Volume I, Number 4 September 1st, 2000

Immunizations When Traveling to Egypt

At present, Egypt does not require travelers arriving from the USA, Canada and most European countries to have any immunizations. Only two inoculations may be required of other travelers for entry to Egypt under certain circumstances, yellow fever and cholera. But there are several immunizations that health authorities recommend to travelers crossing national borders. The following information includes data from the Centers for Disease Control Fax Information Service for International Travel. You can obtain more information by calling the CDC at 404-3320-4565 and following the prompts.

Required Immunizations

Yellow Fever. Currently a yellow fever vaccination is the only immunization Egypt officially requires of arriving travelers, but this is required only of travelers arriving from infected areas of tropical Africa and Latin America. People planning to travel in sub-Saharan Africa should have a yellow fever vaccination as this is also officially required by most of these countries, but no one coming to Egypt directly from North
America or Europe who is not planning to visit sub-Saharan Africa will need this.

Cholera. Egypt has not required travelers from North America to have a cholera inoculation for many years. Cholera occurs only among populations living in extremely unsanitary conditions during the hottest
summer months, conditions travelers coming directly from North America are not exposed to. Also, the World Health Organization holds that because a cholera vaccination cannot prevent the introduction of the
infection into a country, it should not be officially required of any traveler. However, travelers coming from an infected area in South America, the Middle East or sub-Saharan Africa should ask their airline whether
there is a government health advisory in effect regarding a cholera inoculation requirement for entry to Egypt.

Recommended Immunizations

Although most travelers will not need any "required" inoculations, there are some immunizations that are highly recommended by public health authorities. The U.S. Centers for Disease Control (CDC) advises, "For travelers over 2 years of age the following immunizations normally given during childhood should be up to date: measles, mumps, and rubella (MMR) vaccine; diphtheria, tetanus, and pertussis (DTP or DTaP) vaccine until age 7, then Td vaccine; polio (OPV) vaccine; haemophilus influenza B (HbCV) vaccine; and hepatitis B (HBV) vaccine. Children over 2 should be "on schedule" with each vaccine's primary-series schedule, while adults should have completed the primary series." Adults unsure of their vaccine history should consult their physicians.

Tetanus/diphtheria booster. Health authorities recommend administration of a tetanus-diphtheria toxoid (adult type, or Td) booster every 10 years.

Poliomyelitis booster. The CDC advises that unvaccinated or partially vaccinated travelers should complete a primary series of polio vaccine that is appropriate to their age and previous immunization status. Adult travelers to developing countries who have had a primary series should receive an additional single dose of polio vaccine. "This additional dose of polio vaccine should be received only once during the adult years. Enhanced Inactivated Polio Vaccine (eIPV) is recommended for this dose."

Typhoid fever - primary or booster depending on one's previous immunization status. A new single-injection vaccination, called Typhim Vi, is available and is approved for children as young as 2 years. There is also an oral vaccine for typhoid. Consult your physician about the vaccine most appropriate for you. Health authorities advise that individuals subject to increased risk, such as residents of developing countries, should have a typhoid booster every three years.

Hepatitis B is contracted through direct contact with blood, or secretions, or intimate sexual contact with infected persons. Hepatitis B vaccine is recommended now as part of the childhood vaccination program in
the U.S. In Egypt, there is a campaign every year to encourage adults and children to be vaccinated, and the vaccine is available there. Primary vaccination against hepatitis B consists of 3 doses: the second administered 1 month after the first, and the third administered 5 months later.

Rabies. Few cases of rabies are reported, perhaps because most people avoid touching stray animals. There is a pre-exposure rabies vaccine series which the CDC recommends for persons living in or visiting (for more than 30 days) countries where rabies is common. The United States
Naval Medical Research Unit in Cairo, NAMRU-3, also recommends that American residents in Cairo have the pre-exposure series because the post-exposure vaccine is not always available there. The pre-exposure rabies vaccine is administered in three doses over 21 days (day 0, 7, and 21), and must be completed 30 days or more before departure for Egypt. A person who has had this series who later is exposed to rabies must still undergo post-exposure immunization therapy, but such therapy is milder than the treatment that must be given to someone who has not had the pre-exposure series.

Viral hepatitis A, spread in contaminated food and water, is also common in Egypt. There is a new vaccine, HAVRIX, available in the U.S. for viral hepatitis A, but as yet it is not available in Egypt from official sources. The CDC recommends hepatitis A vaccine or immunoglobulin for protection against Hepatitis A. For persons over 18 years of age, hepatitis A vaccine is given in a two-dose series 6 to 12 months apart. For children and adolescents (2 to 18 years), a three-dose series of hepatitis A vaccine is recommended; the second dose is given one month after the first, and the third dose 6 to 12 months after the first dose. Immuno-globulin (gamma globulin), which is available in Egypt, is recommended for children less than two years of age, and for persons of all ages who desire only short term protection every 6 months (or 3 months for someone directly exposed to someone with hepatitis A).