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Q.Dear VeloNews Training Center,
I’m taking a cycling trip to Africa next summer and will need to get some vaccinations before my trip. I plan on riding long days (70+ miles) for six days straight. I’m wondering whether my riding might be affected by any of these vaccinations (Hepatitis A Meningococcal meningitis Rabies Typhoid). What about to other countries that you might know of?
The best approach to limit any side effects that might occur after undergoing vaccinations for your travels to Africa is to visit your primary doctor or travel medicine specialist at least six weeks before your trip. This ensures plenty of time to complete your vaccination schedule and gives you a couple of weeks to improve from any adverse reactions should they occur, as this could affect your cycling. Adverse reactions to vaccines when they occur are usually mild and persist for two to 10 days. Once over the side effects you can expect no ill effects in terms of your performance.
I am not sure exactly where your travels will take you in Africa but I’ll assume it is sub-Saharan and I will use Ghana as an example. The CDC has a great website for travelers at www.cdc.gov and the recommendations are to be up-to-date on your routine vaccinations and these may include: measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, poliovirus, influenza vaccines. The recommendations for travel include Hepatitis A, Hepatitis B, Typhoid, Polio booster even if previously immunized, Meningococcal and Rabies vaccines. The required vaccination is for Yellow Fever and travelers can be barred from entry into their destination country if not immunized.
When you get your vaccines you will receive a Vaccination Information Page that includes the potential side effects that may occur as a result. Below I have included some of the common documented adverse reactions in adults to the vaccinations you may receive in the near future:
Hepatitis A — 1 in 2 adults report soreness at injection site, headache reported in 1 in 6 adults, fatigue 1 in 14 adults and duration of symptoms is 1-2 days.
Hepatitis B — 1 in 4 adults report soreness where shot given, temperature increase greater than 99.9 degrees Fahrenheit in 1 in 14 adults.
Typhoid — with inactivated virus vaccine fever in 1 percent, headaches in 3 percent, redness or swelling at injection site in 7 percent, with live vaccine fevers or headache in 5 percent.
Polio — soreness at injection site, no other side effects reported with Inactivated Polio Vaccine (IPV)
Yellow Fever — about 25 percent of individuals report soreness, redness and swelling at injection site, fevers, aches and these generally last 5-10 days after vaccine
Meningococcal – 50 percent report redness and soreness at vaccine injection site, small percentage report fever as well, duration is 1-2 days for symptoms
Rabies – soreness, redness, swelling and or itching at injection site in 30-74 percent, headaches, nausea, abdominal pain, dizziness, muscle aches in 5-40 percent hives and joint pain in 6 percent of booster doses
In many areas of Africa, chloroquine-resistant malaria is present and chemoprophylaxis is recommended for travelers especially when biking around the countryside. If you and your doctor do decide to take chemoprophylaxis medications you should purchase these in the States and not internationally, where they may be substandard. A common drug used abroad called Halofantrine can actually be dangerous to your health. Atovaquone/proguanil (Malarone) is usually the best tolerated medication and is what I recommend to athletes to take if indicated. Side effects do occur in a minority of people and may include nausea, vomiting, abdominal pain, headache, diarrhea, weakness, loss of appetite, and dizziness. The point is that these side effects, if they occur, do have the potential to impact your cycling and should be considered.
To view travel alerts and other recommendations concerning travel abroad go to the CDC website mentioned above and see the Traveler’s Health section. From there you can choose from over 200 international destinations and view the most recent alerts and recommendations.
I hope your trip is a safe and enjoyable one!
— Jason Glowney, MD, CAQSM
Boulder Center for Sports Medicine was founded by Andrew Pruitt, EdD, PA-C, in 1998. For the past 12 years BCSM has been providing athletes from around the world with the highest possible level of care. BCSM offers a wide range of services, including Orthopedic Clinics, Physical Therapy, Expert 3D Bike Fitting, Running Gait Analysis, Coaching & Training, Nutrition Services, Performance Testing, and more. For more information, visit www.bch.org/sportsmedicine, or call (303) 544-5700.