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Injections/tablets for Borneo

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Kent
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Injections/tablets for Borneo

Hi,

I just wondered if someone could assist me please. We are travelling to Malaysia in March this year and going to KL, Langkawi and Borneo.

I have just spoken to my doctors surgery to find out what innoculations we require and they have advised me that we will need Malaria, yellow fever and rabies. We are staying at the Rasa Ria in Borneo for 6 nights but are going to visit the Orangutangs at Sepilok and this is the reason we have been told that we need the rabies/yellow fever. However, Im not sure if my GP has simply looked at Malaysia and just recommended everything thats mentioned!!!! Obviously I would never risk our health so if we need them we will pay to have them but I hadnt seen anyone else mention these on here and they are VERY expensive! Has anyone else that is heading to this area been recommended the same jabs?

Thanks

Abi

Conwy, United...
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1. Re: Injections/tablets for Borneo

First off, you DO NOT need Yellow fever as it is only found in South America and Africa.

Rabies is only advised if you are planning an extended stay - and Borneo (and all of Malaysia) does not have a significant problem.

You do need to have

Measles, mumps, rubella (MMR) - you should have had immunisation as a child

Tetanus-diphtheria, Polio - you should be up to date - check with your GP

Hepatitis A and Typhoid are recommended.

Hepatitis B is recommended but unless you are planning unprotected s*x with a s*x trade worker or casual accuaitance, or sharing a needle for drugs then this is not necessary

Malaria

This is a copy of an earlier post covering this topic:

MOSQUITO PROBLEMS

Dengue Fever (a more common problem than Malaria)

This is an infection from a type of virus known as a flavivirus, spread by mosquitoes in tropical and subtropical areas. The illness is found in both rural and suburban environments.

There are four different subtypes of flavivirus that cause dengue fever. Infection provides life-long immunity to the subtype causing the illness, but not to other subtypes. This means a person living in a dengue-endemic area can have more than one dengue infection during their lifetime.

Symptoms

Dengue causes a high fever, headache, nausea and weakness. It usually occurs in two phases - the initial fever, accompanied by a skin rash, usually settles after a few days only to return (usually not so severely) along with a second rash before finally disappearing again.

Dengue fever can cause severe pain in the bones, muscles and joints, and because of this is also known as 'breakbone fever'.

Most cases of dengue fever don’t lead to any permanent harm, but in a small percentage of cases there are complications. The virus can cause blood vessels to become leaky, leading to haemorrhage or bleeding from the gums, nose and various organs, along with clotting problems.

This is known as dengue haemorrhagic fever or DHF, and if untreated has a high mortality rate. In as many as one in three cases of DHF, another serious complication, known as dengue shock syndrome or DSS, occurs.

There's a much greater risk of DHF/DSS when a person has immunity to one of the other types of dengue virus as a result of previous infection.

Treatment

Drinking plenty of fluids, taking painkillers and resting is very important since there's no specific treatment. Those who are severely affected may need to be admitted to hospital for observation. Although it may take a number of weeks, most people recover fully without further problems.

There's no vaccination available yet, although trials are under way. So it's important when travelling to tropical regions to use mosquito repellents and to cover up with suitable clothing.

Unlike the mosquito that carries malaria, which bites in the evening or at night, the mosquito that carries dengue (Aedes aegypti) bites during the day, so it's vital to protect yourself against mosquito bites during the day.

MALARIA AND MALARIA TABLETS

Many people are under the impression that taking anti-malarials will stop you getting malaria. This is absolutely NOT true. You can still get malaria when taking the pills.

I can and do protect myself very well from mosquito bites. Good DEET repellant, long sleeves and trousers work a treat, that’s experience gained in practice, not just reading the theory of it.

The side effects of the pills have to be weighed up against the risk of malaria and the risk of getting bitten in the first place. Anti malaria pills are NOT smarties. They aren’t some relatively harmless pill. They have hideous side effects. In some instances much worse than a timely diagnosis of malaria.

Anti-malarials mask the symptoms of malaria and lead to the diagnosis of malaria taking place at a much later stage than it would have been diagnosed had the person not been taking anti malarials.

How malaria is treated: Basically, what you use as an anti-malarial is also what is used to treat you if you contract malaria. Only difference being when you are using anti-malarials as a precaution against getting malaria and you then contract malaria you need much higher doses of the same medicine. Couple that with the point above about the pills masking the symptoms of the malaria and you are looking at massive doses of very harmful drugs. These doses could be lowered drastically if we didn’t use the drugs as anti-malarials (certainly in low risk areas and with adequate DEET and clothing protection) and if we got diagnosed on time.

Malaysian doctors (and I assume Thai, Singapore, Indonesian etc) are much more used to diagnosing and treating malaria than their western counterparts.

Western doctors are generally clueless on the subject of Malaria. We westerners go on holiday or business trips and live with the malaria risk for very short periods of time, the locals live with it on a daily basis. They really are the experts on this subject, and they don’t take anti-malarials daily.

Do NOT follow my advice. I recommend that everyone do their own research. But, Please remember the influence of multi-million dollar drug companies on our western medicine/Doctors. There are massive profits to be made in the anti-malarial market and to get to the real truth of the matter you often have to dig deeper than standard marketing material churned out on (or on behalf of) the drug companies. Also bear in mind many western doctors have about as much experience with malaria (both avoiding it and treating it) as I have with nuclear fission or space walking.

Summary:

a) the pills don’t stop you getting malaria

b) the pills mask malaria in its early stages meaning a late diagnosis

c) if you take the pills as a precautionary measure and contract malaria you will need higher doses of the pills for longer periods of time and therefore can end up with a worse form of malaria.

ENCEPHALITIS

Encephalitis is inflammation (swelling) of the brain tissue. It's caused either by infection, usually viral, or by an autoimmune disease. An autoimmune disease is when your immune system tries to fight off an infection but attacks parts of your body at the same time.

The viruses that cause encephalitis are often common viruses and can be contracted through insect and animal bites, food or direct infection.

JAPANESE ENCEPHALITIS

Japanese encephalitis is caused by a virus. It is passed to humans by the bite of infected mosquitoes. It can not be transmitted by other humans.

Japanese encephalitis is usually a mild illness. In many cases there are no symptoms. However, in a small number of cases (about 1 in 200 infected people) the illness is much more serious. In these people the infection may start with fever, tiredness, headache, vomiting, and sometimes confusion and agitation. This may progress to encephalitis (inflammation of the brain). This can cause permanent brain damage and is fatal in some cases.

Japanese encephalitis occurs throughout South East Asia and the Far East. It is mainly a problem in rural farming areas. It occurs more commonly in the rainy season when the mosquitoes are most active.

A vaccine is available if you plan to stay for longer periods in rural areas.

You should also try to prevent mosquito bites

Immunisation is only one aspect of preventing illness whilst abroad. Immunisation is not 100% effective and you should also try to avoid mosquito bites when in 'at risk' areas. Mosquito bites can be avoided by the following:

Sleep in rooms that are properly screened. For example, rooms with close fitting gauze over windows and doors.

Spray the bedroom with insecticide just before evening. This kills mosquitoes that may have come into the room during the day.

If you sleep outdoors or in an unscreened room, use mosquito nets impregnated with an insecticide. The net should be long enough to fall to the floor all round your bed and be tucked under the mattress. Check the net regularly for holes. Impregnate with fresh insecticide every six months.

Use an electric mat to vaporise insecticide overnight. Burning a mosquito coil is an alternative.

Mosquitoes that carry the Japanese encephalitis virus are most active at dusk and in the evening. If possible, avoid going out after sunset. If you do go out after sunset then wear long sleeved clothing, trousers, and socks. Light colours are better as they are less attractive to mosquitoes.

Apply insect repellent to clothing or exposed skin. Diethyltoluamide (DEET) is effective.

For information - I have spent extended time in Borneo and, as I do not visiting the heart of the island or very remote areas, I do not take malarial tablets.

North Coast, N...
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2. Re: Injections/tablets for Borneo

nathnac.org/ds/…country_page_MY_BORX.htm

This is a good link. My boyfriend and I travelled last September to Malaysian Borneo and did quite a lot of research. Incidentally, we got slightly different advice from our local surgeries and at the end of the day, a lot of it is advice, even from the health professionals.

I have no idea why you would need yellow fever. It was not mentioned to us and according to the above link, is not an issue unless you are travelling from a yellow fever area. Assuming you are travelling from the UK to Malaysia, this would not apply.

We were told to consider immunisation for rabies and japanese encephalitis. In the end, we decided that there was virtually no risk of rabies and we would take precautions against being bitten.

So, we ended up dosing ourselves in DEET - you do need loads in the heat and covering up well. we did still get bitten - don't make my mistake of being lazy with applying deet at night after a shower. Something nibbled away at my ankles at night at Mulu!!! You really need to use it loads in the jungle areas. This also helps protect against dengue fever which mosquitoes also carry.

We got the usual hepatitis A, typhoid jabs etc but these are pretty much essential rather than the optional rabies, hepatitis B, japanese encephalitis jabs. And we did take malaria tablets (maladrone) although as you will know from reading this forum, not everyone does.

I hope that link at least is useful! As everyone will tell you, the main thing is trying to prevent yourself from being at risk so wear good insect repellent and cover up and avoid feeding animals.

Kent
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3. Re: Injections/tablets for Borneo

Thank you for your response. I am currently awaiting a call back from my GP as I have asked him to double check with his original advice but your response has certainly been helpful. I have looked on the NaTHNaC website and this also states what you have said. I know its our health but £500 is an awful lot of money if we dont need to have the jabs!

Thanks again

Abi

Kent
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4. Re: Injections/tablets for Borneo

Ponaire- thank you for your reply as well. You must have posted just before I did and that is the website that I have just looked on. Malarone is the anti-malerial tablet that we have been advised to take and we will definately take this one. As you said, the rabies one does appear to be optional and as we are only in the jungle for 3 days, I dont think we will opt to have this one. I have no idea why they said about the yellow fever one- this is exactly the reason I have asked them to query it!

Abi

5. Re: Injections/tablets for Borneo

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belfast-UK
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6. Re: Injections/tablets for Borneo

I agree with esorlegin having just been to the Docs and i'm going for Malarone for the malaria

jj.....

Kota Kinabalu...
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7. Re: Injections/tablets for Borneo

Hi abi,

If you're going to sepilok from shangrila rasa ria, it'll takes 5 - 6 hours driving which means 11 hours driving to and fro. If you intend to go to sepilok which is in the sandakan district, I recommend you to overnight there.

And if you intend to see the nature & wildlife at sukau eg proboscis monkey, crocodile etc & gomantong cave, I recommend you stay another 1 - 2 nights.

and if you planned to go to the turtle island park or lankayan island, another 1 night is recommended.

If you're looking for some nice beaches for snorkelling & seawalking, there are many great islands for diving as well.

Some islands in KK like Manukan, Mamutik & Sapi, Sandakan like Lankayan, Semporna like Kapalai & Mataking.

For divers, can opt for Sipadan & Mabul in Semporna, Mantanani in Kota Belud etc.

For more information about the islands, please check the following site:

sabahtourism.com/sabah-malaysian-borneo/…

But I can't comment on the injection as I'm not a medical doctor though I'm a Dr by title (PhD).

cheers

Kent
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286 posts
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8. Re: Injections/tablets for Borneo

Hi Viral-Group- for this one we are doing a pre-booked tour for the Sepilok trip so there wont be much driving this time (unlike our KL trip!). I know TravellingMitch told us that we could have got this cheaper by arranging it ourselves, but on this one we are happy to have someone else arrange it for us. We fly to Sandakan and will be staying in the area for 3 days/2 nights during which we are visiting turtle island (I think we stay there for 1 night) and then a river trip followed by a trip to Sepilok and then back to Kota Kinabulu for 1 night staying at the Tanjung Aru before we fly to Langkawi for the last part of our trip.

There is just so much to do and I wish we could have stayed longer but unfortuunately its not possible, so we will just have to come back one day!!!!

Kota Kinabalu...
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9. Re: Injections/tablets for Borneo

hiya abi,

the trip is ok too. but flying from KK to sandakan, you'll miss lots of attraction along the journey which is Mt Kinabalu view, kundasang war memorial, poring hotspring, fish spa in the river, tea plantation etc.

But earlier you mention that your staying 6 nights at rasa ria? Rasa ria is in Tuaran which is about 1 hour driving from KK.

Are you saying that you'll stay 6 nights in Rasa Ria + 2 nights in Sandakan? A total of 8 nights in Sabah?

for the 3 days 2 night at sandakan is good. Definitely you stay 1 night at turtle island as you only view the turtle laying eggs at night. The river cruise will be at sukau where you'll be viewing the proboscis monkey, fireflies etc. sepilok is for the orang utan. If you have time, ask the tour guide to bring you to the gomantong cave as well.

There are few option to travel in Sabah:

1. Through travel agencies - the most expensive.

2. Rent & drive - approx RM150 for Proton wira / satria & RM90 for perodua kancil. Better to rent a car from KK city centre rather than at the airport.

3. Rent a car with driver rather than without driver as it's not much different. Normally a car rental with driver will cost around RM200 / day (they will work for 10 hours a day. for additional hours just ask them for some tips & mostly they will be more than happy to do that). All inclusve for a rental within KK area.

Regards

Kent
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10. Re: Injections/tablets for Borneo

We are staying at the Rasa Ria from 14th March to 19th March then we are on the Sabah Nature Tour from 19th till 21st March and then we stay at the Tanjung Aru for 1 night before flying to Langkawi on Monday 22nd March. We do go to the caves as well on that tour. Are you 100% sure about their being fireflies there!!!!!!!!!

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