I am setting off to south america in 2 months, i think i've pretty much got it all sorted except malaria tablets and rabies vaccinations. I will enter santiago in chile, and 6 months later will exit from quitos in ecuador. The rough idea i have is chile, bolivia, peru and ecuador, but i'd rather leave setting my itineary until i get out there. I have hopes of spending some time in the jungle, but i'm also on a tight budget, and i'd prefer to spend my time in the rural areas rather than cities. With this in mind, what would you suggest in terms of malaria tablets? Take a certain amount out there with me, covering me for a certain amount of time?
Secondly, my understanding is that the rabies vaccination doesn't actually stop you from catching the disease, but just gives you longer to get to a hospital. I think it's an expensive injection, though of course not too expensive if it saves my life! But obviously if it's not completly necessary, i'd rather not take it.
What are your thoughts?!
only place you'll need anti-malaria is in the jungle in either Bolivia, Ecuador or Peru.
We took some with us which was enough to cover our trip... however... others we met bought them in the respective country as they were cheaper... up to you.
Rabies jas indeed give you 48 hours instead of 24... however... the jab also means you only need (I think) 2 more jabs if you get bitten as opposed to the 4 (not entirely sure again) that you'd need otherwise... Also I think there's more time involved between jabs for the 4 option.... Search on the site here as I'm sure there's plenty of posts on the whole malaria and rabies issues.
Just FYI.... the only place we needed to take our malaria tables in our 6 months down here was in Bolivia and ONLY in Madidi National park.... the Pampas they reckon you don't need to take it however.... as always.... do some research yourself before you go.
As Taffski stated, Bolivia, Ecuador and Peru are malarial areas while Chile is not. All three countries have Chlroquine-resistent strains of the malaria parasite. Doxycycline would be my recomendation as an anti-malarial for the following reasons:
- It is extremely effective and can be used up to 2 years without interruption.
- It is the least expensive anti-malarial and can be purchased as an OTC in all 3 countries.
- It has minimal side effects.
On that note, Doxycycline can increse one's sensitivity to the sun - meaning sunburn so have a good sunscreen. Do not take it in the evenings before bedtime. It can cause heartburn so take it with plenty of fluids or food. Some women do develop yeast infections with long term use because it is an antibiotic. I recommend taking along one OTC (yeast infection) treatment as I don't know how readily available they are (OTC) in CA/SA. As always, check with your physician. Also, you will start the treatment about a week before entering a malaria area and continue for 4 weeks following your departure.
Realize, anti-malarials do not prevent the disease either. They work by killing the parasite once it has entered your body via a mosquito bite. This is the reason the treatment is started prior to entering an area (so you have an adequate amount of drug in your system initially) and continued upon exiting (for any bites you may have received as you wave good bye - so to speak). Discontinuing the treatment early is unwise.
Rabies vaccinations come down to personal choice. I recommend them when someone's travels will be spent in primarily rural areas, working on farms or with wildlife. Otherwise, don't pet the skunk or the monkey. Common sense is your best defense.
The regimen for pre-exposure is a series of 3 injections given on day 0, day 7 and day 21 or day 28 (depending on your clinic). The vaccinations do give you about 24 hours additional time to reach medical care. If you have received the pre-exposure regimen and are bitten, you will receive 2-4 additional injections. The number will be based on the time between the bite and treatment. Without the pre-exposure injections, treatment will be a series of 5-7 vaccine injections and a rabies immune globulin injection.
Again, it's a personal decision but it's money that could be spent traveling...
Hope this helps!
Thanks Taffski and Isadora, your information is very helpful. I think i'm going to have the rabies jab, and will take enough Doxycycline to cover me for 3 weeks.