Pokes & Pills

Ouch!

I had my travel clinic appointment today ($40 for a consultation in addition to any vaccinations you receive). They recommend the following for India:

- hepatitis A & B ($45 & $25)
- tetanus (?)
- Typhoid ($30)
- Polio ($45)
- Influenza ($18 - free to people at high risk or living with high risk people)

If you are traveling to rural areas they also recommend:

- Rabies ($125)
- Japanese encephalitis ($110)

I was up to date on everything. But influenza & polio. I didn't absolutely need either, but since the polio adult booster is good for the rest of your life and the influenza shot is cheap I figured better safe than sorry.

They also recommended taking an anti-malarial medication. One of the following:

- Mefloquine aka. Larium ($1.12/day): you only take one pill per week, but there are some serious psychological side effects possible that could ruin your trip. Do some research and if you decide to go with Larium try it at home before you leave to see how you react to it.

- Doxycycline ($0.7/day): you must take one pill daily, but the side effects are limited to some gastrointestinal upset, photosensitivity and yeast infection.

- Malarone ($5/day): you must take one pill daily and side effects include: nausea, vomiting, and headache.

With all these medications you must take them for 1 - 4 weeks after leaving the malaria risk area to allow time for the incubation period to pass. All of these treatments seem to be equally effective so it comes down to convenience, cost and side effects.

Since I will need a 100 day course of these drugs I went with Doxycycline. It is inexpensive and I don't generally have any stomach upset with antibiotics.

In addition to this they suggested I get a short course of Ciprofloxacin (500mg twice a day for 3 days) in case of traveler's diarrhea.

I had to sit in a medical centre for 90mins to get these prescriptions from a doctor (the travel clinic staff are all nurses) and I still have to hit a drug store to get them filled.

If you want to visit a travel clinic before your trip make an appointment early. I had to wait three weeks to get in, since the Christmas season is a peak travel time. Don't wait till the last minute.

If you want to save time and money you can research the required vaccinations and malaria treatments, and then go to your doctor who can administer them. It is also possible to buy pharmaceuticals without any prescription in India. You could buy a week's worth in Canada and buy the rest in India at a considerable savings. If you go this route just check on a traveler's bulletin board which types of anti-malarials are commonly available.

Beyond drugs and vaccines travelers in India should:

- avoid mosquito bites as much as possible
- use DEET repellents (I don't personally - I can't handle the idea of coating my skin in DEET)
- wear long sleeve shirts and pants in the evening when mosquitoes are out
- use a mosquito net at night
- wash your hands often
- only drink treated water (check that the bottle is sealed)
- don't drink anything with ice cubes in it
- only pasturized dairy products
- wash and peel your own fruit
- eat hot fresh food and avoid any food that has been sitting around

I updated my travel insurance policy to cover me in India. It cost an additional $140 on top of the $70 I pay annually for coverage for my US trips. If you are Canadian your provincial health insurance will cover you anywhere in the world, up to a maximum of what the treatment you receive would have cost at home. So for travel in the US you need additional coverage for places like India and Mexico, where medical services are cheaper than Canada so you could get away without extra insurance. The downside is that you have to pay your medical bills first and then submit them to the government for reimbursement. Also additional coverage gives you benefits like free travel home if you get ill or injured. Whatever you do think it through and make sure you understand what will happen if you need medical treatment. If you get extra medical insurance read your policy thoroughly - there is lots of fine print that could be important to you later.