits, or when diaper-changing caregivers don’t wash their hands. The vaccine is a series of two shots – the first gives excellent protection for a year or more, while the second gives lifelong immunity. Those who have had the disease are permanently immune. They cannot pass it on and do not need vaccination.

Hepatitis B

This serious disease can lead to death from liver failure or cancer. Transmission comes through contact with contaminated needles or body fluids. It can be passed through blood transfusions, IV drug use, tattoos with unclean needles, sharing personal items like toothbrushes, razors and nail clippers, or having sex with someone who is infected. Hepatitis B can also be transmitted from an infected mother to her baby during pregnancy. Infection rates are high in populations living in Asia, Africa and the Caribbean. Transmission is similar to that of hepatitis C and HIV, neither of which can be prevented by vaccinations. Once infected with hepatitis B, you may recover completely or carry the virus forever. If you carry it, you may not have symptoms but can still transmit the disease to others. You may also progress to liver failure and death.

After infection, symptoms do not usually appear for about six months. Symptoms are similar to Hepatitis A but more severe. Treatment can only support the disease, not heal it.

Since many people consider hepatitis B a lifestyle disease, they do not feel they are at risk. However, you can become ill or injured and require medical or dental treatment in a place where no clean needles are available (yes…that happens). Physical or sexual assault in areas of the world where hepatitis B is common can also expose you to the disease.

This vaccine is a series of three shots, with protection after the first two, and, commonly, lifelong immunity after the third. In Canada, most children born in the past 20 years should have received the vaccine in school, although the age at which it is given varies among the provinces. If they have had all three shots, they most likely have lifelong immunity.

Twinrix

This is Hepatitis A and B in one vaccine. It requires two shots for initial protection, and three for long-term immunity.

Tetanus/Diptheria

This vaccine comes with protection for both these diseases. Routine public health immunizations keep children up to date until their last shot at age 14. You will receive this shot if you step on a nail or have a dirty wound. Repeat it every five to ten years, depending on the location and type of travel you are doing. For adults requiring a booster, it is recommended to give Adacel, which provides protection against tetanus, diphtheria and pertussis.

Typhoid

Salmonella bacteria cause this nasty disease. Like hepatitis A, it can be transmitted to food and water by a healthy carrier. Raw or inadequately cooked shellfish, or water contaminated by sewage, can also transmit the disease.

The shot, which can be given to those over the age of two, provides protection for about three years. A live oral vaccine is also available for those over age six, and provides protection for five years.

Polio

Protection from childhood polio vaccinations gradually lessens with age. This is not a concern in North America, where we no longer have the disease. However, polio is still a serious problem in some parts of Africa and Asia. If you plan to travel in these areas, a polio booster (by needle) is recommended. One booster, for people over the age of 18 years, is felt to provide lifetime immunity. A new requirement for travel to Saudi Arabia is proof of polio vaccination for all travelers aged 15 years and under.

Meningitis

Besides the requirement for travelers to Saudi Arabia (see Required Vaccines), the meningitis vaccine may be recommended in certain situations. In many African countries, meningitis outbreaks occur regularly during the dry season (December to June). There are also periodic outbreaks in other countries around the world. Vaccine protection lasts about three years.

Different bacteria cause disease in different areas. You need to ensure that you receive a vaccine that covers four different types of bacteria if you are going to a risk area.

Influenza

Don’t forget your flu shot! Flu season is November to May in the northern hemisphere, April to September in the southern hemisphere, and year round in the tropics. Remember, your biggest risk of getting the flu is in an environment where there are a large number of people. This includes airports and planes. Since the flu virus changes every year, vaccines must be taken annually for protection. If you are planning travel to a risk area, consult a travel clinic for advice on personal protection.

Rabies

Any mammal, from aardvarks to zebras, can carry rabies. Most transmission in developing countries is from dogs – often wild, aggressive, and running in packs. Untreated rabies is 100 per cent fatal. Anyone (including children) at high risk can get a series of three shots of pre-exposure vaccine prior to travel.

Any animal bite or scratch that breaks the skin needs immediate medical attention. Those who have had pre-exposure vaccine will need two more shots. Someone who has not had pre-exposure vaccine requires the full series of post-exposure treatment.

Japanese Encephalitis

That pesky mosquito again! This virus causes severe inflammation of the brain, with a high risk of brain damage or death. It is not very common, but does occur seasonally in various parts of Asia. Despite the name, it is very rare in Japan. The offending mosquito likes to breed in rural rice paddies and fishponds. The vaccine requires two shots, with boosters every three years for those at risk.

Dukoral ™

Hooray – this one is not a needle! It is a two-dose oral vaccine that helps protect against travelers’ diarrhea caused by E. coli. It is effective for three months. Since other bacteria can also cause traveller’s diarrhea, the need for Dukoral™ is assessed on an individual basis. You still must be very careful with food and water outside North America and Europe. Dukoral also provides some protection against cholera, but this is mainly an issue for aid workers in refugee camps.

Malaria

This is mentioned here because many people think there is a shot for malaria. Sorry, not yet. Protection from malaria requires pills. Talk to a travel health professional to determine your risk and discuss the best medication.

The last word

Consult a travel clinic six to eight weeks before your trip.

Remember to allow time to get immunizations done. Some vaccines require more than one shot and some require a specific period of time before travel to be effective. If you can, consult a travel clinic six to eight weeks before your trip. Some vaccine schedules can be accelerated if time is short. Still, ‘better late than never’ applies here! The travel clinic can advise you on how to stay safe if there is not enough time for the vaccine. No two trips are alike and no two travelers are alike. Protecting yourself is a vital part of planning your trip.

Bon voyage!

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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