The pre-travel consultation is a risk assessment process that provides a guide to prioritize and customize pre-travel health care for individual travelers. The goal of this pre-travel consultation is to effectively and efficiently prepare the traveler with the appropriate information, vaccinations, and medications to help reduce the risk of illness and injury related to travel.

Because of the possible need to complete a series of vaccinations, the pre- travel visit ideally should occur 4-6 weeks before travel. Travelers who are not able to seek care during this time, however, will also benefit from visiting a health-care provider, as last-minute vaccinations and travel advice could be useful .

Recordkeeping Procedures
The designated clinic should observe and maintain high standards of recordkeeping. The minimum entries in a patient record following yellow fever vaccination include the date of vaccine administration, the product name, lot number, expiration date, injection site, and name of the person administering the vaccine. There are additional requirements when completing the International Certificate of Vaccination or Prophylaxis (ICVP).

In addition to vaccine-related information, staff should record the general information listed below about the patient. These details should be recorded in either the traveler's permanent medical record, or in situations where no permanent record exists, in an ad hoc medical record.

• Date of birth
• Relevant medical history (e.g., allergies, prior adverse events, immune status, and medical conditions and treatments)
• Destination country (e.g., cities and regions to be visited)

For children who receive yellow fever vaccine, vaccination records should be kept according to state health department requirements. For example, records should be documented in the same way as other childhood vaccines.

In the event of closure of a designated clinic, patient records should be archived according to official state health department guidance.

If you’re planning a safari or a trip to an exotic geographic area, talk to your doctor about whether or not you should receive the yellow fever vaccination prior to embarking on your voyage.

YELLOW FEVER is a severe viral disease that is transmitted to humans through the bite of infected mosquitoes. The disease can be prevented through immunization for most individuals. Travelers to the tropical regions of Africa and parts of South America are recommended to receive yellow fever vaccine. In addition, travelers are urged to take precautions against mosquito bites, including staying indoors at dawn and dusk, wearing DEET-containing insect repellant and insect repellant treated clothing with long sleeves and pants, and using bed nets or sleeping in screened rooms.

According to the Centers for Disease Control and Prevention (CDC), the risk of acquiring yellow fever for travelers in Africa is estimated at 50 cases per 100,000 travelers per two-week stay during the peak transmission season, which is July through October. The average risk in off-season is closer to 10 per 100,000 per two-week stay. In South America, the risk is somewhat less.

Symptoms and Treatment
It can take from three to six days to see signs of illness after contracting yellow fever. Most yellow fever infections are mild, and go undiagnosed, but severe cases can be life-threatening. Symptoms of severe infection include fever, chills, headache, muscle aches, vomiting and backache. After a brief recovery period, the infection can lead to shock, bleeding, and kidney and liver failure. Liver failure causes jaundice, which yellows the skin and eyes. (This is how the disease got its name.) Treatment for yellow fever is based on the symptoms present. Rest, fluids and ibuprofen, naproxen, acetaminophen, may relieve symptoms of fever and aching. Aspirin should be avoided. Because international regulations require proof of yellow fever vaccination for travel to certain countries, travelers should get vaccinated for yellow fever before visiting areas where yellow fever occurs.

In the United States, the vaccine is given only at designated yellow fever vaccination centers. If you are at continued risk of yellow fever infection, a booster dose is needed every 10 years. Be sure to talk to your doctor about whether or not you should receive the yellow fever vaccine before traveling overseas.

For Information and Vaccinations
For information on current outbreaks, consult CDC’s Travelers’ Health Web site. To learn more about Travel Medicine services at Corona Doctors Medical Clinics call from 9:00 a.m. to 6:00 p.m., Monday through Friday, Saturdays from 10:00 a.m. to 4:00 p.m.


Your Appointment and Travel Medicine Questionnaire
We're glad you've chosen Corona Doctors Medical Clinics to handle your Travel Medicine needs! Now that you've made your appointment, be sure you're prepared for your visit.

For your visit:

• Arrive 20  minutes prior to your appointment.
• Bring your trip itinerary.
• Bring your current immunization record.
• Parents of pediatric patients should bring their child's current immunization record.

Print, fill out and bring this Travel Medicine Questionnaire with you to your appointment. (If you're unable to bring your Travel Medicine Questionnaire with you, a staff member can provide you with a copy upon your arrival.)

• Yellow Fever vaccinations administered by state certified providers.
• Pre-travel consultation with immunization nurses trained using Centers of Disease Control and Prevention standards.
• Travel consult nurses with access to an online resource that provides up-to-date information on every country.
• Customized, informative reports related to your destination, including required environmental issues, socio-political climate hazards and recommended immunizations.
• Advice to patients regarding food, water and insect precautions.
• Contact information for embassies and recommended medical facilities (where available).
• Prescriptions for Malaria and Oral Typhoid when needed.
• Travel medicine Kits designed especially for your travel destination.

If you need additional assistance, feel free to call our Travel Medicine specialists at 951-371-9500

Immunization Facts:
When planning a trip, the last thing you want to think about is illness.

Immunizations are one of the best ways to protect yourself from serious diseases, many of which can be life threatening.

The purpose of a vaccine is to stimulate the body's defense system in order to prepare it for a future encounter with an infectious disease.

There are three types of immunizations:

• Routine
• Required
• Recommended

1. Routine Immunizations
All adults should update these routine immunizations every 10 years, even if they do not plan to travel:

• Tetanus and Diphtheria
• Health Tip: Certain health conditions can dramatically increase a traveler's risk. If you are pregnant or have a chronic medical condition such as allergies, asthma, diabetes or epilepsy, be sure to consult a health care professional or a Corona Doctors medical Clinics Travel Medicine Professional prior to departure.

2. Required Immunizations
Some countries will require proof of these immunizations before entry:

• Yellow Fever
• Meningococcal

3. Recommended Immunizations
Depending on your itinerary, planned activities and current health status, your health care professional may recommend one or more of these immunizations:

• Poliomyelitis
• Influenza
• Hepatitis A
• Hepatitis B
• Thyphoid
• Japanese Encephalitis
• Meningococcal
• Rabies
• Measles, Mumps, Rubella
• Yellow Fever

If traveling with children, additional vaccines may be required for them.

Consult with Corona Doctors Medical Clinics for advice on planning a safe and healthy trip.

What is Yellow Fever?
Yellow fever is a viral illness, carried by some species of mosquitoes in Central and South America, and in tropical regions of Africa. A mild attack may have symptoms similar to those of the flu. More severe symptoms may include nausea, vomiting, bleeding, abdominal pains and yellowing of the skin as a result of liver damage.

Where Is It?
Yellow Fever is a viral disease endemic in the Sub-Saharan Africa and South America.

Prevention Tips
Your best defense is to avoid mosquito bites altogether, but travelers can reduce their risk of acquiring yellow fever by:

• Taking precautions against exposure to mosquitoes when traveling in areas with yellow fever transmission.
• Remaining in well-screened or air conditioned areas when possible.
• Wearing clothing that adequately covers the arms and legs.
• Applying DEET-containing insect repellent to both skin and clothing.
• Yellow fever vaccination may be required for entry if you are traveling to, or stopping in a country where the disease exists.

Consult with Corona Doctors medical Clinics Travel professionals to determine if your travel itinerary will require you to be immunized for yellow fever.

Available Immunizations:
Immunization is required in certain countries. The vaccine must be administered at an approved yellow fever vaccination center. Contact your local state health department for the nearest vaccination center. Vaccinees should receive complete International Certificate of vaccination, signed and validated with the center's stamp where the vaccine was given.

This certificate is valid 10 days after vaccination and for a subsequent period of 10 years. This certificate should be carried with your passport at all times.

DISEASE IMMMUNIZATION AND FACTS

What Is It?
Tetanus (Lockjaw) is a rare but severe disease that causes muscle contractions which can lead to breathing problems and even death. Tetanus can occur if contaminated soil enters cuts or wounds, such as a burn.

Diphtheria is a disease of the respiratory passages, transmitted from person-to-person, which may cause severe heart disease. In the developing world, diphtheria is sometimes spread via unpasteurized milk.

Polio is a widespread disease in the developing world outside North and South America, which may result in paralysis. Polio is transmitted primarily through food or water contaminated with feces.

Prevention Tips
You should have your first immunization series against tetanus, diphtheria and polio during childhood. If you're traveling with infants and children, you should discuss their immunization needs, especially if traveling for extended periods of time, which might interrupt your child's normal immunization schedule.

Available Immunizations

• A booster dose against tetanus and diphtheria is recommended every 10 years, whether traveling abroad or not.
• If you have not received the complete primary series, consult your health care professional about completing it.

Please consult your travel clinic physician to determine which vaccines are appropriate for you

DISEASE IMMMUNIZATION AND FACTS

What is Japanese Encephalitis?
A virus that is spread by the bite of an infected mosquito causes Japanese encephalitis. This disease affects the brain causing confusion and may lead to coma and death. In some countries, the Japanese encephalitis transmission season lasts year around, while In other countries, transmission is seasonal.

Where Is It?
Japanese encephalitis is transmitted by mosquitoes in various areas of Asia (from India east to Korea, Japan and Indonesia)

Prevention Tips

• Depending on your destination you may benefit from Japanese encephalitis vaccination. Talk to your Travel Clinic to determine if vaccination is right for you
• Always practice personal precautions against mosquito bites (especially between dusk and dawn)

Travelers can reduce their risk of acquiring Japanese encephalitis by:

• remaining in well-screened or air conditioned areas when possible
• wearing clothing that adequately covers the arms and legs applying
• DEET-containing insect repellent to both skin and clothing

Available Immunizations
Vaccination for Japanese encephalitis is recommended if you are traveling to a country during a Japanese encephalitis transmission season and you are planning extensive outdoor activities in rural areas for any length of time, or you plan to travel for 30 days or more to a country during a Japanese encephalitis transmission season, regardless of your planned activities.

Immunizations for the purpose of foreign travel are not typically covered by health insurance plans. Therefore, Corona Doctors Medical Clinics does not file a claim to your insurance plan. We will collect the full fee for each immunization administered at the time of service. We accept cash, or credit card for payments. All appointments are nurse visits.

2016 Immunization Fee Schedule	Price	Comments Prices may vary
Foreign Travel only Consultation	$65.00	Patient receives consultation, but declines immunizations or prescriptions.
Consult to Obtain	$65.00	Malaria and/or Oral Typhoid Prescription only
Dtap	$135.00
Hepatitis A, Adult	$140.00	Per injection. Two injections are required. One now, second in six months. Good for life.
Hepatitis B, Adult	$140.00	Per injection. Three injections are required. One now, second in one month, final in six months. Good for life.
Influenza (Flu) Vaccine	$25.00
Japanese Encephalitis (Ixiaro)	$430.00	Price is per injection. Two doses series required. Given only to people 17 years of age and older. Doses are spaced 28 days apart. The last dose should be given at least 1 week before travel. Rarely given.
Meningococcal (Meningitis) Menactra	$200.00	Ages 2 to 55 years
Meningococcal (Meningitis) Menommune	$190.00	Ages 55 and older
MMR	$115.00
Pneumococcal	$105.00
Polio	$85.00	Adult booster required when traveling to certain countries.
Rabies	$400.00	Price is per injection. Series of three required. Rarely given.
TB - PPD Skin Test	$25.00
Tdap	$75.00​
Typhoid	$150.00	Every two years.
Varicella (Chicken Pox)	$185.00
Yellow Fever	$185.00	Every 10 years. You will receive the International Certificate of Vaccination (Yellow Card).
Vaccination verification by titer level	$00.00	Ask for Laboratory prices at front desk (only cash patients)

Corona Doctors medical Clinics has travel medicine kits recommended especially for your travel destination! Packaged contains the following:

• Ace Bandages
• Anti-diarrheal caplets
• Bismatrol Chewable Tablets
• Carmex
• Curad Bandaids
• Denttemp O.S. (repairs loose fillings and loose caps)
• Eye Wash
• First Aid Tape
• Foille Medicated First Aid Ointment
• Gas Relief soft gels
• Gentle Laxative
• Halls
• Hydrocortisone
• Ibuprofen
• Gauze pads.
• Loratadine Antihistamine tablets
• Motion Sickness tablets
• Nasal Decongestant (12-Hour)
• Nasal Decongetant (Maximum Strength)
• Q-DRYL Allergy Medication
• Triple Antibiotic Ointment
• Tums Extra Strength
• Tylenol Extra Strength
• Wet Ones Antibacterial Wipes

The following Health-Wise checklist will assist you in preparing for international travel. Print this list and cross through the items that do not pertain to your travel plans. Check the remaining boxes as you complete each item.

1. Learn about your destination - type of accommodations, food and water preparation, type of geographical areas you'll visit, and medical services available.
2. Visit our Travel Clinic or your health care provider.
3. Get appropriate immunizations for your destination. Obtain an International Certificate of Vaccination or yellow fever card and keep it with your passport.
4. Have a dental check-up and complete medical examination, especially if traveling for three months or more.
5. Arrange for an adequate supply of your prescription medication.
6. Obtain a medical alert bracelet for medical conditions such as diabetes or drug allergies.
7. Purchase an extra pair of eyeglasses or contact lenses and sunglasses.
8. Obtain a directory of English-speaking physicians.
9. Collect items for a first aid travel kit especially if traveling long-term, or off the usual tourist routes, or purchase a Travel Kit from your Pharmacy.
10. Check your health insurance coverage.
11. Buy additional health/accident travel insurance. Ensure you're covered for any current health conditions (such as heart, pregnancy, etc).
12. Remember your identification and necessary papers (such as passport, visa, etc.)

This checklist is not all inclusive. Travel smart! Consult with Corona Doctors medical Clinics for advice on planning a safe and healthy trip.