Vaccines and Health Abroad

Introduction

I recently had my appointment at a travel clinic to discuss vaccines and other medical issues, and learned a lot that I can impart to future travelers. Obviously, don't use this information as a substitute for actual medical advice--it is only a guide for what to expect when you do your own research.

First and foremost, make sure you get travel insurance any time you are going out of the country for a few weeks or travelling far enough away that an emergency wouldn't be covered by your insurance. There are many places to purchase travel insurance, but I was really satisfied with STA Travel's international traveler's insurance. It can be found here. The benefits include covering trip cancellation/interruption, travel delay, lost/damaged baggage and personal effects, baggage delay, medical and dental expenses, emergency medical transportation (for adventure traveler types med-evac is super important), air flight death and dismemberment (ew), and travel accident death and dismemberment. You also can work through them to consult a doctor when you are abroad and they take care of most out-of-pocket medical expenses when you need acute care.

With all the big stuff out of the way, now there is the question of vaccines. Get into a clinic with at least a month to go--you need to give your body time to build up immunity to these diseases before you leave. Make sure that you have your vaccines on record if you go to a travel consult. You'll need all of your regular vaccines (MMR, DTP, Tdap, Hep A and B, varicella or proof of chickenpox, etc.) and those should be covered by your insurance if you haven't had them all already. The other ones that are not required are generally paid out of pocket. A consult should cost between $50 to $75, so make sure you plan on shelling out some cash even before you get your vaccines.

In SE Asia, the "common" ailments you will run into are:

1. Traveler's diarrhea (more info)
2. Typhoid (more info)
3. Malaria (more info)
4. Dengue Fever (more info)
5. Rabies (more info)
6. Japanese Encephalitis (more info)
7. Sexually Transmitted Infections (I know this doesn't apply to everyone, but if it does apply to you it is absolutely important you keep it in mind) There's a good list here.

Transmission and Prevention Straegies

Malaria, Dengue, and Japanese Encephalitis are all transmitted by mosquitoes. For all three diseases, then, effective prevention is key. Yes, DEET is not fun--but that stuff works wonders. The most recommended product is a sort of DEET lotion that is 34% DEET and lasts 12 hours. It comes in 2 oz. tubes so it can be carried on planes. You can (and probably should) also treat your clothing with permethrin, which lasts for about 6 washes or one month. There's also a possibility that mosquito nets will be beneficial, especially if you plan on spending a lot of time outdoors or in malaria-rampant countries.

Luckily, the specific locations I am going in my countries have a pretty low incidence of malaria, so my recommended strategy is prevention only. If your risk is higher, you may be prescribed anti-malarials. Beware--they can cause hallucinations. Also, keep in mind that some areas in the world have malaria strains that are resistant to major treatments. You'll need to consult an expert to get information specific to where you are travelling.

Dengue has no specific treatment or vaccine. Prevention is key, because it's all you have.

Japanese encephalitis does have a vaccine, but it costs about $600 (depending on location) with both doses. My Nurse Practitioner said that only 11 Americans have gotten J.E. since 1981. So, even though the symptoms can be very bad and there is a medical prevention strategy, the odds against getting it and the sorry state of my wallet voted in favor of general mosquito protection.

image from: http://www.hdmicablescheap.net/malaria/ 

How do I stay in contact with friends and family?

Emergencies, gossip, check-ins: there are a plethora of reasons to want to stay in contact with friends and family members while you travel abroad. A good rule of thumb is that the more immediate and direct the contact, the more it will ultimately cost. Can you wait to update your travel blog until you are at a hostel with included internet, or do you need to send an email right away? Do you need to call and talk to someone, or will a text message do? These are good things to consider and they'll all have a financial impact while you travel abroad.

Although I like to be an unfettered traveler, I do recognize the need to keep in contact with friends and family. I want them to see what  my travels are like, and I tend to favor typing to hand-writing anyway. So for me, a blog is a great way to keep in touch while also recording my travels. But what if it is more immediate? I don't know where I'll be every night, so it would be hard for my parents or friends to call a hotel that I'm staying at if there were an urgent matter to discuss. If it's not completely urgent, they can email. But if it is in fact a real emergency, it's comforting to know that I could be reached more immediately. That's why I am going with an international phone that is cheap on the front-end and more expensive after. I don't plan on using my phone often, if at all. But, if an emergency did indeed crop up, it's good to know that my friends and family can contact me almost instantaneously.

Source

The phone that I chose cost me only $40 and has no monthly fees. I just get charged what I use while I travel. There are certain countries you can't call out of (the US being an obvious one, and then some other countries including ones in Central America), but all countries I plan to visit are included. What I like is that receiving texts is completely free (so my dad texting to say "Brooke--haven't heard from you in a while. Please send an email update by tomorrow so we know you're OK" doesn't cost me anything to read and is cheap to answer if I just use internet). Sending a text costs $0.80 per message, which really isn't that bad. A call costs anywhere from $1.50 to $3.95 per minute depending on which country I'm in. Yes, it's pricey--but I honestly don't plan on using the calling feature of the phone except in true emergency situations. So, if you're like me and just need a phone for emergencies, check out Mobal's website. However, if you are closer to friends and family than I am or are just chatty person, you should read a blog post about the "true" costs of Mobal vs.other users. Hopefully, once I'm done with my trip, I'll remember to write a review and let readers know what I think of the service after actually using it.