Required Vaccations?
 

i'm up to date on hep a, hep b, teatnus, polio, diptheris, persustus, etc

i will be travelling to mumbai & delhi for a week each in mid-january 2007. what else do i need? nothing else is required by cdc but... should i get thpyoid & malaria pills? which type of malaria pills should i take?

thanks in advance....

Yes, vacations should be required of everyone - the more the better.

As for vaccinations, the CDC also recommends Typhoid. The two antimalarials recommended for India are Malarone and Doxycycline. There have been several threads on this forum on the relative advantages and disadvantages of each. Do a search...

We always visit our travel clinic before taking a trip like this and you should probably do the same.

we too visit the travel clinic....we are taking malerone for malaria during our nov trip to india as prescribed by the travel clinic

Note that these are recommended vaccines, not required.

Do check and see whether you will be in malarial risk areas in India. Only parts of India are malarial risk. www.cdc.gov/travel

Typhoid vaccine (either the oral vaccine which is good for 5 years or the shots which are good for 2-3 years) as Craig notes, is recommended.

Are you up to date on your polio vaccine? India is one of the countries with current/recent polio outbreaks.

Also, there has been a major outbreak of dengue in Delhi. Make sure you use mosquito repellant!

mmr (measles mumps rubella) shot was also recommended to us at the travel clinic.

Average temps in New Delhi in January in the morning and evening (when Malarial mosquitoes are active) will be in the 50s F to upper 40s F. Believe me, you will be wearing socks and closed shoes, not to mention a sweater or jacket, so you don’t need to worry about exposed ankles or arms. You also don’t need to worry too much that many mosquitoes will have survived into January at those temps, in a well- drained city where it will not have rained since September. If you want to wear mosquito repellent underneath your socks, shoes and sweater, that is certainly fine, but I would not take Malaria meds, they are not worth the potential side effects IMO.

For Mumbai, average temps will be warmer, but it is still the “cool” season there. Much of Mumbai is also built on marsh land so it is not as well-drained as the Delhi area. As you probably will want to have mosquito repellent on for the Dengue fever issue, I don’t see any reason to take Malaria meds, as the repellent is enough IMO. Also, if you are staying in a hotel with air conditioning, the main source of exposure (sleeping in open-air rooms) is removed and again the repellent is enough. (Personally I don’t wear repellent in Mumbai or Delhi at all, but I can see that not everyone would go with my choice. I don’t even wear it in Bangkok.)

Remember that Malaria meds are not 100% effective even if you take them exactly as directed, so you have to wear mosquito repellent EVEN IF you are taking Malaria meds. You also need to wear repellent as a protection measure against Dengue, as there is no prophylactic medicine for this.

My doctor here did not seem to think that the Typhoid vacc was effective enough to warrant having it, so I haven't. But I don't think the side effects are nearly what the Malaria meds could be so, you might want to do it. Again, in the dry season in January and the two places you are going, Typhoid would seem a very rare chance.

shakti, you are quite right that MMR is recommended for those who did not have the childhood illnesses.

Cicerone, your emphasis on the side effects of antimalarials leads me to belive that you are thinking of larium. Larium can indeed have significant side effects, but there are effective anti-malarials with many fewer side effects, namely doxycycline and malarone. And while no medication of any kind is 100% effective, these anti-malarials have effectiveness rates in excess of 95%. Delhi and Mumbai are both considered malarial risk (Bangkok is not). Areas in India above 2000 meters are not considered malarial risk.

Typhoid is a food and water bourne disease, with the same transmission vectors as Hep A. The vaccine is only about 80% effective, but as there are antibiotic-resistant strains of typhoid in south and southeast Asia, I prefer to be vaccinated. We have little control over the handwashing habits of those handling our food.

I gor most of the shots you mentioned and thyphoid. I also always get malaria pills and use Malarone. This is the ONLY kind I would use. If anyone offers Larium just say no. To many dodgy side effects. Malarone has no side effects in my experience. Also you only need to take a few days before. Better to be safe than sorry