Japanese encephalitis is a disease that involves the inflammation of the brain and is caused by a viral infection. The risk for developing Japanese encephalitis is in Asian countries, however this risk is usually very low. The risk for Japanese encephalitis increases in rural and agricultural areas and for travelers visiting affected areas for periods greater than one month.

•The Ixiaro® vaccine is generally recommended for people staying in areas at risk for Japanese encephalitis for one month or more, those visiting rural agricultural areas, and those working, hiking, or camping at night.
• The vaccine Ixiaro® is given as 2 doses 28 days apart. Both doses should be completed at least 1 week before travel.
• A booster dose of Ixiaro® should be given 1 year after the initial injections if there is a risk for re­exposure to Japanese encephalitis.

• Japanese encephalitis is spread by mosquito bites, therefore mosquito bite avoidance measures should be taken.
• How to decrease the risk of mosquito bites:

•  Air conditioned accommodations decrease the risk of mosquito bites
• Use bug nets if your accommodations don’t have air conditioner or
  appropriate screens or windows. Bug nets have usually been treated with insecticide and need to be re­treated every 6 months.
• Use an insect repellant that contains at least 25% DEET. DEET is safe to use if the instructions are followed carefully and appropriately.
• Wear loose fitting and light colored clothing including long pants and long shirts if possible.
• Ensure you are using effective insect repellants as products such as citronella candles and tea tree oils are not considered appropriate nor effective.

Dengue is a disease that is spread by mosquitoes. Dengue generally causes mild symptoms but some people will develop more serious symptoms and complications.

• There are currently no vaccines available for dengue and therefore prevention is best done through mosquito bite avoidance.
•The mosquitoes that cause dengue are more active from dawn until dusk (daytime hours) than dusk until dawn (evening hours).
• How to decrease the risk of mosquito bites:

•  Air conditioned accommodations decrease the risk of mosquito bites
• Use bug nets if your accommodations don’t have air conditioner or
  appropriate screens or windows. Bug nets have usually been treated with insecticide and need to be re­treated every 6 months.
• Use an insect repellant that contains at least 25% DEET. DEET is safe to use if the instructions are followed carefully and appropriately.
• Wear loose fitting and light colored clothing including long pants and long shirts if possible.
• Ensure you are using effective insect repellants as products such as citronella candles and tea tree oils are not considered appropriate nor effective.

Chikungunya is a viral infection that is spread through a mosquito bites by infected mosquitoes. Select countries in North America, South America, Europe, Asia, and Africa contain mosquitoes that are capable of spreading the virus that causes chikungunya. There is no vaccine to prevent the development of chikungunya, therefore it is important to avoid mosquito bites while traveling.

•Chikungunya is caused by mosquito bites and therefore mosquito bite avoidance is important to reduce your risk of contracting chikungunya.
• There is currently no vaccine to protect against chikungunya.
• How to decrease the risk of mosquito bites:

•  Air conditioned accommodations decrease the risk of mosquito bites
• Use bug nets if your accommodations don’t have air conditioner or
  appropriate screens or windows. Bug nets have usually been treated with insecticide and need to be re­treated every 6 months.
• Use an insect repellant that contains at least 25% DEET. DEET is safe to use if the instructions are followed carefully and appropriately.
• Wear loose fitting and light colored clothing including long pants and long shirts if possible.
• Ensure you are using effective insect repellants as products such as citronella candles and tea tree oils are not considered appropriate nor effective.

Malaria is a disease spread by mosquitoes that are infected with parasites called Plasmodium. There are over 100 countries where the risk of developing malaria exists. These countries are in warm climates in countries below the equator include countries in Africa, South America, Asia, and the Caribbean.

• There are no vaccines for malaria, however other medications can be taken while you are in a malaria zone to reduce your risk of developing malaria.
• The medications to prevent malaria are only effective for as long as you are taking them, and therefore do not provide long term protection against malaria.
• Medications to prevent malaria include Malarone® and doxycycline. It is important to take your malaria medications as directed by your prescriber to ensure they are effective.

• Malaria is caused by mosquito bites and therefore mosquito bite avoidance is important to reduce your risk of contracting malaria.
• A general rule for preventing and recognizing malaria is to follow ABCD:

• Awareness of the risk of malaria ­ make sure you know which countries you are traveling to carry a risk of malaria
• Bite prevention ­ use appropriate insect repellents, wear appropriate clothing and use sleep nets when required
• Chemoprophylaxis ­ use antimalarial medication such as Malarone® or doxycycline before, during, and after you travel to protect you from developing malaria
• Diagnosis and treatment should be prompt. If you are experiencing any symptoms it is important to seek medical attention immediately

•Other tips to decrease the risk of mosquito bites:

•  Air conditioned accommodations decrease the risk of mosquito bites
• Use bug nets if your accommodations don’t have air conditioner or
  appropriate screens or windows. Bug nets have usually been treated with insecticide and need to be re­treated every 6 months.
• Use an insect repellant that contains at least 25% DEET. DEET is safe to use if the instructions are followed carefully and appropriately.
• Wear loose fitting and light colored clothing including long pants and long shirts if possible.
• Ensure you are using effective insect repellants as products such as citronella candles and tea tree oils are not considered appropriate nor effective.

Yellow fever is a disease that is present in 43 countries and is spread by mosquito bites. Travelers to certain countries are required to be vaccinated for yellow fever before entering the country. Before traveling, make sure that you are vaccinated if any of the countries in your itinerary require vaccination. The countries that require yellow fever vaccination are in sub­Saharan Africa and tropical South America. You will be provided a card as proof of vaccination that you can bring with you on your travels.

•The YF­VAX® vaccine for yellow fever is given as a single dose and it is effective for at least 10 years.
• Re­immunization is recommended every 10 years as travelers may be denied entry into a country requiring yellow fever vaccination if they have not had a booster within the previous 10 years.

• How to decrease the risk of mosquito bites:

•  Air conditioned accommodations decrease the risk of mosquito bites
• Use bug nets if your accommodations don’t have air conditioner or
  appropriate screens or windows. Bug nets have usually been treated with insecticide and need to be re­treated every 6 months.
• Use an insect repellant that contains at least 25% DEET. DEET is safe to use if the instructions are followed carefully and appropriately.
• Wear loose fitting and light colored clothing including long pants and long shirts if possible.
• Ensure you are using effective insect repellants as products such as citronella candles and tea tree oils are not considered appropriate nor effective.