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Travel Clinic

The following list of health topics are of particular interest for travelers.  Please check out the "health topics" tab at the top for more.

Immunizations

Immunizations
Available at Hall Health Center

UW Measles Requirement
All enrolled matriculated students, and all students living in University of Washington residence halls or single-student apartments, are required to provide proof of measles (rubeola) immunity.


Hall Health Center offers the following vaccines.

NOTE: The Centers for Disease Control and Prevention (CDC) provides thorough, up-to-date information on vaccines. The Immunization Action Coalition is also a reliable resource.

Immunization No. of injections Protection period Exposure More information
Cholera (not recommended) 2 injections Incomplete protection Contaminated food and water CDC information

Hemophilus influenza type B (HIB)

Variable Lifetime Respiratory

CDC information

Hepatitis A

2 injections 20+ years Contaminated food and water CDC information

Hepatitis B

3 injections Lifelong Blood and bodily fluids What You Need to Know About Hepatitis B (Hall Health Center)

Hepatitis A/B combination

3 injections 20+ years to lifelong Blood and bodily fluids

CDC information (A)

CDC information (B)

Human Papillomavirus (HPV) 3 injections Lifelong Skin to skin

HPV Vaccine FAQs (Hall Health Center)

All About HPV     (Hall Health Center)

Influenza 1 injection or nasal spray 1 year Respiratory virus CDC information
Japanese encephalitis 2 injections 1-2 years Mosquito CDC information
Meningococcal 1 injections 3-5 years Respiratory CDC information
Measles, Mumps, and Rubella (MMR) combination 2 injections Lifelong Respiratory

CDC information

Polio (IPV) Childhood series + 1 injection as an adult Lifelong Contaminated food and water CDC information
Pneumococcal 1 injection or childhood series 10+ years Respiratory CDC information
Rabies 3 injections Partial protection Mammal exposure: bite, scratch CDC information
Tetanus, Diphtheria, and Pertussus combination TD or TDaP
Dtap (children)
Approximately 10 years Infected wound, respiratory CDC information
Typhoid 1 injection OR oral pills

2 years for injection;
5 years for oral tablets

Contaminated food and water CDC information
Varicella (chicken pox) 2 injections Lifelong Respiratory CDC information
Yellow Fever 1 injection 10 years Mosquito CDC information
Herpes Zoster (shingles) 1 injections Lifelong Previous chicken pox CDC information

 


What is malaria?

Malaria is the most significant parasitic disease threat you will face in most tropical and subtropical countries. It is a microscopic blood- borne parasite transmitted to humans by the bites of infected mosquitoes.  There are 300 to 500 million cases a year of malaria worldwide —approximately 1000 a year are reported in U.S. travelers. 


What is Dengue (deng-gay) Fever?

Dengue fever and dengue hemorrhagic fever are viral illnesses transmitted by the bite/sting of a mosquito. The mosquito species that carries dengue virus is active, biting during daylight hours, with a peak of activity just after daybreak, and then again for several hours before dark. These insects are often present indoors, and are common in areas of human habitation, including urban and rural areas throughout the tropical areas of the world.

Symptoms

Symptoms of dengue fever include:


mosquito.jpgBy avoiding insect bites during your travels to tropical and subtropical regions, you can prevent the following diseases:

  • Malaria
  • Dengue fever
  • Yellow fever
  • Japanese encephalitis
  • Lyme disease
  • Tick typhus
  • Chagas disease

Care should be taken to protect yourself and your family from most of the flying bugs you might encounter. 

Tips to avoid bites and stings

Be aware

  • Learn about the feeding and nesting habits of insects at your destination and take extra precautions and/or minimize activities accordingly. Ask your hosts about seasonal or local pests to be on the lookout for.

Use insect repellant

  • Use an appropriate insect repellent. DEET (N,N-diethylmetatoluamide) has a long and safe track record and is very effective at sufficient concentrations. Hall Health Pharmacy sells DEET insect repellant.
    • The Centers for Disease Control and Prevention (CDC) suggest DEET strengths of up to 30-50%. Concentrations up to 30% are  considered safe in children 2 months and older.  Concentrations greater than 50% do not provide better protection, but may have longer lasting protection. We do not recommend concentrations greater than 50%.  When you purchase insect repellant, check the label for strength information.
  • Repellents containing Picaridin at 7% and 15% concentrations are also available, and compared to the products above, may be as effective, but need more frequent application.
  • When applying both insect repellent and sunscreen, always apply the sunscreen liberally first, wait 10 to 15 minutes if possible, then apply insect repellent.

Dress for success

  • Wear protective clothing such as long sleeves and pants whenever practical.  Shirts should be tucked in.  Foot wear that provides maximum coverage is ideal, including socks, (sandals are not recommended).  Avoid jewelry and bright or dark-colored clothes; the best colors are light green, tan and khaki.
  • Do not walk barefoot.

Insect proof your surroundings

  • When at the beach or pool, lie on a chair or, at the very minimum, on a blanket or long towel.  Do not lay clothes on ground since perspiration or other scents may attract insects.  Shake them vigorously before putting them back on.
  • Sleep in well-screened areas, air-conditioned rooms, or use bed (mosquito) nets.
  • Clothing and bed nets can be impregnated with permethrin insecticide.
  • Avoid using fragrance-containing products such as perfumes, colognes, after-shaves, scented soaps, shaving creams, hair sprays, etc.  Use only unscented hygiene products.

Insect behavior and habits

Mosquitoes

  • Species that carry malaria and Japanese encephalitis bite from dusk till dawn.
  • Species that carry dengue fever, chikungunya fever, and yellow fever bite during daylight hours.
  • Mosquitoes are most active right around dawn and right around dusk, so extra care at those times is necessary.

Ticks

  • Burrow into your skin.
  • Are carried on animals, but picked up by humans from brush, grass, trees.
  • Check your skin at least once daily for presence of ticks if in high risk areas. Armpits and hairline are common places for ticks.
  • Remove ticks with a slow steady tug, pulling perpendicular to the skin at the site of attachment of the tick, using tweezers or a tick remover, if available.

Fleas

  • Especially present on and around animals and in sand and soil.

Product information: What to buy

The following products are used to avoid bites and stings of insects, and thereby reduce the risk of contracting the diseases they carry.   They can be purchased in many pharmacies and outdoor supply stores (e.g., REI), including at Hall Health Pharmacy.  Some specific products are listed for your information.

Repellents for use on the skin

NOTE: Please note that these repellents are to be used only on exposed skin and not under clothing.

DEET repellent – DEET (N, N-diethyl-m-toluamide) is the most effective repellent against mosquitoes, chiggers, ticks, fleas, and biting flies.  Controlled release formulations have longer lasting effectiveness. Avoid contact with eyes, mouth, and synthetic materials. Toxic only if swallowed.

We strongly recommend DEET-containing repellents over all others, based on its proven safety, effectiveness, and ease of use. Look for a minimum concentration of 20% and a maximum concentration of 50%.

Other repellents

Picaridin – available for many years in Europe at 21% concentration. Higher concentrations provide longer duration of protection.

  • Cutter Advanced® sprays containing 7% and 15% picaridin are available.
  • Sawyer Go Ready® spray contains 20% picaridin

Higher concentrations provide longer lasting protection.

Newer repellents

  • Cutter Lemon Eucalyptus® spray contains Oil of Lemon Eucalyptus (PMD), approved by the EPA and CDC as a "biopesticide repellent"
  • Sawyer makes a DEET-free repellent containing IR-3535, another biopesticide repellent approved by the EPA and CDC.

Insecticide for use on clothing and nets

Permethrin is available in various formulations, as a spray for clothing, or as a liquid for soaking clothing or bed nets. It effectively repels and kills insects. See manufacturer's recommendations for application of and duration of effectiveness for the various formulations available.

Some manufacturers now offer clothing that is already impregnated with permethrin. Check outdoor clothing suppliers for more info.

Mosquito nets

Locally, REI sells mosquito nets. Various companies sell mosquito nets and netting on the web. Here is a sampling, in no particular order, and without endorsement.

Military surplus stores also may stock mosquito nets.

Bee stings

Talk to your travel consultant at Hall Health or your personal health care provider if you are allergic to bee stings. The products discussed above may not be effective against bee stings and you should be appropriately prepared to manage a bee sting reaction.

Additional resources

Check out the Environmental Protection Agency's online tool to find an insect repellent that's right for you.

Schedule an appointment with Hall Health at least 4 weeks prior to your departure date to discuss how to protect yourself from insects.


Physician

Dr. Haulman graduated from the University of California at San Diego School of Medicine in 1980 and completed her residency in pediatrics at the Children's Hospital Medical Center in Seattle in 1983. She is board certified in both Pediatrics and Emergency Medicine. She currently holds the faculty appointment of Clinical Assistant Professor of Pediatrics in the UW School of Medicine.

In 1996 she returned to the UW.  Since that time she has been involved in travel vaccine research.  She is currently the Medical Provider for the Travel Clinic and serves as the communicable disease liaison for the UW Campus.  Her clinical practice is currently limited to counseling pre-travel patients.


1. Why is it important to maintain a medical record?

Each time you visit a Hall Health Center provider, a record of your visit is made. Typically this record contains your symptoms, examination and text results, diagnoses, treatment, and a plan for future care or treatment. This information, often called your health or medical record, serves as:


Family Nurse Practitioner

Britt Murphy is a Family Nurse Practitioner with an interest in college health and travel medicine. She has been a health care provider at the Hall Health Primary Care Center on the University of Washington campus for over 10 years.  
 
Ms. Murphy earned her BSN from the University of Vermont in 1992.  After working as an RN in oncology, she served as a Peace Corps Volunteer in Nepal from 1996 -1998.   Following her service in Nepal, Ms. Murphy pursued her MSN from the University of Washington, graduating in 2000.  She is a member of the International Society of Travel Medicine and is certified as a travel healthcare provider.


Patient Care Philosophy
I enjoy listening to my patients’ concerns and working together with them to maximize their health and wellbeing.

Personal Interests
International travel, outdoor activities and spending time with family

Clinical Interests
Primary care, travel medicine, including pre-travel concerns and infectious disease.  Has special interest in health care of the transgender community.

Languages
English

Expertise
Primary Care, Travel Medicine


Nurse Practitioner

Ms. McCadden has been an Nurse Practitioner since 2006. Prior to graduate school she worked as RN within the University of Washington system for over 20 years in such diverse specialties as ICU, ER, Research, and Occupational Health. She currently works as a Nurse Practitioner at Hall Health in Employee Health, Primary Care, Travel Medicine, and the Health Science Immunization Program.


Family Nurse Practitioner, Manager, UW Medicine Travel Clinic at Hall Health

Anne C. Terry is a nurse practitioner who works in primary care and travel medicine at Hall Health Center at the University of Washington. Her special interests include pre- and post-travel assessments, infectious disease challenges and dermatology. Anne is currently the director of the UW Medicine Travel Clinic at Hall Health Center.

She obtained her Master of Science in nursing at the University of Tennessee, Knoxville in 1997. In addition, she has a Certificate in Infectious Disease and Infection Control from the UW School of Nursing and is certified as a travel provider by the International Society of Travel Medicine (ISTM).


Patient Care Philosophy
I strive to inspire patients to make good health decisions and to give them the tools to make things happen. Without patient input and effort, good health cannot be achieved.

Personal Interests
International travel, hiking, cycling and knitting.

Clinical Interests
Travel medicine, including pre-travel consultations and figuring out complex post-travel issues; infectious disease; and dermatology, including the management of acne with Accutane.

Teaching Interests
Mentoring nurse practitioner students and UW residents in global health.

Languages
English

Expertise
Primary Care, Travel Medicine


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