Will be traveling to India (Rajasthan) for 2 weeks in Feb. and my M.D. has recommended going to the "Travel Clinic." I know they suggest anti-malaria pills and possibly other vaccinations. Is this really necessary for a fairly short stay at good hotels?

YES!!! The standard of the hotels has nothing to do with it! One of my friends did without the malaria tablets and was very ill. People will tell you that they haven't taken and nothing's happened to them but my friend says now that he was really stupid. By the way, make sure you start taking them early enough- I think it has to be 2 weeks before going but you will obviously find that out. Take whatever your doctor says!!!!

2 weeks is more than enough for a single malaria-infected mosquito to bite you or for catching some other life-threatening disease (think hepatitis for example) while you are out of your good hotel. The risk/benefit ratio of anti-malaria pills and vaccination is well established. Don't risk paying with your life the avoidance of a benign discomfort.

I think the cdc's website is the best source for info on travel medicine: www.cdc.gov Click on your destination.<BR><BR>I expect your travel clinic will recommend that you get a number of immunizations, including tetnaus, thyphoid, and a polio booster. There are a number of kinds of anti-malarials. The cdc website has info on all of them, the advantages and disadvantages, and which are effictive in particular locations.

Well, an ounce of prevention is worth a pound of cure....But, you have to weigh the risks. Is Rajastan the only place in India that you are traveling? I have been there and the risk of getting malaria is small. If you stay covered and wear mosquito repelent, you should be OK. Now, if you were going into the bush or jungle I would recommend the medication. <BR><BR>There are so many things you can pick up in India, that concentrating on malaria is a little ridiculous. Should you also get shots for dengue fever or hepatitis? <BR><BR>Your biggest threat is food poisoning and/or diarrhea. You can also become easily dehydrated. Drink lots of water, don't eat any raw fruit or vegetable that you can't peel, and DON'T leave home without IMODIUM.<BR><BR>But, whether to take anti-malaria pills is up to you. If you are going to constantly worry about coming down with malaria while in Rajastan, and not enjoy your trip, then you should take the pills. <BR><BR>An ounce of prevention is worth a pound of worry......

Are there shots for dengue? We were told there aren't, and it's a concern here in Malaysia. Anyone know for sure??

If you get a bad case of food poisoning or acute diarrhea, don't just take Imodium as that will "keep" everything in(your body is trying to flush them out). Most doctors in the tropics suggest lots of fluids with a course of antibiotic(librax) to get rid of the germs and they advise strongly against the immediate use of Imodium in this case. Imodiums are used only after the antibiotic have been use for a few days.<BR><BR>Dengue fever, I don't think that there is a vaccine for that. Where long sleeve shirts and pants to limit "exposed" area for the mosquitos.<BR><BR>PS. I'm not a doctor, only an experienced sufferer!

Jen, you are correct that there is no vaccine for Dengue.<BR><BR>John's point about the need for Hep A vaccine is a good one. That's why a visit to a travel med clinic is a good idea. They will help you assess the risks and make informed decisions about vaccines, anti-malarials and any "emergency" meds to take along.

In response to Apiwat's posting, librax is not an antibiotic. It is an antispasmodic agent with a benzodiazepine, similar to valium.

Oops, I meant to say "Lexinol"!

I have been a pharmacist for over 10 years and never heard of an antibiotic called Lexinol. Could it be Levsin? Please DO NOT take any medications without checking with your doctor or your pharmacist. Some antibiotics could cause severe drug-drug or drug-food interactions. Don't forget drug allergy too!

I agree, consult your doctor before taking any medicine.<BR><BR>Lexinor(not Lexinol - sorry) other name = Norfloxacin a derivative of 4-oxo-quinolone carboxylic acid, was most prescribed for the treatment of acute diarrhea or dysentery in this part of the world.

Apiwat, when I came down with severe diarrhea in Varanasi, I was told by the hotel doctor TO TAKE IMMODIUM. He did not know what was wrong with me, but suspected either food poisoning or having accidently swallowed some water when taking a shower. My own doctor always tells me before I go on visits to Asia to take IMMODIUM at the first sign of persistent, watery diarrhea. I have never heard any doctor say to let the diarrhea "flush out the germs" of food poisoning or illness. In fact, I have been in US hospitals where the nurses have given me IMMODIUM for diarrhea. They never said, "Oh, lets flush out those germs first before we give you some."<BR><BR>However, I will ask my own doctor when I see him next Tuesday.<BR><BR>I don't know if there is a vaccine for Dengue or not. My point was that you can get a million and one vaccines and still come down with some "unseen" illness. You can't obsess over it.<BR><BR>And yes, do not take any antibiotic or prescription drug without the knowledge of a doctor. You can become very ill if you take the wrong antibiotic for the wrong illness. <BR>

John, most cases of diarrhea you normally encounter in the States you can just take Immodium. No disrespect for your doctor but you should consult the doctors in the country where you visit since I'm sure a doctor in the States does not see many cases of tropical chronic diarrhea. <BR><BR>Here's a clipping from WHO(World Health Organization):<BR>The World Health Organization has determined that several types of drugs widely used in the industrialized world to treat diarrhea are ineffective or even dangerous. These include adsorbents and antimotility drugs, both of which can stop the diarrhea, sometimes at the risk of intestinal obstruction, but still leave a child with the risk of dehydration. Even in developing countries, manufacturers may have no financial incentive to produce such a simple product for commercial sale. <BR><BR>Immodium and other antimolility drugs are not necessarily safe or effective and they do not stop diarrhea. Actually, the diarrhea keeps on, but they stop the movement of the intestine so that bloating can occur. Because the intestine stops squeezing, and the diarrhea continues, that is why children (or anyone) can get dehydrated. <BR><BR>If you're in Thailand and get chronic diarrhea there are many good modern hospital in Bangkok where they will take good care of you.

Just had lunch with a doctor friend and the subject of our conversation was, yummy, chronic diarrhea. His advice was that if you get chronic or acute diarrhea(many, many trip to the loo within a short peroid, cramping, bloating etc..), do not take Immodium and go see a doctor(preferably at a hospital - not a hotel doctor).<BR><BR>Also, I got some more information from the CDC:<BR><BR>The use of nonspecific antidiarrheal agents such as adsorbents (e.g., kaolin-pectin), antimotility agents (e.g., loperamide - main ingredient for Immodium), antisecretory drugs, or toxin binders (e.g., cholestyramine) is a common practice in many developed and developing countries. Despite the theoretical benefits from their use, available data do not demonstrate their effectiveness in reducing diarrhea volume or duration. For example, although stool consistency can be improved by binding agents, stool water losses are unchanged and electrolyte losses may increase. Indeed, side effects of these drugs are well known, including opiate-induced ileus, drowsiness and nausea due to atropine effects, and binding of nutrients and other drugs. One report from Pakistan detailed 18 cases of severe abdominal distention in association with use of loperamide, including at least six deaths. Another study reported that even in a controlled clinical setting, six of 28 patients administered loperamide experienced side effects (i.e., ileus, drowsiness) requiring discontinuation of therapy. In addition, reliance on antidiarrheal agents shifts the therapeutic focus away from appropriate fluid, electrolyte, and nutritional therapy; can interfere with oral therapy; and can unnecessarily add to the economic cost of the illness.

Apiwat, I called my sister-in-law, who is a dermatologist, and she confirmed that if you do indeed have food poisoning, you should allow your bowels to flush for about 24 hrs. before using anti-diarrhea medication. However, she stated that most travellers who do come down with diarrhea DO NOT have food poisoning, but what is called "traveller's diarrhea." She also stated that it is nice if you have the freedom when traveling to spend a day in bed before taking anti-diarrhea medication, such as IMMODIUM, but if you must travel, then you have no other choice but to take the medication.

That's good advice from your in-law John. Just beware that in S.E. Asia and most tropical places, germs are more potent and abundent! Many people die every year from dysentary and chronic diarrhea so it's wise to know when you have the symptoms for them(and how to treat them!).

Hi Cathy:<BR>Just back from a trip to India. We took Hep A & B and Larium for the malaria. We are fine but there appears to be some controversy about Larium in the UK? At least, take the Hep A. A good friend contacted Hep A from a 5 star hotel in Paris!<BR><BR>Enjoy your trip!

This maybe helpful for some, something I learned while visiting Mexico. First you need to drink lots of water (bottled of coarse) otherwise you get dehydrated in the hot climate and that will cause diarrhea. While experiencing these symptoms myself a friend suggested drinking what is called a mechelada (spelling could be incorrect). The ingredients were lime juice on the rim then dipped in salt, ice, lime juice and a beer poured in the glass. Sounds like a Margarita doesn't it. Well I must say after about 2 hours I was feeling incredibly better. For me if I follow those two things, lots of water and eat limes or drink lime juice it solves the problem. One more tip from the Indians of Mexico, use onion juice instead of Off for the mosquitos. I haven't tried it because of lack of mosquitos when visiting there. I'd like to know if it works. My two cents worth so good luck to all. Enjoy your travels. Jim

Cathy, <BR>I'm traveling to India (north&south both) this Nov. with my Indian uncles, who happen to be both doctors. We are planning to take Hepatitis A shot 2 weeks prior to traveling, as well as the anti-malarial pills prior to going. Thing is, you must take the pills even after you return back for 2-3 weeks for protection. Also, drink only bottled water from trusted sources (i.e. large hotels) or drink hot/boiled drinks like tea. I love spicy Indian food, but I'm bringing a stash of energy bars from here for a back-up of trusted food. Definitely do the immunizations--because once you have malaria, it never truly leaves you. You will have an enjoyable trip, with a few precautions.