Immunizations and Disease Prevention

From Geoffrey: I don't think I have a Japanese B Encephalitis.  I have a rabies because I was bit by a dog.  My son was bit by a cat recently so he has that too.  I think typhoid comes from bad water, like after a flood everything gets contaminated, or from rainwater from a roof that hasn't been let to wash off sufficiently before collection. So, the only one that I think would be of any use would be the Japanese B Encephalitis.

I think the best malaria prophlactics are mosquito repellent and a mosquito net.  But we really don't have any malaria right here were I live (or anywhere I've been in Thailand).  Besides, malaria mutates rapidly so the prophylactics need to be constantly changed.  The real danger is from Dengue fever which is on the rise.  And there is no vacine for that.  You'll be in South East Asia during the rainy season. If you do some traveling into rural areas of neighboring countries it wouldn't hurt to take anti-malarials.

Piyashat Boonpha, a pharmacist in Phen District, writes:

1. Japanese Encephalitis

For persons over 3 years of age, the recommended primary immunization series is two 0.5 ml doses given at 0 and 7-14 day. If over 60 yrs and who will go into endemic areas where the disease is considered a public health concern, have to be extended one more dose, after 1st and 2nd dose for 1 month. = 0.5 ml x 3 doses x 100 Baht = 300 baht.
Note :
For children 1 - 3 years of age reduce to 0.25 ml
A booster dose should be at least every 3 years after the primary immunization series.

[Justin Baker adds: I'd like to get the Japanese Encephalitis vaccine once I arrive in Thailand. My only concern is how the vaccine will take to become effective. Take a look at this, from the CDC web site:

The last dose should be administered at least 10 days before the commencement of travel to ensure an adequate immune response and access to medical care in the event of delayed adverse reactions.

The CDC article says the risk is low]

2. Typhoid

prophylaxis drug not recommended, just take medication when you have symptoms. (Thyphoid is not fatal). There are typhoid vaccines, but none of these vaccines are available in Udon.

3. Rabies vaccine

347.5 x 3 dose =....Baht (price at Phen Hospital)
 For pre-exposure immunization
Primary-vaccination : according to the WHO recommendations
3 x 0.5 ml injections by the intramuscular route on days D0, D7, D21 or D28, followed by a booster one year later.
Boosters : thereafter, one injection every 5 years or whenever the titre is found to be less than 0.5 IU/ml.

4. Malaria

I asked hospitals in Udon (ah..hospitals can speak?), no injection.
There is Doxycycline at the Phen District Hospital. (0.5 B/ cap)

Health Care Access

Ban Nikom Health Center

2 kms from CVBT

Phen District Hospital

15 kms from CVBT

Udon Thani Provincial Hospital (map; and other hospitals in Udon)

33 kms from CVBT

Aek Udon Hospital

34 kms from CVBT

Wattana Group Hospital

33 kms from CVBT