My wife and I have booked to go on the Highlights of Nepal trip in October. We have received conflicting advice regarding the necessity of some of the "advisory" innoculations (Japanese Encephalitis, Cholera & Rabies). Some sites say it's only necessary if your in Nepal for a long time (over 30 days) others say you really ought to not take the risk.
We were wondering what other peoples experience is?
Thanks for your help.
I'd go and talk to a specialist travel clinic rather than rely on web sites. Having been on a trip to Tibet where someone had to be evacuated at speed because they were bitten by a possibly rabid dog and hadn't had the jabs to give them extra time, I'd err on the side of caution with that one at least - rabies is an increasing problem in Asia. If you have the jabs, at worst you have wasted some money; if you don't, the cost might be to your health.
I spent 4 months in Nepal 2 years ago, mostly during the monsoon season. I didn't take any specific medicine except for very strong mosquitoe spray (they can be a killer) and was obviously careful not to drink tap water. Result was not even an upset stomach. There was an outbreak of cholera when I was there but not really in the area where I was staying.
I enquired about vaccine against rabbies at a travel clinic before my trip. I was told at the time that this vaccine only buys you time - to get proper treatment if you do get bitten by a rabbid dog - in the tune of a couple of days (similar to treatment against malaria in a way). I would not worry in your case, as clearly you will not be more than a day journey (by bus/plane...) from a hospital.
First and foremost I agree with Emma, best to visit your local travel clinic and get some detailed advice. In my opinion rabies vaccine before you go is really important, yes you still need to get to medical attention asap after being bitten and receive two further vaccines, but you don’t need an injection of other people’s (or horses) antibodies to fight the virus. This is very difficult to get hold of in India, and can be very expensive. Cholera vaccine is given as two drinks separated by 1-6 weeks and is of real use to people working in poor sanitary conditions with little fresh water. Finally Japanese encephalitis is primarily a rural disease transmitted by mossies that usually feed on pigs and waterfowl, and whilst there is no doubt that at times during the trip you will be in the right areas, the duration will be short and bite avoidance should suffice. Jason Gibbs, MRPharmS DipTravMed(Gla) MFTM RCPS(glasg). Pharmacist in Charge. Nomad.
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