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Jabs etc. for Far eastern travel.


CarMad
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Right we are off to the far east in Jan 09 all things being well but we are trying to find out what we might need or not as the case might be. smile.gif

I guess the biggest questions might be if we need to take malaria tablets or not. We might be trying to create CarMad Junior around the same sort of time and we aren't sure of the risks, some say you can get tablets that aren't a problem. But do we even need to take them ?!?

I know you will all come back and say go to the doctors and we are but the closest appointment is two weeks away and we need to book the holiday by the end of the week if poss.

Where are we going well this is the list of locations. Most of them we will be doing little more than visiting the ports or major cities I guess, its a cruise so its up to us what we do or don't do.

Singapore

Sihanoukville, Cambodia

Bangkok/Laemchabang,thailand

Ho Chi Minh(Vungtau),vietnam

Nha Trang, Vietnam

Hue (Danang), Vietnam

Sanya, China

Hong Kong, China

Xiamen, China

Shanghai, China

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Shanghai, China

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grin.gif take some pollution masks - its the most polluted city I've ever visited 169144-ok.gif

grin.gif If you are hitting a malarial zone then Malarone is supposed to be the best of the anti-malarials available - though we did notice if you take your daily pill just before bed it gave both of us really odd, vivid dreams yelrotflmao.gif

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Mate, can't help on the tablets but looking forward to the write up. That's practically city for city the trip I'm doing in november and december laugh.gif

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grin.gif We are doing it via a cruise with Royal Caribbean, adding a few days in Singapore at the start and one in Shanghai. Let me know how yours goes and any tips on where to go. 169144-ok.gif

Bazza I've already got the Lens fun started, can I get things cheaper in Singapore / Hong Kong. grin.gif169144-ok.gif

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I'm at home at the moment.. have all the literature at work.. will check tomorrow. 169144-ok.gif

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Cheers Dave. Its mainly about if my other half was to get preggers or we were to be trying, someone told me you couldn't or it was advised not to try for 6 months after taking Malaria drugs, but then I understand with some its not a problem now. confused.gif

We want to go on the cruise but if it delays starting a family or at least trying we may have to rethink. 169144-ok.gif

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see here for advice on malaria - http://www.traveldoctor.co.uk/malaria.htm

Note that thailand has mefloquine resistant maleria.

Avoidance and reduction of bites play a big part. Use a DEET based spray, if your are not sensitive and cover up with long sleeves/trousers in the evenings. Avoid standing water.

I travelled fairly extensively in middle east, se asia and india, including rural areas. The above advice and a daily dose of doxycycline worked for me. YMMV. Doxy may not be suitable for someone on the pill, and you have to remember to take it every day. It is cheap though, and widely available.

Some prophylactics require you continue after you leave the malaria region - don't skip this. If you get any flu like symptoms within 3 months (iirc - check this out) of returning, contact your GP *immediately* and emphasise you've been to a malaria region.

If you've got time in Sin City, check out the night time zoo safari - it's good. Also use the metro system to go anywhere, cheap and quick. Walking any distance in the humidity gets boring quickly.

HTH and have a great trip.

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Length of Prophylaxis

* Chloroquine, Proguanil & Maloprim

Start one week before travel, throughout your stay in an endemic area and continue for four weeks after return.

* Mefloquine (Lariam) Start two and a half weeks before travel, throughout your stay in an endemic area and continue for four weeks after return.

* Doxycycline Start two days before travel, throughout your stay in an endemic area and continue for four weeks after return.

*Malarone Start two days before travel, throughout your stay in an endemic area and continue for one week after return.

from http://www.traveldoctor.co.uk/asia.htm#2nda

The page also has advice on suitability while pregnant / breastfeeding.

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Re vaccinations, Diphtheria/Tetanus/Polio, Hep A and Hep B may be worth considering. Some are free on the NHS, others you have to pay for privately.

General good hygine goes a long way to staying out of trouble. Wash hands with soap/water (or alco gel as a backup) before and after eating, and before and after toilet. Wet-wipes are your friend. A couple of small bottles of alco-gel hand rub are also very handy.

Don't eat food that hasn't been peeled/cooked or washed with bottled water. Street vendors often have really tasty and cheap food, but don't eat anything you haven't seen being cooked in front of you.

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Regarding vaccinations you need:

Hepatitis A, Typhoid, Tetanus, Diphtheria and Polio.. all of which should be available from your local surgery.

There is a question mark of Japanese Encephalitis Vaccine, but generally only given to people who stay is for longer than one month.

Regarding malaria prophylaxis you have the choice of 3 :Mefloquine, Doxycycline (being the cheapest) and Malarone (being the most expensive).

Doxycycline can upset some people and make them feel quite sick. If you can tolerate it then fair enough, but I would always take Malarone as my drug of choice, but it CANNOT be taken during pregnancy. (nor can Doxycycline!)

You will need a private prescription for any of these medicines so a chat with your GP will be in order. They can advise you on the options. 169144-ok.gif

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Bazza I've already got the Lens fun started, can I get things cheaper in Singapore / Hong Kong. grin.gif169144-ok.gif

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grin.gif In Hong Kong just jump on the metro to Mong Kok, Sai Yeung Choi street. The whole area is full of electornics/camera shops - remember to bargain between shops and check the prices before you go 169144-ok.gif

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