Travel Medicine Centre

Other Concerns


Health Canada

Dengue Fever 

CDC text   

WHO Dengue page


Altitude sickness

CATMAT recommendations

CIWEC Clinic Katmandu Nepal detailed info

CIWEC homepage

Food and Water and Diarrhea

CDC food precautions

CDC water treatment

Heath Canada Food and Water

Catmat recommendations

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

  1. most episodes of travellers’ diarrhea are usually mild
    and self-limited;
  2. therapeutic options (oral rehydration, dietary
    management, antimotility, and antibiotic treatment) are available
    if prevention fails;
  3. < 50% (range 25% to 50%) of travellers’
    diarrhea cases are caused by ETEC bacteria;
  4.  the protection by
    the vaccine against ETEC diarrhea is approximately 50%; and
  5. vaccinated travellers may gain a false sense of security and
    possibly avoid being as strict in observing food and water

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

CATMAT recommendations

Protection Against Mosquitoes  CDC

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