Health Concerns For "Exotic" River Cruises

We'll be in Vietnam/Cambodia for our river cruise/vacation this winter, and today we had the opportunity to consult with a nurse who is a travel specialist. It was extremely informative! We each got a few vaccines (which weren't required by the CDC, but were suggested by her), and we were clearly explained the risks of any other health issues, how to mitigate those risks, and given a pro-active antibiotic prescription in case we find ourselves with traveler's diarrhea. She even gave us recommendations for the best mosquito repellent to use, and provided us with a very thick packet of information related to our destination, including how to contact the embassy if we fall seriously ill.

I am not overly concerned about our health while we're on this trip, but I do believe it's better to be informed, and reduce risk as you see fit. I didn't realize that there were doctors that specialized in this type of thing. Wondering if anyone else has done it? We'll definitely be seeing her again if we choose to book additional trips outside of modern areas.

Curious to hear others' experience with this sort of preparation.

I do research in global health and work for an infectious disease doctor, so now I get my advice from him, but have used travel clinic (both independent and the one at my university) in the past and they can be very helpful. Tend to be slightly overzealous, but sometimes it is better safe than sorry. Things like malarial preventives - my boss spends 1/3 of his year in a malarial area but never takes anything. I made one trip there and did. Balanced my risk - and the fact that mosquitoes love me. Often times there's not one right answer for everyone, and talking with pros can be helpful.

I do stress pros, though, as for one of those trips I was getting the anti-malarial while at my primary care doc, texting with my boss to get the right prescription & strength to tell my doc so she could write the prescription;)

I also am on the "if there's a vaccination, I want it" bandwagon. I know not all are, but I don't have any underlying health conditions, and I like vaccines. So gimme!

I'm with you on the "I can vaccinate? I'll take it!" bus.

We're doing anti-malaria while we're in Cambodia, even though we're mostly in low-risk areas. We'll also use the recommended lotion insect repellent and the spray for our clothes.

I was pleased to find out there is now an oral vaccine for Typhoid, and it's effective for 5 years, rather than 2 for the injection, so at least we'll be protected for one or two more trips to areas with risk of the disease.

I'd much rather take some pills, get some shots, and be cautious than end up sick when I should be enjoying my vacation.

I am not overly concerned about our health while we're on this trip, but I do believe it's better to be informed, and reduce risk as you see fit. I didn't realize that there were doctors that specialized in this type of thing. Wondering if anyone else has done it? We'll definitely be seeing her again if we choose to book additional trips outside of modern areas.

 

Curious to hear others' experience with this sort of preparation.

We did the same thing when we went to Egypt. We visited a travel specialist as recommended by the DOH web site. We wound up getting things like DPT boosters because at the time there was an outbreak in some areas, and we got typhoid and hepatitis as a precaution as well. Obviously we didn't need it, but I don't ever have to have them again and when it comes to my health, I tend to err on the side of caution.

I also am on the "if there's a vaccination, I want it" bandwagon. I know not all are, but I don't have any underlying health conditions, and I like vaccines. So gimme!

Just had my pneumonia prevnar 13 yesterday. I totally agree if my doctor recommends it, and I trust him with my life (which he already saved once), why would I NOT take advantage of the vaccines.

We received Typhoid and Yellow Fever for Africa as well as polio booster and of course DPT. Always get a current flu shot for those YUCKY germy airplane rides and take Vit C and Echinacea. So will be covered for a few years...will try and pack as many trips as possible! We take anti malarial...haven't any side effects (other than cost)....so dont want the risk...bad disease if you get it!

What I am not sure about for our next trip is the altitude sickness Rx...we are going to be in Lake Titacaca after an Amazon Cruise and Machu Pichu. We had no problems in Quito, not as high ...so may just hope the cacoa tea is sufficient.

Anyone have any experience?

... malarial preventives - my boss spends 1/3 of his year in a malarial area but never takes anything. I made one trip there and did. Balanced my risk - and the fact that mosquitoes love me. Often times there's not one right answer for everyone, and talking with pros can be helpful..

...We take anti malarial...haven't any side effects (other than cost)....so dont want the risk...bad disease if you get it!

 

What I am not sure about for our next trip is the altitude sickness Rx...we are going to be in Lake Titacaca after an Amazon Cruise and Machu Pichu. We had no problems in Quito, not as high ...so may just hope the cacoa tea is sufficient...

Most people who acclimate slowly rarely suffer from altitude sickness, but if you are flying to Cuzco there is a good chance of having some altitude sickness symptoms. I have been to Lake Titacaca twice (crossing once by hydrofoil, and once by Bolivian Naval vessel) and had no symptoms, but in both cases I was actually arriving from higher altitudes (14-15,000 ft), and had spent several days acclimating at mid-altitude (8,000) before proceeding higher. I have also been to Cuzco twice, once coming down from higher altitude, and once flying in from sea-level. Flying in from sea-level proved that I am not immune to altitude sickness (nagging, but not severe). I suspect you are on a tour and have no control over your schedule. There are medications specifically for altitude sickness.

Thom

We received Typhoid and Yellow Fever for Africa as well as polio booster and of course DPT. Always get a current flu shot for those YUCKY germy airplane rides and take Vit C and Echinacea. So will be covered for a few years...will try and pack as many trips as possible! We take anti malarial...haven't any side effects (other than cost)....so dont want the risk...bad disease if you get it!

 

What I am not sure about for our next trip is the altitude sickness Rx...we are going to be in Lake Titacaca after an Amazon Cruise and Machu Pichu. We had no problems in Quito, not as high ...so may just hope the cacoa tea is sufficient.

 

Anyone have any experience?

We do the same taking Airborne 2x daily, even at home. I know the medical research pooh-poohs it, but we both noticed a difference between taking it and not.

I haven't been to Machu Pichu but I have been to the top of Pikes Peak, which is higher (14,114') than MP (7,972) and Cuzco (11,152') and had no problem. Since you had no problems in Quito you may not be as susceptible to altitude sickness as others. I know first time I did Pikes Peak I got a little light-headed while people around me were reeling. I was told to stay away from coffee/caffeine and just drink lots and lots of water. I've been up there several times since and had no problem at all.

What I am not sure about for our next trip is the altitude sickness Rx. We are going to be in Lake Titacaca after an Amazon Cruise and Machu Pichu. We had no problems in Quito, not as high, so may just hope the cacoa tea is sufficient. Anyone have any experience?

YES! The Cocoa Leaf Tea is great! I saved my coke & water bottles and constantly refilled them from the giant teapot in the lobby of our hotel in Cuzco. Also, I bought the cocoa leaves at the airport. You put them under your tongue and feel wonderful. The little people come running up to your van as soon as you turn into the parking lot and sell a sandwich-sized bag for $1. Plenty enough to bring home and I shared with my friend. ;)

I did get a prescription from my doctor for pills to take starting the day before disembarkment from my Princess cruise and took them as prescribed. I love Machu Picchu, so magical. :D

Today we had the opportunity to consult with a nurse who is a travel specialist. It was extremely informative! We each got a few vaccines (which weren't required by the CDC, but were suggested by her), and we were clearly explained the risks of any other health issues, how to mitigate those risks, and given a pro-active antibiotic prescription in case we find ourselves with traveler's diarrhea. She even gave us recommendations for the best mosquito repellent to use. Curious to hear others' experience with this sort of preparation.

Hi, Ewizabeff,

I have surely enjoyed your Blogs. Thank you. ;)

Can you share your "best mosquito repellent to use?" The mozzies just love me. :eek:

DEET. That is the best mosquito repellent to use. As high a percentage as you can get and tolerate.

My husband uses a thermacell when he hunts, and it's VERY effective, but not great for travel. OTOH, DEET comes in nice 50ml tubes these days :D

Thanks, Hoya,

I did buy some Avon repellant pads. They seem to work for me in my garden. I just use them on my arms and neck (only skin that is exposed). I do not know if they contain the Deet. :confused:

The Thermacell looks like an interesting concept; however, taking the Butane may be a problem. :eek:

I would still like to know the brand name of the one recommended by ewizabeff's Nurse. ;)

One of our university's in my city has a travel clinic. I haven't needed to use it for where I have gone but where I work, people are always traveling and they do go down there for their shots/advice, etc... Great resource!

These are the two specific repellent lotions our travel consultant recommended:

3M Ultrathon

Sawyer Ultra 30

She also recommended buying premethrin spray to pre-treat our clothing before vacation so we wouldn't get bitten through our clothes.

Apparently some people are allergic to DEET, but thankfully DW and I are not so we still use the 100% DEET we bought many years ago. The insects haven't learned yet. :D

We received Typhoid and Yellow Fever for Africa as well as polio booster and of course DPT. Always get a current flu shot for those YUCKY germy airplane rides and take Vit C and Echinacea. So will be covered for a few years...will try and pack as many trips as possible! We take anti malarial...haven't any side effects (other than cost)....so dont want the risk...bad disease if you get it!

 

What I am not sure about for our next trip is the altitude sickness Rx...we are going to be in Lake Titacaca after an Amazon Cruise and Machu Pichu. We had no problems in Quito, not as high ...so may just hope the cacoa tea is sufficient.

 

Anyone have any experience?

YES! The Cocoa Leaf Tea is great! I saved my coke & water bottles and constantly refilled them from the giant teapot in the lobby of our hotel in Cuzco. Also, I bought the cocoa leaves at the airport. You put them under your tongue and feel wonderful. The little people come running up to your van as soon as you turn into the parking lot and sell a sandwich-sized bag for $1. Plenty enough to bring home and I shared with my friend. ;)

 

I did get a prescription from my doctor for pills to take starting the day before disembarkment from my Princess cruise and took them as prescribed. I love Machu Picchu, so magical. :D

Not to put to fine a point on the discussion, but you want Coca tea/leaves. Since it contains low levels of cocaine, and can be refined into HIGH levels of cocaine, one might be wise not to bring it home.

Not to put to fine a point on the discussion, but you want Coca tea/leaves. Since it contains low levels of cocaine, and can be refined into HIGH levels of cocaine, one might be wise not to bring it home.

That could make for some REALLY interesting conversation with the customs people!!! Good point on the difference between cocoa (chocolate) and coca (cocaine) :D

My husband does fly with the thermacell (domestically) but you're right - he might buy the butane at his destination. He also has the permethrin spray (he's a hunter, we live in the southeast, so....) It works nicely - lasts through a few washings. The mosquitoes love me, but my husband's problem is ticks, so he sprays socks & underwear a couple times a summer and it has really helped.

And yes, it's the Sawyers :D

We spray outside on non-windy days (and make sure no pets are around) and hang clothing to dry on clothesline.

YES! The Cocoa Leaf Tea is great! I saved my coke & water bottles and constantly refilled them from the giant teapot in the lobby of our hotel in Cuzco. Also, I bought the cocoa leaves at the airport. You put them under your tongue and feel wonderful. The little people come running up to your van as soon as you turn into the parking lot and sell a sandwich-sized bag for $1. Plenty enough to bring home and I shared with my friend. ;)

 

I did get a prescription from my doctor for pills to take starting the day before disembarkment from my Princess cruise and took them as prescribed. I love Machu Picchu, so magical. :D

You brought Coca leaves home?! What about agriculture inspection/declaration or drug enforcement? You do know Coca leaves have Cocaine in them?

My husband does fly with the thermacell (domestically) but you're right - he might buy the butane at his destination. He also has the permethrin spray (he's a hunter, we live in the southeast, so....) It works nicely - lasts through a few washings. The mosquitoes love me, but my husband's problem is ticks, so he sprays socks & underwear a couple times a summer and it has really helped.

 

OK, I'm from the Northeast, so help me out here: you use butane as a spray on your body and clothing? Isn't that dangerous. I was never good at chemistry but I do remember when I smoked I lit up with a butane fueled lighter. We have mosquitoes and ticks here too, but I've never heard of using butane as a repellent. And once we get past the human torch thing...how do you get it on a plane?

This might help make sense of why he might be buying butane...

http://www.thermacell.com/mosquito-repellent

Do please check the link before attempting any personal application of butane :)

This might help make sense of why he might be buying butane...

 

http://www.thermacell.com/mosquito-repellent

 

Do please check the link before attempting any personal application of butane :)

OK so you don't wear it, you place it nearby. I can see backyard usage, hunting, fishing, picnics, camping, etc. but why would you bring it on a river cruise?

OK so you don't wear it, you place it nearby. I can see backyard usage, hunting, fishing, picnics, camping, etc. but why would you bring it on a river cruise?

You don't. Did you read my post? I said it's very effective ( which is one of the topics of this thread) but NOT great for travel.

You don't. Did you read my post? I said it's very effective ( which is one of the topics of this thread) but NOT great for travel.

I did read that in your post, but that was when I was thinking you had this can of butane and your sprayed it all over yourself! What can I say, I failed chemistry and my only experience with butane was the cigarette lighter I use to use. :D

OK, no worries :-)

I'll summarize my bug recs - for those like me who are super attractive to biting insects:

Spray clothing with permethrin before travel

Bring repellent with as much DEET as you can tolerate.

I've even travelled with bed nets but presumably not necessary for a river cruise ;-)

Product links earlier in the thread.

Or, as my husband says, just bring me! Mosquitoes never bother him as they're too busy with me ;-)

When we went to Alaska the mosquito warnings were so dire ("they carry off small children!") that we bought Head Nets. These were very effective. Checking on Amazon I see one that claims to work on No-See-Ums -- this should be even more effective. You do look like a dork [and I have pictures to prove it] but they work!