When This Is, That Is

Exploring the world of conditionality

A visit to Vaccine-ville

imageAt some point in our preparations for travel the Mexico, I realized we should take precautions against illness. My doctor’s office recommend I go to a “travel clinic,” a term I’d not heard before. There’s one in Vancouver, and I made an appointment for the two of us.

I had no idea what to expect when Robin and I arrived at the tiny office. We sat across from the nurse at her desk. A map of the world covered most of the wall to my right. A bookshelf covered most of the Western Hemisphere. A few smaller shelves and tables lined walls along with a small stainless steel refrigerator. A stack of boxes stood by the door. On a shelf or table behind the desk was a computer. On the screen was information about Oaxaca.

The nurse treated us to a thorough description of what diseases we could encounter—and step-by-step procedures to counter them. We learned that mosquitos may be a problem anywhere below 6,000 feet. Oaxaca is around 5,100 feet, so malaria, mosquito-borne, is a concern. First came the prescription for Malarone, to be taken once a day, beginning two days before leaving and extending seven days after returning. We’ll take that with breakfast. To counter the effect the drug will have on the GI tract we’ll have a friendly dose of probiotic with dinner.

But why take chances getting bit by mosquitos at all? The nurse advised we use one of two mosquito repellents. The first was Ultrathon, which is 34% DEET. Did you know DEET has a safe zone of 20–35%? This will last 12 hours, great for those who party to dawn. The second was oil of lemon eucalyptus, with 30% oil. This will last six hours, plenty long for our needs. Anyway, we went to REI in Portland and got a container of each.

Next came information on food- and water-borne illness. No water (including ice) unless it’s bottled. Here Robin told a story of a years-ago trip to Mexico where she made the massive mistake of putting tap water on her toothbrush. The nurse nodded in sympathy. Carbonated drinks are ok, too (but remember, no ice). The nurse instructed us to eat only cooked food, served hot. Nothing fresh except fruits that have a skin, which we must peel ourselves. As a precaution we received a prescription for ciprofloxacin, a powerful antibiotic. And, did you know that probiotics are 65% effective against diarrhea? But we’ll be taking that anyway, right?

Finally came the immunizations. I was verifiably up to date on my TDAP, but Robin wasn’t sure. In addition, we each got inoculated against hepatitis A and typhoid VI. That’s when the purpose of the refrigerator became apparent. It’s home to all those tiny vials of vaccines.

The whole thing took about an hour. The presentation was organized and informative. I’m still a bit stunned at the cost: about $850. Insurance will cover most of it, I hope. But if the benefit is staying healthy, it’s worth the cost. I’ve paid more just to get one tooth fixed.

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