andybiggs

Fantastic information, Chuck, and something I have paid very much attention to. I often see people bringing Levaquin along to Africa, and is this now more in favor than Cipro, given similar situations?

safarichuck

Hi Andy,
Both Levaquin and Cipro belong to a class of antibiotics called Fluoroquinolones. Other popular antibiotics that belong to the same class are 1) Noroxin and 2) Maxaquin. There is not much difference between them although the makers would have you believe otherwise. Levaquin does have a slightly broader spectrum of action, being effective against some gram + organisims that Cipro does not seem as effective against. However, these are not the causitive organisimes in TD. Levaquin has also been much more suspect in causing more tendon problems than some of the other (Cipro) fluoroquinolones. If I were choosing a fluoroquinolone, I would stay with Cipro. I suspect the reason some of your customers have been showing up with Levaquin is that many Docs are giving out samples provided by the drug company. Also, Levaquin is frequently prescribed for urinary tract infection in women and prostatitis in men. Many people already have a supply in their kits to deal with these problems and are told to just take them instead of Cipro. For someone like yourself who travels to Africa regularly (envy++) I would suggest you talk to your Doc about Rifaxamin (Xifaxan by Salix Pharmaceuticals). The advantage with this antibiotic is that it appears to be as effective as the fluoroquinolones in treating TD, it is not absorbed from the gut, it can be taken (although many Docs don't like to use it that way) as a preventative (3 X day). I use it that way and avoid TD. Without it I am dead in the water (or worse). People who get ill in a hotel or on a cruise ship don't have quite the same problem we do on safari. Andy, I have a question for you. Those fantastic motion blur shots of yours......did TD have anything to do with creation? Just kidding, but its nice to be able to give you some helpful information for a change. We are off to Botswana in less than 8 weeks, sure hope I can get my hands on a new EOS 1D Mark 3 before then.
Cheers-Chuck

Marija

While on the topic of Cipro, do you think two year old Cipro and Vicodin pills are OK? We've taken them to China, East Africa and now must decide if we need a new supply for Botswana. Fortunately we've never needed them.

andybiggs

Again, wonderful information, Chuck. Thank you for taking the time to illuminate and educate. I probably take Cipro about 2 or 3 times a year for the entire course prescribed. So about 3 or 4 days each time. I just hope I am not killing my body by doing this. Heck, Malarone is probably doing worse stuff to me!

Funny question about my motion blur stuff. I wish it was caused by TD, but it has more to do with trying to find more creative outlets for my photography. I have pretty much saturated the motion blur genre, with the exception of a few species. I probably have a motion blur of every mammals species right now that I am happy with, and tons of examples of common mammals like zebra and wilebeest. I am still hunting (with my camera, of course) for more elephant and giraffe blurred pans. Those are definitely the hardest to obtain.

You should be able to get the 1DMkIII before your Botswana trip. This will be a very hot camera, but supply should be up to snuff by then. Even though it should be a great camera out in the field, my 3 year old 1DMkII is still one heck of a camera. Most of my favorite shots have been taken with it. I am considering keeping mind and putting it into my camera equipment rental program. I currently have a 20D, 400mm f/4 DO IS and a 500mm f/4 L IS. If I add the 1DMkII to the program it will elevate the quality that much more.

safarichuck

Marija,
During the recent Anthrax scares, Cipro was stockpiled by various agencies. They asked that same question. Bayer, the maker of Cipro eventually suggested 7 years as the useful shelf life. This assumes a cool dry environment (dessicant no light etc.). My own view is that these antibiotics begin deteriorating the moment they are made and so I would not use anything older than 3 years. As far as your Vicodin, they are just fine.

LoriS

Thanks Chuck for the helpful information. I'm taking my first trip to Tanzania next month and have received prescriptions for Malarone and Cipro from my doctor. The only contrary position I received was that my doctor said not to take Imodium AD as it merely blocks up the bad stuff and you need to get it out of your system as quickly as possible. You note that the CDC indicates to take along with the Cipro. Is there a difference between Imodium and Imodium AD?

Thanks!

Marija

Thanks, Chuck. Our Cipro will get another trip.

safarichuck

LoriS,
I mentioned in my post that Imodium should only be taken if there is no blood in the stool. No blood indicates uncomplicated TD and the recommended treatment is, as I indictate, an antimotility drug such as Imodium + a suitable antibiotic. Your doctor would be correct if it were complicated and blood was seen, however in the absence of any complication, it is important to slow passage through the GI system and to allow water to be absorbed as material passes through the gut. This obviously reduces the watery stool and the symptoms of diarrhea. Taken with an antibiotic, the offending bacteria can be controlled. This is the standard accepted treatment, check it out at the CDC website if you can. As far as Imodium is concerned it was developed by Jansen Pharmaceutica in 1969, originally available only by Rx and has been renamed Imodium A-D (Anti Diarrhea). Same drug, different name. The active ingerdiant is Loperamide. One concern with TD is dehydration that accompanies it and it can happen very fast (24 hours or less). By initiating Loperamide treatment at the onset, dehydration is avoided, or at least mitigated.
Hope this clears thing up a bit.

moremiles

We will, of course, be seeing a travel doc before our next trip, but I'm wondering if anyone else has had a first symptom of vomiting, rather than diareah and how that was handled? My husband got very ill on our Botswana trip but thanks to the WS staff and a Dr. in Maun, he got excellent care but missed a couple of days with us. He immediately had to stop taking the Malarone since it happended about 24hrs after the first dose and no one is sure if that was the cause so he will be testing it out here in the US before we leave if our Dr. recommends it.

atravelynn

<b>Kenya &amp; Tanzania: Have you gotten sick?</b>

Everytime I come home. It's called the post-Africa blues. The only cure is a return trip in the works.

sandi

moremiles -

Upchucking with a first Malarone is listed as a possibility from the info sheet for this med. Often this happens if taken on an empty stomach, why it's recommended the pill be taken with food, preferably dairy. However, it does indicated, you eat something then take a second pill... and hope this and subsequent pills stay down.

Many lodges/camps (East Africa, I can comment on) have doctors on staff of nearby should visitors take ill with the malaria meds, upset tummies (for other reasons), or whatever. They may need 24/hrs of relaxing,, but good to go thereafter.

Generally, as scrolling down this thread, few posters have taken ill from meds, food, too much sun or fresh air ... a good sign, I'd say.

samcat

On four trips, I've never been sick. On one Kenyan safari, Lynn Leaky was our guide. She recommended eating yogurt as it tends to prevent stomach problems. I do that now, and have had not problems.
Samcat

lenlu

I am very worried about this. I can't imagine stomach issues in a bumpy vehicle while driving to your next spot that you must get to.

atravelynn

Lenlu, Please don't worry. It will give you stomach problems.

Better those problems in a vehicle than a small plane.

I keep some Peptos on my person just in case.

LoriS

Thanks Chuck! Much appreciated!

PatrickSch

My wife and I just returned from Kenya and Zanzibar and ate everything. I was fine, my wife had a very mild problem. However my question is this: The guide books that I read really didn't have the warnings about food-especially fruits and veggies that you find in the guide books for places like Guatamala and Mexico-I concluded that food problems are not serious for travellers in Kenya and Zanzibar. Can anyone comment?

sandi

Patrick -

Generally not a problem. Especially at safari lodges/camps, where much of the veggies and fruits are grown in their own organic gardens. Though there are items shipped in from Nairobi and the coastal areas. Besides, much of Kenya's produce is shipped worldwide, mostly to Europe - so in a sense the gardens of the world. You should see the Dole pineapple plantations in the highlands north of Nairobi.

Can there be a problem? Of course? As with elsewhere, you have to be aware of what you're eating. Though some will eat from street stands, others whose tummies may be more delicate, may choose not.

Momliz

I just got sick in Chicago, at a pretty fancy restaurant...

love2travelnow

We were in Kenya and Tanzania for 18 days this year. We didn't sick at all. I'm with Momliz. I got sick after easting at a restaurant in NYC.

TravelLover2

Barefootbeach: We were in Tanzania and Kenya 18 days last month and stayed in mid-priced tented camps and lodges. Imodium did come in handy for me a couple of days but nothing more serious. We were VERY careful about water - we brushed our teeth with bottled water no matter where we were and only ate things that were peeled or cooked. We also avoided glasses and drank out of bottles or cans when we could. I would definitely get a prescription from your doctor for an anti-diarrhea medicine(like Lomotil) and a prescription for Cipro just in case you need a general anti-biotic. I think we had about 10 pounds of medicinal stuff with us and the only thing we used was the Imodium. But the rest of it gave us piece of mind.
Enjoy your trip - it will change how you look at life!