The Dreaded Lurgy

13.December 2008

Pre-Trip, Vaccinations

It’s time to look at all the vaccinations and illness avoidness techniques that we will need while we’re away.

As we are traveling primarily in disease endemic areas, there are plenty of vaccinations, medications and precautions that we will have to have in order to ensure that we don’t catch some dreaded lurgy. This is on top of regular medications and remedies.

In September we visited our local travel clinic. We had sent them our itinerary ahead of time so, when we got there, they were ready with all kinds of documents, advice, questions and ideas.  We left there weighed down with pamphlets, leaflets, warnings and precautions — and completely overwhelmed!! The pile of stuff sat, untouched, in our office for weeks as we were unsure how to wade through it all.

This week I realized it was time to get busy with it. Being so much closer to selling our place has pushed us to the other side of ‘holy $hit, we better get going if we’re going to do this!!’, and so I sorted through the pile and distilled the important information out.

There is, of course, a cost for all of this.  I’ll include what we expect to pay as I know that when I was first researching cost was one of the things I always wished people would include (which reminds me, I really should work on that budget page I’ve been planning). Remember people that these are Canadian dollars!!

Consultation: the travel clinic we visited charged $60 for the two of us for the initial consultation.  They very kindly didn’t charge me anything for yesterday when I went back to ask a few more questions.

Hepatitis B: we both already have hep B immunizations and so won’t require it now.

Hepatitis A: we both need to get this vaccine but won’t need the booster before we go – the initial vaccination provides enough protection for the year we’ll be gone. $60 each.

Tetanus/Diphtheria/Polio: J had this one a few years ago after his mountain biking accident (okay, he fell off the ladder while taking a mountain bike off the car – but that counts, right?). I will need this one as I can’t remember having it recently. Free, here in Canada.

Thyphoid Fever: we both need this one. $40 each.

Japanese Encephalitis: this one was a little confusing. The travel clinic nurse mentioned it but left it to us to decide, telling us that most people opt out of it. The literature says there is a low risk of transmission and, from what I can tell, most travelers decide not to be vaccinated. The cost is high for this one – 3 shots at $125 each (that would be $750 for the two of us!) – but I can honestly say that did not factor into our decision, cost is not a consideration in health. However, we did decide not to get this one – I couldn’t find any compelling research to convince me that it was needed.

Yellow Fever: this vaccination is important for two reasons. First of all so that we don’t get Yellow Fever, but also because many countries require proof of vaccination to gain entry if you have been in Yellow Fever countries. Jason will be getting this one at a cost of $85, but I will not be getting it. I have Chron’s Disease and take an immunosuppressive drug to keep it in remission.  The Yellow Fever vaccine is a live vaccine, which means there is a risk of contracting the disease from the vaccine itself if you are immunocompromised. Instead I will get a ‘get out of vaccine free’ card that looks like the real thing but, in fact, says that I am unable to be vaccinated. We don’t expect to be in any real endemic areas and, if we are, I am expected to take extra care in mosquito prevention. 

Malaria: this one is the most confusing of all. There are three options for malaria prevention – expensive (Malarone), reasonable (Mefloquine) and dirt cheap (Doxycycline). Each comes with its own list of pros and cons but, regardless, we will be in malaria countries for 6 months and so taking any of them for that long isn’t recommended. I think what we’ll do (and what was recommended) is look at where malaria risk is very high and take Malarone for those times.  The rest of the time we will use mosquito prevention to lower the risk.

Dukorol: this is used to lower the risk of ‘Dehli Belly’ and all of it’s friends. It was recommended again because of the Chron’s, but in reality it won’t be of much use because we won’t be in the countries that most need it until 6 months after leaving – and we can’t carry the Dukoral with us.

Broad Spectrum Antibiotic: likely we’ll also take something like Ciprofloxacin with us too to combat any bugs that we catch along the way.

Even with all these preventative measures, there is no doubt in my mind that we will get sick.  These will just minimize the severity and keep us from contracting the most dangerous possibilities. There will still be strange food, altitude sickness and hangovers to contend with but we’ll be as well prepared as possible.

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10 Responses to “The Dreaded Lurgy”

  1. Jana Says:

    I am so happy you will taking all these precautions, makes me feel better…Now what about Jose poisoning???? Too bad there was no vaccine for that one!!

  2. Linda Says:

    What do you use for “mosquito prevention?”

  3. Ruthe Says:

    Wow thanks for such a comprehensive write up.

    IMO Malarone is the best one for malaria prevention (that, DEET, and carrying your own mosquito net) because of the shortest pre/post dosing times. When we visited Asia that was the only thing my Dr. insisted I take but my insurance didn’t cover it so I got stuck with Doxycycline – and I was on it for a FULL MONTH after we got back from the trip. Better safe than sorry though :).

  4. Gillian Says:

    @Jana: Oh how I wish!! At least you know a hangover will be over…eventually!

    @Linda: Mosquito prevention means covering up with clothing, staying inside after dark if possible, using DEET to annoy the buggers, carrying netting (as Ruthe suggests) and not sleeping with chickens or pigs!

    @Ruthe: Doxy just isn’t practical given the length of time we’ll be in malaria countries (thank goodness – it doesn’t sound like fun!) so Malarone is the way to go, plus a little good luck I think. I know enough to know that there are lesser forms of malaria and so can protect selectively based on that too.

  5. zoey Says:

    don’t get african sleeping sickness.. :P heheheheeheh…..

  6. Ant Says:

    Remember to do research into DEET and consider not using it in areas where it will make it’s way into the local waterways. There are some natural alternatives, depending on where you are you’ll hear travellers singing the praises of the ‘stuff in the shop up the road’. Plus DEET has a nasty habit of melting your clothes, so I only ever use it when I absolutely must.

  7. Tom Says:

    We took Mefloquine on our trip to Nepal. “Bad Dreams” doesn’t begin to describe the psychedelic side-effects – this is really good shit. After three weeks, my wife had to drop off it. Malarone sounds much better.

  8. Deidra Says:

    Just booked our appointment with the travel clinic. I told her our rough itinerary over the phone when we are departing and she put us in for mid May. My arm already hurts just thinking about it.

  9. carrie Says:

    I’m glad I found this article. I’m getting ready to embark on my first around-the-world adventure and was told by one travel nurse that I needed to get vaccinated for Japanese Encephalitis, but then another told me to skip it. I decided against it, but it’s good to see that someone else couldn’t find anything to support getting the vaccination either.

  10. Ross Says:

    Hey Gillan,

    What are your thoughts on the Rabies vaccine?

    I’ve read you still need I get shots after the bite (2 injections if youve already had the pre course treatment) but can’t find anywhere where it states why get the shots before hand? Other than the fact you need fewer shots post exposure, do you know of any other advantages?