Bobby

I'm about to go on a safari in Kenya (actually a dual sight trip - one week
safari and one week beach).

Can anyone advise me what injections (or other means of inoculation) I need
before I go?

Cheers.

Bobby

Liz

In message <[email protected]>
"Bobby" <[email protected]> wrote:

    > I'm about to go on a safari in Kenya (actually a dual sight trip - one week
    > safari and one week beach).
    >
    > Can anyone advise me what injections (or other means of inoculation) I need
    > before I go?

Your best bet is to go to a doctor/travel nurse/travel clinic for
information which will take your personal medical history into
consideration. Don't even think about going without taking malaria tablets
at the very least.

Safari njema and slainte mhath

Liz


--
Virtual Liz now at http://www.v-liz.com
Kenya; Tanzania; Namibia; India; Seychelles; Galapagos
"I speak of Africa and golden joys"

Not the Karl Orff

In article <[email protected]>, "Bobby" <[email protected]>
wrote:

    > I'm about to go on a safari in Kenya (actually a dual sight trip - one week
    > safari and one week beach).
    >
    > Can anyone advise me what injections (or other means of inoculation) I need
    > before I go?

for _injections_, at least a tetanus update. I got hep A (b advisable
too), typhoid (though that can be oral as I took), yellow fever.

Claudel

In article <[email protected]>,
Not the Karl Orff <[email protected]> wrote:
    >In article <[email protected]>, "Bobby" <[email protected]>
    >wrote:
    >> I'm about to go on a safari in Kenya (actually a dual sight trip - one week
    >> safari and one week beach).
    >>
    >> Can anyone advise me what injections (or other means of inoculation) I need
    >> before I go?
    >for _injections_, at least a tetanus update. I got hep A (b advisable
    >too), typhoid (though that can be oral as I took), yellow fever.

http://www.cdc.gov/travel/


Claude

Justin Miles

Definetely you require a valid yellow fever certifcate

Cheers
Justin Miles


"claudel" <[email protected]> wrote in message
news:[email protected]...
    > In article <[email protected]>,
    > Not the Karl Orff <[email protected]> wrote:
    > >In article <[email protected]>, "Bobby" <[email protected]>
    > >wrote:
    > >
    > >> I'm about to go on a safari in Kenya (actually a dual sight trip - one
week
    > >> safari and one week beach).
    > >>
    > >> Can anyone advise me what injections (or other means of inoculation) I
need
    > >> before I go?
    > >
    > >for _injections_, at least a tetanus update. I got hep A (b advisable
    > >too), typhoid (though that can be oral as I took), yellow fever.
    > http://www.cdc.gov/travel/
    > Claude

Hans-Georg Michna

On Wed, 01 Dec 2004 01:30:08 GMT, [email protected]
(claudel) wrote:

    >http://www.cdc.gov/travel/

Claude,

good web site, but of course it issues blanket recommendations.

A tourist spending only a few weeks in selected areas doesn't
need most of them. They are also not required.

The big exception is malaria.

Hans-Georg

--
No mail, please.

Hans-Georg Michna

On Wed, 1 Dec 2004 11:14:00 +0200, "Justin Miles"
<[email protected]> wrote:

    >Definetely you require a valid yellow fever certifcate

Justin,

you definitely do not need any yellow fever certificate when you
visit Kenya.

Hans-Georg

--
No mail, please.

Claudel

In article <[email protected]>,
Hans-Georg Michna <[email protected]> wrote:
    >On Wed, 01 Dec 2004 01:30:08 GMT, [email protected]
    >(claudel) wrote:
    >>http://www.cdc.gov/travel/
    >Claude,
    >good web site, but of course it issues blanket recommendations.
    >A tourist spending only a few weeks in selected areas doesn't
    >need most of them. They are also not required.
    >The big exception is malaria.

Perhaps some of the immunizations are not required, but
personally I'd rather get an extra shot or two and not
be one of those on the sad end of the statistics...


Claude

Hans-Georg Michna

On Wed, 01 Dec 2004 17:42:40 GMT, [email protected]
(claudel) wrote:

    >In article <[email protected]>,
    >Hans-Georg Michna <[email protected]> wrote:

    >>On Wed, 01 Dec 2004 01:30:08 GMT, [email protected]
    >>(claudel) wrote:

    >>>http://www.cdc.gov/travel/

    >>good web site, but of course it issues blanket recommendations.
    >>A tourist spending only a few weeks in selected areas doesn't
    >>need most of them. They are also not required.
    >>The big exception is malaria.

    >Perhaps some of the immunizations are not required, but
    >personally I'd rather get an extra shot or two and not
    >be one of those on the sad end of the statistics...

Claude,

if only it were that simple. The problem is that the injection
has its own side effects. A few people die from inoculations.
Taking a few extra shots doesn't necessarily put you on the safe
side. Also, they cost money that you could spend on other things
that increase your likely lifespan.

Another problem is a mathematical one. It is always difficult to
treat very small risks properly, and people tend to be unable to
deal with them (so they play the lottery, for example).

To give an example, you pay money for a shot that decreases your
one-in-a-billion chance to die from yellow fever during your
two-week vacation. Then you cross the street in Nairobi and
incur a one-in-a-million (a thousand times higher) risk to get
run over by a car (particularly because the cars come from the
wrong side, but that's another matter). If you spent that same
money on a local guide, it might be vastly more effective in
decreasing your total small risk of premature death.

Even spending the same amount of money on reducing the residual
malaria risk further may be more efficient, for example by
selecting and buying the most efficient insect repellant (which
would reduce your yellow fever risk at the same time, by the
way).

In short, the yellow fever shot may not be the most
cost-efficient way to prolong your life.

I will only mention on the side that you could probably save the
live of a sick African child by spending that same money on him,
rather than on yourself.

Hans-Georg

--
No mail, please.

Marc Lurie

Hans-Georg,

That's an intersting angle to look at the situation, and I can
certainly see where you are comming from.

Because I work in those areas, and the chances of being bitten by a
dog, rat, mongoose, bat etc. are pretty high, I have made sure that I
was vaccinated against rabies because I know that rabies is incurable
once the symptoms present, and I also know that I won't trust my life
to a potentially dodgy east African doctor with potentially dodgy
generic Indiam medicines.

The shots were (are) expensive, but I weighed it up and figured they
were well worth it.

You're quite right about a good insect repellant - worth much more
than all the tablets.

You're also right about getting run over in Nairobi :-)

Marc

On Thu, 02 Dec 2004 15:36:25 +0100, Hans-Georg Michna
<[email protected]> wrote:

    >On Wed, 01 Dec 2004 17:42:40 GMT, [email protected]
    >(claudel) wrote:
    >>In article <[email protected]>,
    >>Hans-Georg Michna <[email protected]> wrote:
    >>>On Wed, 01 Dec 2004 01:30:08 GMT, [email protected]
    >>>(claudel) wrote:
    >>>>http://www.cdc.gov/travel/
    >>>good web site, but of course it issues blanket recommendations.
    >>>A tourist spending only a few weeks in selected areas doesn't
    >>>need most of them. They are also not required.
    >>>The big exception is malaria.
    >>Perhaps some of the immunizations are not required, but
    >>personally I'd rather get an extra shot or two and not
    >>be one of those on the sad end of the statistics...
    >Claude,
    >if only it were that simple. The problem is that the injection
    >has its own side effects. A few people die from inoculations.
    >Taking a few extra shots doesn't necessarily put you on the safe
    >side. Also, they cost money that you could spend on other things
    >that increase your likely lifespan.
    >Another problem is a mathematical one. It is always difficult to
    >treat very small risks properly, and people tend to be unable to
    >deal with them (so they play the lottery, for example).
    >To give an example, you pay money for a shot that decreases your
    >one-in-a-billion chance to die from yellow fever during your
    >two-week vacation. Then you cross the street in Nairobi and
    >incur a one-in-a-million (a thousand times higher) risk to get
    >run over by a car (particularly because the cars come from the
    >wrong side, but that's another matter). If you spent that same
    >money on a local guide, it might be vastly more effective in
    >decreasing your total small risk of premature death.
    >Even spending the same amount of money on reducing the residual
    >malaria risk further may be more efficient, for example by
    >selecting and buying the most efficient insect repellant (which
    >would reduce your yellow fever risk at the same time, by the
    >way).
    >In short, the yellow fever shot may not be the most
    >cost-efficient way to prolong your life.
    >I will only mention on the side that you could probably save the
    >live of a sick African child by spending that same money on him,
    >rather than on yourself.
    >Hans-Georg

Claudel

In article <[email protected]>,
Hans-Georg Michna <[email protected]> wrote:
    >On Wed, 01 Dec 2004 17:42:40 GMT, [email protected]
    >(claudel) wrote:
    >>In article <[email protected]>,
    >>Hans-Georg Michna <[email protected]> wrote:
    >>>On Wed, 01 Dec 2004 01:30:08 GMT, [email protected]
    >>>(claudel) wrote:
    >>>>http://www.cdc.gov/travel/
    >>>good web site, but of course it issues blanket recommendations.
    >>>A tourist spending only a few weeks in selected areas doesn't
    >>>need most of them. They are also not required.
    >>>The big exception is malaria.
    >>Perhaps some of the immunizations are not required, but
    >>personally I'd rather get an extra shot or two and not
    >>be one of those on the sad end of the statistics...
    >Claude,
    >if only it were that simple. The problem is that the injection
    >has its own side effects. A few people die from inoculations.
    >Taking a few extra shots doesn't necessarily put you on the safe
    >side. Also, they cost money that you could spend on other things
    >that increase your likely lifespan.

Everything in life is a risk. One runs a higher risk of being
killed in traffic in almost any village/town/city in the world
than having an adverse reaction to most modern vaccines. A competent
physician can help inassessing any specific risks to an individual.
In many cases, such as mine, existing medical insurance covers
prophlyactic vaccinations at no additional charge. YMMV

    >Another problem is a mathematical one. It is always difficult to
    >treat very small risks properly, and people tend to be unable to
    >deal with them (so they play the lottery, for example).
    >To give an example, you pay money for a shot that decreases your
    >one-in-a-billion chance to die from yellow fever during your
    >two-week vacation. Then you cross the street in Nairobi and
    >incur a one-in-a-million (a thousand times higher) risk to get
    >run over by a car (particularly because the cars come from the
    >wrong side, but that's another matter). If you spent that same
    >money on a local guide, it might be vastly more effective in
    >decreasing your total small risk of premature death.

The two possibilities you mention have no connection.
Having a complete set of vaccinations does not preclude hiring
a competent guide. If one's finances are so dodgy that this type
of tradeoff is necessary than somebody should stay home until
their finances improve.

    >Even spending the same amount of money on reducing the residual
    >malaria risk further may be more efficient, for example by
    >selecting and buying the most efficient insect repellant (which
    >would reduce your yellow fever risk at the same time, by the
    >way).
    >In short, the yellow fever shot may not be the most
    >cost-efficient way to prolong your life.

Maybe not, but having that shot should not impede other sensible
precautions, especially involving more likely possibilities
such as contracting malaria.

    >I will only mention on the side that you could probably save the
    >live of a sick African child by spending that same money on him,
    >rather than on yourself.

Well, of course. That statement would possibly be true regarding a
large percentage of the activities of Westerners. I'm not sure how
it is relevant in the bounds of this discussion of appropriate
vaccinations for tourists.


Claude

Claudel

In article <[email protected]>,
Marc Lurie <[email protected]> wrote:
    >Hans-Georg,
    >That's an intersting angle to look at the situation, and I can
    >certainly see where you are comming from.
    >Because I work in those areas, and the chances of being bitten by a
    >dog, rat, mongoose, bat etc. are pretty high, I have made sure that I
    >was vaccinated against rabies because I know that rabies is incurable
    >once the symptoms present, and I also know that I won't trust my life
    >to a potentially dodgy east African doctor with potentially dodgy
    >generic Indiam medicines.

Even in "civilized" areas the treatment for rabies after exposure
in no fun. A friend of mine and her children had to undergo it
after their dog got into a disagreement with a rabid raccoon.
The low competence of the local health authorities didn't help.

1st bureaucrat: It's dead? Put it in a plastic bag and freeze it.

2nd bureaucrat: You touched it? You weren't supposed to do that.

At least the current series of shots is fewer than it used to be
and no one got sick.

My doc recommended that I skip the rabies vaccination because
of the low possibility of contact since I don't work with animals.

    >The shots were (are) expensive, but I weighed it up and figured they
    >were well worth it.

I'd do/pay just about anything to avoid post-exposure rabies
treatment.

    >You're quite right about a good insect repellant - worth much more
    >than all the tablets.

Yep. Relatively inexpensive as well.


Claude

<snip>

Riverman

"Hans-Georg Michna" <[email protected]> wrote in message
news:[email protected]...
    > Claude,
    > if only it were that simple. The problem is that the injection
    > has its own side effects. A few people die from inoculations.
    > Taking a few extra shots doesn't necessarily put you on the safe
    > side. Also, they cost money that you could spend on other things
    > that increase your likely lifespan.
    > Another problem is a mathematical one. It is always difficult to
    > treat very small risks properly, and people tend to be unable to
    > deal with them (so they play the lottery, for example).
    > To give an example, you pay money for a shot that decreases your
    > one-in-a-billion chance to die from yellow fever during your
    > two-week vacation. Then you cross the street in Nairobi and
    > incur a one-in-a-million (a thousand times higher) risk to get
    > run over by a car (particularly because the cars come from the
    > wrong side, but that's another matter). If you spent that same
    > money on a local guide, it might be vastly more effective in
    > decreasing your total small risk of premature death.
    > Even spending the same amount of money on reducing the residual
    > malaria risk further may be more efficient, for example by
    > selecting and buying the most efficient insect repellant (which
    > would reduce your yellow fever risk at the same time, by the
    > way).
    > In short, the yellow fever shot may not be the most
    > cost-efficient way to prolong your life.
    > I will only mention on the side that you could probably save the
    > live of a sick African child by spending that same money on him,
    > rather than on yourself.
    > Hans-Georg


Hans-Georg:

What an idiotic and academically wasteful argument. Your point is only
well-taken if you have a very finite amount of money and need to make a
single choice and use risk-based decision making about where to spend your
money: either on a yellow-fever shot, malaria meds, mosquito net, tour guide
or bug dope. If that's the situation in someone's life, they might be even
better off not spending money on the plane ticket to get to Kenya, or better
yet, they should skip a meal (0% chance of death by doing that) to buy a
long sleeve shirt (measurable chance of avoiding a mosquito bite) instead.
Life is full of choices, and its impossible to limit each single choice to a
cost-efficient analysis....especially when the costs are so trivial compared
to the cost of the actualized risk, no matter how slim it is.

Risk-analyses are based on multiplying the chances of incurring an illness
times the seriousness of that illness. A microscopic chance of getting
Bubonic Plague doesn't necessitate getting vaccinated. A huge chance of
stubbing your toe doesn't neccessitate getting steel-toed boots. But a
small, but measurable, chance of getting Yellow Fever <does> imply the
importance of getting vaccinated.

Furthermore, a cost-based risk analysis means to divide that assumed risk by
the cost, for a 'unit cost of assumed risk' factor. If the risk of side
effects are small enough, and the cost is low enough, it makes statistical
sense to take the medication based on that, alone. It costs $20 to take the
meds, and there is amost a zero percent chance of serious side effect, and
the illness is VERY serious, then its a no-brainer.

The reality is that we all take <multiple> precautions in life, some with
predicatable and measurable effects, others with unpredictable effects. But
the cumulative effect is what matters: get a Yellow Fever shot, your HepA
and HepB shots, your tetanus shot, your MMR and typhus shots, and then you
have a cumulative protection that is measurable, at relatively low cost, and
with minimal chance for deleterious side effects.

--riverman

Hans-Georg Michna

On Mon, 6 Dec 2004 15:18:16 +0100, "riverman" <[email protected]>
wrote:

    >What an idiotic and academically wasteful argument.

Riverman (and Claude),

do your sums. Estimate the likelihood of side effects. Compare
it of the likelihood of contracting yellow fever. Both can kill.

Without the numbers your statement has no meaning. The argument
that it can't hurt to get the shots is simply not true.

Hans-Georg

--
No mail, please.

Claudel

In article <[email protected]>,
Hans-Georg Michna <[email protected]> wrote:
    >On Mon, 6 Dec 2004 15:18:16 +0100, "riverman" <[email protected]>
    >wrote:
    >>What an idiotic and academically wasteful argument.
    >Riverman (and Claude),
    >do your sums. Estimate the likelihood of side effects. Compare
    >it of the likelihood of contracting yellow fever. Both can kill.

Speaking for myself, I did.

I balanced the cost of the vaccination, which in my case was zero
as it was covered by insurance, and the possibility of adverse side
effects from the vaccination against both the likelihood of contracting
yellow fever and the possibility of encountering some sort of bureaucratic
snarl at an inconvienient moment due to the lack of the vaccination doco
and decided to have it. I _did_ discuss the possibilities of adverse
reactions to the various vaccines with my physician before I had any
shots.

If I had it to do over again I would not have had the first Hepatitis A&B,
Diptheria/Tetanus, Typhoid, first Japanese Encephalitis, and YF shots all
at the same time. :^). There was a time factor involved, though.

It took me a couple of days for my immune system to recover and I was pretty
much wiped out. Better than _really_ getting sick, though, I suppose.


Claude