Leslie_S

I'll be traveling to rural Thailand with a friend and her 12 year old son. She & I have gotten the JE vaccination as a worst-case scenario precaution since we'll be working outside in rural area where there are farms, etc. She was told though that the FDA doesn't allow the vax for children under 17 in the US and that she should just make sure her son wears DEET and is not outside from dusk to dawn.

Of course we'll take mosquito precautions but we're staying in little cabins, not a hotel - not sure how mosquito-proof we can get ourselves. Another option mentioned was having him vaccinated when we get to Thailand as it's routinely given to children there.

Anyone have any experience either getting JE vax for a child in the US or in Thailand?

I think the odds are very low - we won't be there the 4 or 6 weeks they say put you into the risk level of needing it - but still she does not want to take any chance with her son.

And as far as the # of weeks goes --- I understand the longer you stay somewhere the greater the chance of being exposed to a mosquito carrying the disease. But if that disease is carried by mosquitoes in that region even if you're there a shorter time you're still at risk. So I'm not sure I understand saying only get it if you'll be somewhere a month vs. a couple weeks. Am I missing something?

Kathie

You need to discuss this with a travel med or tropical med doc.

JE is not a common disease; it is carried by a small minority of the mosquitos in JE areas (rural farming areas with ducks and pigs in close proximity). The chances one might get bitten by a mosquito that carries JE goes up the longer you are in a risk area. In making public health recommendations, the risks of disease must be weighted against the risks of the vaccine. The cdc, which is pretty conservative, only recommends it for adults who will be in a risk area for 6 weeks or more. Personally, I would follow the cdc recommendations unless there is some specific risk the child has (e.g., chronic disease, immune dysfunction) that would change the risk/benefit ration.

The important ways reduce mosquito bites include the use of a good, deet-containing repellant. The best are the micro-encapsulated types, such as those made by Sawyers. Get one in the 20-30% deet range; use insectiside-impregnated bednets; wear long sleeves and long pants outside in the dawn/dusk times.

If your friend doesn't feel that those precautions are enough for her son, I'd suggest she re-consider whether to take him along. There is no way to eliminate risk.

qwovadis

mdtravelhealth.com correct JEVax info seasonally in a few areas it is indicated mostly though ususally not. istm.org
good travel MD cutteradvanced.com and insect preventon works
best in most areas for most kids risksare season and low.

qwovadis

The risk of Japanese encephalitis for most travelers appears to be very small. From 1992 to 2008, only four cases were reported in U.S. residents. All were Asian immigrants or family members who traveled to Asia to live or to visit friends or relatives and who had not been vaccinated against the disease (see MMWR). From 1973 to 1992, only 11 cases of Japanese encephalitis were reported in U.S. residents, only five of whom were civilians

crosscheck

Sorry, but as a parent, I strongly feel that this is the not the place to do medical research. Please tell your friend to seek advice from her pediatrician and travel doc, not from strangers on the internet.

lcuy

When I asked my doctor why the risk is greater over time (after all, one bite on your first day is all it takes) he said part of the equeation is that if you are there for a short time, you are more likely to be careful about applying your repellant.

Leslie_S

to clarify -- my friend did check with her doctor, i'm not doing medical research here. i mainly was interested in whether people had experience with getting the vax in Thailand which was suggested by her doctor. i worded my original post in such a way that that was not clear.

Curt1591

As "qwovadis" points out, most "travelers" don't have much of a risk. So, most on travel boards won't have much personal insight. As you pointed out, you're not doing the typical "travel" experience. Your mileage can definitely vary!

Assuming you are entering Thailand through Bangkok, you could easily stop by Bumrungrad, BNH or Sametivej, and get their input into the boy's situation.

Leslie_S

Thanks Curt.

crosscheck

Leslie, Sorry for the misunderstanding. Decisions like these are complicated and I'm just a firm believer that parents should to speak to medical people they trust, then weigh the pros and cons for themselves. You've probably seen this, but here is a current CDC statement, which includes info about why they continued the JE pediatric vaccine in the U.S., number of cases in U.S. kids, statistics about side effects and options for getting the vaccine in Asia: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a6.htm

Leslie_S

Thank you! I know she's doing a lot of research on her own also & talking to drs but I thought I'd tap into the fodorites' store of knowledge.