Job Discussion Forums

[soulsearchin]

Help! I just spent the afternoon at my local health clinic and was a wee baffled at the amount of vaccines they recommend ? Can anyone help me ? how important are these? Rabies, typhoid and japanese enceph. yikes very scary things and very expensive prices! I will be in H.C.M.C. end of march if I have any cash left .

[sigmoid]

[huxter]

Hepatitis A and B and Typhoid were the three "biggies" strongly recommended to me (and which I had) before I left NZ.

Diphtheria/Tetanus also if you're due it (that's the 10-year one)

MMR, if you never had it as a child

BCG (for TB), again if you never had it as a child.

As for malaria, JE, rabies etc I was told these are only risks if you're spending extended periods of time in rural areas. I presume you'll be teaching in one of the cities so there's no need for you to get them, IMHO. You can always get them out here anyway if you plan to travel in high-risk areas.

I got everything above for less than US$200 - money well spent I reckon.

Hope this helps.

[makhno]

I went to the Travel Clinic of the Infectious Diseases Department of the best local hospital in my the area where I was visiting some relatives just before coming here to VN (in the southern New England, USA area), and here's the deal according to their doctors who monitor illnesses around the globe, especially in the tropics:

* everyone should be up-to-date on tetanus/diptheria and measles/mumps/rubella, even if you live in the most posh neighborhood of the most modern US/Western Europe/Oz/NZ city -- but then you knew that already, as did I before I went to the Travel Clinic, so I guess this comment of mine isn't adding much value here ...

* Hepatitis A & B is very strongly recommended (wish there were a hep C vaccine!). There's a combined hep A&B vaccine (called Twinrix in the US and, from what I've heard, it's called that elsewhere as well). It's a 3-injection process -- the stuff you might read on the internet usually says it's 3 shots over a series of some months, but the Infectious Diseases specialists whom I consulted said that there's a roughly equally-effective process in which you get the second shot a week after the first, then get the third one 2 weeks after the second. I paid almost USD $100 a pop for a sum of nearly $300, which seemed like a lot to me at first ... then I reflected upon the matter and realized that coming up with $300 is a tiny burden compared with the burden of living with (and eventually possibly dying of) hepatitis. Also, the US health care system is infamously overpriced, so I'm sure you can get the same protection elsewhere for a lot less money.

* Typhoid is also strongly recommended. My prescription from the Travel Clinic doctors was for 4 pills of weakened-but-live (keep it refrigerated!) typhoid culture with instructions to take one pill on an empty stomach every other day. Don't take any antibiotics while taking the typhoid pills, because the antibiotics will render the typhoid prophylaxis useless. Unlike the hep A&B Twinrix, the typhoid stuff was pretty cheap -- a little more than USD $15 for the 8-day regimen.

* rabies ... well, there's probably just as much of it among urban/suburban wildlife such as raccoons, bats, feral dogs & cats, etc., in places like Chicago, Leeds, Melbourne, etc. What the hospital Travel Clinic told me is that the greater risk in SE Asia is not of *contracting* rabies (which is a rather slight risk pretty much wherever you go, if you're reasonably careful about contact with the critters) -- but rather, of not getting adequate treatment in the unlikely event that you *do* contract it. If you're in Saigon or Hanoi: probably no problem (and certainly no problem if, as I hope you'll do, you make the relatively modest investment in the insurance that'll fly you to Singapore for any first-rate emergency medical care perhaps lacking in Saigon and Hanoi). Here's the real risk: just as in North America, etc., then if you're in a rural area a few days away from access to modern Western medical care when you get infected, then you've got a problem on your hands, as rabies needs fairly prompt treatment. My choice (approved by the Travel Clinic) was not to get the rabies immunization.

* Japanese encephalitis: the Infection Diseases specialists didn't even mention it to me until I said that I'd seen it mentioned in a travel guidebook. They said that in SE Asia it affects humans so rarely that they actually consider risk of contracting and getting seriously ill from the disease to be less than the risk of adverse reactions to the vaccine (reactions which evidently can be moderate to severe for a lot of folks). As with the rabies stuff, I declined.

* malaria: in VN, at present it's only a noticeable problem in the central highlands. The bug here is thought to be resistant to most anti-malaria prophylactics, so they prescribed (and I bought) some stuff called Malarone (atovaquone and proguanil hydrochloride) for when I tour that part of the country. And reportedly the quinine in tonic water is a moderately-effective anti-malarial agent if one consumes enough of it ... but that's not what the Travel Clinic told me; it's just apocryphal lore (perhaps the "if one consumes enough of it" part of the lore is really just an excuse to drink lots of gin & tonics ...)

Hope this helps.