Preperation

Don’t Pet the Animals – They Probably Have Rabies!

Vaccination day is here – or, as I now think of it, Free Folder Full of Nightmares day! The Vanderbilt Travel clinic did a tip-top job of plunging me into the depths of anxiety hell and vaccinated me for all sorts of terrifying diseases that we may encounter on our travels. I ended up with three shots and prescriptions for everything from Malaria to altitude sickness. There was some discrepancy between the doctor’s advice and the guide book’s advice, so for those of you following along at home, I have kept score below. Points are assigned based on comfort level.  Medical information courtesy of the CDC website which you should only visit if you want to have nightmares for weeks.  For a daily dose of horrors, sign up for their super fun e-newsletter!

Here are some of the beauties that are floating around this great world of ours:

Hepatitis A

Q: How do you get it?

A: Viral infection of the liver, acquired by drinking contaminated water or coming in contact with an infected person.

Q: What’s it like?

A: Fever, malaise, jaundice, nausea, vomiting and abdominal pain and severe liver damage.  NO TREATMENT.

Doctor’s Advice – Buy bottled water.  Everywhere, even in Europe. Get vaccinated (done.)

Guide Book Advice – Tap water is generally fine, stop buying bottled water because you are killing the planet.

Doctor: 1, Guide Book: 0

Hepatitis B

Q: How do you get it?

A: Usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected.

Q: What’s it like?

A: Hepatitis B is a serious disease caused by a virus that attacks the liver. Can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.

Doctor/Guide Book Advice – Get vaccinated (done.)

Doctor: 1, Guide Book: 1

Typhoid 

Q: How do you get it?

A: Eat food or drink beverages that have been handled by a person who is shedding (I am very uncomfortable with this that word) Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food.

Q: What’s it like?

A: Sustained fever as high as 103° to 104° F (39° to 40° C). Weakness, stomach pains, headache, or loss of appetite. In some cases, patients have a rash of flat, rose-colored spots.

Doctor/Guide Book Advice – Boil it, cook it, peel it, or forget it. Get vaccinated (done.)

Doctor: 1, Guide Book: 1

Malaria

Q: How do you get it?

A: Mosquito-borne disease caused by a parasite.

Q: What’s it like?

A: Fever, chills, and flu-like illness. Left untreated, you may develop severe complications and die. Golly gosh, how fun.

Doctor’s Advice – We don’t really see Malaria that much any more where you are going.

Guide Book Advice – Where you are going, you are going to get Malaria.  Get medications (done.)

Doctor: 0, Guide Book: 1

Dengue Fever

Q: How do you get it?

A: Dengue is caused by any one of four related viruses transmitted by mosquitoes. There are not yet any vaccines to prevent infection with dengue virus and the most effective protective measures are those that avoid mosquito bites.  Which is hard if you are made of sugar, like me.

Q: What’s it like?

A: Characterized by a fever that lasts from 2 to 7 days, with general signs and symptoms consistent with dengue fever. When the fever declines, symptoms including persistent vomiting, severe abdominal pain, and difficulty breathing, may develop. This marks the beginning of a 24- to 48-hour period when the smallest blood vessels become excessively “leaky”, allowing the fluid component to escape from the blood vessels into the peritoneum (causing ascites) and pleural cavity (leading to pleural effusions). This may lead to failure of the circulatory system and shock, followed by death, if circulatory failure is not corrected. In addition, the patient with DHF has a low platelet count and hemorrhagic manifestations, tendency to bruise easily or other types of skin hemorrhages, bleeding nose or gums, and possibly internal bleeding.

Doctor/Guide Book Advice – Screw the earth…use DEET all the time.

Doctor: 1, Guide Book: 1

Japanese Encephalitis

Q: How do you get it?

A: Humans can be infected when bitten by an infected mosquito.

Q: What’s it like?

A: Most human infections are asymptomatic or result in only mild symptoms. However, a small percentage of infected persons develop inflammation of the brain (encephalitis), with symptoms including sudden onset of headache, high fever, disorientation, coma, tremors and convulsions. About 1 in 4 cases are fatal. There is no specific treatment for JE.

Doctor’s Advice – Meh, unless you are camping the jungle, you should be fine.

Guide Book Advice – Vague – vaccination is recommended if you are in rural areas for more than a month, during the summer, or if spending more than 3 months in the country.  So, what does that leave…in the city, in the winter, for a week?  Blueugh.

Doctor: 0, Guide Book: 0 – equally vague and depressing

Rabies

Q: How do you get it?

A: Cujo-esque scenarios.  Dogs, bats, monkeys…hopefully not sloths.

Q: What’s it like?

A: Horrible.  You just die.  Optionally, you can trap people in a small car for a weekend and kill half your loved ones.

Doctor’s Advice – Meh, don’t pet the animals.  You probably won’t get rabies.

Guide Book Advice – Increasingly common. Don’t pet the animals.

Doctor: 0, Guide Book: 0 – equally depressing.

Bonus Horrors

While there are no vaccinations for the following, these are some lovely tidbits my guidebooks sprinkled in for good measure:

Schistosomiasis – Minute worms in water.  Don’t bathe in the rivers in China.  Irreversible organ damage.

Giardiasis – Common parasite. Eggy burps.

Taenia – Tapeworm in South America. Leads to a chronic brain infection.

Chagas’ Disease – Insects that inhabit crevices in the walls and roof of sub-standard housing in South America.  They poo on you in the night.

Leishmaniasis – Sand files in South America.  Their bites lead to slow-growing ulcers on the skin which can disseminate to the bone marrow, liver and spleen. No vaccine.

SEA SNAKES – Southeast Asia.  Yet another reason not to go into the ocean.

Hookworm – Tiny worms that live in the soil. Always wear shoes, otherwise they enter your foot and make their way to the lungs and lymph nodes, and eventually end up in your gut.  You will experience general abdominal discomfort while they go about laying eggs.

Final Score – Doctor: 4, Guide Book: 4, My Genius Theory About Not Going in the Water: 2.

Sweet dreams tonight!

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