Inoculations

[Cool Water Palace]

I shall be spending more time in Thailand soon, and it seems sensible to have the inoculations I require there.

1. I need some dental treatment, and so seek a hepatitis B course.

2. If I spend time where it could make it necessary, how much for anti-rabies inoculations?

3. I've had the first of the 3 jabs necessary for polio combined with tetanus, and typhoid, I think, and need the 2nd and 3rd.

In UK it would, I think £100-150, although I've been told that the polio should be available on NHS by a health nurse in a travel clinic because I never had the jab as a child, and it's becoming more widespread. There have been problems with the system in arranging the jabs here to date.

Finally, although I understand that malaria prophylaxis is not recommended normally in SE Asia, what do mefloquine or whatever is recommended cost? Mefloquine is more suitable, I think, in Africa.

Can anyone offer guidance? Thanks.

[sbk]

Don't bother with the anti-rabies until you actually get bitten by a dog.

Don't bother with the anti-malarials unless you plan on going into malarial areas.

[Cool Water Palace]

Don't bother with the anti-rabies until you actually get bitten by a dog.

Don't bother with the anti-malarials unless you plan on going into malarial areas.

I should have mentioned that about rabies. And as for malaria, I understand that even in malarial areas medical prophyaxis is not necessarily recommended because of the complicated pattern of resistance. Cover up, rub on, and repel seem to be the answer. There's a Thai university website with a research department, which has a lot about it, but I've forgotten the name. I think a search should find it.

[Totster]

I should have mentioned that about rabies. And as for malaria, I understand that even in malarial areas medical prophyaxis is not necessarily recommended because of the complicated pattern of resistance. Cover up, rub on, and repel seem to be the answer.

Taking preventative measures to stop getting bitten is the answer, keep covered up, and use repellent on exposed areas... There is alot of negative discussion about anti-malarials, my advice is to research and make an informed decision on whether to use or not. If you are going to be in the main areas of Thailand then I would say the risk is very slim.

totster

[cruciate]

It is true that vaccination cost in Thailand is much cheaper than in the Western country. And the efficacy is similar. But it is generally recommended for western traveler to complete their vaccine shot before arriving the tropics. Since after vaccination, it takes some time to develop the immunity.

But "Doctor, do I really need that vaccine?" is a very common question in traveler. Individual assessment is very essential. Since the real risks depend on many factors, such as the duration of stay, the exact destination, the season, the activity of traveler and so on. And we have to concern about the diseases, itself such as the morbidity and mortality rate. We should weight between risk to get particular diseases and the risk of vaccine, itself.

For example, the real risk to get Japanese Encephalitis in short term business travelers to Bangkok is very rare. It may less than 1 in a million, in some report. The risk is very, very low, and it may be similar to the risk to get severe reaction from vaccine itself. So that situation, we usually do not recommend JE vaccine. But if the travelers spend most time in the rural area in the northern part of Thailand, and in a high risk season. The risk is much higher, some authorities say, it may upto 1 in 30,000. It still so little risk,isn't it?, but JE has high morbidity and high mortality rate, and no one know who will be that unluckly one?? So JE vaccine is usually recommended in that situation.

And for malaria, the real risk to get malaria in South East Asia is very low compared to those who travel to Africa. In previous reports, the estimated risk is around 1 in 12,000 - 1:20,000. So antimalarial prophylaxis may not necessary. But every traveler should know basic knowledge about malaria. Early detection and early treatment is the key.

For some adventure travelers, especially travel in Laos, Burma, Cambodia: standby drug may be a good option.