Getting sick abroad is not fun. Getting REALLY sick while traveling is the absolute worst (trust me, I’ve been there).
Because I prefer to spend my time on the beach, not in the ER, I went in for a travel medicine consultation a couple weeks ago. I visited that Capitol Travel Medicine clinic in Arlington (which I absolutely recommend if you are in the DC area). The nurse practitioner, Tanya Hardwell, was extremely helpful as she went over my itinerary and suggested the appropriate precautions I could take to reduce my risk of, you know, dying of some horrible exotic disease.
The travel clinic gathers information on all the countries on your route, determine the most dangerous (health-wise) and advise you based on the guidelines there. In my case the most dangerous country was Cambodia. I ended up getting a tetanus booster, a meningitis booster, the Hepatitis A vaccine and a Typhoid vaccine (which luckily for my poor arm came in pill form). The Japanese Encephalitis vaccine was also recommended, but due to the diseases rarity and the vaccinations high cost I decided to take my chances.
Tanya also prescribed me 6 months worth of malaria pills for my SE Asian adventures and gave me some great general information on staying healthy on the road.
Because I’m such an insatiable blogger, she also happily agreed to answer some of my most pressing questions for you guys:
Why is it important to get the proper shots before you travel?
The health risks in other parts of the world, particularly developing areas, can vary greatly compared to the United States and there are a lot of diseases our immune systems just aren’t prepared to handle.
What is the benefit of visiting a travel clinic versus your regular doctor?
Travel clinics specifically cater to overseas travel so they are the most current and informed regarding recommendations and requirements. They get daily updates on outbreaks around the world.
Remember that travel clinicians aren’t there to sell vaccinations to you; they are there primarily to give advice. What you choose to do is totally your own decision.
Are there places where shots are “mandatory” or are they usually just recommended?
The only vaccine that is ever mandatory is the one for Yellow Fever, which is required in certain parts of Africa and South America. All of the other vaccinations are merely advised.
Are travel shots ever covered by insurance?
It really depends on your policy- some people with higher-level PPO plans or federal insurance plans might find themselves covered. It’s probably better to assume not though.
What if you don’t have enough time to get all the necessary shots before you leave?
Come in anyways. The antibodies in most vaccinations begin working within the first week and some protection is always better than nothing.
There are fours drugs licensed for use in the US:
– Chloroquine Phosphate (Aralen)
– Mefloquine (Lariam)
Each has their pros and cons. There are possible side effects and cost considerations. A travel clinician can talk you through your options and help you decide which is best for you.
Of course there are so many strains of Malaria that none of these medications are 100% effective. It’s always important to take precautions and use bug spray when in infected areas.
Incidentally, the cheapest place to get your malaria prescription filled appears to be Costco.
I’ve heard you can get some medications (like malaria pills) cheaper in Asia, what are your thoughts on that?
This can be very tempting because of the cost but there are a lot of quality control issues and there is a risk of counterfeit medications. If you do buy medication abroad you want to take care to make sure they are coming from a reputable source.
What diseases are travelers at risk for that cannot be vaccinated against?
Dengue fever is probably the biggest one. Rates are rising rapidly- even in places like Texas and LA! Developing a vaccine for Dengue is very difficult because vaccines work by giving you small doses of a disease, but Dengue is much more dangerous the second time it infects you.
The NIH is working on a malaria vaccine but that could take many years to come to fruition.
What advice would you give a twenty-something going abroad?
Don’t be intimidated by the risks. Knowledge is important of course but the best thing you can do is get out there and see the world.