Firstly, Hepatitis A and Typhoid can be avoided by watching what you eat and drink and by taking care over your personal hygiene habits. If treated, Typhoid is rarely fatal. Hep. A is untreatable with medication but other than in those aged over 60 or so, is also rarely fatal.

Hepatitis B is not prevalent in Central/South America, is spread by invasive contact with blood or body fluids. So don't share needles and use a condom with the local lads/lasses. I'd be more worried about STD's in general though.

Rabies; invariably fatal, but when was the last time you got bitten by a dog, monkey whatever? It's very likely that locals will take care of any "loco" animals before you meet them. It's not really an issue, as I see it.

Malaria, Yellow Fever and Dengue are human diseases spread by bites from some mosquitos, during or shortly after the rainy season. Proof of Yellow Fever immunisation is necessary for travel to Brasil and therefore unavoidable, should you intend to go there. However, prevention of mosquito bites is the first line of defence. Use of appropriately treated nets, sprays, electric coils, cintronella incense and perhaps even garlic, have their place. Making sure you are protected during dusk is the most important thing.

Dengue has no prophylaxis and the treatment consists of fluids and anti-febriles.

You can be bitten once and contract these diseases, you can be bitten many times and not.

As far as I am aware, the extremely serious stains of Cerebral Malaria are not found in the Americas.

With regard to Malaria, you are only really at risk when others in the area have the disease. That's hard to know when you are travelling rapidly and so is choosing the correct prophylaxis. Prophylaxis is not a guarantee of protection and an alternative is to hold back your medication for treatment in the event that you contract the disease.

There are only some parts of Central/South America where Malaria is an issue, so you need to consider your routes. Some areas of the coast and the Amazonas are where you are going to potentially encounter problems. Above 800 metres you will not encounter problems. Problem is; if you take the correct prophylaxis and rely on it, you are going to need to keep taking the medication regardless of your location.

Should you decide to use it, in South American affected areas, (North), the prophylaxis/treatment is:

Atovaquone/Proguanil, Doxycycline, or Mefloquine.

In Central America, Ecuador and Bolivia the prophylaxis/treatment is: Chloroquine/Proguanil.

We have discussed this here before, but let's not forget that there are potential side-effects and damage associated with this medication.

Personally, I prefer to have the treatment available, take precautions, regulate my lifestyle...and see what happens.

Just my view.

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How much does a man live, after all?
Does he live a thousand days, or one only?
For a week, or several centuries?
How long does a man spend dying?
What does it mean to say “forever”? - Pablo Neruda

Be aware that Brazil, which was the only South American country requiring yellow fever vaccinations, has been joined by Panama and Ecuador.

I entered Ecuador yesterday and there was a big sign at immigration stating that yellow fever vaccinations were required. However, they did not ask me for proof of vaccination. Your milage may vary.

Panama was to start requiring yellow fever shots beginning October 1. However, since so many people traveling from Panama needed the shots -- and the only clinic where they were available was swamped -- they delayed implementation until November.

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Steve Barnett
Panama City, Panama

Aparently the Yellow fever thing comes into action on the 1st of November
Al theturtleshead

Hi

With regard to Yellow Fever vac. If you are an Aussie, you must have a specific vaccination booklet showing you have a current vaccination. This is NOT for the country you are going to, it is for you to prove to the Aussie quarantine people when you go back home.

Without this Yellow Fever pass, you will not be allowed back home, except if you stay in quarantine for the required time period.

So, after it has been filled out, guard it with your life

Cheers
TravellingStrom

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www.travellingstrom.com

You dont need to take 1 year reserve of tablets.
When travelling, I just made sure to go to a pharmacy and enquired of malaria zones where I was planning next destination. We never went to areas where malaria was a significant risk hence never used our tablets!
We only had doxycycline for 1 month with us.
Whatever you need, you can buy cheaper locally. In countries like Bolivia or Peru, where (according to a local doctor who warned us) many medicines could be fake. Use hospitals pharmacy to buy anything you need, or well established pharmacies. We just did that and it was ok. I would not travel with a big pharmacy box again. We got rid of most our stuff along the way, just too bulky and medecines are available locally.
Also, as said above, you may require a different anti-malarial depending on regions. In that case it is best to buy locally.

My husband need strong medication for high blood pressure. We bought tehm as we went along. No need for prescription, the pharmacists where always helpful and when we asked nicely checked his blood pressure for free.

Healthcare (private) overall in these countries when we needed it, was cheap and very good.

For rabies, dogs are out of control in Argentina, running wild in packs, and if you read the local papers, you will find out that they do attack and bite people! I got bitten once and nearly got bitten several more times. Most dangerous when walking in the street.
Take care with them and only if for peace of mind, get vaccinated. When walking around, if a dog (or a pack) threaten you, go down and take a stone (or pretend you do). that should send them running away.

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Maria

www.franglais-riders.com

Salut Maria!

I was looking exactly for that info!
Thanks. Au prochain verre,
Isabelle & John, Wimbledon xox

FWIW, I have not seen Malarone at a reduced price anywhere. If this is your preferred anti-malarial (as it is mine), don't expect to find it cheaply on the ground.

enjoy,

Mark

David- Misinformation/inaccuracies on websites can cause risks... be careful.

Doxycycline needs be taken for a period of time before reaching the risk area then again for a period of time after leaving it- It cannot be taken when you get there as levels have to build in your body- neither does it prevent Malaria but buys you time if symptoms are seen.

Malarone can be used as both - cure and prevention but you still need to get to medics if you are infected.

In Africa, they use a local cure called Arinate (Artesunate) (that I carried with me as well as taking 'Doxy') made by Dafra Pharma (info@dafra.be)

For medical stuff, always consult your GP - or other Specialist - it isn't worth the risk. ( p.s. I am not a medic either!)

Hospital for Tropical Diseases

Malaria Foundation International

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I do not list my vehicles or the places I have travelled to nor do I live my life seeking validation from others.

Sorry waterfox! didn't want to cause offence!
You are right a kick in the teeth is a good repellent but groups of dogs in small towns can be sometimes very agressive and very intimidating, as I got bitten bit one while I was walking down a street minding my own business.
But then, I have been particularly unlucky on my trip, and things seem to happen to me that do not usually happen to anyone! :confused1: Causing great entertainment among my friends of course!

BAck to the question of vaccinations, I prefer to cover all grounds considering how much accident prone I can be!

Cheers,

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Maria

www.franglais-riders.com