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Mexico (North America) * Confirm primary courses and boosters are up to date as recommended for life in Britain - including vaccines given to special groups because of risk exposure or complications (e.g. hepatitis B for health care workers, influenza and pneumococcal vaccines for the elderly). * Courses or boosters usually advised: tetanus; hepatitis A; typhoid. * Vaccines sometimes advised: diphtheria; rabies; hepatitis B. * No vaccine certificate required. * ** Tetanus is contracted through dirty cuts and scratches. This is a serious infection of the nervous system. ** Typhoid and hepatitis A are spread through contaminated food and water. Typhoid causes septicaemia and hepatitis A causes liver inflammation and jaundice. In risk areas you should be immunised if good hygiene is impossible. ** Diphtheria is also spread by droplet infection through close personal contact. Vaccination is advised if close contact with locals in risk areas is likely. ** Hepatitis B is spread through infected blood, contaminated needles and sexual intercourse, It affects the liver, causes jaundice and occasionally liver failure. Those visiting high risk areas for long periods or at social or occupational risk should be immunised. ** Rabies is spread through bites or licks on broken skin from an infected animal. It is always fatal. Vaccination is advised for those going to risk areas that will be remote from a reliable source of vaccine. Even when pre-exposure vaccines have been received urgent medical advice should be sought after any animal bite.

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