A traveler, new to our clinic, called me about a month ago and asked me to call in prescriptions for her for malaria without seeing her. She had gone to the CDC web site for Thailand and so knew what she needed. She went to her primary care provider, who gave her the shots she asked for based on what she read on the web site, but he wouldn’t prescribe the malaria pills.

I asked her what she got for this 2 week trip and he gave her hepatitis A and B, a tetanus booster (don’t know what kind), rabies shots and Ixiaro, to prevent Japanese encephalitis. “Did he give you a flu shot? “ I asked. “No.” Then I asked where she was staying and what she was planning to do for activities there.

She asked , “What has that got to do with anything?”

And I said, “Everything .”

A backpacker planning on visiting a refugee camp on the Thailand – Cambodian border has very different needs than the company executive staying at a high end hotel in Bangkok whose needs are entirely different than the couple on their honeymoon at the beaches. The CDC web site is a great reference but it consists of one size fits all information not tailored to individuals.

She was planning a trip with a tour group and visiting the traditional tourist sites. She didn’t need the Ixiaro or the rabies vaccines, which cost her almost $1,000. She’s not sure her insurance company will pay for that, either. She did need a flu shot for that long plane ride during peak flu season, cost $25. So I gave her an appointment where we also discussed jet lag, dengue fever and traveler’s diarrhea prevention, gave her the flu shot and a prescription for malaria and azithromycin for $125.

She’s planning a trip to see her daughter in Peru next summer. She’s planning on coming to us first, for that trip.


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