Cholera vax for Thailand, Cambodia
 

We've just been to the Travel Clinic to pick up antibiotic prescriptions for diarrhea in case we need them, and to get the 4-capsule course for typhoid, as our typhoid immunization will expire mid-trip.

The travel nurse strongly urged us to take the new cholera vaccine (powder mixed in liquid and drunk in her office): $300, and good for three months. She assured us this is very necessary in Thailand and Cambodia.

Thoughts? We will be in Chiang Mai, possibly the MHS loop, Bangkok (plus day trips),possibly beaches on the Adaman coast, and in Cambodia in Seim Reap and Phnom Penh. Staying in mid-range accomodation (about $50/night average) and exercising all the usual precautions for food and drink, especially when eating street food.

The cholera vaccine seems a bit overkill for our February plans. Thoughts?

Thanks,
EJZ

"The cholera vaccine seems a bit overkill..."

I'd say so. The trouble with "travel" clinics is they're in the business of selling you as many items as possible, whether you need them or not. As Nancy would say, "just say no".

By the way, I discovered in Asia that the cost for vaccines is a fraction of that here in the US. My typhoid had expired and I went to a clinic out of curiosity in Bali. They had it and it cost next to nothing.

An extract from the UK NHS website re Cholera vaccine.

"Cholera: spread through consumption of contaminated water and food. More common during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. It would be unusual for travellers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene."

I seriously doubt that you are likely to encounter those conditions on your trip. If you do, you are staying in the wrong places :-)

I had to have it once when working on a volunteer project in Sierra Leone, it lasted for two years and cost around $50. Change your travel clinic!

Why am I guessing this is a for-profit travel clinic?

Cholera is an issue only if you are working in a refugee camp.

My thoughts, exactly. And yes, it is a for-profit travel clinic. <sigh>. We only went because our typhoid were due to expire, and we needed Rx for cipro. And we are about 2000 miles from our home MDs right now.

I was aghast at the "necessary" travel kits they wanted to sell us for mosquitoes and diarrhea, at vastly inflated prices for the contents. I can put together a comparable "kit" for a 10th of the cost, and routinely do.

Thank you!

I have no doubt it's a for-profit clinic, all of these doc-in-a-box clinics, travel & otherwise, are. I also have no doubt that the "travel" nurse has no appreciable education in the field but has orders to sell up whenever possible. The only reason to use them is for help in disposing of excess cash, the assumption being I suppose, that anyone with the funds to travel should give them some, too.

Often, one's primary care physician can order what you need and won't order what you don't need. And since information regarding what we actually need is so readily available, we really shouldn't be so gullible. I'm glad you didn't just take their word for it, EmJayZee. Next time get your antibiotics prescription from your regular doctor on a covered visit and save yourself some money there, too. I realize there can be exceptions but for routine travel, a routine doctor is fine.

Our posts crossed, so, very good.

Does a dog or a monkey know not to bite or scratch you if you're on a bit of 'routine travel'?

Last time I went to a Travel Clinic [MASTA], I made the appointment via our UK GP.

The appointment lasted 30 minutes, and we each got a bespoke Health Brief tailored exactly to the trip we were abot to make.

It was free, and although we were told what optional medication was available there was no pressure to buy it.

LL, you live in a country where there is a civilized approach to providing health care. Those of us in the US do not - and it is only going to get worse. So your experience has exactly zero relevance to the OP.

Zero, indeed. And gloating is never attractive.

<<<Does a dog or a monkey know not to bite or scratch you if you're on a bit of 'routine travel'?>>>

And the answer is?

I can't see where the gloating comes in either. Making sure you have proper health proection is important. I notice the Op is considering Northern Thailand. While not exactly off the beaten track that area isn't exactly 'routine travel' either. Optional [albeit expensive] medication has to be balanced against the risk.

Frankly, the biggest risk in N. Thailand is the driver behind the wheel of the tourist van. Whether you are in the van or merely sharing the road puts you at risk.
Where's the vaccine for that?

<<<Where's the vaccine for that?>>>

Stay at home indoors!

Some risks are unavoidable if you want to see the world. But other risks are preventable, many at a financial cost. They can only be weighed up by the individual.

LL, are you recommending another vaccine or medication for Northern Thailand? Are you suggesting the pre-exposure rabies vaccine? Unless they are doing something that places them at exceptional risk for dog or money bites and scratches, the pre-exposure rabies vaccine is not recommended.

BTW, Thailand has exceptionally good facilities for treating people who have been exposed to rabies.

I'm not recommending anything Kathie. Like you I'm Dr Google not a practitioner of Tropical Medicine. But I do urge caution especially if considering changing routine travel to something a bit more adventurous.