I can't decide what to do re: injections. I know the standard injections i need to get but a health professional said it might be worth getting the following jabs as well: Hep B, Rabies and Japanese B En.
I'm going to Thailand, then short time in Laos, Vietnam and Cambodia, back to Thailand then Kuala Lumpar, Singapore, Bali and Jakarta before going to Oz, NZ, Fiji and LA
Do i need to get the three listed above or not really?? I've been quoted £350!!!! so if i can swing it then great
Thanks in advance
take the Hepatitis and Tetanus.
Hep B is transmitted by blood to blood or sexual contact with an infected person. Rabies is transmitted by being bitten by an infected animal. Note that the Rabies jab does not make you immune, it just buys you a little more time. Japanese encephalitis is transmitted by infected mosquitoes, is prevailant in many areas of Asia but is rarely contracted by tourists and short term visitors. Only 1 in a hundred people who are infected with the virus show signs of infection, 10% of these may die. 10,000 people in Asia die from Jap en every year.
Assess your own personal risk and then decide. If you plan on having sex with a rabid mosquito, then have all three. £350 is a small price to pay for your life!
Personally I would go with the Jap. en. Rabies jabs are horrendously expensive, only last 6 months or so and you still need another jab within 24 hours of being bitten. I know it sounds morbid, but I had the Hep B purely in case I was in the unfortunate situation of being raped. I had the full course and so this should do me for at least the next ten years.
Sorry its not a very jolly reply
Hey Telli - I agree with both Marlis and Claire (baluba) about getting the Hep B and Tetanus. I also agree with assessing your own risk and Japanese Encephalitis may be a reasonable one to receive. The J. Enc. infection is on the rise but it doing so quite slowly. It is also more prevalent in rural areas so judge that by where you really will be traveling (rural, urban, etc.).
As for the rabies - that's a personal decision and again, based on the risk factors. If you will be spending most of your travel time in rural areas, working on farms or with wildlife, then rabies is worthwhile. Using common sense is your best defense against being bitten - basically don't pet stray dogs, monkeys or the cute little skunk. Claire is correct about the expense and it is a course of 3 jabs spread over time. As she stated, they do not give you full immunity but give you a few extra hours before immediate medical attention is required. If bitten, they reduce the number of post-bite injections you will receive. (basically going from 5-7 injections down to 3-4 jabs). Boosters may be given at 1 year. Because of the work I have done in the past, I have had my share of rabies vaccinations. Some people may need the booster sooner and others as far as 3 years out. If you choose to take the jabs, before getting the booster automatically, request a blood titer (which is cheaper in the long run) to see where your immune levels really sit.
Personally, my recommendations are:
J. Encephalitis (if rural travel is your main thrust)
The links take you to the Travel Health section for each disease and found in the TP Travel Guide. Those pages also contain the links to the CDC, WHO, Mayo Clinic and other pertinent sites.
Thanks to you all for the advice ... going to have to have a think about it ... so with the rabies, if i were unfortunate enough to get bitten i'd still have to rush to hospital?? seems pointless having it before then or am i wrong?
I'd get the rabies shot if I were you. Just in the extreme chance that you come across an infected animal (and it doesn't have to be a dog either) somewhere really out of the way. The jab will buy you time as has been said, and time is a very important factor when dealing with the disease. I'm sure you realise this already, but in case anyone else is reading this, you don't have to be Bitten by an infected animal to become infected, saliva can do the same job nicely thanks. I'm sure you'll be fine, but wouldn't you feel much better if the nearest health clinic was two days away...
Sorry Telli - I should have also linked the Rabies page and now I have:
As for transmission of the rabies virus, zaksame is correct. The most common route of exposure is through a bite wound but the virus can be transmitted through contaminated saliva entering an open wound or coming in contact with mucous membranes (eyes, nasal passages and/or mouth - such as being licked by an infected animal). Yes, such transmissions do happen but the occurrences are statistically quite low for travelers. Even with taking the pre-exposure vaccinations you WILL REQUIRE IMMEDIATE medical attention. The vaccine slows the spread of the infection through the body giving you a maximum of 24-48 hours more to find treatment. (Do not rely on that extra time to decide if you need to seek treatment.) You will also receive fewer post-exposure inoculations at time of treatment though hospitalization will be mandatory for observation either way.
Mayo Clinic - Causes
CDC - Transmission
Treatment Info With and Without Pre-Exposure Inoculations:
CDC - Pre-exposure Information
CDC - Post-exposure Information
I wonder whether you really have to pay for the Hep A+B jabs.
Here in Germany most statuory insurance funds cover it bc it is cheaper to give people the jabs for free than have them come home with Hepa and cover their treatment.
Talk to the NHS.
You also should check whether your "standard" jabs are up to date (blood titer test), this would be Tetanus and Polio. (I am assuming you got these shots as a kid.) If not, get a booster.
Polio is not as important as Hep A+B for your upcoming trip, but in general it is on the rise, especially in Central Asia, Russia, rural India and Africa. The booster lasts for 10 years, considering the consequences of a polio infection it is a good thing to have whereever you are.
Tetanus is a must have, again the booster is good for up to 10 years.
[ Edit: Edited on 30-Jan-2009, at 17:40 by t_maia ]
I got a lot of my injections done by my GP. Paid for some of them but not 350 quid. Japanese B enchephalitis is not really necessary unless you are going to spend a lot of time in a high risk area. i.e. some months in the rainforests of Laos. But if you are going to be in populated areas most of the time not so necessary.
Im having the first of my jabs tomorrow ... which are as follows:
Hep A & B (x 3 injections)
Revaxis - Polio, Diptheria and Tetnus
My GP Nurse is doing these on one script for me (just £7.10).
Im going to the School of Tropical Medicine for the serious consideration ones which are Jap En, Rabies and Yellow Fever.
Not sure which of the 3 above ones i'll get yet but have been quoted approx £45 each.
P.s im visiting same countries as poster.
[ Edit: Edited on 22-Feb-2009, at 10:01 by nics26 ]