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Vaccinations for the Philippines

December 17, 2010 in Health Philippines

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A: Recommended for all travelers

Typhoid: For travelers who may eat or drink outside major restaurants and hotels

Yellow fever: Required for all travelers greater than one year of age arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.

Japanese encephalitis: For long-term (>1 month) travelers to rural areas or travelers who may engage in extensive unprotected outdoor activities in rural areas, especially after dusk

Hepatitis B: For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months

: For travelers who may have direct contact with animals and may not have access to medical care

Measles, mumps, rubella (MMR): Two doses recommended for all travelers born after 1956, if not previously given

Tetanus-diphtheria: Revaccination recommended every 10 years

Most cases of travelers’ diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.

If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

Insect protection measures are essential.

There is no malaria risk in metropolitan Manila and other urban areas. There is also thought be no malaria risk in the plains or at altitudes above 600 m.

For further information on malaria in the Philippines, go to the World Organization – Western Pacific Region (includes maps which show the risk of malaria in different parts of the country) and Roll Back Malaria.

Dengue fever, a flu-like illness sometimes complicated by hemorrhage or shock, is highly prevalent throughout the Philippines.

Dengue is transmitted by Aedes mosquitoes, which bite primarily in the daytime and favor densely populated areas, though they also inhabit rural environments. An unusually large number of cases was reported in 1998, possibly related to climatic changes due to El Nino. Fewer cases were reported in 1999 and 2000, but the numbers began to rise again in 2001. See the for details. No vaccine is available at this time. Insect protection measures are strongly advised, as below. For further information on dengue in the Philippines, go to the World Health Organization – Western Pacific Region.

(human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.

Traveling with children in he Philippines

December 17, 2010 in Travel with Children Philippines

: Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed (see the Embassy website).

All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).

When traveling with young children, be particularly careful about what you allow them to eat and drink (see precautions), because diarrhea can be especially dangerous in this age group and because the vaccines for A and typhoid fever, which are transmitted by contaminated food and water, are not approved for children under age two. Baby foods and cows’ milk may not be available in developing nations. Only commercially bottled milk with a printed expiration date should be used. Young children should be kept well-hydrated and protected from the sun at all times.

Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.

Health recommendations for Indonesia

December 12, 2010 in Health Indonesia

HEALTH RECOMMENDATIONS FOR

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A: Recommended for all travelers

Typhoid: For travelers who may eat or drink outside major restaurants and hotels

Polio: One-time booster recommended for any adult traveler who completed the childhood series but never had polio vaccine as an adult

Yellow fever: Required for all travelers greater than one year of age arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.

Japanese encephalitis: For long-term (>1 month) travelers to rural areas or travelers who may engage in extensive unprotected outdoor activities in rural areas, especially after dusk

Hepatitis B: For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months

Rabies: For travelers who may have direct contact with animals and may not have access to medical care

Measles, mumps, rubella (MMR): Two doses recommended for all travelers born after 1956, if not previously given

Tetanus-diphtheria: Revaccination recommended every 10 years

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Indonesia does not have a nationwide emergency phone number, such as “911″ in the United States. Many hospitals have their own ambulances, but staffing and equipment may not be comparable to that in Western nations and response time may be slow. The following hospitals offer ambulance service :

R.S. MMC Kuningan: call 527-3473
R.S. Medistra: call 521-0200
R.S. Pondok Indah: call 750-2322
R.S. Graha Medika: call 530-0887-9

Those staying in Indonesia for prolonged periods should identify private ambulance services in their area.

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Medical services are limited. Most expatriates go to either International SOS or Global Doctor, which offer 24-hour emergency as well as routine care. International SOS has locations in , Balikpapan, and Bali: JL Puri Sakti No. 10 Cipete, Selatan, , ph. 62 21 750 5980, 750 6001; PKT Office, Jalan Pupuk Raya 54, Balikpapan, ph. 62 542 765966; Pt. Abhaya Eka Astiti, Klinik SOS Medika, Jalan Bypass Ngurah Rai 505 X, Kuta 80361, Bali, Indonesia 80361, ph. 62 361 710 544. Global Doctor is located in South at Jl. Patimura 15 Kebayoran Baru, South ; ph. 021-723-1121. Only Indonesian doctors are allowed to treat patients in Indonesian medical facilities. However, International SOS has an expatriate consultant physician on the premises most of the time and Global Doctor offers telemedicine appointments with a consultant in Perth.

For a cardiac emergency, go to Pusat Jantung Nasional (National Cardiac Center) (Jl. Letjen S. Parman Kav. 87; Jakarta Barat; ph. 568-4085, 568-4093). If hospital admission is necessary for non-cardiac problems, options include R.S. MMC Kuningan (Jl. H.R. Rasuna Said Kav. C21, Kuningan, South Jakarta; ph.021 520-3435/45) and R.S. Medistra (Jl. Jend. Gatot Subroto Kav. 59, South Jakarta, ph. 021 5210200), both of which have 24-hour emergency rooms and their own ambulance services. However, most expatriates prefer to be transferred to a country with state-of-the-art medical facilities, usually Singapore or Australia, for serious medical problems.
For a guide to other physicians and health facilities in Indonesia, go to the U.S. Embassy website. Routine medical care is available in major cities, but not elsewhere. Many doctors and hospitals will expect payment in cash, regardless of whether you have insurance.

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There are many well-supplied pharmacies (“apotik”) in Indonesia, including a number of chains, such as Century Healthcare (website http://www.apotikcentury.com/), Guardian Pharmacies (based in Malaysia), and Apotik Melawai. Do not buy medications from street vendors.

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Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.

Because of a recent polio outbreak, all children traveling to Indonesis should be fully immunized against polio. All children should be up-to-date on routine childhood immunizations. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).
The recommendations for malaria prophylaxis are the same for young children as for adults, except that (1) dosages are lower; (2) Malarone is not recommended for children weighing less than 25 pounds; and (3) doxycycline should be avoided. DEET-containing insect repellents are not advised for children under age two, so it’s especially important to keep children in this age group well-covered to protect them from mosquito bites.

When traveling with young children, be particularly careful about what you allow them to eat and drink (see precautions), because diarrhea can be especially dangerous in this age group and because the vaccines for hepatitis A and typhoid fever, which are transmitted by contaminated , are not approved for children under age two. Baby foods and cows’ milk may not be available in developing nations. Only commercially bottled milk with a printed expiration date should be used. Young children should be kept well-hydrated and protected from the sun at all times.
Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.

are more likely after natural disasters. Never attempt to kill or handle a snake. In the event of a venomous snake bite, move the victim a safe distance from the snake and place him or her at rest, with the affected extremity immobilized and kept below the level of the heart. Remove constrictive clothing and jewelry. Apply a pressure bandage which does not impede blood flow. Avoid tourniquets, which are no longer recommended. Bring the victim immediately to the nearest medical facility for administration of antivenom and supportive care. To reduce the risk of snake bites, wear boots and long pants and avoid perfumes and cologne.
For further information, go to Indonesia earthquake – Advice for relief workers and other travelers to affected areas on the NATHNAC website.

All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.

Vaccinations for the Maldives

December 12, 2010 in Health Recommendations Maldives, Our Liveaboards, Vaccinations Maldives

VACCINATION INFORMATION FOR THE

Maldives:

A: Recommended for all travelers

Typhoid: Recommended for all travelers

Yellow fever: Required for all travelers arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.

Hepatitis B: For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months

: For travelers who may have direct contact with animals and may not have access to medical care

Measles, mumps, rubella: Two doses recommended for all travelers born after 1956, if not previously given

Tetanus-diphtheria: Revaccination recommended every 10 years

Polio vaccine is generally not recommended for any traveler who completed the recommended childhood immunizations, since polio has not been reported from the Maldives in recent years. A single dose of inactivated polio might be considered for extended travel to rural areas.

Cholera vaccine is not generally recommended, except for relief workers in tsunami-affected areas. Cholera is not being reported from the Maldives at this time

Yellow fever vaccine is required for all travelers arriving from a yellow-fever-infected country in Africa or the Americas, but is not recommended or required otherwise.

Go to the – South-East Asia Region for further information. All travelers should visit either their personal physician or a clinic 4-8 weeks before departure.

Manta Ray

Vaccinations for Thailand

December 10, 2010 in Health Thailand, Vaccinations Thailand

information for

: A vaccination: Recommended for all travelers

Typhoid vaccination: For travelers who may eat or drink outside major restaurants and hotels

Yellow fever vaccination: Required for all travelers greater than one year of age arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.

Japanese encephalitis vaccination: For long-term (>1 month) travelers to rural areas or travelers who may engage in extensive unprotected outdoor activities in rural areas, especially after dusk

Hepatitis B vaccination: For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months

vaccination: For travelers who may have direct contact with animals and may not have access to medical care

Measles, mumps, rubella (MMR) vaccination: Two doses recommended for all travelers born after 1956, if not previously given

Tetanus-diphtheria vaccination: Revaccination recommended every 10 years

All travelers should visit either their personal physician or a clinic 4-8 weeks before departure.