ing on conditions in your destination, your doctor may prescribe a prophylaxis against malaria.

Finally, the U.S. Embassy recommends vaccination against Japanese encephalitis. The disease, which can cause serious brain damage and has a 25-percent fatality rate, is transmitted by mosquitoes and occurs mainly from June through September in rural areas of Asia. The National Center for Infectious Diseases reports that the risk among American travelers is less than one case per year for each million travelers to Asia. The risk for travelers to rural areas, however, is one in 5,000 in a one-month period. In temperate areas of China, there is no risk during the winter. The Japanese encephalitis vaccine is available in the United States under the trade name Je-Vax, distributed through Connaught Laboratories in Swiftwater, Pennsylvania. Your physician can order the vaccine (1-800-VACCINE), which is administered in three doses spread over 30 days.

The International Medical Center in Beijing also provides the three-shot series at a cost of US$60 each. The shots are given in Beijing at one-week intervals.

Your physician should also be consulted about prescribing disposable syringes to take to China, since not all Chinese hospitals use them and since even "disposable" syringes have been reported to be recycled. Some people suggest bringing two types of syringes: one for administering injections and the other for drawing blood. Be sure to bring a copy of the prescription in case you are questioned at customs.

If you are bringing children with you to China, make sure that the child's basic immunizations are up-to-date and bring your family's international health card with a record of basic immunizations. The U.S. Embassy recommends that the encephalitis vaccine not be given to children under 12 months of age unless they will be in a rural area. The hepatitis-B vaccine series is usually begun at the age of one year. The Centers for Disease Control and Prevention now recommends that gamma globulin be given to infants and children as prophylaxis for hepatitis-A.

Useful information about relevant immunizations, diseases, and prevention can be found in the pamphlet Health Information for International Travel (publication #017-023-00192-2), available for $6.50 from:

Superintendent of Documents

U.S. Government Printing Office

Washington, D.C. 20402

Telephone: 202-783-3238

or contact:

The International Travel Clinic