solsenz

Hi All-

Headed to mainly Botswana in 9/08. A couple 1 day trips to Namibia,Zimbabwe/Zambia, and of course JoBerg stop Arrival/Leave. Nothing is mandatory, but
Typoid is an option to take prior. Is this something we should do? We are doing the Malarone&Cipra, but wasn't sure about Typhoid.Thanks.

skibumette

Typhoid is spread through contaminated food and water (or the person preparing them) -- but the vaccine is, at best, only about 70% effective. So whether to take it or not depends on several factors: length of trip (longer than 2 weeks might argue in favor of getting the vaccine), adventurous eating habits (or little control over what you eat), and how risk adverse you are (some people would rather get the vaccine and worry less; other say "I'm really careful about what I eat; I think I'm OK without it"). I'm a nurse in a travel clinic and I think either answer is right.

If you get the vaccine, you can either get the shot (sore arm for 1-2 days guaranteed) that last 2 yrs. or take the oral vaccine (more trouble to do but it lasts 5 yrs.) My hubby and I will get it before our 3-week Africa trip -- he got the shot but I'm doing the oral.

happytourist

Do the oral. Then you're protected and you don't have to worry. The oral is four pills taken every other day. The most important thing to remember is that the vaccine MUST be kept refrigerated. You might want to take an insulated bag to the doctor's office to take the vaccine home in. If it gets warm, it's ineffective.

ruthtraveler

These comments do not replace consulting a doctor, but this is my personal experience:

When my son and I went to West Africa in January I took the 4-dose oral typhoid vaccine, Vivotif aka Ty21a, while my son had the single dose injection. (These replace the old 2 dose injection and are supposed to have fewer side effects.) My son, a college student, had the injection because he did not have a refrigerator to keep the oral vaccine during the 1-week treatment period (take 1 dose every other day for 4 doses). Also, the oral is supposed to last longer (5 years) than the injection (2 years) and I was likely to return to Africa. Here are some important qualifiers:

1. Whichever type of typhoid vaccine you use, take it at least 4 weeks ahead of your trip. For one thing, it needs time to develop immunity. For another, there is a POSSIBLE interaction with Malarone, which you need to start 2 days before you leave. (The drugs in the Malarone MIGHT kill the germs in the typhoid vaccine that are supposed to be developing your immunity. This possibility has not been definiteively proven with Malarone as compared to other anti-malarials, but it is possible.) Avoiding malaria is WAY more important than avoiding typhoid. So your Malarone is your more important drug. Don't delay starting the Malarone just to increase the efficacy of the typhoid vaccine.

2. Efficacy of typhoid vaccine is estimated between 30%-70%. It shouldn't hurt to take it but if you come home with diarrhea, no doctor should rule out typhoid just because you had the vaccine. Be very careful what you eat and drink and what you eat and drink out of, not just for typhoid but also parasites. I drank only bottled water and juice, from the bottle, and ate only cooked food, but still got a parasite anyway. (I did not have the effects until after I got home and it went away on its own after 2 weeks.) So a doctor should also test for the parasites common in your countries.

You should also have Hepatitis A & B vaccinations if you have not had them already. Also, be sure you are up to date on measles (MMR), polio (adults might need a booster), DPT and other routine vaccinations. The CDC has a good chart for routine vaccinations at http://www.cdc.gov/vaccines/recs/sch...t-schedule.htm. Other shots to consider are flu and rabies.

Also, you mention JoBurg. It is very unsafe.

happytourist

I can't emphasize enough what ruthtraveler said about parasites. Be VERY careful about water and fresh fruits and vegetables. My daughter lived in Mali for 2 years in the Peace Corps and had parasite problems all the time. She has not had any long-term effects. Our son went to visit her, picked up a parasite and, according to his doctor, it was responsible for setting off Crohn's Disease. His body attacked the parasite, but after the parasite was killed with medication, his immune system wouldn't shut off. I don't want to scare you--obviously this is an extreme example--but it's a good reason to always keep food and water safety in mind.

sandi

Not to use me as an example, but for 13/years traveling to Africa, I've been provided a script for "oral" Typhoid for each visit. Never filled any of them.

That said, I am current on Tetanus (good for 10/yrs), HepA (good for 10/yrs) and Polio booster (for balance of life), take malaria meds (early on used Lariam and now Malarone) and always have a script for Cipro.

If you are scheduled for standard tourist destinations, staying at named camps/lodges, it's unlikely to encounnter issues with food or water. Always drink bottled water and for brushing teeth. Fruits and veggies at these properties should have been washed using bottled or purified rain water. Likewise, ice cubes made from bottled water.

Do people get tummy upset? Of course, but more often than not this has to do with long flights, early game drives and a generally hectic schedule. Just listen to your body and pace yourself accordingly; if not sure about food or drink, then don't.

Safari njema!

solsenz

Thanks all. Good Info! We just had the 1st Hep A shot. A little annoyed w/the travel clinic, as I called a few Months ago and they said "call back." Now obviously, we don't have time for the 2nd dose, but they said about 80% good.
They suggested taking the Typhoid about 2 weeks out. Will now get it earlier.We're doing pretty touristy stuff so will hope for the best with that.Thanks again.

sandi

The 2nd HepA jab can be scheduled anytime between 6/mo to 1/yr after the first. The initial jab will serve for your upcoming trip. The 2nd will cover you for 10/years.

skibumette

Hep A (after your second one) is now good for 20 years -- so keep planning lots of future travel

sandi

20/years........... wow, can travel till there's no travel left in this gal... whooopie

chris45ny

We're headed to East Africa for 3 wks. this August. Travel clinic gave us yellow fever jab, polio booster jab, and typhoid jab. Was concerned arms would be sore but nothing!! Got 1st Hep A last August for trip to China along with tetanus booster. Got 2nd Hep A month ago. Doctor gave scripts for Malarone (me), Lariam (husband), Cipro for both of us and porchlorperazine for me in case of nausea/motion sickness due to traveling in the vehicles over bad roads. What it comes down to is where you are going, where you are staying, and what you feel is best for you. I guess we're perhaps overly cautious but better that then to get sick on the trip thousands of miles from your home and doctor. We also take sensible precautions regarding water and food. Have never been sick on a trip, knock on wood!! Enjoy your trip.