Road to Rangoon: Health Matters

My two trips to sub-Sahara Africa in the nineties introduced and initiated into the issues and practices for health maintenance and disease prevention while traveling abroad, and for a little over a decade I kept current a rather exotic shot record:

• yellow fever (feels like an injection of "sting juice"--perhaps a characteristic of a "live virus" shot)
• typhoid (makes the arm a bit sore for a day or two)
• hepatitis A
• hepatitis B
• hepatitis C (probably not necessary but I have it)
• polio booster

I also became more mindful of maintaining relevant not-so-exotic inoculations like these:

• tetanus-diptheria-pertussis
• flu

There are some others that often appear on the recommended list of shots before travel, but I have never had a doctor suggest them for me yet:

• rabies
• Japanese encephalitis
• measles-mumps-rubella
• chickenpox (However, I've had shingles twice--once on a trip in Thailand! My primary care doctor does intend to have me get the shingles vaccine as soon as I am old enough that my insurance will pay for it. Apparently, it is an expensive one.)

On the other hand, malaria and dengue fever--rather pervasive in many areas of interest to me in both Africa and Asia--have no preventive vaccines developed to date. Lamentably, where these two diseases are concerned, there is no easier/better living through chemistry yet.  Instead, one must employ due diligence to prevent mosquitoes from supping on one's blood--repellent, clothing choices, and mosquito nets. Granted, in the case of malaria, certain drugs used to treat the disease have proven effective in limiting one's susceptibility to the disease when taken in smaller doses as a preventive measure. The strain(s) of malaria in the area visited determines which drug(s) to take as a prophylactic. I have taken different drugs for malaria prevention, and my body rebels in some measure to all of them.  Nothing of too dire a nature as of yet--although that one doctor wanted me to take a pregnancy test after my return from my second trip to Africa because "all your symptoms indicate you're pregnant"--but malarial prophylactics and I share no bonhomie! In fact, I heave a major sigh of contentment when my research on a potential travel destination includes "little to no malaria risk" in the health information section.

And dengue fever? Yeah, well,...all due diligence is all there is!

For the last ten years or so, I have updated nothing on the shot record, regular flu shots and tetanus-diptheria-pertussis updates not withstanding. I think I have incurred only one prescription for malaria medication in that timeframe as well. Somehow I have kinda-sorta believed a trip to Myanmar could unfold without a hitch in my slide into first-world medical "slackdom." Yes, the travel literature for Myanmar strongly suggested a viable typhoid inoculation (necessary every three years) and urged a serious discussion with a travel doctor about the need for malaria medication. But, I argued with myself, I have friends who lived through a trip to Myanmar without any health preventatives at all except due diligence.  And I studied the map showing malaria risk in Myanmar. I studied it multiple times. Yangon and Mandalay showed no malaria risk. Yes! Both will be major stops on the travel itinerary. Yangon and Mandalay...and that is all of Myanmar that shows no risk.

My friend Tammy went to a travel doctor in Germany. I went to a travel doctor in Seoul. Now we each are freshly inoculated for typhoid, and we each are in possession of malaria medication. SIGH--and not of contentment--for the malaria medication.

But hey, Myanmar, we will come all healthy-like, and--best case scenario--we will remain all healthy-like!


ADDENDUM.  While perusing Myanmar travel sites online today, I read this:  "Myanmar has one of the highest incidences of death from snakebite in the world. Watch your step in brush, forest, and grasses." Alas, another SIGH! But I will not contemplate this factoid any further until such a time as I may tread in Myanmar's brush, forest, and grasses.