The 2017 hurricane season was especially active with Hurricane Irma and Hurricane Maria causing severe damage in a number of countries and territories. Significant damage from the hurricanes has caused problems with water supplies, sanitation, food supply, electricity, transportation, shelter, communications, security, medical care and mosquito control. Those who must travel to these areas, including those who are traveling for humanitarian aid work, should adhere to the following recommendations:

Pre-Travel Care

As soon as possible, schedule a visit with your physician who can provide vaccines, medicines and advice on how to stay safe and healthy while you are traveling for the specific areas you are visiting. Your doctor can also make sure you’re physically fit for the demands of the work. Your doctor may also decide to refer you to a travel medicine specialist if necessary.

Recommended vaccines include:

• Tetanus: In accordance with the current CDC guidelines, responders should receive a tetanus booster if they have not been vaccinated for tetanus during the past 10 years. Td (tetanus/diphtheria) or Tdap (tetanus/diphtheria/pertussis) can be used.
• Hepatitis B: Hepatitis B vaccine series for persons who will be performing direct patient care or otherwise expected to have contact with bodily fluids.

Prevent Illness and Injury While There

• Use Caution: Be aware and avoid downed power lines, water-affected electrical outlets, and broken gas lines.
• Prevent Bug bites: Mosquito-borne illnesses such as Zika, dengue, and chikungunya may be found in these areas. Travelers should take steps to prevent bug bites. Malaria is also a risk in Haiti and parts of the Dominican Republic, so travelers should talk to their doctor or health care provider about taking medicine to prevent it.
• Avoid floodwater: Avoid swallowing floodwater or water from lakes, rivers, or wading in flooded areas, especially if you have any cuts or abrasions.

Vaccines Recommended for Evacuees of a Disaster

If immunization records are not available, adults over 18 years of age should receive the following recommended immunizations:

• Adolescent/adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) if not previously received no matter when last dose of Td was given.
• Pneumococcal polysaccharide vaccine (PPSV23) and Pneumococcal conjugate vaccine (PCV13) for adults 65 years of age or older.
• Pneumococcal conjugate vaccine (PCV13) and PPSV23 for adults 19 years of age or older with an immunocompromising condition.

The following vaccines should be given to evacuees living in crowded group settings, unless the person has written documentation of having already received them:

• Influenza: Everyone 6 months of age or older should receive influenza vaccine.
• Varicella: Everyone 12 months of age or older should receive one dose of this vaccine unless they have a documented record of immunization or documentation of health care provider diagnosed of chickenpox or shingles.
• MMR: everyone 12 months of age or older and born during or after 1957 should receive one dose of this vaccine unless they have a documented record of 2 doses of MMR or other evidence of immunity.