Medical costs to consider when travelling

Moneybags journalist Jessica Wood looks at what common vaccines are required when travelling, and what regions require vaccines, as well as other medical costs associated with travel.

When planning to take a trip, it is often easy to forget about the additional medical costs that you may have to incur. Certain countries and regions require people to have vaccinations for diseases prevalent in the area, as well as take preventative medication for diseases such as malaria.

According a recent report, climate change could see tropical diseases such as malaria, Chagas disease and dengue fever spread to new regions, as the vectors (the hosts or insects that carry these diseases) are able to survive and thrive in new areas.

If insects continue to migrate to new areas because of climate change, soon more regions will require people to have vaccines before they are allowed to enter. In addition, preventative medication for diseases such as malaria will also be required in different regions.

For example, if climate change continues on its current path, areas of Europe, including the United Kingdom, as well as eastern Asia and parts of the United States, could become habitable for mosquitoes that transmit dengue fever and other tropical diseases.

Malaria

Malaria, perhaps one of the better known tropical diseases, is transmitted by the female Anopheles mosquito. Sister Marion Wing, a registered nurse qualified in travel medicine, reveals: “These mosquitoes are found in the tropical and subtropical countries.” See the image below which highlights the high malaria risk areas.

“There are tablets (chemo prophylaxis) that can be taken to help prevent malaria, but none of them are 100% effective. Therefore protection against mosquito bites is the first line of defence against malaria,” adds Wing.

There are three types of preventative tablets available for malaria.

  1. Malanil is a daily tablet that you start a day before entering the high risk area, and is taken daily while in the area and for a further seven days after exposure.
  2. Mefliam or Lariam are weekly tablets that you start one week before entering a high risk area. The tablets are taken weekly while in the malaria area, and for four weeks after exposure.
  3. Doxycycline is a daily tablet that you start taking two days before entering a high risk malaria area, and continue to take daily while in the area and for a further 28 days after exposure.

The cost of these will vary according to which pharmacy you purchase it from, however, Wing notes that Malanil is expensive.

Malaria_map

Source: http://upload.wikimedia.org/wikipedia/commons/d/d5/Malaria_map.PNG

Yellow Fever

Yellow Fever is transmitted by the Aedes or Haemagogus mosquitoes. Wing highlights that Tanzania, Zanzibar and Zambia have been declared low risk areas for Yellow Fever, and therefore vacinating against this disease is no longer a requirement for entering these countries.

Wing states: “[It] depends where they are travelling to, but Yellow Fever is required for a large part of Africa and South America.”

Although some countries no longer require you to have a Yellow Fever vaccine before entering the country due to the low risk, it is still recommended that you are vaccinated before entering a Yellow Fever area (see image below for more details).

Yellow_fever_risk_map

Source: http://www.frontiersoftravel.com/disease_maps/Yellow_fever_risk_map.png

Dengue Fever

There is no vaccine or preventative medication for Dengue Fever. As it is transmitted by the Aedes Aegypti mosquito, Wing suggests taking precautions to avoid mosquito bites.

Global_DengueTransmission_ITHRiskMap

Source: http://gamapserver.who.int/mapLibrary/Files/Maps/Global_DengueTransmission_ITHRiskMap.png

Other diseases to look out for

Some of the other common diseases that travellers should be aware of are: rabies, cholera, typhoid, Hepatitis A and Hepatitis B.

Wing points out that it is advised that travellers also get vaccinated against Hepatitis A, Hepatitis B, Typhoid and Tetanus. “Other vaccines that are advised and administered regularly are Hepatitis A, Hepatitis B, Typhoid, (Tetanus, Polio, Diptheria, Pertusis) 4 in one and Meningitis.”

Travellers need to be aware of what they consume and only eat food that has been well cooked, as well as ensure that they only drink bottled water to avoid contracting typhoid, and Hepatitis A.

Although there is a vaccine against cholera, according to reports, the World Health Organisation (WHO) and the Centre for Disease Control (CDC) do not recommend it because it doesn’t help up to half of the people who receive it, and the vaccine only last a few months.

The importance of revealing your medical history

Wing stresses that it is important for people to disclose their medical history to the nursing sister or doctor that is going to administer the vaccines.

“Because the Yellow Fever vaccine is a live vaccine (meaning that it has some of the virus in it to help the immune system build up antibodies), it may be dangerous to administer it to a person whose immune system is compromised. Some medication such as cortisone, may also cause certain vaccines to be ineffective.”

Additional concerns are allergies. If a person is allergic to any component of the vaccine it could cause an allergic reaction. Therefore it is imperative that you tell the person administering the vaccine about any medications that you are allergic to.

Furthermore, pregnant women and women who are breastfeeding cannot be given the Yellow Fever vaccine, as it may cause a miscarriage. “One [also] shouldn’t fall pregnant for three months after a Yellow Fever vaccine,” adds Wing.

Certain malaria tabs can also make the contraceptive pill ineffective. And the malaria prophylaxis (medication) that is prescribed depends on a person’s medical history and medication they are currently taking.

Vaccine costs

The cost of vaccines will vary according to where you have it administered, as the doctor’s room or travel clinic will charge a mark-up on the cost of the vaccine.

Wing explains that the costs depend on what vaccine is being administered, and highlights that certain vaccinations are a requirement for entry into a country. On top of the required vaccines, there are also some vaccines that are recommended.

“The advised vaccines are offered for the traveller’s protection against certain diseases, such as food and water borne diseases, but are not compulsory or required before traveling,” adds Wing.

The estimated cost of vaccines including VAT are as follows:

travel vaccine costs

In addition to the cost of the vaccines and the mark-up that the doctor or clinic may charge, there is also a consultation fee that will be charged. This fee will also depend on the clinic or doctor’s room that you visit.

Before going to the clinic to receive the vaccines, phone ahead and speak to the nursing sister or doctor on duty to find out what exactly you will need for your travels, and how much it will all cost, so that you are prepared.

Medical aids will cover a portion of the cost of the vaccines as long as you have savings. However, if your savings are depleted, you are responsible for covering the entire cost of the vaccines. When travelling it is a good idea to contact your medical aid to see if they will cover the cost of the vaccines, and what percentage of the cost they will cover.

Covering your medical costs when you are abroad is vital too. This is why travel insurance is so important – for more click here.



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