Table 4.
Recommendation for patients with sickle cell disease traveling to austere countries*.
| Issue | Recommendations |
|---|---|
| Vaccination† (see also Table 3) | Ensure all age-appropriate vaccinations in Table 3: • Streptococcus pneumoniae (within 5 years) • Neisseria meningitidis (within previous 3 years) • Haemophilus influenzae B (once) • Influenza (annually) Additional vaccinations: • Yellow fever (if traveling to endemic African/American countries) • Salmonella typhi vaccination (if traveling to endemic areas) |
| Mosquito-borne illnesses (malaria/Dengue) (see also Table 3) | • Ensure basic preventive methods (mosquito nets, insect repellants, avoiding marshy/wet areas with mosquito habitats) • Chemoprophylaxis (all major prophylactic regimens are acceptable) • Prompt diagnosis and treatment of suspected malaria |
| Gastroenteritis/enteritis (see also Table 3) | • Avoid contaminated food and water • Employing adequate hand washing prior to eating or preparing food, after using bathroom • Carry oral electrolyte replacement solutions to ensure proper hydration and to avoid hypovolemia/vaso-occlusive crisis in the setting of gastroenteritis |
| Invasive bacterial infection(see also Table 3) | • Prophylaxis for duration of travel (amoxicillin 250–500 mg PO BID) • Seek medical advice promptly for management of febrile illness • Standby treatment of febrile illness (amoxicillin 3 g PO vs. fluoroquinolone) |