There are some pretty serious things out there, and there are parts of the world where if you are going there you'll need to look into things like courses of anti-malarials (many times anti-malaria medications need to be started before you actually travel. If you are going to a part of the world where malaria is a danger, check in early with your doctor) and other heavy ammunition. Visit a doctor who has been out of state a few times, or check with serious folks like the World Health Organization.

If you are pregnant, or hoping to become pregnant, consult your doctor early and often before taking any immunizations, especially anti-malarials. We have some additional information for pregnant travelers you may also want to take a look at.

The International Society of Travel Medicine Clinic Directory is an exhaustive listing of clinics all over the U.S. and in many other countries that can provide travel-related medical care, such as immunizations.

You can also call the National Vaccine Information Center at (800) 909-SHOT for additional information about immunizations.

Even if there is not a doctor with specific travel medicine-related experience near you, your home town physician may be able to consult with a collegue you help locate to better assist your family.

What everyone should do however before traveling internationally with kids is to make sure their standard immunizations are up to date. Even for grown ups, checking that your tetanus booster is in order is very important. Tell your doctor where you'll be going and ask her to check on what additional immunizations are recommended.

Ask your doctor, or prepare yourself, a list of immunizations with dates for each child. Many times foreign doctors who you cannot speak with in English will recognize the medical terms used for common shots such as tetanus.

An accurate shot record might spare you some headaches and heartaches, and your child an injection they might not have to take. In parts of the developing world where sterile needles may not be widely available, avoiding an unneeded shot is extra important.

If you are reading this from the UK, the British Airways travel medicine center provides one-stop shopping for immunizations, tickets, maps of everywhere and a nice selection of travel books.

An excellent source for information is the U.S.-based Centers for Disease Control. You can also call them at 877-FYI-TRIP (877-394-8747), or contact their toll-free automated FAX service at 888-CDC-FAXX (888-232-3299).

You may also want to write to the Government Printing Office and request a copy of their booklet Health Information for International Travel. It costs $20, so check with your doctor, the library or a public health office in your local city hall before giving up the Andrew Jackson.

The Printing Office's address is Government Printing Office, Superintendent of Documents, Washington, DC, 20402-9328.

New Germs

While we are on the topic, I'm not a doctor, but I have a theory why our kids always seem to get colds when traveling overseas: new germs.

Airplanes are especially nasty incubators for germs, with their dry, recycled air. Sad to say, but as soon as you step off the plane in exotic wherever, lots of local germs which have never tasted your kind of flesh will be doing high-fives and celebrating diversity. One possible defense would be if you live in an area where a more internationally-oriented physician might be able to look into flu shots designed for the part of the world you'll be going to, in addition to what is cooked up for where you are living now.

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