Highland Travel Medicine



 is a bacterial disease, caused by Clostridium tetani, which affects the nervous system. The bacteria enter the body through a break in the skin. If left untreated, it causes death in 1 out of 5 people. Early symptoms include lockjaw, stiffness in the neck and abdomen, and trouble swallowing. Late symptoms include severe muscle spasms, seizure like activity and abnormal heart rhythms.

Diptheria is a bacterial infection that causes a thick covering in the back of the throat, resulting in severe respiratory compromise. It is spread by respiratory droplets of an infected person carrying the bacteria and is not symptomatic at the time.

Pertussis, known as “Whooping Cough,” is spread by respiratory droplets from an infected individual who is not symptomatic at the time of transmission.  It causes severe coughing spells, vomiting, rib fractures and even pneumonia. Whooping cough is not considered life threatening in an adult, but if an unimmunized child is infected, death can occur. Since 2005, the incidence of adolescent and young adult infection with pertussis has been on the rise, causing an effort to revaccinate adults whose immunity has waned.


Anyone age 19-64 years, who has not had a TDAP in the last 10 years should receive one as part of their routine vaccinations, and especially before travel to a foreign country. As an adult, if you have not received a full series of tetanus-diphtheria toxoid vaccination (Td) as a child, then you should receive a full three dose series, at day 0, 1month later then 6months later; with one of those shots being TDAP. If a woman is pregnant and her last Td was ≥10years ago, she can receive the Td vaccine in the second and third trimesters.

This vaccine should not be given to someone who has had an allergic reaction to previous tetanus vaccines. As with most vaccines, a mild reaction is not uncommon; including pain at the site, mild fever, fatigue, and GI upset. A small amount of adults may suffer more severe pain at the injection site, but it subsides after a few days.  A severe reaction found in clinical trials resulted in nervous system problems, which resolved on their own and could not be completely attributed to the vaccination.