What Shots Do I Need In the Pilippines
May 12 '06
The Bottom Line Sure, this is a long list, but in the end it's up to you. So far I haven't had any ill effects of getting nothing beyond my Hep shots.
**Sorry to stick this here, but there's not listing for the Philippines under Health and Safety.**
I have a fascination with diseases. I’m also a tiny bit hypocondriacal. I appease my fascination and allay my fears at the same time by doing research. I’ve talked to doctors, read books and checked with the Centers for Disease Control. Doctors by their nature are cautious and the CDC can be positively fear mongering. There are times when looking at the CDC’s cautions that I want to crawl back in bed and never, ever leave. Unfortunately my bed is in Korea so I’ve got solid evidence that the CDC is being a hair overprotective. Still, everything in quotes here is directly from the CDC site with my comments following. Not surprisingly, some of my comments are the same for Korea so if you’ve read that essay, you’ll recognize one or 2 things.
1. "Hepatitis A or immune globulin (IG). Transmission of hepatitis A virus can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested in contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling."
One shot is good enough for coverage, the second shot six months after the first is a booster that gives permanent immunity unless you already have Hep C, or an impaired immune system. Hep A is actually not a huge threat though it can mean being fatigued and yellow for 6 months. You actually may have had it as a child because children don’t show symptoms and no one knows they have it until Mom or Dad gets sick after changing diapers. It doesn’t hurt to get the shot anyway (well, it does, but just for a second.) Side effects are fatigue, headache and a sore arm where you got the stick.
2. "Hepatitis B, especially if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11㪤 years who did not receive the series as infants."
Hep B has a death rate of about 1% according to the CDC but a 30%-90% chance of becoming chronic. It can also lead to things like cirrhosis and liver cancer, both of which end your drinking career and can kill you. You can have all three shots condensed into a 2-month period, but the FDA hasn’t approved it. However you do not need to start over again if you get shots 1 and 2 at home and then get a different brand for shot 3. If you’re really worried about getting the same brand, ask the nurse for the box. And as an added bonus you will be immune to Hep D. Check out the CDC site for more information or, if you can, find Dr. Melissa Palmer's Guide to Hepatitis & Liver Disease: What You Need to Know . If you plan on having sexual contact with anyone, pack condoms because Philippine condoms aren’t … um … big enough for the average Western male.
3. "Japanese encephalitis, if you plan to visit rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis."
Japanese Encephalitis is endemic (a permanent part of the landscape) and animals are reservoirs for the disease so an outbreak doesn’t have to be human. Unfortuntely, it’s really hard to stay out of rural Philippines because most of it is rural. Avon’s Skin So Soft is a great repellant. (You’ll want that anyway. Mosquitoes carry lots of nasty stuff.) This vaccination is also staggeringly expensive. I’ve heard quotes between $85US and $110US and that’s for each shot of the three shot series.
4. "Malaria: your risk of malaria may be high in some of the countries in this region. See your health care provider for a prescription antimalarial drug."
Malaria can be very ugly, but it can also be treated pretty easily and I've heard that the malaria drug is very expensive. The Aussie doctor is spoke to in the Philippines said not to worry too much about it. That combined with an acquaintance who’s gone to the Philippines twice a year for the past 5 years without trouble makes me pretty secure about not worrying.
5. "Rabies, if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities."
I didn’t actually witness any rabies type behavior, but I did see wild monkeys coming very close to cars and there are dogs roaming loose everywhere. You should probably avoid petting any animals, just to be safe. Just because you no longer have to get 13 shots to the stomach doesn’t mean you want to get treated for rabies in a 3rd world country.
6. "Typhoid, particularly if you are visiting developing countries in this region. Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors."
I went without Typhoid vaccination. The Korean doctor I spoke to said I was better off taking the risk and getting treated if I got sick. The vaccine makes you very sick and if you are careful you can minimize your risk. Bottled water, no ice, no food from street vendors (even if it looks really good), only eat salads or raw fruits from reputable restaurants.
7. "As needed, booster doses for tetanus-diphtheria and measles."
You need this stuff in the States so you shouldn’t be without it anyway. My husband got stung by a hornet in Ohio and his hand swelled up to double in size in about 6 hours.
8. "Yellow Fever. There is no risk for yellow fever in Southeast Asia. A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from countries in South America or sub-Saharan Africa. Food and Waterborne Diseases."
Just so you know.
9. Parting shots
"Avoid buying food or drink from street vendors, because it is relatively easy for such food to become contaminated."
"Make sure your food and drinking water are safe. Food and waterborne diseases are the primary cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout Southeast Asia and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage ( hepatitis)."
If you take Pepto Bismol or the generic equivalent for the length of your flight and the first day of your trip, you’ll save yourself a lot of suffering. I wouldn’t take it longer than that because it might mask a bigger problem and if you don’t go you’ll create a big problem.
"Do not swim in fresh water (except in well-chlorinated swimming pools) to avoid infection with schistosomiasis. Leptospirosis (leprosy), a bacterial infection often contracted through recreational water activities in contaminated water, such as kayaking, is common in tropical areas of this region. An outbreak was reported among expedition travelers in 2000."
While leprosy is probably not in your future I still wouldn’t swim in fresh water. I didn’t swim in the pool for heaven’s sake. No matter how attractive that hike to the Mt Pintubo crater that ends with a swim in the crater looks, don’t do it. Schistosomiasis is really hard to treat and no fun at all.
You need to start this stuff 6 months before you go to get in all the shots in the right stuff in the right schedule. Trust me when I tell you that the Philippines are really dirty and, unlike Korea, you are going to want to have all the protection you can get. A little planning and you’ll have a great trip.
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