Typhoid, hepatitis and yellow fever, oh my!

by Kim on November 28, 2011 · 48 comments

Vaccinations needed to travel the world

Brian and I spent two hours in the travel clinic today discussing our travel plans and getting vaccinated for our trip. Because we don’t know exactly where we’ll be going, the clinic recommended almost every vaccine known to man. We received some of the recommended vaccinations, turned a few down, and are on the fence about another. Our health is incredibly important, but I am having a hard time distinguishing between perceived and actual risk, and I have always been weary of vaccines.

Vaccinations for travel

These are the vaccinations that we received in preparation of our travels:

Hepatitis A– Hepatitis A is a virus that causes liver disease.  It is found in stool and is usually spread by close personal contact and sometimes by eating food or drinking water.  Countries with high or intermediate prevalence of hepatitis A include Central and South America, Mexico, Asia, Africa and eastern Europe.

Hepatitis B– Hepatitis B is a virus that affects the liver.  It is spread through contact with the blood or body fluids of an infected person.  Hepatitis B is endemic in China and other parts of Asia but is also frequently found in the Amazon and the southern parts of eastern and central Europe.  There is a low rate of Hepatitis B in the middle East, India, western Europe and North America (World Health Organization).

Polio– I thought the last person to get Polio was Tiny Tim, but apparently it is alive and well in some parts of the world.  Polio is a virus that enters the body through the mouth and can cause paralysis and sometimes death.  Brian and I were both vaccinated against Polio as children.  Most adults in the US do not need the polio vaccine unless traveling to areas of the world where polio is common.  As of 2011, only Afghanistan, India, Nigeria and Pakistan remain polio-endemic (World Health Organization).

Typhoid– Typhoid is a bacteria that causes fever, weakness, stomach pains and loss of appetite.  If not treated it can kill up to 30% of people who get it.  Typhoid is contracted through contaminated food or water and affects about 21 million people a year.  The vaccine is recommended to people traveling in northern and western Africa, southern Asia, parts of Indonesia and Peru (World Health Organization).  Unlike the other vaccinations we received, the Typhoid vaccination is taken by mouth as a series of pills (a shot is also available, but the pills were cheaper).

Yellow Fever- Yellow fever is a serious disease caused by a virus.  It is spread through the bite of an infected mosquito and is found in certain parts of Africa and South America. Receiving this vaccination truly freaked me out because 1 person in 55,000 has a severe allergic reaction, 1 in 125,000 has a severe nervous system reaction and 1 in 250,000 develops a life threatening severe illness and organ failure (gulp).  I’m still alive to tell you this so so far, so good.  

An important note: Proof of the Yellow Fever vaccination is required before entering some countries.  Brian and I each received a stamped International Certificate of Vaccination that we must keep with our passports.  

Malaria– Malaria is a parasitic infection transmitted primarily through the bite of a mosquito.  It causes fever, chills, headache, body ache and, in severe cases, seizures, kidney failure, coma and death.  Malaria occurs in parts of Africa, Central and South America, the Caribbean, Asia, Eastern Europe and the South Pacific.  Brian and I will carry anti-malarial medication and take it when necessary.  Anti-malarial meds can cause vivid dreams and hallucinations so we will use sparingly, or sell on the streets to make money (just kidding!).  

 Photo by Gerald Yuvallos, Flickr Creative Commons

The vaccinations we declined

Rabies– Humans get rabies when they are bitten by an infected animal.  Weeks or even years after the bite, rabies can cause pain, fatigue, headache and irritability followed eventually by seizures, hallucinations, paralysis and death.  Brian and I decided against the rabies vaccination for a couple of reasons.  1) We’ve managed to avoid rabid animals this long, 2) The vaccination can be applied after exposure.  The vaccination is also expensive ($600 per person), but we don’t believe that cost alone is a good enough reason to decline a vaccination. 

Meningococcal– Meningococcal disease is a serious bacterial illness not always treatable by antibiotics.  Those that contract the bacteria can lose their arms or legs, have problems with their nervous system, become deaf or mentally retarded, or suffer seizures or strokes.  As serious as Meningitis can be, Brian and I decided to forego the Meningococcal vaccination mainly because we do not plan to travel to the region in Africa known as the meningitis belt.  

The vaccination we can’t decide on

Japanese Encephalitis– Japanese Encephalitis is an infection caused by a virus that spreads through the bite of infected mosquitoes.  The risk of Japanese Encephalitis is very low for most travelers, but higher for people living or traveling for long periods in rural parts of Asia.  Brian and I aren’t sure if we’ll be traveling for long periods in rural Asia, but we don’t want to rule it out as a possibility.  The vaccination costs $800 per person which, again, isn’t ultimately a factor, but ouch.

The cost of travel vaccinations

In the United States, insurance coverage for travel vaccinations varies depending on individual policies.  I’m not sure yet if our policy will cover the cost of our vaccinations, but I’m not holding my breath.

All told, my vaccinations cost $468 (Hep A, Hep B, Polio, Yellow Fever).  Brian’s vaccinations were slightly less because he was able to receive the Hepatitis A/B combined vaccine (not an option for me since I began the Hepatitis sequence in 2007).  This total does not include the Typhoid medicine, Malaria pills or Japanese Encephalitis if we decide to take it.

Next Steps

Slowly but surely we are crossing things off of our massive to-do list.

Next up:

Survive the holidays without breaking the bank.

Find cheap insurance that is HIPPA compliant and will cover us in case of emergency as we travel.

Schedule a litany of doctors appointments to make sure we are in good health before waving goodbye to our employer-provided health insurance (sigh).

Travelers, Help!

If you have any insight about vaccinations, especially the Japanese Encephalitis vaccination, please leave a comment.  

Disclaimer: I’m not a doctor. If I was, I’d already have the money saved to leave on this adventure.