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Chikungunya Disease

Chikungunya is a nasty disease carried by the Asian tiger mosquito or Aedes albopictus mosquito which is the vector for both dengue fever and chikungunya. You can check-out www.wikipedia.org for pictures of this mosquito. It is usually a daytime biter and a "weak flyer".

With the global warming, this and dengue fever are diseases that are becoming issues in new areas. There was an outbreak in Ravenna, Italy in 2007 with about 300 reported cases. The mosquito has been in Ravenna since 2004 and is now found in much of Europe. We spotted the tiger mosquito vector with its striped legs in Udine, Italy in October of 2008.

Dengue fever was also a concern when we visited Tunisia in 2008.

Typhoid Fever Vaccinations

We were given a great tip by a travel medicine nurse in January of 2008 when we received our 4 little capsules of oral typhoid fever vaccine. The live little buggers are known to create nausea and loose stools, which I had experienced when I took my first batch of pills in 2000, but the current  nurse had a trick. She said to chug 2-3 glasses of cool or cold water immediately after taking each capsule (warm water will melt the capsule). The hope was that the capsule would be floated farther down into the gut, past the place where it would make one sick.

Her instructions were in addition to the general ones, which are to take the capsule on an empty stomach 1 hour before dinner. I chugged closer to 4 glasses of water (just to be sure) in 10-15 minutes after popping the capsule and had mild cases of loose stools but no nausea. The loose stools were actually reassuring because it meant that the bugs were growing a bit in my gut, which they needed to do to trigger the desired immune response. Bill got distracted after dose #2 and only drank a glass and a half of water. He was reminded of his error by being awake most of the night with GI discomfort. Needless to say, he didn't get distracted with doses #3 and #4.

I normally sleep through the night without a trip to the toilet, but chugging almost a quart of water before dinner changed that in a hurry. I shifted to taking the capsules before lunch for doses #3 and #4 and was able to again sleep through the night. Taking the capsules at noon instead in the evening also eliminated any risk of accidentally drinking alcohol before the requisite 2 hours after ingesting the capsule.

So, we are believers, that the suspect theory of flooding the capsule farther through the gut does work. Taking 4 capsules over 8 days was enough experimenting to convince us.

Typhoid fever vaccination can be achieved with a single injection, which eliminates this rather rigid regime. Both forms are supposed to have the same level of protection, which is upwards of 85%. But the injection form is effective for 2 years, the oral form for 5, which is why we selected the oral form. And given that the prices are roughly $70 for the injectable form and $80 for the oral, the oral is a much better value and means fewer trips to the doctor.

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