abaya

Well, as many of you know I am traveling to Zambia this summer for 6 weeks. We will be in the outback, camping about 6 hours' drive from anything modern (medical/water/electricity).

So: I went to my uni's travel clinic today and had a consultation. I had my tetanus-diptheria booster, polio booster, Hep A shot, and took the first of 4 typhoid pills. I've also got my meningitis, tuberculosis, Hep B, and all childhood shots taken care of from beforehand. I plan to get a yellow fever shot in 2 weeks, and also to start malaria pills before arriving in Zambia.

Am I missing anything? Obviously you aren't all professionals, and the woman I talked to today was very knowledgeable and updated on the latest CDC... but I'm wondering if any of you have traveled recently in central-sub-Saharan Africa and have recommendations. Specifically I want to know whether it's worth investing $500 in a rabies series and also which malaria pills you recommend.

Right now I am signed up for Malarone, even though it's quite spendy ($130 for two weeks' supply). For me, it seems to have the least side effects... I don't want more weird dreams/psychological issues than I already have (mefloquine) and I don't want to be at risk for more yeast infections and sunburn than I already am (doxycycline).

Thoughts? Thank you!

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greytone

Before you take a trip like this you should check out CDC.gov and go to the info for travellers section. They also have links to State Department warnings at times. Make sure to take the link from the African page to the Malaria in Africa page and make sure that Malarone is OK for where you are going. One downside is that it is daily. But then, it is supposed to have less neuropsych side effects than mefloquine. One reason I tend to avoid doxycycline is the high frequency of photosensitivity (imagine the worse possible sunburn). There are many other insect born diseases besides malaria and yellow fever, so be sure to use DEET (the CDC just approved two other insect repellents, but I don't know much about them...the natural one may actually be more dangerous) and a mosquito net if at all possible. Make sure to click on the link to food born illness (traveller's diarrhea). I travel with levaquin to take if I need it (it is a broad spectrum antibiotic useful for GI, GU, and respiratory infections). It is expensive and should be used with caution in women of childbearing age. If you are going to be away from civilization you may need more specific advice. Obviously first aid materials are a must.

Whatever you do, have a good time and take pictures.

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hokiesandwich

I had a friend get the rabies series before heading to Mali. I would rather be safe than sorry, no?

And as a woman, be sure to drink plenty of water and some acidic juice, like cranberry juice. Women are less likely to urinate in outdoors/dirty environments, which can lead to Urinary Tract Infections.

And yes, please take lots of pictures, post them somewhere.

Africa...wow.

abaya

Thanks for advice, also getting lots of it in Lonely Planet's Healthy Travel for Africa book (and the woman in the travel clinic yesterday swamped me w/info from CDC, as I said earlier).

I'm a woman, but not the type to hesitate about peeing in public!! Peeing in the woods is a specialty I developed as a kid (never had time to run 2 acres just to use a silly toilet) and I've done it on dark corners of European city streets when drunk and desperate... (I know, reprehensible).

Also, no need to remind me to take pictures... although without electricity (occasional solar power, that's it) I may run out of digital camera batteries. Time to break out the ol' film again...

__________________
And think not you can direct the course of Love;
for Love, if it finds you worthy, directs your course.
--Khalil Gibran

greytone

I forgot to answer one of your two questions. Rabies shots are generally only recomended for those who are at high risk of exposure. That means people working with an animal population with a high infection rate. That is very few people. Certain areas of Southeast Asia have high rates of rabies in stray dogs. I don't know about Africa. Post exposure prophylaxis is highly effective with the rabies vaccine, so most people can just get the shot if they are bitten by a suspect animal. Once symptoms occur, however it is far too late and I believe only four people in recorded history have ever survived once they have developed active infection. Early generation vaccines are affordable but are associated with high rates of serious side effects. These are no longer available in the US. So, if you have a possibe exposure while traveling abroad, you should go to a local hospital right away and select the most expensive vaccine from the "menu."

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I was there to see beautiful naked women. So was everybody else. It's a common failing.
Robert A Heinlein in "They Do It With Mirrors"

abaya

Thanks, greytone. Well, the people who were in the same field site last year said there were indeed rabid animals, but that most people were not vaccinated and no one got bitten. It pays to be careful, I think.

We will be 6 hours' drive from anything modern & helpful, which seems like an eternity. However the travel clinic nurse told me that most people don't get the pre-exposure prophylaxis unless they are 24 hours from medical help. So in this sense I should be safe if anything happens (though I'd have to get the full 5-shot series once reacing medical care).

How long does it take for symptoms to set in, do you know? And what are the symptoms (of both rabid animals and people)?

Very good suggestion on asking for the most expensive vaccine if anything happens. I just can't fork out the $500 to get the pre-exposure prophylaxis... I'd rather invest in anti-malaria pills, as there are a heck of a lot more mosquitoes than dogs, I think! (though it is the dry season apparently, so less risk there)

__________________
And think not you can direct the course of Love;
for Love, if it finds you worthy, directs your course.
--Khalil Gibran

greytone

I really don't remember what the incubation time is for rabies. I don't think I will ever see a case here in the states. I certainly hope not. I know many people actually start the shots several days after a wild animal bite. If post exposure vaccination is effective, then the incubation time must be quite long. The only other disease that comes to mind is tetanus; and that is actually just a booster.

__________________
I was there to see beautiful naked women. So was everybody else. It's a common failing.
Robert A Heinlein in "They Do It With Mirrors"

im2smrt4u

I took mefloquine when I was going to Kenya and I had no side effects. YMMV.

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