Vaccination

[extensor_digiti_minimi]

Hi guys,

Does anyone know if it's necessary to get a malaria and Hapatitis A vaccine. I read from an accredited website that it's highly recommended to get the vaccines if we're going to Caribbean. Has anyone had these shots?

My other question is about water safety. Do you guys buy water, boil water, or just drink it from the tap.

Thanks,

edm

p.s. I'm a September student from Vancouver, B.C. Canada.

[wolfvgang22]

It's not necessary to take prophylaxis for malaria (there is no vaccine, if you've discovered one I would like to make you a business proposition :D). There are less mosquitoes here than in my Texas backyard.
You don't need a Hep. A vaccine for Saba.

Tap water is fine, but gives a few people the runs until they adjust. The water here is very soft rainwater collected in underground cisterns at each house/apartment/dorm that has guppies put in it to control the mosquito population. I filter my water with a PUR filtered pitcher.

The school sends you a form in your admissions packet that your health care provider fills out when you get the shots that you will need for clinicals, like Hep B. and other shots everyone else should be up to date on anyway. No big deal, you just have to get the shots before clinicals.
Oh yeah, no dengue fever, yellow fever, or what have you here either. There is a lot of AIDS down here from what I have heard from some locals.

[elliemd]

Hi W,
In your post, you mention there is "alot of AIDS down here."
I have no problems with HIV+ patients, however I wanted to know what you meant by that comment.
Is it something that we should be worried about. I know there is AIDS all over the world, does Saba have a higher incidence?
Thanks in advance,
E.

[swinginislanddoc]

Saba does not have a higher incidence of HIV than anywhere else. Don't worry.


I would actually recommend a HepA vaccine. You'll be going somewhere with different food, water etc. We actually had a hepatitis scare while I was on the island but all of the titers supposedly came back negative. I'm sure at that point in time some people were wishing they had gotten it. If it's available to you just get it - better to be safe.


~S

[rdecastro]

People, you should get vaccinations for anything you can. Not because of Saba, because you're going to be health care workers - and who knows what your patients are going to come in with?

And, do you want to risk getting sick in school?

Get Hep-A, Hep-B, Pneumovax, DPT, whatever.

[elliemd]

In regards to Hep A vaccine. I am a bit confused. I am a pathology major and I am certain that Hep A is curable, the patient only suffers from it for 2 weeks and they develop natural immunity. (by suffering I mean "runs")
In Canada there was an incidence where it was found that millions of health care dollars were being spent on vaccinations for patients which was not really necessary.
I don't understand why some people are suggesting a Hep A vaccine. Could someone please clarify. I also refer you to the CDC (Canadian Disease Control Center) website.
Cheerio, Ellie

[rdecastro]

In the US, Hep A vaccinations are required for children entering most schools.

While Hepatitis (all types) is rare in the US, those in close proximity to an infected individual (such as schools, prisons, etc) are likely to induce an epidemic. With HAV, this is rather distressing since it's spread via fecal-oral contact. Wash your hands after visiting the bathroom!

The disease course is typically 4-8 weeks and includes the typical jaundice, hepatomegaly, etc.

Vaccination is recommended for travel to the Caribbean (this is most likely more intended to lesser developed islands than Saba - but what if you take a little trip?)

The following vaccines may be recommended for your travel to The Caribbean. Discuss your travel plans and personal health with a health-care provider to determine which vaccines you will need.



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Hepatitis A (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=hav.htm) 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.
Hepatitis B (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=hbv.htm), 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 11–12 years who did not receive the series as infants.
Rabies (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=rabies.htm), 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.
Typhoid (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=typhoid.htm), 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
Yellow Fever (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=yellowfever.htm), for travelers to Trinidad and Tobago
As needed, booster doses for tetanus-diphtheria (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=dtp.htm) and measles (http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=measles.htm).



http://www.cdc.gov/travel/caribean.htm#vaccines

http://www.cdc.gov/ncidod/diseases/hepatitis/a/faqa.htm#gen

[extensor_digiti_minimi]

Hi there guys,

I'm glad I got so much response on this thread. I just wanted to add one thing here and it's that you can go to a travel doctor and ask him/her all your questions about vaccination. I got my appointment for aug 20th, a week before I leave off to Saba. I know Hep A vaccine comes in two doses: one now and the other one from 6 to 12 months from now. My family doctors says it's likely I can get my second shot in Saba, although I wasn't sure there is access to vaccination in Saba.

Anyways, for those of you who are not vaccinated I highly recommend it. I read and heard from multiple resources it's good to get the shot for travellers to Caribbean.

Needless to say it's a nasty liver disease with countless sequlea.

Another thing not so relavent is for everyone to bring along an umbrella :) It rains every now and then in Saba.

Cheers,

Extensor_digiti_minimi

[swinginislanddoc]

More important than an umbrella si a rain coat. In the high winds and umbrella doesn't do much good. :-D

When I got my Hep A several years back (trip to Romania) there was only one shot. When did they go to two?

[extensor_digiti_minimi]

I guess the vaccine has been coming in two shots ever since it was discovered :) But don't worry if you didn't get your second one. Ask your family doctor to write you a titre test to see your hep.A (anti surface antigen) antibody levels. Then based on that they decide or may make some adjustment on the dose concentration they give you.

Now a little unrelated question: for those of you who've lived in Saba, do you have easy access to do grocery shopping? how about fish, hamberger, chicken. If they are available, are they packed in Saba, St. Martin or the US? Also would someone give comment about food price? e.g. how much is a pack of fish, chicken, etc.

Cheers,



Extensor_digiti_minimi

[skandinavian]

Don't listen to all this balony. You don't need any vaccines before coming to Saba. I didn't get any and I turned out just fine. If you have a lot of money to burn or are just bored, I'd suggest getting a vaccine for bacterial meningitis as there was one sole case on Saba a few semesters ago.


The water is NOT ok. The locals themselves tell me to boil it. It's fine to wash your hair or brush your teeth or cook with however. Many students just buy a box filled with 1.5 liter bottled water to last a few weeks. It's only about 7 USD.

[rdecastro]

What an irresponsible posting. Especially from someone presumably becoming a physician.

Everyone, everywhere should be vaccinated for DPT and influenza. Most people, ESPECIALLY health care workers, should be vaccinated against Hep A and B.

And, everyone should be vaccinated against meningitis.

As it happens, I am also vaccinated against a number of other things, thanks to military service.

In the US, anyway, the vaccinations are not terribly expensive (if they're not on your insurance), you can get them at your local county health department. And the cost is far, far less than getting sick in school and not being 100% for classes, or a test.

[elliemd]

I thought it was bologna...but then I may be wrong, just like the rest of us are about vaccines.

ANYHOW, in regards to Hep A, spoke to doc yesterday, he said that you get initial shot, then you need a booster from 6-12 months after initial shot, in some cases not needed as the original shot provides a large titre.

Also a word of caution, most of you probably already now this..but doc also said be cautious of who you get vaccination from (make sure they're qualified). Example, some travel clinics charge ridiculous prices for vaccines that your doc can prescribe for you to get from pharmacy and then you take back to doc to get injected.

For example, looking on web of a particular Travel Clinic in Vancouver, they charge $50 CDN for a mosquito net, when I got a huge one at Canadian Tire for $20 CDN. My Hep A vaccine cost me $53- but it costs $90 at their clinic. Just do your research first.

Cheerio and see everyone in a bit!
Ellie

[wolfvgang22]

What an irresponsible posting. Especially from someone presumably becoming a physician.

Everyone, everywhere should be vaccinated for DPT and influenza. Most people, ESPECIALLY health care workers, should be vaccinated against Hep A and B.

And, everyone should be vaccinated against meningitis.

As it happens, I am also vaccinated against a number of other things, thanks to military service.

In the US, anyway, the vaccinations are not terribly expensive (if they're not on your insurance), you can get them at your local county health department. And the cost is far, far less than getting sick in school and not being 100% for classes, or a test.
I have to agree, it's better to be safe than sorry regarding vaccinations, especially since as physicians we'll probably get exposed to it all at one time or another.
I use a PUR filter on the tap water for drinking, it works well. I think bottled water tastes better, though it is more expensive over the long run.

*This post is not meant to treat or prevent any disease, including STD's. Should the effect of reading my post last more than 4 hours, please see a physician immediately.