This is a topic that should concern us all. No one wants to get sick or certainly contract some serious disease on this most important trip. After speaking with other couples and doing some research, there is indeed much that one can do when in India, but prior to arrival, receiving vaccinations is often discussed and there is invariably uncertainty on how best to proceed.
Our primary physicians in the States said that we should check with the 'travel doctor' at our hospital for the recommended vaccines for when visiting India. This simply entailed a phone call where I found-out the following should be performed (read, not required): Malaria (pill), Hepatitis A/B, Typhoid, Diphtheria, Tetanus and Polio. And if we didn't have the flu shot already, to get one of those also. Some of these were to be combo shots, but still, that's a lot...
I scheduled an appointment a few days later so we both could receive these shots. I could have made an appointment sooner, but I wanted some time so I could research how these vaccines might negatively impact our success with IVF. Between what my Indian colleague told me, and what the US Embassy in India shared a year or so ago with someone else, Malaria is no longer a serious issue in India. Plus, I've heard of more than a couple instances of folks getting quite ill from taking these Malaria pills.
After chatting with folks who did and did not get vaccinations, and hearing their logic for their decisions, I called to cancel our appointment. My wife still went for her annual flu shot though. The uncertainty as to how these might affect us was bothersome at some level. Also, after researching these diseases, and learning how they are contracted, I felt that with proper hygiene and precaution, we can avoid or very much limit our exposure.
Mosquitoes are quite prevalent in India. As I said earlier, Malaria is very much under control now though. The pills have made some people quite sick. The cost/benefit analysis had us avoid these. We did bring a DEET-based mosquito repellent, but didn’t really need it in December. I’ve also heard that lemon Eucalyptus works well. And from someone in Anand now, apparently there is a repellent cream called “ODOMOS” that works quite well on Indian mosquitoes. It only costs about 50 Rupees and can be had in the local pharmacies, like from those near the Big Bazaar. Also, from a friend, I just learned of Doxycyline which apparently can act as barrier to Malaria. So, for those who want to take something prior to arrival, this would seem to be a worthwhile option to explore. Hopefully folks will begin to chime-in here so we can get more details...
Hepatitis A/B can be acquired via a number of ways, with viral being the most common. This entails a transfer via shared bodily fluids, such as blood, semen, vaginal secretions, breast milk, saliva and tears. For those who don't know, Dr. Patel's clinic uses new, sealed needles for blood draws and injections. Coupled with good hygiene and common sense, including being faithful to your spouse, it would seem that Hep A/B can be avoided.
Typhoid is contracted from bacteria usually found in foods and water. Eat only foods and sauces that have been cooked. At a wedding in India, my wife dipped a chip in a cold sauce, and once she realized what she had done, it was too late. She didn't get Typhoid, but some bacteria that made her quite ill (vomiting and diarrhea) for two days. She had to get an IV at Dr. Patel's clinic, actually twice as I believe the other time was due to her brushing her teeth with tap water. I recommend keeping bottled water in the bathroom for brushing the teeth and washing-out the mouth.
Diphtheria is a contagious disease, and is quite prevalent in India. That said, in 2005 there were just 8,229 reported cases in the world; however 71% (5,826) of those were in India. To put things in perspective, the population in India in 2005 was well over 1 billion, making those infected with Diphtheria .0005% of the population. A numbers game I suppose, but we decided to not get this vaccine.
Tetanus is caused from an infection, usually due to a cut, or wound. We passed on this one also. My thinking was to just be careful so as to avoid falling down or getting injured somehow. Easier said than done I suppose, but we managed.
Polio is spread from person to person, usually from fecal material to the mouth. When you shake some one's hand, visit a restroom and touch objects inside, always wash hands well afterwards. When leaving a bathroom for example, after washing my hands, I always take the paper I dried my hands with and use it to open the door, discarding it at the next available trash can, hopefully right by the door. Heck, I do this in the office here in the States also, as do some of my colleagues. Just good practice really. Also, while it's helpful to be cautious of what you come in contact with, you can further protect yourself by limiting how often you touch your eyes, nose and mouth with your hands.
So, this was my/our logic for not get any vaccinations. Right or wrong, we didn't get any. Also, ask Dr. Patel for her thoughts. When we did around September 2008, and in her opinion, we didn't need to. If she would have said otherwise, this would have made a difference in our thinking. I encourage you to inquire also just in case circumstances might have changed.
With respect to bottled water, popular consensus was that AquaFina and Bisleri were the best. The hotels have them, but the prices are higher, but still pretty cheap though. If I can find the photo, I’ll share where we got 2 liter bottles very near the clinic, and for just 25 Rs (about 50 cents). I brought many Mountain House
meals that we made in our room. I figured that if my wife wasn’t feeling well, leaving to eat wouldn’t be desirable. Plus, they really taste good! If and when you do go out to eat, you might want to wash your silverware. The couples we dined with did this as a precaution. Again, only eat hot foods and sauces. If you want fruit like my wife, it is recommended to only eat those that are peel-able. Dr. Patel's driver walked us to a fruit stand right near the clinic. When leaving her clinic, make a right turn. At that major road, across the street, slightly to the left are some fruit vendors. He has a nice selection and charged us the local (fair) price. The phonetic spelling of his name is "Iles" and I attached a photo of him below (sitting down).
For an idea as to what fruit costs, my wife got a whole pineapple (cut there on the spot and bagged), 6 - 8 oranges, and 1 pomegranate, and I think something else for 150 Rs, or about $3 USD.
I hope this helps and it would be great if others can add to this knowledge base...
Four cycles with Dr. Nayana Patel, with the first and fourth giving us two beautiful, healthy baby girls! Persistence and determination are often rewarded, so stay the course...