1. IMMUNIZATIONS

The following vaccines are recommended:

- Diphtheria (adult dose) /tetanus

- Polio

- Hepatitis A

- Hepatitis B

- Typhoid (Typhim vi)

NB: A Yellow Fever vaccination certificate will be required for travellers coming from infected areas.

2. MALARIA PROPHYLAXIS AND TREATMENT

A) Malaria Prophylaxis

Recommended Prophylaxis:

Mefloquine or Doxycycline

Dosing: Mefloquine prophylaxis: 5mg/kg in a single weekly dose to be started at least one week before entering the endemic area

Doxycycline prophylaxis: 1.5 mg salt/kg daily, to be started the day before entering the endemic area.

NB: Under normal circumstances, Chloroquine plus Proguanil would be the recommended malaria prophylaxis. However, at present there are large-scale population movements and a destruction of services, including malaria control interventions, combined with an influx of non-immune foreigners, in East Timor. These circumstances favour the spread and increase of both malaria transmission and antimalarial drug resistance (Plasmodium falciparum resistant to Chloroquine and resistant to sulfadoxine/pyrimethanime has already been reported in East Timor).

B) Emergency Stand-By Treatment

Quinine, 8 mg base/kg orally, three times daily for seven days.

Alternative stand-by treatment when on Doxycycline prophylaxis:

Mefloquine, 15mg/kg in a single dose.

Self-treatment is a first aid measure and one should seek medical advice as soon as possible. Mefloquine prophylaxis should only be resumed seven days after the last self-treatment dose of Quinine. Doxycycline prophylaxis can be resumed immediately.

Staff should be informed as to how to protect themselves against mosquito bites (repellents, impregnated mosquito bednets) to reduce the risk of contracting malaria, dengue fever and other vector-born diseases.