Vaccinations?

travelnow

Hello again,

We are leaving for hyderabad on Thursday. Obviously no time for vaccinations now, but are there any specific ones recommended before moving there? I have already had Hepatitis A & B, Tetanus, and Polio.
Is the risk of malaria a problem year round or seasonal?
Thanks

Nick-H

Please browse the site and consider the many threads already here on malaria, and the widely differing views on anti-malarials.

The risk is not seasonal.

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edwardseco

How long is your stay, that makes a big difference. You need to spend some time on the numerous threads on this topic as Nick says because its necessary to be an informed user for malarials. I have used Doxy (as my posts will indicate) but a lot depends on age and gender. Below 10-12 it isn't recommended and women on contraceptives or prone to yeast infections, etc. So you get what I mean by an informed user. There is nothing automatic.
People will say there is no malaria in big cities but that is garbage (putting it gently). Standing water is all it takes and mosquitos fly an enormous territory. I use a net and a fan to handle the heat. Power cuts are something else.
Welcome to the twin cities, Hyderabad & Secunderabad..

zorts

If you're really going to be here a while, you might consider vaccines for Japanese encephalitis (though the vaccine is one of the nastier ones...) and rabies - yes, rabies. There are a LOT of stray dogs, at night they run in packs, and, frankly, they scare me. I carry a walking stick after dark; it might or might not help me out if dogs attacked, but it makes me FEEL better.

On the anti-malarial front - as others have said, do some reading. Personally, I take mefloquine once a week (not everyone can tolerate it...) and do my best to keep the skeeters away. I had screens installed on my windows (my landlady thought I was nuts...) - so far, very effective.

Hyderabad's a funky place - enjoy!

-- Jerry

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Rama

In case you do not know, there is no vaccination for malaria.

The IAMAT recommends the following immunizations for India as a whole (which, as you know, is a very large country - this is like saying immunizations for all of Europe):
- Poliomyelitis
- Cholera*
- Viral Hepatitis A
- Typhoid Fever

Selective Immunization** for India:
- Viral Hepatitis B (HB is like HIV, sex or blood transmission)
- Japanese Encephalitis
- Plague
- Rabies

For Children over 6 months of age in India:
- Yellow Fever (certificate required)

* Notice that Cholera vaccination is not available everywhere. Could be because some countries do not like medicine that you cannot make money off of (who knows). For example, it is not possible to get it in the USA. You *can* get it in the UK, Australia, Canada and the EU. No vaccine lasts over 6 months. Oral vaccine is NOT recommended, unless where cholera epidemics are occurring and there is limited access to medical care.

** Selective Immunization means long term stays in risky areas or short term stays in high risk areas.

Information taken from IAMAT (International Association for Medical Assistance for Travelers) "World Immunization Chart", Status as at March 15, 2007.

edwardseco

Cholera vaccine is now considered of doubtful value in some quarters..

Stephen Jones

The cholera vaccination is fairly painful.

With regard to mosquito-borne diseases there has been a massive epidemic of chikungunya in South Asia, in a more virulent mutant form. Dengue is also a severe problem in the cities. As they are diseases that mainly attack poor people nobody has bothered to develop a virus for either.

Bubonic plague is easily treatable with tetracycline, so I wouldn't bother with a vaccine.

Nick-H

Yellow Fever?This is from the Airports Authority of India site and you can find the list of relevant countries on that page too.

I don't think there is a yellow fever risk here

Nick-H

I think the virus developed itself quite happily without any help!

They are diseases affecting anybody in India, not just poor people. The fact that there is no vaccine is not necessarily due to economics. There is no vaccine for the common cold virus, either, despite decades of research.

Chikungunya, like the common cold, has no real cure, other than to treat symptoms. I think Dengue is treatable. In fact, I think it is lethal without treatment?

There is filaria too, along with the various strains of malaria.

What it is perfectly true that no-one has bothered to do (a matter of political will and application) is to control the mosquitoes spreading these diseases. That requires no new research; just appropriate action.

Stephen Jones

There is a vaccine for filaria, otherwise known as elephantiasis. The Sri Lankan government periodically distributes it for free to the whole country.

Finance was the reason research into a chikungunya vaccine was discontinued. To quote wikipedia
Vaccine trials were carried out in 2000, but funding for the project was discontinued and there is no vaccine currently available. http://en.wikipedia.org/wiki/Chikung...ive_measure s
I suspect one of the reasons was that it was neither widespread nor fatal until the 2005 -2007 South Asian epidemic.

There is no treatment for dengue fever. The important point is to avoid dehydration and not take aspirin, which will ease the pain but increase the hemorraging.

Nothing like as easy to get rid of the mosquitos as you think. Dengue is an urban disease, and the mosquito breeds in small stagnant pools of water such as flower pots or disused yoghurt pots or upturned tyres. In Sri Lanka the highest rate of dengue infection was in Colombo 7, the most expensive area in the country, the equivalent of Mayfair. The reason was that there are a load of bungalows with gardens there, and the often elderly inhabitants are dependent on their gardener or houseboy to clear them up. And as you know from living in Chennai the average Indian just doesn't see rubbish. The plastic bags and yogurt pots, let alone flower pots or saucers, will stay in the garden providing a breeding ground for the mosquitoes.

Bex

Painful tasting maybe? I just had my first dose of the Oral yesterday.
MMMmmmmmMMMM raspberry flavoured bi-carb.

zorts

Getting rid of them is impossible. Controlling human exposure is a different story. Proper used of treated bed nets and spraying the interior walls of homes with DDT can dramatically reduce infection rates, at low cost. But DDT has acquired such a bad rap (because of agricultural overuse) that it's difficult to promote its appropriate use for malarial control. See this great NYT magazine article for details...

Nick-H

I understand that, some years back, malaria was more or less eliminated in Mumbai. Then the politicians told themselves they'd done a good job and just sat back.

It is probably impossible to eliminate the mosquito, but it can be substantially controlled. Close to my house, for instance, the several flooded empty plots and the canal could be treated with larvicide. This would bring to population down to 'normal' or below. I'd rather see a hundred mosquitos a day rather than ten thousand.

My only regret would be that they are part of an ecosystem which brings dragonflies to feed on them, and beautiful birds to feed on the the dragonflies.

Mossies can be controlled at the larval stage.

Thanks for the DDT link: I'll check it out later. Might be useful for me!

brownboy66

sorry....are you leaving for or moving to Hyderabad on Thursday? And no time for vaccinations? Was this a sudden sort of thing?

excellent advice - pretty comprehensive. The only things missing above are MMR, TB, Tetanus, and Menigitis. Some of these will depend on what sort of child vaccinations you've had in the past, and what you've had recently. Which leads to the next question - do you (did you) have a doctor?



very good Nick. What with that, advice on bedsheets, and the "what are you" line to the wondering Sadhu - you're on fire!

evilnyberg

wow guys, steady on. i wouldn't think any less of travelnow if she was scared half out of her wits by all of this...

like others recommended, please do a bit of research on whether to take anti-malarials... malaria is -not- a big problem in hyderabad - one of the reasons for this being that the type of mosquito that carries malaria likes clean water to breed in (as opposed to the type carrying dengue and chikungunya), meaning that it'll generally be more prevalent in rural areas.

having said this, taking some anti-malarials at this time of year (end of monsoon) might be advisable. (though i live happily without anti-malarials year round, as do most indians.) luckily the chloroquin + proguanil combo still works in india - it's cheap, widely available and has relatively few side effects.

for your own sanity as much as anything else, protect yourself from mossies using bednets, screens, long sleeves and natural repellents such as citronella or neem oil. (the chemical stuff is carcinogenic and won't do you any favours in the long run.)

also, familiarize yourself with the symptoms of malaria, so as to ensure prompt treatment should you get infected.

if you choose to go for any of the additional vaccinations mentioned by others in this thread, you might consider doing them once you get to hyderabad (since i gather time is short). this should be both safe and easily arranged.

the rabies vaccine does not stop you from getting rabies, but simply buys you some extra time to get to the hospital. if you are staying in hyderabad this shouldn't be necessary, as there are plenty of good hospitals around. also, lympathic filariasis is not a big problem in the city.

of course. there is no end of horrible and exotic diseases that you might potentially contract when travelling to a tropical country but, hey, a brick might hit you in the head on the way to the airport. by all means, be safe... but don't let it get the better of you.

good luck with the move and welcome to hyderabad!

a