Travelling to remote destinations in tropical climates – especially if you’re spending many days, weeks or months there – comes with unique potential health hazards.
While risks shouldn’t prevent you from adventure travel, there are ways to be smart about managing those risks.
In the case of potential health risks, we’re firm believers that prevention is the best medicine. This is a description of the vaccines we got for our six month trip to South-East Asia, including: Singapore, Malaysia, Vietnam, Cambodia, Laos, and Thailand.
While we sincerely believe that you should invest in your health and well-being you have to prepare yourself for the costs because for most people in most jurisdictions vaccines require serious financial investment. We spent all year saving for these because we knew that we’d be away for a total of six months and wanted the option to visit rural and inland locations, which increased our exposure risk (*Note: if you are fortunate enough to be able to afford additional insurance coverage there is a good chance that at least some of the costs will be covered).
If you’re travelling for a shorter period of time (e.g.: for a week or two) and staying in mostly largely populated cities or coastal destinations, you have more discretion about which vaccines are necessary, and which ones you can likely do without (see below).
Disclaimer: Our decisions outlined here reflect our personal choices taken after considerable research and consultations. Always consult a travel clinic and your family physician before making any choices about vaccinations.
Toronto Travel Clinic
Our preferred clinic in Toronto is Passport Health. We’ve always had great service at their islington location.
1243 Islington Ave
Ste. 700
Etobicoke, ON
View On Google Maps
Clinic Costs:
These are not covered by OHIP:
Appointment fee – $50
Dispensing fee – $25
*Neighbourhood food tips (because we can’t help ourselves): We’ve found two great lunch options near this travel clinice. You can go to Bonimi – a great Serbian restaurant. Or you can check out Hyderabad Spices Indian Cuisine – an excellent, small spot for really delicious South Asian fare.
Japanese Encephalitis
This is a virus that is spread to people through the bite of an infected mosquito. Most people who get infected experience mild or no symptoms. While most cases are mild, some people become seriously ill. Early symptoms include fever, headache, and vomiting. It can also cause inflammation of the brain. These symptoms may be followed by disorientation, coma, and seizures. Seizures are more common in children. About 1 in 4 cases of severe development are fatal. Read more at the CDC.
Vaccine Name: Ixiaro
Dose: Two doses taken 28 days apart. You should have your vaccine completed at least 1 week before departure. This lasts two years. There is an option to do a third dose one year later, which makes the vaccine effective for 10 years.
Cost per dose (*In Ontario): $387
Total: $774
Typhoid
Typhoid fever is caused by bacteria. People infected with these bacteria can spread them to others. This typically happens when an infected person uses the bathroom and does not wash their hands. The bacteria can stay on their hands and contaminate everything that the person touches, including food and drinks.In countries with poor sanitation, the water used to rinse and prepare food and beverages, including tap water, can also be contaminated with these bacteria. People with these diseases usually have a fever that can be as high as 103 to 104°F (39 to 40°C). They also may have weakness, stomach pain, headache, diarrhea or constipation, cough, and loss of appetite. Some people have a rash of flat, rose-colored spots. Internal bleeding and death can occur but are rare. 1 in 5 severe cases are fatal. Read more at the CDC.
Vaccine Name: Vivotif
Dose: 4 pills. This provides protection for 7 years. Get the pills into a fridge within 6 hours of receiving them. One pill is taken every other day. Complete taking the pills three weeks before the trip. Side effects are common and are usually Gastrointestinal like abdominal pain, nausea, headache, fever or diarrhoea.
Total: $95
Rabies
This one is a serious investment. If you're primarily an urban traveller and know not to try and touch monkeys or dogs, you can probably do without this. However, we are rural travellers and are particularly fond of nature tours, and intended to stay for six months, so we decided this would be a wise decision. Rabies is a fatal but preventable viral disease. It can spread to people and pets if they are bitten or scratched by a rabid animal. It's endemic in South-East Asia. Read more at the CDC.
Vaccine Name: Imovax
Dose: Three injections. The second dose is taken on day seven, and the third on day 28 (*Note: three doses gives you lifetime protection, but not complete immunity - see below).If you are bitten or scratched by an infected animal you still have to seek medical help within 48 hours, but this usually just means getting an extra booster shot. Unvaccinated treatment can be invasive and painful.It is critical to note if clinical symptoms appear in an untreated case, rabies is virtually 100% fatal.
Total: $1,029
E.coli
Escherichia coli (abbreviated as E. coli) are bacteria that normally live in the intestines of healthy people and animals.E. coli are a large and diverse group of bacteria. Although most strains of E. coli are harmless, others can make you sick. Some kinds of E. coli can cause diarrhoea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses. 5-10% of cases are fatal.You may be exposed to E. coli from contaminated water or food — especially raw vegetables and undercooked ground beef. Healthy adults usually recover from infection with E. coli O157:H7 within a week. Young children and older adults have a greater risk of developing a life-threatening form of kidney failure. Read more on the CDC.
Vaccine Name: Duckoral
Dose: 1 dose. This is a drinkable vaccine that also protects you against Cholera. The first dose should be taken at least two weeks before your departure date and your second dose is taken a week later. This provides three months of protection.
$121
Tetanus
Tetanus is a serious disease of the nervous system caused by a toxin-producing bacterium. The disease causes muscle contractions, particularly of your jaw and neck muscles. Tetanus is commonly known as lockjaw.Severe complications of tetanus can be life-threatening. There's no cure for tetanus. Treatment focuses on managing symptoms and complications until the effects of the tetanus toxin resolve.Because of the widespread use of vaccines, cases of tetanus are rare in Canada, the United States and other parts of the developed world. One can contract tetanus through cuts or wounds exposed to soil or manure and a foreign body in a wound, such as a nail or splinter. Read more on the CDC.
In Ontario OHIP covers your tetanus booster. Contact your family physician to make sure you're up to date.
Malaria
Malaria is a disease caused by a single-celled parasite. The parasite is spread to humans through the bites of infected mosquitoes. People who have malaria usually feel very sick with a high fever and shaking chills. It is common in tropical and subtropical countries. In 2020, an estimated 627,000 people died of malaria—most were young children in sub-Saharan Africa. Read more on the CDC.
Medication Name: Atovaquone Proguanil (generic) or Malarone tabs.
Dose: Take one tablet daily while starting two days before entering malaria zone, while in zone and for seven days after with food.
We'll be travelling in areas with potential Malaria exposure for six months, but taking these pills for that long isn't great for the kidneys. Also, these pills have given one of us nausea in the past. So, rather than take tablets for six months, we'll use them while in our highest risk location - Cambodia. We'll do our best to stay on the regimen, but side effects may change that. Stay tuned for a post-trip update.
$136 for a two month run
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