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Current location: Chicago, IL

06.22.10

Price of beer in a bar: I swear it’s creeping up constantly in my neighborhood.  I’m going to go with $6.50 a pint.
Song currently stuck in my head: Black Tambourine by Beck off of Guero

The first time I left The Country was for a trip to Belize around 2003 (or something), and as part of my preparations I got a litany of vaccinations.  I had to go to a travel clinic, since my doctor didn’t really have access to any of these crippled diseases and I had to pay out of pocket since my medical insurance provider didn’t care if I died.  These things were not cheap but I still couldn’t resist.  They gave me a menu that looked startlingly like a list of drink specials; my subsequent indulgence was consistent with that motif.  I looked it over, diseases in the left column, prices on the right, and said “So I pay you… [finger pointing] this much money and you make it so I can NEVER DIE FROM… [finger pointing] THIS DISEASE?”.  It didn’t take much salesmanship.  I was making good money and spending it on not dying seemed like the way to go.  I bought:

2 rounds of Hepatitis A Vaccine
3 rounds of Hepatitis B Vaccine
1 injection of Typhoid Vaccine

There’s no vaccine for Hep C, so my dream of whiling away the afternoon doing speedballs with Tommy Lee will have to wait.  The Hep A and B vaccines appear to last a lifetime, though studies are still underway.  Right now the most they can say is they appear to last longer then 25 years.  The typhoid vaccine only lasts a couple of years (or something), so I had to boost that in 2007 when I opted for the longer lasting oral treatment.

I’d like to get a rabies vaccine this time around, because I love dogs, but it runs about US$900 and won’t prevent you from getting and dying of rabies (it only gives you more time to seek medical attention after exposure, but it’s still measured in days).  Why my cat can get a shot that prevents rabies is still a mystery to me, why it only costs $50 is somewhat less so.

Other major concerns are malaria and dengue.  Both of these diseases are transmitted by mosquitoes so avoiding getting bit (via repellent, nets, cooler climates) can help.  And really, with dengue that’s about all you can do as there is no further preventative regime.  There are plenty of anti-malarials out there though.  My favorite is doxycycline, which is nice and mild with few side effects.  They prescribe this stuff to kids with acne to clear up their complexion, but a lot of doctors are hesitant to prescribe it as an anti-malarial because it can increase your sensitivity to the sun.  Since malaria hangs out in warm sunny places this can be a rough intersection for some.  I’ve never had an issue though.

The worst anti-malarial, and really the worst drug of any kind, that I’ve ever used was larium (mefloquine).  I know people who have taken it and, on a subsequent and untreated occasion, gotten malaria.  They were quick to say the malaria was preferable.  I certainly can’t imagine it was any worse.

I’m not a doctor, but these people are, as are some readers on this list.  Please feel encouraged to reply to any outdated or misleading info I may have included or, better yet, post to the comments section on the blog.

Comments are enabled.

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3 Responses to “Current location: Chicago, IL”

  1. Mike Vendel Says:

    What is the efficacy of doxycycline? When traveling to Guyana I chose to not get vaccinated for malaria partly because of the horror stories I heard about the terrible malaria drugs but also because all of the drugs are not 100% effective at preventing malaria.
    It just didn’t seem worth it.

    Also, fyi, This American Life, has a great story about a guy who gets amnesia on a trip to India due to anti-malaria meds. Episode 399
    http://www.thisamericanlife.org/radio-archives/episode/399/Contents-Unknown?bypass=true

    • cgearhart Says:

      The phrase I keep running across is “very”, but I seldom see that quantified. Here’s a very small study that put it at 99% effective: http://www.annals.org/content/126/12/963.full.

      I heard that episode and initially thought “those sound like the side effects of larium”. I don’t remember if we caught the show in the car and I had missed the beginning or if they hold that info back for a while.

  2. scott Says:

    not to start trouble, but i always use mefloquine. found myself buying in bulk recently in new delhi. regardless of what you use, use something. as someone who has had malaria several times, its not worth risking. its a life changing experience if you run up against the wrong strain. protect yourself against this at any cost. i contracted cerebral malaria more than 18 months ago and i still feel the effects on a daily basis.


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