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Anguilla
(U.K.), Antigua & Barbuda, Bahamas, Barbados, Bermuda
(U.K.), Cayman Islands (U.K.), Cuba, Dominica, Dominican
Republic, Grenada, Guadeloupe, Haiti, Jamaica, Martinique
(France), Montserrat (U.K.), Netherlands Antilles, Puerto
Rico (U.S.), St. Lucia, St. Vincent & the Grenadines,
St. Kitts & Nevis, Trinidad & Tobago, Virgin Islands
(U.S.), Virgin Islands (U.K.)
The preventive measures you need to take while traveling
in the Caribbean depend on the areas you visit and the
length of time you stay. You should observe the precautions
listed in this document in most areas of this region.
Travelers’ diarrhea, the number one illness in travelers,
can be caused by viruses, bacteria, or parasites, which
can contaminate food or water. Infections may cause diarrhea
and vomiting (E. coli, Salmonella, cholera, and parasites),
fever (typhoid fever and toxoplasmosis), or liver damage
(hepatitis). Make sure your food and drinking water are
safe.
Malaria is a preventable infection that can be fatal if
left untreated. Prevent infection by taking prescription
antimalarial drugs and protecting yourself against mosquito
bites. Travelers to all areas of Haiti are at risk for
malaria. Travelers to rural areas of the Dominican Republic,
especially in the provinces bordering Haiti, are at risk
for malaria. No risk in resorts in the Dominican Republic.
The other Caribbean islands listed are not malaria-risk
areas. Travelers to Haiti and rural Dominican Republic
should take chloroquine to prevent malaria.
A certificate of yellow fever vaccination may be required
for entry into certain areas of these countries if you
are arriving from a tropical South American or sub-Saharan
African country.
Dengue, filariasis, and leishmaniasis are diseases carried
by insects that also occur in this region. Protecting
yourself against insect bites will help to prevent these
diseases.
Schistosomiasis, a parasitic infection, is found in fresh
water in parts of Antigua, the Dominican Republic, Guadeloupe,
Martinique, Montserrat, Puerto Rico, and St. Lucia. Do
not swim in fresh water (except in well-chlorinated swimming
pools) in these countries.
CDC recommends the following vaccines (as appropriate
for age):
See your doctor at least 4–6 weeks before your trip to
allow time for shots to take effect.
- Hepatitis
A or immune globulin (IG) should be considered if travel
to areas of questionable sanitation is anticipated.
- Hepatitis
B, if you might be exposed to blood (for example, health-care
workers) or travelers who have sexual contact with the
local population, stay longer than 6 months in Haiti
or the Dominican Republic, or might be exposed through
medical treatment.
- Rabies,
if you might be exposed to wild or domestic animals
through your work or recreation.
- Typhoid,
particularly if you are visiting developing countries
in this region.
- Yellow
fever, for travelers going outside urban areas in Trinidad
and Tobago.
- As
needed, booster doses for tetanus-diphtheria and measles.
Hepatitis B vaccine is now recommended for all infants
and for children ages 11–12 years who did not receive
the series as infants.
All travelers should take the following precautions,
no matter the destination:
- Wash
hands often with soap and water.
- Because
motor vehicle crashes are a leading cause of injury
among travelers, walk and drive defensively. Avoid travel
at night if possible and always use seat belts.
- Always
use latex condoms to reduce the risk of HIV and other
sexually transmitted diseases.
- Don’t
eat or drink dairy products unless you know they have
been pasteurized.
- Don’t
share needles with anyone.
- Eat
only thoroughly cooked food or fruits and vegetables
you have peeled yourself. Remember: boil it, cook it,
peel it, or forget it. Never eat undercooked ground
beef and poultry, raw eggs, and unpasteurized dairy
products. Raw shellfish is particularly dangerous to
persons who have liver disease or compromised immune
systems.
Travelers visiting undeveloped areas should take the
following precautions:
To stay healthy, do...
- Drink
only bottled or boiled water, or carbonated (bubbly)
drinks in cans or bottles. Avoid tap water, fountain
drinks, and ice cubes. If this is not possible, make
water safer by BOTH filtering through an “absolute 1-micron
or less” filter AND adding iodine tablets to the filtered
water. “Absolute 1-micron filters” are found in camping/outdoor
supply stores.
- If
you visit an area where there is risk for malaria, take
your malaria prevention medication before, during, and
after travel, as directed. (See your doctor for a prescription.)
- Protect
yourself from insects by remaining in well-screened
areas, using repellents (applied sparingly at 4-hour
intervals), and wearing long-sleeved shirts and long
pants from dusk through dawn.
- To
prevent fungal and parasitic infections, keep feet clean
and dry, and do not go barefoot. To avoid getting sick...
- Don’t
eat food purchased from street vendors.
- Don’t
drink beverages with ice.
- Don’t
share needles with anyone.
- Don’t
handle animals (especially monkeys, dogs, and cats),
to avoid bites and serious diseases (including rabies
and plague).
What you need to bring with you:
- Long-sleeved
shirt and long pants to wear while outside whenever
possible, to prevent illnesses carried by insects.
- Insect
repellent containing DEET (diethylmethyltoluamide),
in 30%–35% strength for adults and 6%–10% for children,
as well as a bed net impregnated with the insecticide
permethrin. (Bed nets can be purchased in camping or
military supply stores.)
- Over-the-counter
antidiarrheal medicine to take if you have diarrhea.
- Iodine
tablets and portable water filters to purify water if
bottled water is not available.
- Sunblock,
sunglasses, hat.
- Prescription
medications: make sure you have enough to last during
your trip, as well as a copy of the prescription(s).
After you return home:
If you have visited a malaria-risk area, continue taking
your antimalarial drug for 4 weeks (Lariam®, doxycycline)
or seven days (Malarone™) after leaving the risk area.
Travelers who become ill with a fever or flu-like illness
while traveling in a malaria-risk area and up to one year
after returning home should seek prompt medical attention
and should tell the physician their travel history.
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