Vaccinations

Old Feb 11th, 2016, 08:12 AM
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Vaccinations

My Husband and I will be traveling to Vietnam and Cambodia. We have had the series of Hep A and all of the usual , Tetanus, MMR etc. We are staying in 5 star hotels and cruising the Mekong on AMA
waterways. We will be on guided tours and not venture into rural areas. We are not big fans of street food, and take the usual precautions when eating and drinking such as no ice, only bottled water that we open and stay away from veg that is washed.

Other than anti-malaria meds is there anything else that we need to get. I talked to the CDC but they said there are no specific requirements, just suggestions.
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Old Feb 11th, 2016, 08:17 AM
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You will notice that the cdc recommends typhoid vaccine as well as the ones you have gotten (good work, by the way!). Typhoid is another food and water-borne illness and even staying in 5 star places and taking a cruise doesn't guarantee you won't be exposed.

Have a wonderful trip!
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Old Feb 11th, 2016, 10:05 AM
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Thank you for the information. I made an appointment for us to
get the shot
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Old Feb 11th, 2016, 11:53 AM
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Another useful 'usual precaution' is to take plenty of hand sanitizer with you, and use it regularly.
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Old Feb 11th, 2016, 11:59 AM
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Note that the typhoid vaccine in the shot form is good for two years; in the oral vaccine it's good for 4 years.
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Old Feb 11th, 2016, 07:04 PM
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Hi nobugs--
Kathie was right on. The typhoid oral vaccine is so much easier, and longer-lasting. If you have seen your doctor in the last year, why not have him/her call in a prescription for the oral vaccine, and you can take it at home? That's exactly what I did last year. BTW, I sometimes ask my dentist to call in prescriptions of this nature.

Also, you should each get a prescription for a wide spectrum antibiotic such as Cipro to take with you just in case. I run into many people, particularly Americans, who are afflicted with food poisoning during their travels.

Be careful about drinking any juices. Hotels will typically offer you a welcome drink of fruit juice. I pretend to take a sip, and I put it down. Never use any ice, and always make sure the water bottles are sealed.

LancasterLad made a great suggestion about hand sanitizer. The public bathrooms may have no soap, and if they do, it may be a disgusting looking bar. I take a three ounce bottle of Purell, and I attach it to my purse, and refill it every night. My guys put the little bottles in their pockets.
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Old Feb 11th, 2016, 08:15 PM
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Taking along an antibiotic in case you get a bacterial GI problem is a good idea. But, do make sure you know when and how to use the antibiotics, and/or the anti-diarrheal drugs and use one that is still effective in that geographic area. Cipro is no longer effective in Thailand, Cambodia and VN (and some other places as well, like Nepal) Take a look at the cdc travel pages and you'll see that the currently recommended antibiotic for this area is azythromycin.
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Old Feb 11th, 2016, 08:42 PM
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Wow, Kathie, I did not know that about the antibiotics. You are quite the expert on this important topic of health care. Thank you!
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Old Feb 11th, 2016, 09:20 PM
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If I want expert advice on travel medicine then I'd be reluctant to take it from anyone on a travel forum, no matter how well meant that advice is.

Part of pre-trip preparation should be to have a face-to-face with someone trained in travel medicine and who is also authorised to give that advice. In Uk that expert advice is usually free although the recommended medication may cost. I use MASTA via my GP Travel Clinic, and the bespoke Health Guide I get at the end of my free appointment is very reassuring.

If you need to claim on your travel insurance, then you'll have to say what precautions/medicines you took, and where you got your advice from. If you say that your advice came from an 'expert' on Fodor's then you might have a bit troube having your claim approved.
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Old Feb 12th, 2016, 08:36 AM
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Don't take it from me - as I said, take a look at the cdc pages. You will find the info on which antibiotics are recommended for which areas on those pages.
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Old Feb 12th, 2016, 09:42 AM
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LL, Check your policy as i feel your last point is incorrect. There is no requirement of any travel insurance policy that I know of, to seek any sort of pre-trip advice nor to take any medications whatsoever (excepting of course for those relating to any pre-existing conditions which should be fully disclosed). If you have been asked that when making a claim, I would change insurers/underwriters!
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Old Feb 12th, 2016, 11:39 AM
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Hi Crellston. I know there is no requirement to take pre-trip expert medical advice. BUT in the unfortunate event of you making a claim against your travel insurance, you are more likely to have a successful claim if you can prove that you took all reasonable precations. The MASTA Health Document, bespoke to that particular trip would support any claim, and practically ensure the claim was successful with the minimum of fuss from the Insurer.
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Old Feb 12th, 2016, 12:46 PM
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I've never heard of anyone being asked about pre-travel precautions as part of a travel insurance claim. And MASTA, as a for-profit entity is not who I would rely upon for travel medicine recommendations. There have been plenty of complaints about for-profit travel clinics recommending unnecessary immunizations or medications. The NHS has an excellent website and their recommendations are the standard of care in the UK, just as the cdc is the standard of care in the US.
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Old Feb 12th, 2016, 07:31 PM
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Kathie. When I make an appointment at my NHS GP Surgery to see the Travel Clinic, the appointment that is made for me is with MASTA. The appointment is conducted at my NHS GP Surgery. So it's reasonable to assume that as the NHS employ MASTA as their Travel Clinic,that the NHS is happy to recommend their services.

The appointment is face-to-face with a nurse trained and qualified in travel medicine, and my medical records are in front of us should they need to be referred to.

The consultation is based solely on the trip I am about to make. Lots of questions, eg. Where to, how long, lifestyle, and in the case of mosquito prevalent areas what my normal precautions are. We discuss my answers. All this is fed into a database, and at the end I receive a bespoke Health Brief which is valid solely for the trip I'm about to go on.

There is no hard sell, athough it'd be foolish not to buy any medication/innoculations which are compulsory for that destination. If you are out of date for any of the UK standards then that medication will be provided free.

I realise that non of the above is compulsory to support a claim against my travel insurance. But apart from being 30 minutes well since spent, it is reassuring, and I know that should I need to make a claim that I have taken all reasonable precautions, and have supporting documents from a recognised provider of expert medical travel advice.

The NHS and cdc might have excellent websites, but a website doesn't know my personal medical history, my lfestyle, or any medication allergies I might have.
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Old Feb 12th, 2016, 11:47 PM
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LL - I totally agree with you that it is far, far preferable for individuals to seek advice from a properly qualified professional rather than anonymous strangers on a travel forum an have long expounded that opinion here and elsewhere. MASTA has a terrific reputation an is the de facto leader of private travel clinics in the UK ( not sure they are Non profit though. They are excellent and I used to use them when based in central London and found them to be super efficient. If only my GP surgery would engage them!

I just visited my GP "travel clinic" for my pre trip South America check and found the travel nurse to be absolutely useless in terms of knowledge and really not a specialist by any definition. In the end I gave up, got my vaccination history and went off to Superdrug who run private travel clinics - much better in terms of both knowledge and efficiency.
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Old Feb 13th, 2016, 06:43 AM
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The secret is to find a good travel clinic that has enough patients to really be on top of things. My guess is that this is only a true option for those who live in major metropolitan areas.

We just left Cambodia and are now in Laos. When we visited our travel clinic right before we left, we were also given new polio shots because polio is now present in one of these two countries (can't remember which, sorry).

nobugs--I am sorry, but do you intend to be in a bubble your entire trip? Will you only eat at 5 star hotels or on the cruise? If so, you will be missing out on some of the most marvelous experiences of traveling in this part of the world. You've done all of the right things as far as immunizations, now open yourself up to a few risks.

As Kathie said, 5 star hotels and top-of-the-lline cruises are no guarantee.
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Old Feb 13th, 2016, 07:39 AM
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LL, as I have said many times, I think it is always wise to have a consultation with a travel med or tropical med doc prior to travel. For-Profit Travel Med clinics in many places have had complaints against them (recommending the Yellow Fever vaccine for people traveling to Thailand is one of my favorites), so I am interested to hear that the NHS contracts with them. That seems like a fine recommendation.

I am of the belief that as patients, we all have a responsibility to be well-informed about health issues so we can ask intelligent questions during our medical consultations. I always read the cdc webpages (and sometimes the nhs web pages as well) before a travel medicine appointment. I recommend to everyone that they read up on the health issues associated with the places they are traveling to. There is lots of info on the webpages that doesn't just have to do with vaccines - issues like food and water precautions, recommended mosquito repellants, etc.

Information on a forum like this is never a substitute for a medical consultation, but can help inform all of us.

Julies, I am sorry to hear that one of your destination again has polio cases. This is one of those things that changes constantly, and it is useful info.
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Old Mar 7th, 2016, 04:46 PM
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Wow! When I asked a simple question, I certainly didn't expect all of this banter. However, I have found it both informative and amusing.

We are departing for our trip in a few days, and I am grateful to everyone that has participated in this forum.

Respectfully,
NOBUGS
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