Question

A mother who has recently given birth wants to move with her newborn to a foreign country where there are endemic diseases not prevalent in her homeland. What would you advise her and why? Immunology point of view

Answer 1

Endemic disease is defined as a disease which is specific to a particular region or geographical area.

Since, subject who wish to travel in the given question has given birth recently and has a newborn with her, there are high chances of risk of exposures to infection. Hence, proper knowledge of the Local climate, insects and parasites in the foreign country and sanitation is required to estimate the risk factors and take preventive measures.

Vaccination against the common diseases like Diptheria, Tetanus, pertussis, Influenza, Measles, Mumps and Rubella, Polio, Hepatitis A, B, Typhoid are to be administered to the new born which provides the artificial active immunity in the newborn.

Mother needs to take the Booster dose of vaccines if not previously taken to improve the active immunity.

Apart from the above mentioned diseases, the following are the endemic diseases and the region in which they are widespread:

Disease	Country/region to which it is endemic	Preventive measure and its purpose
Yellow fever	Sub-Saharan, Central African and South American countries	Yellow fever vaccination for prophylaxis
Meningococcal infections	Saudi Arabia	Meningococcal vaccination
Malaria	Tropical and subtropical countries	Antimalarial drugs (Chloroquine, Pyrimethamine, Primaquine, Pamaquine etc) to prevent the disease
Zika virus Infection	Africa, South East Asia, Pacific islands, Brazil, Caribbean Islands, Central America, Mexico, South America etc	No vaccination is currently available, Preventing mosquito bites by using mosquito repellants

Apart from the above precautions, Personal hygeine, prompt recognition of symptoms and other signs, food and water safety, preventing mosquito bites can help prevent the diseases in both the mother and the new born

As mother and new born are completely moving out to foreign country away from homeland there is also risk of traveller's diarrhoea which can be prevented by taking vaccination as mentioned before, increasing healthy flora concentration in gut by consumption of yogurt, dairy products, maintaining good hydration helps to combat the Travellers Diarrhoea

The underlying health of the mother and newborn were completely assessed before travelling, mode of transport, season, duration, destination were analysed to find out any other possible risks.

If the journey can be postponed, it is advisable to delay the travel atleast upto the baby is few weeks old and has sufficient immunity is developed against the common flu and other illnesses which are not discussed in the above list.