FAQ Part IV - Malaria & Vaccination

I am sure that at least my mum will read this post and be pleased to see that I am up to speed - so here we go!

Vaccination
I went to do my vaccination about two months in advance (15 days is OK). By the way I strongly recommend CHU St Pierre in Brussels: great staff, competent and fast enough. Main places to do vaccinations in Brussels may be found here.

There are plenty of vaccinations to do before you travel to Southeast Asia, some of which must be done in 2/3 times to be fully vaccinated (i.e. doing it for the first time would protect you for only one year, whilst doing it the third time will work for your whole life).

Main vaccines to be done before departure:

• Typhoid;
• Hepatitis A;
• Hepatitis B;
• Tetanus;
• Polio;
• Diphtheria.

The last three can be done by while single injection covering the three diseases; however, all the others require several injections before being fully immunised.

Other vaccines (that I did not do) include:

• Japanese Encephalitis B: this one is to be done if you spend extended period in Southeast Asian countryside, for instance doing volunteering to build a school in the middle of nowhere;
• Rabies: The doctor I saw advised me not to do this one as the treatment consists in several injections causing significant side effects, and hence this might not be worth the pain. The funny thing is that rabies is widespread in Asia; hence if I get bitten by a dog or a bat I will only then do the (efficient) post exposure prophylaxis.
• Lastly note that there are no mandatory vaccines in the area I am going to.

Malaria
Malaria is present in Vietnam, Laos, Cambodia, Myanmar and the North of Thailand.

Last time I went to Southeast Asia I took some Malarone (which I recommend: no side effects, bit expensive though) but for longer trip this one does not work. Hence I will go for Lariam, which is cheaper and may be used during longer periods. Hope everything is fine with that one as it is subject to significant controversies on its side effects, such as paranoia and depression. More info on this may be found on the "To Lariam or not to Lariam" website. On top of this I also bought some mosquito repellent of course: preventing bites is always the most efficient way to tackle malaria.

Other medication
Having proper medication is of course indispensable, heavy and sometimes expensive. Here is what I have (please note this is my personal choice; not official recommendation):

• Zitromax: an antibiotic without penicillin (to which I am allergic);
• Imodium: to treat diarrhea;
• Blephagel: against eye infection;
• Cetirizine: against allergies;
• Nufofen: anti-everything :-)
• Erceflora: antibiotic against food contamination;
• Products for ears;
• Spasfon – also in case of food contamination;
• A needle – just in case you need one.

Hygiene and Food
Having been to India with my girlfriend were both of us were sick, I believe it is difficult to avoid sickness during a four month trip. We will see, but in any case here are some (basic) recommendations:

• Never use tap water on contact with mouth - do not drink or brush your teeth with tap water;
• When eating vegetables always eat them once cooked;
• No ice and no ice creams;
• Observe basic hygiene rules, for instance in the toilets; don't go to dodgy restaurants;
  Wash you hands before and after eating, and after toilets (you should be doing that anyway, shouldn't you?).

See you later
Manu