Don's Home Travel High Altitude and International Trekking Check list Contact

Countdown to departure

  • 10-12 weeks: Make sure your passportis current.
  •  8-10 weeks: Visa applications if necessary.
  •   6-8 weeks: Dr. appts. for shots and prescriptions (see below for what you need). (I tried to figure out what I needed and went to my family doctor where I got my Hepatitis shots and prescriptions, but could not get a Typhoid shot. I needed an Infectious Disease specalist for it. He had a better database and said I didn't need the malaria pills I already got. I'd recommend starting with an Infectious disease specalist who may give you a nice printout of risks and general health precautions for the areas you plan to visit. The insurance companies database was outdated, so it took a while to find an Dr. who would accept my insurance for typhoid shots.

    You need to start early. You usually need to wait 1-2 weeks after a booster shot before you're fully protected.

     Prescription Drugs:
      Cipro® for bacterial infections. (See: Traveler's diarrhea page)
      Lariam® (Mefloquine), doxycycline, or Malarone for malaria.
      Note: Mosquitos are not prevalent above 5,000 ft. elevation, so malaria 
    medication is usually not necessary in places like Tibet and Kathmandu even
    though it is recommended for Nepal and China.
    I could only get a 1 mo. supply and you need to start taking it before you leave. Diamox® for altitude sickness. (See: Altitude Sickness page) Flagyl® (Metronidazole) for amebic dysentery (optional only for trips longer than 3 wks.). Shots: Tetanus - Every 10 yrs. Hepatitis A (immune globulin -IG), immunization recommended for all travellers in Nepal and China. (You can get a single shot for 1 time protection or a series of 3 shots for lifetime protection) Hepatitis B recommended for stays over three months. Typhoid - 10 to 12 days in advance. (You can also get pills you take over 8 days, which last for 5 yrs.)
  • 3 weeks: If you are using Ginko Biloba instead of Diamox start taking 60 - 120 mg. twice a day for three weeks prior to arriving at altitude.
  • 2 weeks: If you are going to high altitude, take Diamox for a couple of days to test for unpleasant side effects.
  • 1 week: Take first Lariam® (Mefloquine) for malaria.
    Get over the counter drugs e.g. Imodium® for diarrhea, sunscreen, Insect repellant (with DEET).

Packing list

See Recreation/Backpacking List

See Also: Nepal Equipment List at,

Immunizations and Medications

See Centers for Disease Control and Prevention (CDC), MD travel, Country Guides at Magallan's Info. Center

What medications to take depend on thinks like:
1. How long you will be gone. The longer you are exposed the greater the chance of contracting something. Will you will be home before the disease has a chance to progress and is it treatable?
2. How adventurous you are in eating or traveling off the usual tourist routes.
3. What kind of medical facilities are available. Can the disease can progress before you can reach medical help? Will you be exposed to sub standard facilities? (e.g. Hepatitis B can be transmitted by re-used needles. Some medical facilities can't afford disposable needles.)
4. How is your general health? Older people and those with other medical conditions are at greater risk.

Tetanus - Boster every 10 yrs

Hepatitis A (immune globulin -IG), immunization recommended for all travellers in most 3rd world countries. (You can get a single shot for 1 time protection or a series of 3 shots for 10 yr. protection)
Hepatitis B recommended for stays over three months.
Typhoid - 10 to 12 days in advance.

Health Details

Typhoid fever is a seasonal disease being more common in the early monsoon months but we do see it all year round. The vaccine is not fully protective but it would be certainly worth taking it. Typhoid is an unpleasant illness that takes a large chunk of your time either being sick or recovering. The time from onset of fever to full recovery is two weeks absolute minimum. It is very rarely a dangerous disease in foreigners as most are treated quickly and effectively as outpatients.

Malaria - Lariam® (Mefloquine) directions for use:

  • The adult dosage is 250 mg (one tablet) once a week.
  • Take the first dose of mefloquine 1 week before arrival in the malaria-risk area.
  • Take mefloquine once a week, on the same day of the week, while in the malaria-risk area.
  • Take mefloquine once a week for 4 weeks after leaving the malaria-risk area.
  • Mefloquine should be taken on a full stomach, for example, after dinner.
See also Lariam info. at Indiana Univ.

Hepatitis A is an enterically transmitted viral disease that causes fever, malaise, anorexia, nausea, and abdominal discomfort, followed within a few days by jaundice. The disease ranges in clinical severity from no symptoms to a mild illness lasting 1 to 2 weeks to a severely disabling disease lasting several months. In developing countries, hepatitis A virus (HAV) is usually acquired during childhood, most frequently as an asymptomatic or mild infection. Transmission can occur by direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested from sewage-contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked, and which can become contaminated during harvesting or subsequent handling.

Hepatitis B is a viral infection with clinical manifestations that include anorexia, abdominal discomfort, nausea, and vomiting, and often progresses to jaundice. Severity ranges from inapparent infections detectable only by elevated liver function tests to fulminating, fatal cases of acute hepatic necrosis.

Hepatitis B virus (HBV) is transmitted primarily through activities that involve contact with blood or blood-derived fluids. The most frequent mode of transmission is through sexual activity. Principal activities that can result in blood exposure include working in health care fields ; receiving blood transfusions that have not been screened for HBV; and having dental, medical, or other exposure to needles contaminated with HBV. In addition, open skin lesions in children or adults, due to factors such as impetigo, scabies, and scratched insect bites, can play a role in disease transmission if direct exposure to wound exudates occurs.

See also: Traveler's diarrhea and Acute Mountain Sickness (AMS) pages.
Recreation/Backpacking List, Recreation/Jeep CheckList

See also: Magellan's, Packing List for Kilimanjaro

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last updated 11 Sep 2002