Hey /trv/ let's talk about Japanese Encephalitis. I'm planning a trip across Western Europe (2 wk), Eastern Europe (2 wk), Japan (3 wk), South Korea (1 wk), China (7 wk), Vietnam (2 wk), Thailand (2 wk), Laos (1 wk) and Cambodia (1 wk) from July 1st until December 20th of this year. I finished all my other vaccines today, but this JE vaccine has been a thorn in my side, and wanted to know what others have done. People seem to fall about 20% in favor of being vaccinated and the other 80% do without. My doctor said it wasn't necessary, as well as most people online, but CDC advises it for trips more than 1 month in length.
To make the thread more interesting, vaccine/medication/getting sick while traveling general thread. For this trip I'm taking antibiotics, malaria pills (Malarone), and am vaccinated for: Hep A, B, Typhoid, Polio, MMR, Chickenpox, Flu and diphtheria-tetanus-pertussis.
Above poster is right that the risk of JE is almost vanishingly small. But the disease does still exist in rural Southeast Asia, and it has a roughly 25% fatality rate. So you almost certainly won't get it. But if you are profoundly unlucky and DO get it, you have a one in four chance of dying from it.
>Lived in Southeast Asia for eight years as a teen and 20something
>Had almost none of the recommended vacs
>Never got sick
>Got job as grownup requiring me to spend 6mo/yr in the region
>Had health insurance
>Got the shots.
You will probably be fine. But if you're not, it will suck. If you can afford it, I see no reason not to do it.
Honestly, since there is a vaccine, I'd get it. There isn't much treatment they do for encephalitis (whatever the cause), and high likelihood of dying. I'd consider 25% damn high. In my locality (Miami), people die from this all the time throughout the year from basic viral encephalitis. They even go to the E.R., get sent home, and die in a few hours. It's just that insane, probably witness about 3 deaths every few months, like kids in high schools. Yet, at the same time, as a Florida native, I don't get bitten by a bug but every couple of years. I simply avoid the dawn/dusk stuff, my house is screened and A/C'd anyway, and I avoid the pool if they're biting.
Mosquitos are attracted to sweat and specifically dried sweat on a person, not some mystery anymore why they like some people and its not their special blood, last I read. So will you be able to gtfo out of the way of mosquitos the moment you k realize they're around? Will you be contained indoors and control them on you? Will you wear repellant, dress suitably?
I don't like unnecessary drugs, but I wouldn't knock a CDC guideline. Glad you got the Hep A. That's key. I'd also wear a mask on the plane (or have a scarf or something handy) if you have a cougher nearby. I pull up a scarf a bit like I'm cold when I go to sleep.
I when to a travel specialist doc before my year off (of which 6 months were in S or SE Asia) and he said absolutely get rabies and JE. You're unlikely to get either of the diseases but if you do then they're extremely serious. to save money though, he recommended getting the vaccinations in India. Instead of paying $450 I ended up paying less than $100. Checked my vaccination status when I got home and I was fully protected.
IIRC the JE vaccination I got in India was actually invented in China where they use a much simpler method of manufacturing. My doc said the research shows it's pretty much as safe and almost as effective as the Western vaccine and he expected it to gain certification here once they worked through the bureaucracy. If you went to one of the bigger hospitals in Beijing or Shanghai I reckon that'd be a cheap and effective way of getting protected.
When you say you're taking antibiotics please tell me you mean you're just going to be carrying them with you, not that you're going to be downing antibiotics as a preventative.
Taking prophylactic antibiotics is a terrible idea and not something any competent doctor would recommend. I assume it would be an attempt to avoid getting traveller's diarrhea but the fact is, you're more likely to experience GI disturbances as a side-effect of antibiotics than you are from local food (at least if you're sensible about what food you eat). And if you're unlucky then you might experience some of the more serious antibiotics side-effects such as pseudomembranous colitis or oral thrush.
>I say this as a practicing doctor myself
Other meds I'd recommend bringing are loperamide and metaclopramide to deal with any vomiting or diarrhea, ideally you don't want to take them so your body can flush out the pathogens but they're definitely worth it if you're sick before a long flight or bus journey.
OP here, thanks for the input everyone, I really appreciate it.
>Yay for brain damage.
This is definitely my main concern with skipping out on JE. Not to sound morbid, but if it were a matter of either 'death or unscathed', I would be a lot less worried. The idea of having brain damage scares me as much as losing my sight or ability to use my legs.
>When you say you're taking antibiotics please tell me you mean you're just going to be carrying them with you, not that you're going to be downing antibiotics as a preventative.
Absolutely the former. I was given a prescription for only two doses of both Azithromycin and Ciprofloxacin. Doc basically said, if diarrhea gets so bad you can't leave the toilet, take a dose of whatever is appropriate for the region.
Getting JE in another area is a great idea. I'll be in China for 7 weeks so that could definitely work. Right now I'm looking at a total cost of $678 for the two doses. I'm in the midwestern US. What's the cheapest anyone has paid for their JE vaccine? You mentioned $450, what region would that have been?
what if i got hit by a meteorite?
chances are so fucking low that if that kills me, fuck it.
im not spending, what was it, $800? around $1500? they wanted to charge me? for meteor-insuran---err, some peace of mind pri---ah, "important encephalitis vaccine"
Will you be working in rice fields? Will you be working with farm animals? Do you plan on fucking farm animals?
If you answered no to all of these, then you should be fine without JE vaccine. I do rice research, I have it.
With that said, it won't hurt to get the vaccine, especially if most of the cost are covered by insurance.
>The idea of having brain damage scares me as much as losing my sight or ability to use my legs.
that moment when OP realises brain damage can cause loss of sight and/or effect ones ability to use their legs.
$450 was the cost to get my JE and rabies vaccinations in Australia.
The cost for the full courses of JE and rabies vaccinations in India was <$100. I expect China would be just as cheap.