The Vaccination Fascination: Diseases, sickness, and bugs.

High in the priorities of any backpacker should be protection against nasty travel bugs that may try and bring your trip to an abrupt halt. If you’re visiting developing countries on your trip, it is likely that hygiene and medicine are not as advanced as they are in European, American, and other ‘westernised’ nations. This is a comprehensive companion guide to The Vaccination Fascination which will detail what travel bugs to look out for, including Malaria, Yellow Fever, and Dengue Fever; where they live; what they do to you; and how you can protect yourself against them.

What do you need to look out for?

DIPHTHERIA, POLIO, AND TETANUS:

  • What is Diphtheria? Diphtheria is a potentially fatal, contagious bacterial infection which can result in a thick, grey-white coating of the throat, a sore throat, and breathing difficulties.
  • How? It is caught by human contact with infected items or persons . 
  • What is Polio? Polio is a serious viral infection for which there is no cure. Symptoms include high fever, muscle pains, stomach pains, and a sore throat, and can lead to paralysis and death. Thankfully no-one in the UK has caught this virus since 1985 but there is still the chance you could bring it home with you.
  • How? Transmission is via bodily fluid; sneezing, coughing, in faeces.
  • What is Tetanus? Tetanus is a bacterial infection which attacks the nervous system and can result in muscle spasms and tachycardia (a fast heartbeat). If left untreated  it can result in suffocation as the lungs are unable to function.
  • How? It is caught by bacteria getting into an open wound, especially a deep one. 
  • Protection: In the UK, we are all vaccinated against these three illnesses at birth and by two boosters in adolescence. This has been the case since the mid-1950s so it is unlikely that you will need to have extra vaccinations against these unless you missed your booster at school. 

Recommendation: If you haven’t had the vaccine then get it

CHOLERA

  • What? Cholera is another potentially fatal disease which infects the lower intestine causing vomiting and diarrhea. In serious cases this leads to severe dehydration and shock. 
  • Where? Similar to Diphtheria and Typhoid, Cholera is most widespread in countries with poor sanitation such as sub-Saharan Africa, South and South East Asia, the Middle East and some parts of Central and South America. 
  • How? It is transmitted by contact with the stools of infected persons; usually either in food or water. There hasn’t been a case of Cholera in the UK for over 100 years but occasionally travellers have brought it back. 
  • Protection: 
    • Always wash your hands with hot water and soap. If clean hot water is not available, use high-strength hand sanitiser until you find hot water. 
    • Avoid using water directly from a source; including drinking tap water or unsealed bottled water, cleaning your teeth/washing food with unpurified water, or eating ice cream or having ice in your drinks. 
    • Consider buying chlorine dioxide tablets or other purification tools such as the STERIpen or Sawyer Mini, to cleanse water you are not sure about.
    • Ask your GP for an oral vaccination; a drink that is usually taken in two doses and increases resistance by 85% in the following months. 

Recommendation: Unless you are going to be involved in medical work, or are visiting regions where Cholera is widespread, I wouldn’t bother. If you maintain good sanitation practices, Cholera is easily preventable. If you do catch it, a simple sachet of Dioralyte will keep you hydrated until the disease is out of your system. 

TYPHOID

  • What? Typhoid is another infectious bacterial fever which can cause red spots to appear all over your torso, as well as severe stomach pains. 
  • Where? Similarly to Cholera, Typhoid is not geographically based and can occur anywhere with poor sanitation. 
  • How? Typhoid is extremely uncommon in areas with developed sanitation and hygiene facilities. Most cases in the UK have been caught in countries where hygiene is less comprehensive. 
  • Protection:
    • Take the same steps as you would to avoid other diseases transmitted by poor sanitation. 
    • Consider getting a free vaccination on the NHS. For non-UK residents, it can also be obtained privately for around £30. 

Recommendation: We suggest that you get this vaccination, it is free on the NHS and pretty cheap privately. 

TUBERCULOSIS

  • What? Known as ‘consumption’ in the old days, it is a bacterial infection that mainly affects the lungs resulting in a persistent cough, and a high temperature amongst other symptoms.  
  • Where? Like many listed here, it is not geographically exclusive but is more likely to occur in close quarters where healthcare and sanitation is not particularly developed. 
  • How? Through coughing and sneezing. 
  • Protection:
    • The routine BCG vaccination for teenagers was discontinued in 2005 and as such, many people in their 20s will not have had it. Visit your GP and discuss whether you need a vaccination for it. 

Recommendation: If you missed out in school, you may want to consider getting it but the risks are pretty small.

HEPATITIS A

  • What? A liver infection which can cause the following symptoms: yellowing of the skin and eyes, tiredness, loss of appetite, muscle and joint pain, pain in the upper-right part of your tummy, dark urine and pale stools. 
  • Where? Not geographically exclusive but countries with lower sanitation regulations tend to be more at risk.
  • How? Contracted by contact with stools of an infected person; travellers in regions with poor sanitation, intravenous drug users, and men who have sex with men. 
  • Protection
    • A free vaccination is available on the NHS, which is sometimes combined with the Typhoid vaccine, provided to people at risk including travellers. 

Recommendation: Although Hepatitis A is unpleasant, it is usually not fatal and can even be treated at home. Despite this, the vaccination is free and you don’t want to be feeling fatigued on your amazing trip. 

HEPATITIS B

  • What? A liver infection which is often symptomless and can pass through your body without you even realising you had it. Children are more at risk of developing symptoms and chronic Hep B which is more serious. 
  • Where? Not geographically exclusive but countries with lower sanitation regulations tend to be more at risk. 

 

  • How? Contracted by contact with the bodily fluids or blood of an infected person. The risks to travellers come from needles, eg drug taking or tattoos with unsanitised equipment, unprotected sex with an infected person, or for those working in medical facilities where contact with infected persons may be required. 
  • Protection: 
    • Getting vaccinated against Hepatitis B is possible but incurs a cost, and quite a substantial one at that. It comes in three doses over three to six months. The NHS does not provide routine vaccinations, so those seeking it for travel reasons will have to pay around £40 per dose. 

Recommendation: Neither Katherine have had this vaccination as we do not consider ourselves to be particularly at risk and nor do our GPs. Only 5% of adults with the virus develop chronic symptoms anyway.

JAPANESE ENCEPHALITIS

  • What? It is a particularly nasty viral brain infection which can cause seizures, muscle spasms and paralysis, and eventual death. 
  • Where? Despite its name, it is not exclusive to Japan and can be found throughout South-East Asia, the Far East and the Pacific Islands. It is rare for a traveller to get it and there hasn’t been a case reported in the UK for 10 years. 
  • How? JE is active in pigs and birds and is passed to mosquitoes when they bite them. Our old mate the Mosquito then passes it to humans. It cannot be passed from human to human. 
  • Protection: 
    • Usual protection against mosquitoes and other biting insects; use DEET repellent spray, wear long sleeves and trousers, and sleep under a mosquito net.
    • A private vaccine which costs around £170 altogether.

Recommendation: Don’t bother! The vaccine is very expensive and it is unlikely that you will ever catch it anyway. Perhaps consider it if planning to hike or camp in areas where it exists

TICK-BORNE ENCEPHALITIS

  • What? A viral infection which has two stages: firstly, flu-like symptoms, and secondly, a far more serious infection of the brain and spinal cord that requires hospital treatment. Only 9 cases were reported in 2013/2014 (the latest available results) and only 1 in 100 cases is fatal.
  • Where? In central, eastern, and northern Europe, and across Russia to parts of central Asia. 
  • How? A bite from an infected tick who’s saliva carries an anaesthetic to prevent you feeling it. These ticks live in grass and woodland in the infected regions. 
  • Protection:
    • Usual measures to [revent against insect bites
    • Wear long clothes if in grassy areas
    • A private vaccine called TicoVac which can be given in an accelerated schedule over two weeks. 

Recommendation: Don’t bother! Again, the vaccine is expensive and unless you’re in the affected regions, it is unlikely that you will ever catch it anyway. 

MENINGITIS

  • What? A serious infection of the protective lining around the brain which exists in six forms; A, B, C, W, X, and Y. The symptoms include: sudden onset of fever, intense headache, neck stiffness, nausea, and vomiting and can occur just hours after contracting the virus. Meningococcal disease incurs high mortality rates and should be protected against. 
  • Where? The regions below are at high-risk of chronic meningitis, particularly during the dry season. It is more common in adolescent and young people, particularly those in closed groups; e.g., military personnel, and students in halls of residence.
  • How? Exclusively via human contact; coughing, sneezing, and kissing for example. 
  • Protection:
    • A combined vaccine for four strands, A, C, W, and Y called Nimenrix or Menveo, is usually offered by your GP as these are the most commonly caught types. Katherine and I have both had this vaccination as we considered it important to both travel and home lifestyles.

Recommendation: 100% without question. Meningitis can be caught anywhere and is each type is potent and potentially fatal. If you catch it on your travels, you will be coming home very quickly.

RABIES

  • What? A very serious viral infection that quickly affects the brain and is nearly always fatal if not vaccinated against. 
  • Where? The biggest risk is in sub-Saharan Africa, Asia, and the north of South America. 
  • How? It is passed to humans via a bite from an infected animal, usually a dog. Other animals, such as bats, raccoons, and foxes can also carry the virus. 
  • Protection:
    • A vaccination will buy you more time to be treated after you’ve been bitten, but you will need another vaccination to stop the spread of the disease.
    • Avoid dogs and animals that may carry the disease. 

Recommendation: I have been vaccinated, Katherine has not. It is expensive and if you are unlikely to be around animals, it may not be worth it. Remember though that it can save your life if bitten; Rabies is extremely potent. 

YELLOW FEVER:

  • What? A serious viral infection with symptoms including: severe muscle and joint pain, jaundice, and nausea and vomiting, culminating in death for up to 60% of those infected. 
  • Where? Exclusively in parts of sub-Saharan Africa, Central and South America, and the Caribbean.
  • How? It is spread by our friend the mosquito, usually during daylight hours, and cannot be passed via human contact. 
  • Protection:
    • If there is any risk of you contracting this virus, get a Yellow Fever vaccination from your GP or privately if your GP does not provide it. It is usually around £50 and is taken in one hit. 

Recommendation: Many infected countries, such as Ghana, and others seeking to protect its citizens, require you to present a certificate upon entry to the country. We both have had this vaccination and recommend you do too. 

DENGUE FEVER

  • What? A viral infection which causes unpleasant symptoms such as an extremely high temperature, bone, muscle, and joint pain, and pain behind the eyes. Serious complications are not common but fatalities have been noted. 
  • Where? It is usually found in tropical and sub-tropical climates with high urban populations.
  • How? It is spread by the Aedes aegypti mosquito which an infected person and then spreads the disease around. 
  • Protection:
    • As yet, there is no vaccination available. Mexico licensed the first vaccine in December 2015 but it is not available in the UK. 
    • As a consequence, protect yourself as you would from any biting insect: wear long sleeves, strong insect repellent, and use mosquito nets in bed.
  • Recommendation: There is no vaccination and as such we cannot recommend anything to you except to see a doctor if you develop a feverish illness in any affected countries. 

MALARIA

  • What? One of the most famous travel bugs, and for good reason. If undetected or left untreated it can be fatal. Initial symptoms are flu-like and can develop up to 7 days after the offending bite. However, in some cases it can take up to a year to develop, so if you experience these kind of symptoms after your return from an infected area, you should see your GP. Other symptoms include, fatigue, muscle pain, and diarrhoea. 
  • Where? It is found in more than 100 countries across the world. Mainly tropical climates where mosquitoes tend to be more numerous. 
  • How? The bite of a female anopheles Mosquito which tends to bite at night time. 
  • Protection:
    • By far the best method of protection is by taking preventative Prophylaxis (anti-malarials). You must visit your GP or a qualified nurse to discuss which ones would be best for you. Some varieties do not work very well in some regions. Visit Fit For Travel to see which destinations require which type of anti-malarial, and how widespread the disease is.
    • Other preventative measures include wearing long-sleeved tops and clothes that cover up your skin, as well as the other bite-preventing measures taken for other potential travel bugs you may catch.
  • Recommendation: We are not going to be taking anti-malarials for most of the trip but we do have just over a months worth for Laos and Cambodia as we are travelling via bus through affected areas. Visit your GP to discuss what you need and make sure you read up on where you are going! 

What vaccinations have we taken?

Katherine and I have different protection as we’ve been on different trips in the past. We are both protected against Yellow Fever, Diphtheria, Polio, Tetanus, Typhoid, and Malaria. I have protection against Rabies, Meningitis A, C, W, and Y, and Hepatitis A and B but that was for a previous trip to Ghana. We have carefully considered the others and decided that the risks of catching either Japanese or Tick-borne Encephalitis are not great enough to be worth the cost. Tuberculosis is similarly not common enough to warrant a vaccination, and Cholera is easily avoidable, and easily treatable. 

Your experiences and anxieties may be different and we’d love to hear from you if you’re planning to a trip. What are you worried about?

 

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WhenTwoWander

We're Sam and Katherine, a young British couple on the trip of a lifetime. We've navigated South East Asia on a tight budget, and we're currently based in Melbourne, Australia. South America is next on the list! Our story is a sign of the times - we met on Twitter! We've been a couple for three years now, but we're still learning about each other.
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4 thoughts on “The Vaccination Fascination: Diseases, sickness, and bugs.

  1. Jaynie Wall Reply

    Great post! I have one to add to your list.
    My husband caught the Chikungunya Virus while we were in El Salvador. It’s transmitted by mosquito, and it took him months to feel back to normal again.
    It’s good to be aware of all the ricks out there!

    • WhenTwoWander Post authorReply

      Wow that sounds awful. I can’t say I have heard of that one, it’s not one the doctor usually recommends. I will have to do some research!

      I hope your husband has fully recovered now.
      Thanks for your comment Jaynie.

      WTW

  2. gobeyondbounds Reply

    Great Post! We all have a travel bug which wants us to travel and explore every part of the world but little do we worry about our health. At the most we carry a first aid. This post is very informative and every traveller should take it seriously! Thanks for sharing.

  3. Pingback: Where do I get vaccinations? - WhenTwoWander

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