Photo by Warren Talbot
It’s not if you get sick, but when. Most people have a sad story about a trip that got derailed by a bug, an injury, or food poisoning. When you travel for months or years at a time, though, the risk goes up. Being constantly exposed to new environments, foods, and customs also means exposure to food-borne illnesses, diseases, and sometimes lower standards of medical care.
We visited the University of Washington Travel Clinic to talk about where we were going, what we could do to lower our chances of illness and disease, and to get the recommended vaccinations needed for long-term travel.
We brought our immunization records, a general itinerary, and the general health paperwork they sent to us beforehand.
Anne helped us figure out what our risk factors would be in each area, how to lower those risks through using mosquito nets, bug spray, a SteriPEN for water purification, and what to put in our general medical kit.
Probably the grossest thing I learned today was that most diarrhea comes from gram-negative material in your food. (Gram-negative essentially means waste. Yes, *that* kind of waste. My apologies if you are eating as you read this.)
It was also interesting to find out that people who take a lot of acid blockers tend to get the worst cases because their stomachs do not have enough acid to protect from the bacteria.
After our chat with Anne we received prescriptions for:
- Acetazolamide for altitude sickness (we live at sea level and our first stop is at 11,000 feet)
- Azithromycin for traveler’s diarrhea in India and SE Asia (yes, there is a different treatment depending on where you go)
- Cipro for traveler’s diarrhea everywhere else. This is also the one time that you can stop a course of antibiotics early. One pill along with Imodium is usually enough to stop it.
- Doxycycline is for malaria, and we take 1 pill starting 1 day before entering a malarial area and continue it for 4 weeks after leaving.
- Disposable syringe kit to be used in medical facilities that re-use syringes.
- Typhoid vaccine is given in a course of 4 capsules over an 8-day period before we leave.
Photo by Warren Talbot
After our visit with Anne we went down for our immunizations. We each got the flu vaccine, H1N1, the first round of hepatitis A and hepatitis B, a polio booster, yellow fever, and a tetanus shot with pertussis. Warren opted to go ahead with his Japanese encephalitis vaccine, which I will get next time. We both got the yellow World Health Organization international vaccine cards that we may have to show in various countries to gain entry (especially regarding yellow fever.)
We still have a few more rounds to go, and the last thing we are waffling on is the rabies shot. Bites from dogs and bats are a worry, but the bigger worry is being in a remote area where medical options are scarce. The vaccine means you have 7 days to get to care. No vaccine means 24 hours. And rabies is always fatal without treatment. The cost is fairly high, about $900 total for 3 rounds of shots, but it is good for life.
No one really expects to be bitten by a bat or a dog, but we do plan to go to some pretty remote places. So we are still considering this one.
The clinic did take our insurance, though we do not know how much of this will be covered. I’ll report back to you when we get the bill.
I’m really glad we took the time to do this. Even though it was a little morbid talking about all the ways we could get sick and die, I feel better knowing the information and how to combat it as best we can. And how to treat it when we eventually do get sick.
If you don’t have a travel clinic in your area, you can go to the CDC website to read up on your planned destination and then bring that info to your doctor to discuss any necessary immunizations or prescriptions before you go.
I guess what it boils down to is research your risks, take the basic precautions, and go have fun. The leading cause of death in the US is heart disease, and most people die from that close to home. I’m cautious about the risks, but not worried at all about our upcoming travels around the world.
About Betsy
This article hurts my arm. LOL. Glad to see you are moving closer to land off.
Yeah, my arms are both pretty sore today, but otherwise I’m okay. Despite having Warren’s repeated comments yesterday about the live yellow fever virus running through our veins. He’s such a comedian.
……you know you want to break one of those ‘live’ virus capsules open don’t you? :-0 Another big milestone in the countdown to departure…..
I just went to the travel clinic in preparation for my trip, too! Luckily, I’d already gotten a lot of the shots for previous trips. I got some of the same prescriptions as you two, though, which should be useful on the road.
Also, I opted to not get the rabies vaccination. Still trying to decide about Japanese Encephalitis which my doctor said I didn’t really need, either.
Adam, thanks for your feedback on the rabies vaccine. I’d be interested to know how many full-time travelers have gotten it.
It’s kind of strange when you think about it – you could spend tons of money and energy worrying about preventing bad things from happening. But I could just as easily catch the H1N1 virus here in Seattle.
It really is all a game of chance, and you just prepare yourself as much as you reasonably can and then live life anyway. Don’t you agree?
Interesting. Don’t forget that travel clinics make a fortune off these shots, so follow the money when researching!
The key to be aware of is that vaccination does NOT guarantee immunity! This is something few people seem to realize. We’ve seen this MANY times in school outbreaks where it is almost always the vaccinated kids who catch the disease and not the unvaccinated ones!
Vaccines also have risks and can harm the immune system and cause death or permanent injury, so thorough investigation (from non biased sources who do not profit from their advice) is important. Weigh the calculated risks of both!
We’ve been on an open ended world tour since 2006 that has included time in 32 countries including some 3rd world, rural areas in Asia & Africa.
So far we have gotten NO vaccinations and my child has never had ANY vaccinations. Most of the “dangers” are vastly over rated.
This article by a well traveled doctor is my fave on this subject.
http://www.mothering.com/health/far-off-adventures
I’ve got immunized within an inch of my life, and I feel glad that I did so. Got j enceph, typhoid and other fun things (even got my smallpox and anthrax). There’s an interesting line to cross. I don’t think that the dangers are overrated, and some people would suggest that not immunizing yourself or your child is asking for it down the road. Unless you’ve seen people come down with enceph or malaria firsthand, it doesn’t hit home that the shots are a necessary evil. Sure, there’s risks, but life isn’t safe.
Immunization doesn’t mean that you’re safe and should play it loose – but instead, keep what you’ve learned from the clinic as sage advice.