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Ask The Travel Doctor-TMVC

Q: We are going on a Panama Canal cruise in Jan 2010. Our ports of call will be Miami, Cartgena, Puntarenas, Puerto Quetzal, Huatolco, Acapulco, Cabo San Lucas, and Los Angeles. We have been to our local travel clinic and were advised we did not require a typhoid fever vaccination as we would not be eating off the ship, however fellow passengers who went to the same clinic and were advised they required this vaccine as food is brought on board in various ports and may not be safe. We are confused and wondered what is your opinion.

B.F.

 

A:  Unfortunately this is not an uncommon situation. Firstly, there can be several reasons that any two travelers going on the same trip can get different advice, as their medical history, previous vaccines, comfort with risk, can all affect any specific recommendation. Getting advice from a doctor or others who are not really travel medicine experts (although they may say they are) is another way to get mixed or sub-optimal advice.

Having said that however, the reasons for variation that you have mentioned above are not consistent- so what is correct? In fact the food and water aboard the cruise boats is extremely safe, and typhoid would not be a risk while aboard. The ships do not take on supplies along the way, unless guaranteed safe. The risk for typhoid is when travelers dine while ashore at the various destinations and there have been plenty of cases where typhoid was acquired by individual and groups of passengers who have just gone ashore in a developing country for a luncheon. So the answer lies in what a passenger plans to do. If all meals are on-board the ship, typhoid vaccination is not required. If some meals are going to be planned in restaurants or street vendors while in Mexico, typhoid vaccination should be considered.

Other vaccines should be considered, and a Travel Doctor "cruise kit" is a ship passenger essential.

Dr Tony

 

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