Read below for travel health advice on Jamaica from the MDtravelhealth channel on Red Planet Travel.
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Summary of recommendations
Most travelers to Jamaica will need vaccination for hepatitis A and medications for travelers' diarrhea. Other immunizations may be necessary depending upon the circumstances of the trip and the medical history of the traveler, as discussed below. All travelers should visit either a travel health clinic or their personal physician 4-8 weeks before departure.
|Hepatitis A||Recommended for all travelers|
|Yellow fever||Required for travelers arriving from a yellow-fever-infected area in Africa or the Americas and for travelers who have been in transit in an airport located in a country with risk of yellow fever transmission. Not recommended otherwise.|
|Hepatitis B||For travelers who will have intimate contact with local residents or potentially need blood transfusions or injections, especially if visiting for more than six months|
|Measles, mumps, rubella (MMR)||Two doses recommended for all travelers born after 1956, if not previously given|
|Tetanus-diphtheria||Revaccination recommended every 10 years|
Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.
Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.
If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.
Malaria in Jamaica: rare local cases have been reported from Kingston. Malaria prophylaxis is no longer recommended, but insect protection measures are still advised, as below.
The following are the recommended vaccinations for Jamaica.
Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.
Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin (0.02 mL/kg) at a separate anatomic injection site in addition to the initial dose of vaccine. Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin (see hepatitis A for dosage) in the place of vaccine.
Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals.
Typhoid vaccine is recommended for those planning an extended stay in rural areas or expecting to consume potentially contaminated food. Typhoid is uncommon in most Caribbean countries. Most travelers do not require typhoid immunization.
Hepatitis B vaccine is recommended for travelers who will have intimate contact with local residents or potentially need blood transfusions or injections while abroad, especially if visiting for more than six months. It is also recommended for all health care personnel. Most travelers do not need hepatitis B vaccine.
Yellow fever vaccine is required for all travelers over one year of age arriving from a yellow-fever-infected country in Africa or the Americas and for travelers who have been in transit in an airport located in a country with risk of yellow fever transmission, but is not recommended or required otherwise. Yellow fever vaccine (YF-VAX; Aventis Pasteur Inc.) (PDF) must be administered at an approved yellow fever vaccination center, which will give each vaccinee a fully validated International Certificate of Vaccination. The vaccine should not be given to anyone who is younger than nine months old, pregnant, immunocompromised, or allergic to eggs (since the vaccine is produced in chick embryos).
Cholera vaccine is not recommended. Cholera outbreaks are not reported from the Caribbean.
Polio vaccine is not recommended for any adult traveler who completed the recommended childhood immunizations. Polio has been eradicated from the Americas, except for a small outbreak of vaccine-related poliomyelitis in the Dominican Republic and Haiti in late 2000.
A malaria outbreak was reported from Kingston, Jamaica, in December 2006. In retrospect, the outbreak probably started in late September. A total of 370 cases were identified, largely from Kingston (chiefly the areas of Delacree Park, Denham Town, Tivoli Gardens, Trench Town, and Greenwich Town). A small number of cases were also reported from St. Catherine, St. Thomas, and Clarendon. All cases were caused by Plasmodium falciparum, the species which causes the most severe illness. The outbreak appeared to have ended in June 2007, but two additional cases were reported from Kingston in October 2007. Three more cases were reported from St. Catherine in September 2008. In March 2009, five cases were reported among persons associated with Caymanas Park, a horse racing track. A single case was reported from Kingston in February 2010. The U.S. Centers for Disease Control no longer recommends malaria prophylaxis, but continues to advise that travelers to Jamaica should apply insect repellent and to keep themselves covered to prevent mosquito bites (see below). For further information, go to ProMED-mail, the World Health Organization, Eurosurveillance, NATHNAC, and the Centers for Disease Control.
An outbreak of leptospirosis was reported in October 2007 after flooding caused by Hurricane Dean (see ProMED-mail; October 16, 2007). Leptospirosis is transmitted to humans by exposure to water contaminated by the urine of infected animals. Symptoms may include fever, chills, headache, muscle aches, conjunctivitis (pink eye), photophobia (light sensitivity), and rash. Most cases resolve uneventfully, but a small number may be complicated by meningitis, kidney failure, liver failure, or hemorrhage. Those engaging in high-risk activities, such as water sports, may consider taking a prophylactic 200 mg dose of doxycycline, either once weekly or as a one-time dose.
An outbreak of dengue fever was reported in October 2007, resulting in more than 4000 suspected cases by late November, including 18 deaths. A major dengue outbreak occurred in 1995, but the number of cases has generally been low in the intervening years. Dengue fever is a flu-like illness which may be complicated by hemorrhage or shock. The infection is transmitted by Aedes mosquitoes, which bite primarily in the daytime and favor densely populated areas, though they also inhabit rural environments. No vaccine is available at this time. Insect protection measures are advised, as below.
An outbreak of eosinophilic meningitis caused by a roundworm known as Angiostrongylus cantonensis was reported among a group of travelers who had visited Jamaica in April 2000. A total of 12 people were affected. The most common symptoms were headache, neck stiffness, numbness and tingling, visual disturbances, photophobia (sensitivity to light), and fatigue. All patients made a slow but uneventful recovery. The source of infection remained unclear, but a Caesar salad consumed by all but one of the victims appeared most likely. Angiostrongylus was subsequently identified in rats and land snails in Jamaica. For further information, see Emerging Infectious Diseases. Food and water precautions, as discussed below, are advised to prevent this and other parasitic infections.
HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.
Food and water precautions
Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, sea bass, and a large number of tropical reef fish.
All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.
If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
When visiting undeveloped areas, do not drink tap water unless it has been boiled, filtered, or chemically disinfected, and do not drink unbottled beverages or drinks with ice.
Insect and Tick Protection
Wear long sleeves, long pants, hats and shoes (rather than sandals). Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night.
Swimming and bathing precautions
Because of the risk of leptospirosis, a parasitic infection acquired by exposure to contaminated water, you should avoid swimming, wading, or rafting in bodies of fresh water, such as lakes, ponds, streams, or rivers. Do not use fresh water for bathing or showering unless it has been heated to 150 degrees F for at least five minutes or held in a storage tank for at least three days. Toweling oneself dry after unavoidable or accidental exposure to contaminated water may reduce the likelihood of becoming infected, but does not reliably prevent the disease and is no substitute for the precautions above.
Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.
Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.
Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.
Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.
Ambulance and Emergency Services
For an ambulance in Jamaica, call Deluxe Ambulance at 876-923-7415 or 876-923-8698 (website http://www.deluxeambulance.com/) or the Red Cross Ambulance at 876-926-6837 (website http://www.jamaicaredcross.org/). For a public ambulance, call 110. Ambulance service may be limited outside Kingston and Montego Bay.
Medical service is limited, especially outside Kingston and Montego Bay. The leading facility is the University of the West Indies Hospital (Mona, Kingston; tel. 876-927-1620-9, 876-977-2607; website http://www.mona.uwi.edu/fms/), which is publicly financed, but has a private wing (the Tony Thwaites Wing) which serves more affluent patients. Some travelers prefer to go to Medical Associates Hospital (18 Tangerine Place, Kingston; tel. 876-926-1400-1, 926-8624, 926-9013), which is a smaller, private facility. For a comprehensive guide to physicians, pharmacies, emergency services, and other hospitals in Jamaica, go to the U.S. Embassy website at http://kingston.usembassy.gov/medical_information.html. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance. Serious medical problems will require air evacuation to a country with state-of-the-art medical facilities.
Pharmacies in Kingston and Montego Bay are generally well-supplied, but many prescription medicines may not be available elsewhere. Pharmacies in Kingston listed by the U.S. Embassy include the following:
Traveling with children
Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed (see the U.S. Embassy website).
All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).
When traveling with young children, be particularly careful about what you allow them to eat and drink (see "Food and water precautions" above), because diarrhea can be especially dangerous in this age group. Young children should be kept well-hydrated and protected from the sun at all times.
Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.
Travel and pregnancy
International travel should be avoided by pregnant women with underlying medical conditions, such as diabetes or high blood pressure, or a history of complications during previous pregnancies, such as miscarriage or premature labor. For pregnant women in good health, the second trimester (18–24 weeks) is probably the safest time to go abroad and the third trimester the least safe, since it's far better not to have to deliver in a foreign country.
Before departure, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency obstetric care if necessary (see the U.S. Embassy website). In general, pregnant women should avoid traveling to countries which do not have modern facilities for the management of premature labor and other complications of pregnancy.
Strict attention to food and water precautions is especially important for the pregnant traveler because some infections, such as listeriosis, have grave consequences for the developing fetus. Additionally, many of the medications used to treat travelers' diarrhea may not be given during pregnancy. Adequate fluid intake is essential.
Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.
(reproduced from the U.S. State Dept. Consular Information Sheet)
Americans living in or visiting Jamaica are encouraged to register with the Consular Section of the U.S. Embassy in Kingston and obtain updated information on travel and security within Jamaica. The Consular Section is located on the first floor of the Oxford Manor building, 16 Oxford Road, Kingston 5, tel. (876) 935-6044. Office hours are 7:15 a.m. to 4:00 p.m. with window services available Monday-Friday, 8:30 a.m. to 11:30 a.m., except local and U.S. holidays. For emergencies after hours, on weekends, and holidays, U.S. citizens are requested to call the U.S. Embassy duty officer through the main switchboard at (876) 935-6000. The Chancery is located three blocks away in the Mutual Life Building, 3rd Floor, 2 Oxford Road, Kingston 5; phone (876) 929-4850 through 59.
The Consular Agency in Montego Bay is located at St. James Place, 2nd Floor, Gloucester Avenue, tel. (876) 952-0160. Office hours are Monday-Friday from 9:00 a.m. to 12:00 noon.
The U.S. Embassy also has consular responsibility for the Cayman Islands, a British dependent territory. The Consular Agency in George Town is located in the office of Adventure Travel, Seven-Mile Beach; telephone (345) 946-1611; fax (345) 945-1811; e-mail: consulus@candwky. Office hours are from 8:00 a.m. to 12:00 noon, Monday-Friday. For additional information on travel conditions in the Cayman Island, please refer to the Cayman Islands Consular Information Sheet.
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