Eat Safe Drink Safe: Twinrix Takes The Worry Out Of Travel
Have you seen the commercials on TV for the Twinrix vaccine? The commercial shows a tropical destination where hepatitis A could be a risk through contaminated food, ice in a drink, or contaminated pool water. It also shows that hepatitis B could be a risk through contaminated spa tools. Hepatitis A and B are viruses that infect the liver and can be a risk in many destinations worldwide including the Caribbean and Mexico, even at a five-star resort. When I travel I like having peace of mind that I received vaccines for hepatitis A and B so won’t get sick from these illnesses. In this blog I’ll tell you more about hepatitis A and B and if the Twinrix vaccine is right for your travels.
What is hepatitis A?
Hepatitis A is a virus that attacks the liver that is spread through food and water contaminated with the feces of an infected person (yuck!). It is one of the most common vaccine-preventable infections acquired during travel. Hepatitis A is a high risk when travelling to countries with poor sanitary conditions, but it can also occur in travellers with typical tourist itineraries and accommodations in developed countries, even at a 5-star resort. Possible ways of being infected with hepatitis A include:
- Raw contaminated fruits and vegetables
- Handling foods after cooking by a person infected with hepatitis A
- Ice and frozen drinks
- Raw or undercooked shellfish (e.g., oysters, clams, mussels, scallops) that has been exposed to sewage
- Direct household person to person contact
- Person to person contact through injection drug use
- Person to person sexual contact, especially men who have sex with men
Not everyone who is infected with hepatitis A has symptoms, so it is possible to spread the virus without knowing you are infected. Infants and children often don’t have symptoms when infected with hepatitis A and can spread the virus for up to 6 months after being infected.
If symptoms of hepatitis A occur they can range from mild to severe illness lasting several months. Symptoms can include fever, fatigue, nausea, vomiting, abdominal pain, dark-coloured urine, and jaundice (yellowing of the skin or eyes). The chance of having symptoms and the severity of the disease increases with age.
What is hepatitis B?
Hepatitis B is a virus that attacks the liver and can cause chronic liver infection. It is spread through contaminated blood and bodily fluids. Possible ways of being infected with hepatitis B while travelling include:
- Unprotected sex
- Contaminated spa tools that have not been properly sterilized
- Poor infection control during medical or dental procedures
- Tattooing, acupuncture, or body piercing devices
- Receipt of blood products
- Injection drug use
- Direct contact with infected blood (e.g., when giving first aid)
At least 50% of hepatitis B infections do not cause any symptoms. When symptoms occur they can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay coloured stools, joint pain and jaundice (yellowing of the skin or eyes).
Some hepatitis B infections will resolve on their own while others will develop into chronic infection. It is possible to have a chronic hepatitis B infection and not know it but can still pass it onto others. Some people with chronic hepatitis B infection can develop liver cirrhosis, liver cancer, or liver failure.
There are higher rates of hepatitis B in Asia, eastern and southern Europe, Japan, the Middle East, Africa, and Russia. The overall risk of hepatitis B is low for travellers who do not have high risk behaviours or exposures to hepatitis B.
Do you need the Twinrix vaccine?
The Twinrix vaccine provides lifelong protection against hepatitis A and B after completing the vaccine series. The Twinrix vaccine is a great option for many travellers, but it’s not the only option. You may have completed the hepatitis B series in childhood as part of your routine vaccine series, or you might have completed the series for school or work in a health care setting. If you’ve completed the hepatitis B series previously then you only need the hepatitis A vaccine. Since I was born after 1980 I received the hepatitis B vaccine in school so did not need the Twinrix vaccine for travelling and just received the hepatitis A vaccine.
The Twinrix vaccine is a great option for anyone needing or wanting both hepatitis A and B protection. The Public Health Agency of Canada recommends hepatitis B protection for people with certain high risk medical conditions, those with behavioural risks for infection, travellers to areas where hepatitis B is common in the population, and anyone wanting protection against hepatitis B.
How many doses of Twinrix do you need?
The Twinrix vaccine is normally given as a series of 3 injections. The first two injections are one month apart followed by a third dose in 6 months. The first two are needed for protection before travel. If you don’t have time to get the first two doses before your trip, do not fret! There are options for accelerated series to ensure you will be protected for your trip, even if you leave tomorrow!
If you think the Twinrix vaccine is right for you, don’t delay in booking your appointment at TravelSafe Clinic! The health care professionals at TravelSafe will determine the best schedule for you to receive the Twinrix vaccines before your trip. Remember, depending on your destination there could be other health risks and vaccines needed for your trip. We always recommend booking a pre-travel consultation to ensure you are fully prepared for travel. Simply call us at 604-251-1975 or complete our online booking form to book your appointment today!
Kristin Cain, RN, BSc, MSc(A) – TravelSafe Clinical Nurse Educator, Nurse Consultant, and adventurous eater when travelling.