Travel to the exotic destinations on Earth and there’s always likely to be a friend or parent fretting about your health.
Visit anywhere outside what’s commonly referred to as the West, and some horrific sounding diseases can become a threat. Ebola, malaria, dengue fever, Japanese encephalitis; you don’t want to contract them, so let’s not linger on them.
Random Vacay has put together an easy to follow guide to vaccinations and medications for your travels.
Travel Health Should Never Be Off-putting
The problem with travel health is that it’s always viewed in the negative. Like when the nurse looks at you funny because you’ve mentioned going to Peru. Or when a neighbor starts praying for your wellbeing because you’re traveling to Mongolia. A few simple vaccinations and medications and the most exotic destinations are as safe as Disneyland. In fact, far safer, given the abundance of snotty nosed kids trying to cuddle novelty mice.
Don’t let the thought of a disease put you off traveling. You get vaccinated and you’re safe. So why stress about it.
The Essential Vaccinations
While risk of various diseases varies from country to country, there are some standard vaccinations applicable across most of the planet. Particularly if you plan to travel for prolonged period, getting inoculated for these three provides a base and safety net for most of your travels in exotic destinations.
- Hepatitis A
- Tetanus – you should have been vaccinated against this as a child but may require a booster.
Like we said before, there’s no point in lingering on what happens if you contract any of these. Just get the vaccine.
Vaccinations Dependent on the Trip
A whole host of other vaccinations may be applicable but the risk depends on both where you’re going and what you’re going to be doing. Disease is undoubtedly more common in poor communities, so if you’re volunteering in a slum for two months then start getting ready for some jabs in the arm. But if you’re spending a week at an all-inclusive beach resort there’s a good chance that these won’t be applicable.
- Diphtheria – Mainly a risk in Africa and the Indian sub-continent. It’s common to receive a diphtheria and tetanus combined vaccination.
- Hepatitis B – Not as big a risk as Hep A but still widespread across the world. To save money, try getting the combined Hepatitis A and B vaccine.
- Japanese Encephalitis – Spread through mosquitoes that breed in the rice paddies of Asia. For a couple of weeks on Asia’s beaches it’s low risk. However, it’s recommended if you’re traveling for extending periods in rural parts of Asia.
- Yellow Fever – see below.
Yellow fever gets its own section because you don’t have a choice about getting the vaccine. Travel to most countries at risk of yellow fever and you’ll need to present a certificate of your vaccination to immigration. This is commonly known as a yellow card. Furthermore, once you leave the country, you’ll need to present the yellow card to the next country’s immigration officials. The following maps show the areas of South America and Africa regarded as at risk.
Vaccinations That Probably Aren’t Worth the Money
If it’s covered by your health insurance then get them all. You never know when travel plans might change or your insurance company will change their policy. However, if these vaccinations are coming out of your own pocket, here are some that probably aren’t worth the $hundreds.
- Cholera – A water bound disease found mainly in Africa and Asia. It commonly spreads after floods and natural disasters and is found in places without clean drinking water. Unless you’ve got terrible personal hygiene or plan to be drinking tap water in very poor communities, this one isn’t worth it. The other notable exception will be those volunteering for extending periods in poor communities.
- Rabies – Spread through infected animal saliva, normally via getting bit by a dog or bat. It’s a rare disease and the vaccination won’t save you. Contract rabies and you’ve probably got 24 hours to find a hospital and get treated. With the pre-exposure vaccine, that’s extended to around 72 hours.
When to Get Vaccinated
Some vaccinations, like the combined Hepatitis A and B, have to be administered over three weeks. Others may not be stocked, especially if you’re in a rural town and most people don’t have a passport. It makes sense to do it as early as possible. Otherwise you end up receiving seven jabs in a month and that isn’t pleasant. It’s also expensive and disheartening to spend so much of the travel fund just weeks before departure.
Unfortunately there is no vaccination against malaria. Here are the basics. It’s a pretty nasty disease spread via mosquitoes and found in most of the tropical world. It’s one of the world’s biggest killers, infecting around 200million and killing over 600,000 a year (World Health Organization figures). While it can be deadly, get treated quick enough and you should be fine. However, contracting malaria isn’t pleasant and will put most people on their arse for a few months. The bottom line of getting malaria usually means the end of a trip.
The map gives an indication of the places where malaria is a genuine risk. But there’s some complexities. There’s usually a much higher risk during the wet season as the mosquitoes are rampant. Likewise, the risk in rural areas far exceeds major cities. So hanging out by a river in Northern Thailand places you at risk. Hanging out in the bars of Bangkok doesn’t. Obviously, the longer your trip the greater the risk.
Protection Against Malaria
Basic daily precautions are the main protection against malaria. Essentially, you’ve got to minimize getting bitten by those pesky mosquitoes. That means covering the ankles and arms at dusk, carrying some insect repellent, and making sure the mosquito net isn’t covered in holes. After a while on the road, these things start to come as standard. Regardless of malaria, a leg covered in mosquito bites isn’t pretty.
Medication Against Malaria
Anti-malarial medication is generally regarded as 90% successful in keeping you safe. The problem are the side effects and cost. Dependent on who you’re doctor is, these are the options:
- Doxycycline – Take one table a day with food. Generally cheap and easy to find across the world. The most popular choice but doesn’t mix well with sun and alcohol, so not good for a full moon party.
- Mefloquine / Larium – Famous for giving some serious side effects, including weird dreams. However, you only need to take one a week. Some places in Asia are resistant to mefloquine.
- Malarone (Atovaquone/proguanil) – Generally lowest side effects but easily the most expensive. Take one a day, so the costs mount if you’re away for six months.
Note that antimalarial medication can be found all over the world and probably at much cheaper prices than at home. However, there are regular reports of fake tablets, especially those manufactured in India and China. In a developing country, it may pay to buy the more expensive brands.
Minimizing the Impact of Malaria
Controlling the risk and danger of malaria is relatively simple. Many countries have developed self testing kits sold through pharmacies. Prick the finger, leave a drop of blood on the sheet, and wait for the line to indicate malaria or no malaria. It’s like a pregnancy test. And just as scary. A common tactic is to use a self test whenever you contract flu like symptoms.
The most standard treatment against a malaria infection is a high dose of one of the antimalarial medications above (a different one from what you’re currently taking). For example, if you’re taking doxycycline then four malarone tablets for three days will probably be prescribed. Carrying an emergency malaria treatment is an easy way to avoid the hassle of poor quality medical facilities while you’re traveling.
Ebola and Other Well-publicized Diseases
Everyone has heard of ebola. The media went into a frenzy and convinced the world that Africa was up to its usual disease ridden tricks. In two years time there will be another well-publicized disease doing the rounds. Ebola carries a tiny fraction of the risk of malaria, AIDS, or any other disease mentioned above. It should not stop you from traveling. The World Health Organization are consistent in arguing that diseases like ebola should not interrupt travel plans, even if you’ve traveling to the infected countries. There’s more detailed information in this video.
Country Specific Information
While the UK and USA don’t quite agree on free healthcare, let’s take advantage of a resource funded by the British taxpayer. The NHS Fit for Travel website contains detailed health information on every country in the world. It clearly lays out the advised immunizations and those that should also be considered. On the individual country pages you’ll also find specific malaria maps detailing which parts of the country are at risk.