Bhutan - Lindsay Brown [220]
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VACCINATIONS
Specialised travel-medicine clinics are your best source of information; they stock all available vaccines and will be able to give specific recommendations for you and your trip. The doctors will take into account factors such as past vaccination history, the length of your trip, activities you may be undertaking and underlying medical conditions, such as pregnancy.
Most vaccines don’t produce immunity until at least two weeks after they’re given, so visit a doctor four to eight weeks before departure. Ask your doctor for an International Certificate of Vaccination (otherwise known as the yellow booklet), which will list all the vaccinations you’ve received.
Recommended Vaccinations
The World Health Organization recommends the following vaccinations for travellers to Bhutan (as well as being up to date with measles, mumps and rubella vaccinations):
Adult diphtheria and tetanus Single booster recommended if none in the previous 10 years. Side effects include sore arm and fever.
Hepatitis A Provides almost 100% protection for up to a year, a booster after 12 months provides at least another 20 years’ protection. Mild side effects such as headache and sore arm occur in 5% to 10% of people.
Hepatitis B Now considered routine for most travellers. Given as three shots over six months. A rapid schedule is also available, as is a combined vaccination with Hepatitis A. Side effects are mild and uncommon, usually headache and sore arm. Lifetime protection occurs in 95% of people.
Polio Bhutan’s last case of polio was reported in 1986, but it has been reported more recently in nearby Nepal and India. Only one booster required as an adult for lifetime protection. Inactivated polio vaccine is safe during pregnancy.
Typhoid The vaccine offers around 70% protection, lasts for two to three years and comes as a single shot. Tablets are also available; however, the injection is usually recommended as it has fewer side effects. Sore arm and fever may occur.
Varicella If you haven’t had chickenpox, discuss this vaccination with your doctor.
These immunisations may be recommended for long-term travellers (more than one month) or those at special risk:
Japanese B Encephalitis Three injections in all. Booster recommended after two years. Sore arm and headache are the most common side effects. Rarely, an allergic reaction comprising hives and swelling can occur up to 10 days after any of the three doses.
Meningitis Single injection. There are two types of vaccination: the quadrivalent vaccine gives two to three years’ protection; meningitis group C vaccine gives around 10 years’ protection. Recommended for long-term backpackers aged under 25.
Rabies Three injections in all. A booster after one year will then provide 10 years’ protection. Side effects are rare – occasionally headache and sore arm.
Tuberculosis A complex issue. Adult long-term travellers are usually recommended to have a TB skin test before and after travel, rather than vaccination. Only one vaccine given in a lifetime.
Required Vaccinations
The only vaccine required by international regulations is yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone within the six days prior to entering Bhutan. If you are travelling to Bhutan from Africa or South America you should check to see if you require proof of vaccination.
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MEDICAL CHECKLIST
Recommended items for a personal medical kit:
Antifungal cream, eg Clotrimazole
Antibacterial cream, eg Muciprocin
Antibiotic for skin infections, eg Amoxicillin/Clavulanate or Cephalexin
Antibiotics for diarrhoea include Norfloxacin or Ciprofloxacin; for bacterial diarrhoea Azithromycin; for giardiasis or amoebic dysentery