Dominican Republic 2004-2005 Winter Vacation Update

Winter Travelers staying for a short visit 1-2 weeks inside a destination resort should consider the following: Tetanus Diphtheria (Td) should be up to date and given every 10 yrs.

Hepatitis A is acquired from contaminated food or water and can make people very sick. The vaccine gives protection for 12 months. A second dose, which must be given no sooner than 6 months, will boost this protection to at least 10-20 yrs. Hepatitis A vaccine, is strongly recommended.
Typhoid is not usually recommended for resorts and short-term tourist vaccinations but may be considered for extended or off the beaten path travels. Two types of vaccines are used: 1) Injectable Typhoid (Typherix or Typhim VI) is good for 3 years. 2) Oral typhoid (ty21a) is 4-vaccine capsules, which are taken on days 0,2,4, and 6. Antibiotics and alcohol interfere with the vaccine. This vaccine gives 7 years of coverage.
Hepatitis B is a different virus also causing hepatitis although it is acquired through blood and body fluids. It is more common, easier to catch and kills more people than HIV. Risk factors for Hepatitis B include: contact with bodily fluids, unclean needles, unprotected sex (although even condoms do not reduce the risk to zero), IV drugs, and blood transfusions. People who will be staying longer than 3 months in countries where Hepatitis B is very high are also recommended to have this vaccine. Hepatitis B should be given in 2 full doses one month apart with a booster dose after 6 months. All the different brands of Hepatitis A and B are equally effective. Some people prefer the pre mixed vaccine of Twinrix but if they use this vaccine they must receive 2 full doses to be adequately protected against either Hep A or B for one year. A third shot taken 6 months later completes the series.
Traveler's Diarrhea is diarrhea caused during travel by exposure to bacteria, viruses and parasites, although it usually refers to the development of extreme symptoms following a bacterial infection. We recommend of course that people be careful with what they eat but traveler's diarrhea also happens to those who are careful since they may be infected through another's careless preparation of food. Pepto-Bismol and Imodium may be taken for mild symptoms. We prescribe antibiotics to take at the early stages of traveler's diarrhea. We aim to prevent the loss of fluids and body salts, which will make one very sick in a tropical environment. Travelers having diarrhea starting after their trip may have an intestinal parasite. If you suspect that you may have a parasite check with our clinic. The vaccine Dukoral protects for about 20% of travelers' diarhhea and lasts 3 months for Traveler's diarrhea.
Malaria is a severe parasite transmitted by night biting mosquitoes. Malaria was not usually present in common tourist areas until a series of reported cases in November 2004.
At present an antimalarial is recommended for all travelers to resorts or rural areas. This includes the Punta Cana area  (Eastern Province) Travelers may wish to consult a clinic on the best type of antimalarial for their trip.
Norwalk Virus causes severe diarrhea in travelers to affected areas. At present there is no vaccination and the only treatment is supportive. As this is highly contagious it is recommended to avoid affected areas and maintain scrupulous hygiene.
Dengue fever is a viral illness transmitted by daytime biting mosquitoes. At present there is no good vaccination or treatment. We recommend good clothing (light loose fitting and covering the limbs), DEET 30% applied to exposed skin, and Permethrin insecticide applied to clothing. Permethrin kills insects on contact but is safe STDs like HIV, gonorrhea, and chlamydia are present and travelers should use the same precautions as they do at home.
Important Dominican Republic Resources:
Department of Foreign Affairs 
http://www.dfait-maeci.gc.ca/latinamerica/dominicanrepublic-en.asp
Hospitals and Clinics in the Dominican Republic: Clinica Abreu (76 beds); general medical/surgical facility; emergency room; frequently used by embassy personnel. Centro Medico Universidad Hospital (200 beds); general medical/surgical facility; In Santiago: Clinica Corominas.
Last Updated Feb 6 2006