To Jab or Not To Jab?

29th June, Adelaide, Australia

Ian writes:

That is the question. Whether it is nobler to suffer the misfortune of being bitten by a mosquito carrying Japanese Encephalitis or the very likely side-effects of an expensive and not-very-pleasant vaccination. Right, enough of the cheesy pseudo Shakespeare nonsense. What am I talking about?!

Japanese encephalitis (JE) is a very nasty thing. It's carried by one specific type of mosquito, and only in areas where there is a lot of low-lying water, such as rice paddy fields, of which Thailand has millions. They are more prevalent during the wet season (we'll be in Thailand in the second half of the wet season), and are statistically more likely to bite at dusk or dawn. If you get get bitten by a mozzie that carries JE, and if you get the clinical disease, your chances of survival are not good - around 10-25% mortality rate or almost-certain permanent neurological damage (ie brain damage). But there is a vaccine.

This seems like good news, but for the fact that it is very expensive and, judging by what we've read up on it, seems to have significant side effects.

So, on the one hand, you've got a disease that can, if you're extremely unlucky enough to get it, kill you or you have a vaccination that will put you out of pocket and likely make you very ill anyway through side effects, problems that can be avoided by not taking the vaccination. What to do, eh?

Some more facts, then. First, from the Canada Communicable Disease Report website:

"The risk of illness to most travellers is as low as 1 per million for short-term travel (< 4 weeks) depending on factors such as season, location, and duration of travel ... Twenty-four cases of JE have been reported in Western travellers from 1978 to 1992."

Oh, nothing to worry about then. Hang on, what's this guy saying (from a newsgroup discussion) ...

"Japanese Encephalitis also seems to be a more common malady for travelers than malaria."

More common? Oh, wait up ... here's some more (from the Canada Communicable Disease Report again):

"For persons travelling to rural areas during the transmission season, the rate per month of exposure is 1 per 5,000 ... "

That seems pretty low.

"... In 1969, at least 10,000 Americans were infected in Vietnam, ..."

Whhaaaaat? 10,000? Then again, I imagine the conditions were slightly diffferent to what we would be experiencing.

"... and 57 encephalitic cases were reported."

Only 57 cases of the clinical disease in all those American GIs, who were in the thick of it, up to their knees in the wet for months on end?

This is the problem.You can read so much information and still not be decided. It's difficult, but right now I'm leaning towards not having the vaccine and putting my faith in the not-so-holy trinity of Aerogard (mozzie spray), long sleeves and common sense avoidance techniques (staying the heck away from any darned rice paddies!).

The reason for this post? Well, today we had a consultation at a travellers' medical centre and although we didn't get any jabs, we had plenty to think about. It's been one of those days - lots of admin kinda stuff (registering for medicare, getting ticket dates changed/confirmed, the aforementioned jab advice and a whole bunch of other things that we didn't find time for).

The strange thing is that we've now been in Adelaide for two days and we only have 3 photos to show for it. Trust me, this is far from normal. As soon as we get a clear day, we'll make amends and stop these fact-laden diary entries. You want pretty pictures? So do we! I'm sure Adelaide will deliver soon.

By the way, am I the only person who thinks Adelaide sounds like the name of some nice old lady?