Pre-Departure Health Information
Bridge Year Program 2017-18
Please read this document carefully and completely. The information provided will help you prepare for a safe
and healthy Bridge Year experience.
All Bridge Year participants must schedule a consultation with a local health care provider who specializes in
Travel Health and Medicine. Schedule this travel health consultation as soon as possible. Depending on your
Bridge Year location, you may need up to one month to receive all necessary pre-travel immunizations and
prophylactic medication. It is expected that students will have received all necessary immunizations and
prophylactic medication prior to arriving on campus for Bridge Year orientation.
On pages 2 and 4 of this document, you will find lists of the immunizations and prophylactic medications that are
required and recommended by the University for participation in Bridge Year. Please be sure to discuss these
requirements and recommendations with your local travel health provider at the time of your consultation.
Please note that your primary health care provider is typically not a travel health specialist. Resources to help you
identify a travel health specialist located near you can be found below.
FINDING A TRAVEL HEALTH SPECIALIST IN YOUR AREA
The following internet resources should help you to identify a travel health specialist located near you:
International Society of Travel Medicine: http://www.istm.org/AF_CstmClinicDirectory.asp
The American Society of Tropical Medicine & Hygiene: http://www.astmh.org/education-resources/clinical-consultants-directory
GENERAL RESOURCES ON TRAVEL HEALTH
The World Health Organization (WHO) and US Centers for Disease Control and Prevention (CDC) are reputable
sources for pre-travel health information. Should you have questions about travel health, these sites are a
great place to start.
CDC Travel Medicine homepage: www.cdc.gov/travel
WHO homepage: http://www.who.int/en
COUNTRY SPECIFIC HEALTH INFORMATION FROM THE CDC
Prior to meeting with your travel health specialist, we ask that you carefully review the Health Information for
Travelers provided by the US Centers for Disease Control and Prevention (CDC). Links are provided below.
Health Information for Travelers to Bolivia:
http://wwwnc.cdc.gov/travel/destinations/bolivia.htm
Health Information for Travelers to China:
http://wwwnc.cdc.gov/travel/destinations/china.htm
Health Information for Travelers to India:
http://wwwnc.cdc.gov/travel/destinations/india.htm
Health Information for Travelers to Indonesia: http://wwwnc.cdc.gov/travel/destinations/indonesia.htm
Health Information for Travelers to Senegal:
http://wwwnc.cdc.gov/travel/destinations/senegal.htm
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PRE-TRAVEL VACCINATIONS AND PROPHYLATIC MEDICATIONS
Pre-exposure vaccinations and prophylactic medications can significantly decrease the chance of
becoming seriously ill while you are residing in a foreign environment.
Students participating in Bridge Year should have completed all routine pediatric immunizations. Additionally,
there are travel-related vaccinations and prophylactic medication that are strongly recommended and must be
obtained prior to departure.
Please note that some vaccines (such as yellow fever) may not be readily available from a primary care provider
and may be obtained only from a specialized travel medicine provider.
Routine Pediatric Immunizations
Required routine immunizations
Students participating in the Bridge Year Program must have received the following required routine vaccinations
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•
•
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Hepatitis B series
Measles, Mumps, Rubella (MMR, 2 doses)
Diphtheria, Tetanus and Pertussis (Tdap)
Meningococcal Vaccine (Men ACWY), including booster dose after age 16.
Students may be exempted from the immunization requirements, if there is a valid medical contraindication or
if religious belief prohibits immunizations. A signed statement indicating specific medical contraindication from
a medical doctor, osteopath, nurse practitioner or a physician assistant is required for medical exemption.
Students with religious beliefs that prohibit them from immunization must submit a signed Declaration of
Religious Objection form. This form may be requested by contacting the Bridge Year Office. Students are still
required to complete other matriculation requirements including health history.
Recommended routine immunizations
The following routine immunizations are strongly recommended to students participating in the Bridge Year
Program.
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Hepatitis A
Varicella (chickenpox)
Tetanus-Diphtheria Booster, if last Td or Tdap more than 10 years ago
Influenza vaccine Influenza (“the flu”) occurs in the northern and southern hemispheres during
“winter” and year-round in the tropics. An annual immunization is recommended, but in the US
availability of the vaccine is usually limited to the fall and winter. In August of 2016, University
Health Services (UHS) at Princeton was able to make the current year vaccine available to Bridge
Year participants during orientation, just prior to their departure. If the 2017-2018 vaccine is
available from the manufacturer in time we plan to offer it again at orientation this August.
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Travel-Related Vaccinations and Prophylactic Medication
The following information on rabies, yellow fever, and malaria prevention, as well as the University’s vaccination
and prophylaxis recommendations for each Bridge Year program site, is based on established guidelines from the
WHO and the CDC and should be discussed during your travel medicine consultation.
Rabies pre-exposure vaccination
Rabies is a very serious viral infection of mammals transmitted by a bite or contact with infected saliva on broken
skin. There is a pre-exposure vaccination series available and the CDC has developed a “risk category strategy”
(available to review at http://www.cdc.gov/rabies/specific_groups/travelers/pre-exposure_vaccinations.html)
that guides travelers in considering whether to complete the pre-exposure series.
Completing the pre-exposure vaccination series does not eliminate the need to receive treatment after an
exposure, but it does simplify treatment because it removes the requirement to receive human rabies immune
globulin (HRIG). This is important in some countries because HRIG may be difficult to obtain in a timely manner.
The decision to complete the rabies pre-exposure vaccination should be discussed with your travel health
provider.
Yellow fever and current vaccine shortage
Yellow fever virus is found in tropical and subtropical areas in South America and Africa. The virus is
transmitted to people by the bite of an infected mosquito. Yellow fever disease ranges in severity from a selflimited febrile illness to severe liver disease with bleeding.
At present, there is a worldwide shortage of yellow fever vaccine which is anticipated to last until spring
2018. Meanwhile, there are several travel clinics that have vaccine in their inventory and can administer it to
prospective travelers. If you will participate in a Bridge Year program at one of the locations for which the
yellow fever vaccine is recommended by the CDC (Bolivia and Senegal), it is advisable that you speak to your
travel medicine provider as early as possible, in order to locate a facility that can administer the vaccine. If
you run into problems finding a local facility that has sufficient vaccine in their inventory, please contact the
Bridge Year office for assistance.
Prevention of malaria and other insect-borne illnesses
Malaria is a serious illness that at present cannot be prevented by vaccination. Prevention of the illness is
supported by taking medication that is begun prior to entering at-risk areas, continued throughout your stay and
continued for a period after you leave. Please note that malaria chemoprophylaxis is not 100% effective and
must be supported by specific preventive practices (described below).
The selection of the appropriate medication for chemoprophylaxis is an individual process that should be
discussed with your travel medicine provider. The CDC reference information describing prescription
medications used for malaria chemoprophylaxis can be found here.
The following preventive measures should be followed, especially after dark, to prevent mosquito bites by which
malaria is transmitted:
• Wear light colored long sleeved shirts and long pants, especially from “dusk to dawn”
• Use mosquito netting over bedding.
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• Use insect repellents on bedding and netting. Permethrin (Permanone) is a common repellent for bed nets,
clothing, and other materials. It is not intended for use on the skin.
• Use EPA-registered insect skin-applied repellents. Speak to your travel health provider and use this
search tool to help select the repellent product that is right for you. Note: DEET repellents, e.g., Off,
Deep Wood, and Muskal, should contain at least 20%, but not more than 50%, DEET. Picardin is a DEETalternative developed in Europe that has been available in the United States with a maximum
concentration of 20% since 2005. Some skin-applied repellents are recommended for both skin and
clothing. Always use insect repellents as per label directions.
It is recommended to use insect repellent during daylight hours as well as from dusk to dawn because
insect-borne diseases can be contracted at different times during a 24-hour period due to the variability of
insect biting habits (i.e. malaria transmitting mosquitoes usually bite after dusk but dengue transmitting
mosquitoes are active day-time biters).
Sunscreen should be used and applied first, (before insect repellent and reapplied as per label directions) to
avoid sun damage to the skin.
For additional information on insect repellents and avoiding bug bites, please visit
https://wwwnc.cdc.gov/travel/page/avoid-bug-bites.
Site-specific vaccination and malaria prophylaxis recommendations
In addition to the routine pediatric immunizations listed on page 2, the following travel-related vaccinations are
very strongly recommended for the specific locations to which you are traveling. Please discuss these carefully
with your travel health specialist.
Bolivia:
hepatitis A; typhoid fever; yellow fever; the primary rabies pre-exposure vaccination series; and
approximately a two week supply of MCP for chloroquine-resistant P. falciparum malaria for use during travel to
Amazonian lowlands. Please note that the rabies pre-exposure vaccination series is required for Bolivia
participants as a matter of program policy.
China:
hepatitis A; typhoid fever; adult polio booster; Japanese encephalitis (Ixario); and approximately 35 day
supply of MCP for “multi drug resistant” P. falciparum malaria (eg. doxycycline or atovaquone/proguanil
(Malarone) for use during travel to parts of rural Yunnan province.
India:
hepatitis A; typhoid fever; adult polio booster; Japanese encephalitis (Ixario); the primary rabies preexposure vaccination series; and MCP for chloroquine-resistant P. falciparum malaria. Please note that Japanese
encephalitis vaccination and the rabies pre-exposure vaccination series are required for India participants as a
matter of program policy.
Indonesia:
hepatitis A; typhoid fever; Japanese encephalitis; and approximately 55 day supply of MCP for
chloroquine-resistant P. falciparum malaria. Note: Excursions to malaria zones will likely be split into two trips,
one lasting 4 weeks and a second lasting 3 weeks.
Senegal: hepatitis A; typhoid fever; yellow fever; adult polio booster; and MCP for chloroquine-resistant
P. falciparum malaria.
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TRANSPORTING PRESCRIPTION / NON-PRESCRIPTION MEDICATIONS
Prior to departure, make a list of all the medications you take on a regular basis. Include prescription and nonprescription drugs, such as pain relievers, antacids and vitamins. Be sure to write down the generic (scientific)
names of these medications, as brand names differ from country to country.
For each medication that you will bring:
1)
2)
3)
4)
Gather an ample supply to last your entire trip, with a few spares if possible.
Keep all drugs in their original packaging.
Bring a copy of the prescription, if it is a prescription drug.
Have your healthcare provider write a note describing the medicine and why you need to take it.
It's best to get this on letterhead paper. Have this note in English and translated into the
language of your destination.
Travelers with histories of severe allergic reactions should carry an anaphylactic kit and a second kit as a spare
(resources include: Ana-Kit®, Bayer Pharmaceuticals, West Haven, CT or EpiPen®, Center Laboratories, Port
Washington, NY). Wearing an allergy bracelet is also a good idea.
OTHER RECOMMENDED INTERNET RESOURCES
CDC:
http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-8-advising-travelers-with-specific-needs/study-abroad.htm
US State Department:
http://studentsabroad.state.gov/
FDA – Stay Healthy While Traveling Abroad:
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049047.htm