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Preparing for Your Trip SE Asia Feb 3, 2013
by John I. Yam, M.D.    ::   Thursday, February 07, 2013

I'm from SE Asia. Why do I need to see a doctor before my trip?

  • Even though you're from SE Asia, you may not have immunity to many infectious diseases.
  • You may need routine immunizations. These are needed even if you don’t travel. Your doctor may not have all your immunization records, so bring them along when you see the doctor. Your doctor can your blood for antibodies to infectious diseases.
  • You may need travel immunizations.
  • If you've been away for a few years, you may be susceptible to traveler's diarrhea. 
  • You may have chronic medical conditions that need special attention on your trip.
  • You may not be aware of what you need traveling to SE Asia.

When should I visit the doctor before my trip?

  • To have the most benefit, see your doctor at least 4 weeks before your trip to allow time for needed vaccines and other medications and information about how to protect yourself from illness and injury while traveling.

What are routine immunizations that I need?

  • These are needed even if you don't travel.
  • Many of us think that childhood illnesses are a thing of the past, but these illnesses still occurs in many parts of the world, so it's important to get immunized before your travel.
  • Many adults have no immunity to these common childhood illnesses. Did not get the shots as children or never been exposed to these illnesses. Antibody tests.
  • Tdap (tetanus, diphtheria, whooping cough). Tetanus every 5-10 years. Whooping cough - there was an outbreak last year of whooping cough in King County – approx 1,000 cases were reported.
  • MMR (measles, mumps, rubella). Measles not uncommon in SE Asia.
  • Varicella (chickenpox) is not infrequent in the US and common in many parts of the world.
  • Polio is still occurs in certain part of the world, e.g. India and parts of China close to India. One lifetime booster dose for those going to China.
  • Flu vaccine - in warmer climates, flu occurs year-round. So far 5 deaths & > 100 hospitalized in Snohomish County from the flu.

What travel immunizations do I need going to SE Asia?

  • Hepatitis A.
  • Haptitis B.
  • Typhoid.
  • Polio. Polio is endemic in India and many parts of SE Asia.
  • Flu shot - flu may occur year round in warm climates.
  • Japanese encephalitis – recommended if you plan to visit rural areas for more than several weeks.

What are other infectious diseases of concern for India & SE Asia travelers?

  • Malaria – Malaria, a disease transmitted by mosquito bites, is endemic in India. Preventive medications are recommended by the CDC.
  • Traveler's diarrhea – affects 20-50% of international travelers. Mostly caused by E.coli, but may also be caused by salmonella, shigella, viruses, cholera, etc. Drink safe water. Avoid ice, raw veggies, opened fruits, etc.
  • Schistosomiasis - parasite found in fresh water lakes & streams. Affects liver, brain, lung, bladder, etc.
  • Leishmaniasis - bacteria found in fresh water lakes & streams. Affects liver, brain, heart, etc.
  • Dengue fever - spread through insect bites.
  • Rabies – avoid close contact with animals, even if they appear healthy.
  • Tuberculosis -  consult your doctor if you have persistent cough after trip to Taiwan.
  • Bird Flu (H5N1). This still occurs in many SE Asian countries. Avoid contacts with chicken and birds.

What should I bring with me on my trip?

  • The prescription medicines you take every day. Keep them in the original container because some drugs available by prescription in the US are illegal in other countries.
  • Malaria medications -  for those going to India. Discuss this with your doctor.
  • Medicine for diarrhea - over-the-counter and prescription medications (both are not for children).
  • Sunscreen (choose one that protects against both UVB and UVA). SPF refers to UVB protection only.
  • Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol.
  • Using insect repellent (bug spray) with 30%-50% DEET.
  • Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide
  • Cold and cough medications, e.g., Mucinex DM – 12 hours.
  • Tylenol. Advil.
  • Neosporin ointment.
  • Hydrocortisone cream 1%
  • Oral rehydration packages
      1. For small children - use Pedialyte powder (available from Walgreen Baby product section).
      2. For older children and adults - you can make oral rehydration fluid using the following formula : 4 glasses of safe water + 4 tablespoonfuls of sugar + ½ teaspoonful of salt + ½ teaspoonful of baking soda + one glass of canned citrus juice.

How do I prevent getting sick from contaminated food and water?

  • Wash your hands often with soap and water, especially before eating and after going to the bathroom.  If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol).
  • Drink only bottled or boiled water, or carbonated drinks in cans or bottles.  Avoid tap water, fountain drinks, and ice cubes, raw veggies. The best way to disinfect water is by boiling for at least one minute.
  • Do not brush teeth with tap water.
  • Do not eat food purchased from street vendors.
  • Do not eat fruits that has been cut opened.
  • Make sure food is fully cooked.

What is Deep Vein Thrombosis(DVT) and how do I prevent from getting it?

  • DVT is clotting of the deep veins in the legs or thigh tha can occur with prolonged sitting without movement, as in long airplane rides. The clots can dislodge and go to the lung, causing serious illness or even death.
  • It occurs more often in older individuals but can occur in young people also.
  • Do massage your legs or move about periodically to avoid clotting of the veins.
  • Below knee compression stockings are also helpful.


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