Travel health

Because I had a previous encounter with a travel immunization clinic in Tacoma, WA before I went to Israel and Ukraine in September of 2010, I looked for one in this area to help us get prepared to have a healthy trip.  Although there are several other clinics in the valley, we chose to make an appointment with the Salt Lake County Health Department International Travel Clinic.  It's located at the Salt Lake County Government Center at 2001 S. State St. Suite S2-400.

When I made the appointment, we decided it would be better to email a copy of our itinerary rather than try to tell them over the phone the names of the 30+ countries we will be visiting.  Doing so allowed the nurse who helped us compile a 35 page report of all the health risks present in those countries.

The first listing is for Yellow Fever.  Panama is listed as a Transmission Risk (but fortunately not the canal zone) and other countries have restrictions on travelers who have visited Panama.  Just to be on the safe side, he filled out an International Certificate of Vaccination or Prophylaxis form approved by the World Heath Organization (and appropriately yellow in color) noting that because we are >60 years of age, the vaccination requirement is waived.

The list went on from there through Hepatitis A & B, Typhoid Fever, Polio, Rabies, Japanese encephalitis, Cholera, and Malaria.  Then on to additional concerns about Traveler's diarrhea, Dengue, Chikungunya (that was one I hadn't heard of--it's a mosquito borne virus that causes headache, fever, and joint pain), Zika, Tuberculosis, Schistosomiasis, Avian influenza, Leishmaniasis, Air pollution, and Brucellosis.  Most of these illnesses are of concern in Egypt, India, Guatemala, Panama, and Cambodia. Beware of being bitten by monkeys in India--they pose a risk for transmitting rabies and Hepatitis B.

In addition to the lists of countries at various risk levels for these diseases, the report had comprehensive information of value to travelers, including Medical Care, Consular Advice, Terrorism Risk, Crime, Civil Unrest, Water Safety, Natural Disasters, and Cross-Cultural Considerations.

All this being noted, we will be in each port on a heavily vetted excursion with local guides and Viking crew members shepherding us along proscribed routes.  I realize we are at a very low risk of contracting much more than a cold from a fellow traveler, but it's always better to be safe than sorry.

The bottom line for us consisted of Hepatitis A, Tdap, and Shingles shots, with David getting one more for pneumococcal  pneumonia because he is over 65.  We opted to take the Typhoid pills (four of them taken every other day) instead of yet another shot.  We got prescriptions for Malarone, an anti-Malarial medication that should be taken the day before entering an endemic area, each day in that area, and 7 days after (side-affects include really bad dreams, yikes!),  and Azithromycin to treat Travelers Diarrhea.  I got a prescription for the Scopolamine patch to treat sea-sickness, if the sea-bands, Dramamine, or Bonine don't work.  David has more problems with motion-sickness than I do, but he didn't want the patch.

One more piece of information to pass on regarding maintaining health on an extended trip--our health insurance company has a provision  for a vacation override which allowed us to get enough of our maintenance prescriptions to last for the duration.  I called the insurance company and they called the pharmacy with a code.  It was that easy!