Back in May Po and I dutifully went off to Jema Travel Clinic in St. John's to discuss what we needed for Madagascar. We found that I was still okay with the Twinrix (hepatitis A & B) injections I had received in 2011 for my trip to Botswana, but Po had to get hers. In addition we have received injections for typhoid, polio, and tetanus. This last week we drank our Dukoral which is supposed to protect us against travellers' diarrhea caused by E. coli. We were also prescribed an antibiotic to take just in case of bloody diarrhea. We hope not to be in the position of deciding if it is time to take them. I am also hoping that all mentions of diarrhea in this blog will end with this post, not later when one of us is suffering from it!
Those things were all kind of standard. But the clinic did suggest a couple of others which we declined. One was rabies. I thought about that one for several days and spent a long time on the Internet, but finally concluded that the odds were really against us getting exposed to it. Apparently there have been no known cases of lemurs giving anyone rabies. The other was the measles/mumps/rubella for which, based on our ages, we have natural immunity. Our family doctor had us get blood tests to confirm.
So we handled all the easy stuff, get the needles, deal with short term side effects and be done with it things. We now had to decide about malarial pills. All of Madagascar is considered malaria endemic, all year round. However, we are going to be travelling in the winter and 90% will be in the dryer part of the island. Still, the on line forums seemed to conclude that it was a good idea to take them.
I am thinking about how the above two paragraphs sound. I am taking my medical advice from on line forums! Well, of course I am, this is how things work now. But I did read the government sites and listened to medical professionals as well.
We had two kinds of malarial pills to choose from, doxycycline or Malarone. The former, as the name suggests, is actually an antibiotic. Doxycycline is cheaper but has more known side effects. So we have gone with Malarone. Thanks to Po's university health plan (she is in the doctoral program at Memorial) the costs were covered. Otherwise we would have been out several hundred dollars.