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.
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.