Solt

My husband and I are going to Peru in early May. We are trekking the Inca Trail to Machu Picchu and then to the Amazon - Lake Tipishca. I read the yellow fever shot is recommended but not required, does anybody have some insight into if this shot is really necessary in this part of the Amazon? I am concerned about the side effects of this shot, expecially in an older person and am having a difficult finding a clinic that gives this shot in southern Orange County, CA. While on the topic of shots, is the typhoid shot also something we should get? We already have all of our Hepatitis shots. I would love to hear from people with previous experience with these immunizations and travel.
Thank you

Neuman605

Have had both Typhoid & yellow fever vacines, didn't have a problem with either, not even a sore arm.

crellston

We had to get just about every vaccine going (i.e. 20+ shots) when we went to Sierra leone on a volunteer project. I had no side effects whatsoever with the yellow fever vaccine, indeed the only problem I had was with the typhoid but that has always left me with a sore arm and mild flu symptoms for a day. I would say that both are essential for Peru but especially the typhoid.
PS don't forget your malaria medication and check your goverment website for up to date requirements on all medical precautions. Here is a link to the UK NHS site

qwovadis

As long as you will not be entering Bolivia

or crossing a border from YF country it is not required.

YF unheard of in a short stay tourist

Just use lots of Cutter Advanced repellant and skip it.

qwovadis

www.mdtravelhealth.com Peru correct CDC info

including outbreaks no YF epidemics currently

in your jungle area..Typhoid wise if eating lots of

street food otherwise skip it careful with food ans water

Always carry some Cipro in my travel kit for TD

Have fun,

mlgb

If you're under 60 get the YF jab. Get the typhoid regardless.

You might ask your tour agency if you will need to produce a YF certificate at the Puerto Maldonado airport.

Solt

Wow! Thank you all for all your good advice. We will definitely get the Typhoid. I am under 60 and will get the YF, my husband is over 6o. Is there a real risk for anyone over 60 getting the YF shot? We have our Maleria prescriptions. Amazing all that is needed for this trip, but really looking forward to it. Thanks all, Solt

mlgb

It's worth asking a travel doctor to weigh the pros and cons, for someone over 60+. The risks of the shot can be severe and in older people may be greater than the chances of contracting YF, depending on where and when you're going. I think they will write a waiver for the shot if it's not advised, just in case someone in Peru asks for proof of vaccination.

mlgb

I just went thru querying my travel nurse (thru Kaiser) about YF, although I'm going to Loreto Dept. They use the CDC guidelines which is "recommended" but it does seem from reading around that it isn't an imperative at the moment.

You might check the SAExplorers website about strikes around Puerto Maldonado..just posted

Check with your tour company especially if on a tight itinerary!

mlgb

BTW I was shocked to hear that Kaiser actually stocks the YF vaccine and that I won't incur any charges for my recommended list of shots (Typhoid, TetanusDP booster, and YF.) Might tip me over to taking it since I'm still under 60.

I haven't decided on Malarone or doxycycline for malaria, but sounds like it is a good idea for Loreto. I gather I will just have a copay (either $35 or $10) for the meds.

After reading what others are paying for their series of jabs....Two thumbs up for Kaiser!

Jeff_Costa_Rica

Typhoid vaccine is available as an injection (gives three years of immunity) or oral capsules (give five years of immunity.) Oral is a series of four capsules taken over seven days, one capsule every other day. You store the capusles in the refrigerator. You'd have the capsules dispensed as a prescription at your pharmacy. Most pharmacies do not routinely stock the oral vaccine but should be able to order it for you from their wholesaler with a one-day turnaround or so. It goes under the product name Vivotif Berna. If you want to go that route, ask your local pharmacy if they can get it. They should be able to.

Jeff_Costa_Rica

I remember my insurance picked up the cost of the oral typhoid vaccine for me, minus my drug copay. The price at my pharmacy back home without insurance would have been about $50.

mlgb

I remember getting those shots when I was little (we lived in the Caribbean) and my arm was alway sore. Probably why I hate shots to this day. But I'm not so sure I want to do that multiday multi pill thing for the Typhoid. I also remember my mother having Malaria and I am definitely going that route although haven't decide Malarone or doxycycline.

Neuman605

mlgb,
Back in the day we had Kaiser we didn't even have a co-pay, they covered it all! oh how I miss them. As for me & malaria topic, I don't take the meds due to poss side effects. Since I have to cover up & use Deet for Dengue anyway.

mlgb

Yeah, I'll try the malaria pills but will also be doing the DEET/clothing/net thing and if I feel side effects will drop the pills. Even though I was always DEETed up in NZ the mossies still managed to stab me in a few spots.

Solt

I have Cigna PPO insurance and they don't cover any travel vaccinations. It is going to cost my husband and I $490.00 to get yellow fever, typhoid and tetanus. That does not even cover the Maleria pills. OUCH! Our County Health Department does not have yellow fever and cannot even get us in for an appointment for the other stuff until after our trip. yeah, a lot of good that does. There is something to be said for an HMO. Thanks for all your responses. MLGB, when is your trip? Are you trekking the Inca Trail?

mlgb

Hi Solt,

I'll be in the Amazon (not the same part as you) in May. I went to the Sacred Valley in Peru in Jan 2009. I didn't do the Inca Trail since I had less than a month's notice, and I wasn't keen about Dead Womans Pass, figuring I might be the dead woman. I walked lots of bits of Inca Trails around the Sacred Valley ..Pisac, Ollantaytambo and of course MP. I also did some trekking down in Torres del Paine. My main objective this trip is to eat my way thru Lima!! I stumbled on some reviews of the Tahuayo Lodge and it called out to me, even with the mozzies. Sounds like the food is pretty good too.

For malaria you could take doxycycline (for the Iquitos area at least) which should be less expensive that Malarone, but you have to take it for much longer and it can cause sun sensitivity and secondary yeast infections. The man who runs the Tahuayo Lodge told me that about 25% of his visitors decide to take malaria pills. He did not think there was any reason to get the YF jab. The more I read the less necessary the yellow fever shot seems at this time, for where I'm going.
If it wasn't free I wouldn't even consider it.

I'm scheduled for my jabs tomorrow, believe it or not Kaiser can set them up with one day's notice. I also get a tetanus/dp booster. That's not even a travel shot so why isn't Cigna paying for it? It's on the list of recommended adult vaccinations.

I found a CDC link that addresses yellow fever in Brazil, it has good advice on the use of insectisides and other avoidance measures.

http://wwwnc.cdc.gov/travel/content/...er-brazil.aspx

Hope you have a good trip. If you're in Ollantaytambo the restaurant at the El Albergue Hotel is excellent, their special dish is alpaca loin. At least in summer it comes with sauco (Peruvian elderberry) huacatay flavored potatoes..yum yum yum! (Can you tell I like food?)

GypsyMama

Repectfully... are you and your husband aware of the rigors of the Inca Trail and its effect on non Inca lungs ?

Solt

Hi MLGB,

Thanks for all the info. Sounds like you travel a lot and have quite a bit of experience in Peru. I got my YF & Typhoid jab today. My arm is a little sore but not too bad so far.

I am concerned about the altitude at Dead Woman's Pass, and just hope my conditioning and altitude pills will pull me through.

We will be in Ollantaytambo for a short stay, will have to check out the restaurant at the Albergue Hotel. Can you recommend some restaurants in Cusco? I really like Saltado. In reading the guide books there are a lot of dishes that sound delicious!

Have a wonderful time in the Amazon.

mlgb

My arm with the YF is still red and itchy around the injection. Annoying.

I tried the Saltado at Pucara near the Plaza de Armas. Other people have commented that they liked that restaurant but it didn't do much for me. My favorite in Cusco was a wood grilled chicken place a bit away from the main square, called Los Toldos. It was a local's place. Pachapapa in San Blas got some favorable mention from people I met while traveling.