I went to the Travel Doctor today. After describing my route to him he said,
"The theme of your trip is feces."
Not exactly what I wanted to hear . . .
Anyone taking an extended trip abroad should see a specialist in Travel Medicine. Often these
doctors specialize in Infectious Disease and then further specialize in Travel Medicine. They
provide invaluable information and have access to the latest news regarding malarial outbreaks,
country-by-country risks, and more.
Immunizations
The biggest medical question most travelers face is which shots to get. Here's what we chose:
- Rabies (3 shot cycle)
- Japanese Encephalitis (3 shot cycle)
- Measles-Mumps-Rubella (MMR)
- Typhoid
- Polio
- Hepatitis A
- Diphtheria/Tetanus
Rabies and JE require 3 office visits over a 1-month period (a shot on your first visit,
another a week later, and the final shot one month later). Other than a sore arm,
neither of us experienced any side effects from any of these shots.
If possible, you should make your initial visit to the doctor 6 months prior to leaving the country. This
allows time for a 6-month booster shot (for example, a Hep-A booster) just before departure. If 6 months prior
isn't possible, allow at least 5 weeks so that you can complete your Rabies cycle (and JE, if desired).
Diarrhea
My doctor's "Feces" quote was - of course - referring to the great risk of diarrhea from unsanitary conditions in many
of the countries to which we're traveling. Shots are great, but the can't protect you from The Big D. To combat "Traveler's Diarrhea" my doctor prescribed the following:
- Imodium A-D or Lomotil for mild diarrhea.
- Ofloxacin (an antibiotic) for moderate diarrhea.
- Metronidazole for chronic diarrhea.
These drugs are used to treat diarrhea once it's hit, but some travelers also take preventative medication. Studies show that high doses of Pepto-bismol (4 tablespoons 4 times a day) can reduce the chances of contracting diarrhea by about 50%. Due to the massive quantity of medication this requires it isn't reasonable for extended travel, but if you only plan to be abroad for 1-2 weeks Pepto-bismol may be a viable option.
Other preventative measures that all travelers can follow -- drink only bottled water (especially carbonated varieties, which can't be as easily re-filled by unscrupulous vendors); peel your own fruit; avoid street vendors; eat only freshly cooked food; carry a water purifier or iodine tablets.
Other Medical Issues
Our doctor also supplied us with sterile needles. Despite the risk of infection, third-world countries still re-use needles.
Bringing your own is the only way to reduce the risk of HIV or Hepatitis infection in the unlikely event that you need an
injection while abroad.
We also received a prescription for Malaria. See the "Gin Enemas and Mefloquine Dreams" dispatch for more information.
A Final Word
Despite all these exotic vaccines, prescriptions, and drugs the biggest threat facing travelers is
automobile accidents. Unfortunately there is not much you can do other than wearing seat belts, avoiding bus travel at night, and crossing your fingers.