Travel Reference
In-Depth Information
The newer injectable typhoid vaccines (eg: Typhim Vi) last for three years and are about
85% effective. Oral capsules (Vivotif) may also be available for those aged six and over.
Three capsules over five days lasts for approximately three years but may be less effective
than the injectable forms. They should be encouraged unless the traveller is leaving within
a few days for a trip of a week or less, when the vaccine would not be effective in time.
Vaccinations for rabies are ideally advised for everyone, but are especially important for
travellers visiting more remote areas, particularly if you are more than 24 hours from med-
ical help and definitely if you will be working with animals (see Rabies Click Here ) . The
disease is a problem in Madagascar because of the half-wild dogs found in many parts of
theisland;thereisalsoatheoreticalriskofrabiesafterlemurbites(seeboxon ClickHere ) .
Experts differ over whether a BCG vaccination against tuberculosis (TB) is useful in
adults: discuss this with your travel clinic.
Inadditiontothevariousvaccinationsrecommendedabove,itisimportantthattravellers
should be properly protected against malaria. For detailed advice, see Click Here .
Ideally you should visit your own doctor or a specialist travel clinic (see Click Here ) to
discuss your requirements at least eight weeks before you plan to travel.
TEETH If travelling off the beaten track, have a dental check-up before you go and if you
have a lot of fillings and crowns carry a dental emergency kit.
INSURANCE Make sure you have insurance covering the cost of helicopter evacuation
and treatment in RĂ©union or Nairobi, which offer more sophisticated medical facilities
than are available in Madagascar. Europe Assistance International, which has an office
in Antananarivo, gives cover for scuba-diving. Divers Alert Network (DAN;
www.diversalertnetwork.org ) is the best insurance available for scuba-diving. With all in-
surance make sure that you tell them about any preexisting problems when applying.
WATER STERILISATION Most traveller's diarrhoea comes from inadequately cooked,
or reheated, contaminated food - salads, ice, ice cream etc - rather than from water. Even
so it is best to take care with what you drink. Bringing water to the boil kills all microbes
thatarelikelytomakeyouillsotea,coffeeor ranovola (ricewater)aresafe.Mineralwater,
although widely available, causes a litter problem and can be quite expensive. Chemical
sterilisation methods do not render water as safe as by boiling, but it is good enough for
most purposes. The cheapest and most effective sterilising agent is chlorine dioxide. To
make treated water more palatable, add vitamin C after the sterilisation time is complete
or bring packets of powdered drink. Silver-based sterilising tablets (sold in Britain under
the trade name Micropur) are tasteless and have a long shelf life but are less effective than
chlorinedioxide.AnalternativeisawaterfiltersuchasthePursystemorAquapureTravel-
ler, which provide safe water with no unpleasant flavour; they are expensive, however, and
 
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