Before you read this I must say that this advice is personal. It’s the advice from a Dutch person who is not a doctor or any specialist in travel vaccinations. I just share my experience on preparations of a big cycle-tour through Europe and Asia in February 2015.
I’m a little bit scared today, I just woke up and prepare myself for a meeting with a doctor. This doctor is going to help me with advice about the travel vaccinations I need for my cycle-tour through Europe and Asia. It is October 20, 2014 and in about three months I am going to leave The Netherlands to cycle to Singapore.
This morning, I cycle for about 15 kilometers to a centre for travel vaccinations or in The Netherlands the so called Health Service and Youth. This part of my cycle-tour preparation is probably the most important one. It’s for safety on health, I don’t think you can skip that when you’re going to wild camp everywhere between The Netherlands and Singapore.
What travel vaccinations do you need for an adventure cycle-tour through Europe and Asia?
Well, you actually need none. But in my case, I’m a spoiled Westerner and in this society I’m used to overcleaned food. So I do need some travel vaccinations in order to lower the risk of unpleasant and possibly fatal diseases. Hence, it is still a personal matter. I like the idea that I can less worry about critical diseases. The Health Service and Youth adviced me about a couple vaccinations. I cross Eastern Europe, West, Middle and East Asia and down through Thailand to Singapore.
The advice was to think about the following vaccinations: hepatitis A + B, DTP, typhoid, Japanese encephalitis, tick-borne encephalitis and precautions for malaria.
I will go through this list with information about the vaccinations.
Hepatitis A
Hepatitis A is a highly contagious infection of the liver. The disease is caused by a virus. The virus leaves the body through feces. A bad hand wash hygiene after visiting the toilet can provide an infection. Door handles, taps, towels, but also food and drinks can be contaminated by people with hepatitis A.
A complete vaccination against hepatitis A (infectious jaundice) consists of two injections and is effective for 25 years. Between the two injections there need to be a period from at least six months. The first shot gives one year protection. A second shot after at least six months gives 25 years of protection.
Should you protect yourself or not?
A hepatitis A vaccination is recommended for almost all countries. The vaccination is not very expensive and has virtually no side effects. It can prevent a lot of misery. I decided to protect myself for 25 years.
Hepatitis B
Hepatitis B is a viral infection that causes inflammation of the liver. This virus is transmitted through blood-to-blood contact or through sexual contact. You can get infected by this virus if you get in contact with infected blood through a wound or through unprotected sexual contact with anyone who is infected with this virus.
Vaccination consists of three injections at month zero, one and six. To ensure life protection, you can do a blood test one month after the last injection.
Should you protect yourself or not?
For many countries the advice is to prepare yourself if you’re staying longer than three months. In the picture above you see me doing a blood test to check if I’m covered for a lifetime. I had this vaccination combined with the vaccination against hepatitis A.
DTP (Diphtheria, Tetanus and Polio)
Diphtheria is caused by a toxin of the diphtheria bacterium. Through coughing, the disease can go from person to person. In 2008, the World Health Organisation worldwide reported more than 7,000 cases of diphtheria. This mainly in India but also in Indonesia, Nepal and Brazil. The time between infection and disease is in average two to five days.
Tetanus is caused by a toxin of the tetanus bacterium. The bacterium can be found in street dirt and soil. You can get infected through a wound in the body. Tetanus is everywhere in the world. The time between becoming infected and being sick is three to twenty-one days.
Polio is caused by a virus. There are three types of polio. Infection occurs from person to person through the stool or feces of contaminated food or water. Especially in Asia and Africa polio is a common disease. The time between infection and being sick is in average seven to fourteen days.
A vaccination of the DTP vaccine protects against diphtheria, tetanus and polio.
Should you protect yourself or not?
In 2005 I was vaccinated against this disease, this vaccination works for a period of ten years. The vaccination has virtually no side effects and is adviced for almost all countries (except countries in Western Europe).
Yellow Fever
Yellow fever is a serious infectious disease that can cause bleeding, jaundice and fever.
The mosquito type Aedes and Haemagogus can bring you the yellow fever virus by a stitch. The disease is not transmissible among humans. The virus is found only in Africa and parts of South and Central America. The time between becoming infected and being sick is three to six days.
Vaccination consists of one injection that provides after 10 days a good protection for at least 10 years.
Should you protect yourself or not?
In this trip I will not visit countries in Africa, South America and Central America but if you do you might want to protect yourself.
Typhoid
Typhoid fever is an infectious disease caused by salmonella bacteria and gives particular intestinal complaints.
A vaccine against the typhoid fever consists of a single injection and provides a protection of 60-70% for a period of three years.
Should you protect yourself or not?
A vaccination for typhoid is recommended for all types of travels when you hit Africa, South America and Asia. This vaccination seemed like a smart choice to me because I’ll go cycling in many countries in Asia.
Rabies
Rabies is a serious infection of the brains, caused by a virus. The virus enters the body through wounds in the skin or mucous membranes (eyes and mouth) when you get bitten, scratched or licked.
Rabies vaccination consists of three injections on day zero, seven and twenty-one. This provides a basic protection. In an incident you should be vaccinated twice, the first one as soon as possible, the second vaccination three days later. Antiserum is only needed without a vaccination 24 hours after you’ve been infected.
Should you protect yourself or not?
Vaccination against rabies is very pricey. As a cyclist, I think this vaccination is a very important one because in not every country there is antiserum to protect yourself from this disease. In addition, as a cyclist you are at the centre of aggressive dogs and of course you never know if they are infected with rabies (most ones are too sick to be aggresive).
Japanese Encephalitis
Japanese encephalitis is a viral infection that sometimes can cause an inflammation of the brains. This can lead to death. Infection occurs through bites of a particular mosquito species (Culex). This mosquito bites at night ‘evening and and breeds in rice fields. The disease is not transmissible among humans.
Should you protect yourself or not?
In countries where this mosquito type is active, the local population is vaccinated against this infection. The vaccination against Japanese encephalitis is expensive as well. If you’re outdoors a lot in nature and (wild)camping you run some risk. If you’re out backpacking in big cities than it is not relevant.
Tick-borne encephalitis (TBE)
Tick-borne encephalitis is a viral infection that causes sometimes inflammation of the brains. You get infected with encephalitis through the bite of an infected tick or by drinking unpasteurized milk. Tick-borne encephalitis is not the same as the Lyme disease.
Should you protect yourself or not?
Are you going longer than four weeks camping or hiking in nature reserves in Europe? Or are you going on vacation in an area where the Russian variant occurs? Only than consider vaccination against tick-borne encephalitis. I will mainly pass through these areas in Europe in the winter and hope that the ticks are asleep around that time.
And what about malaria?
Malaria is a disease that will generally result in a high fever and is caused by the bite of a mosquito of the genus Anopheles. The mosquito adds parasites through a stab. The mosquitoes will stab only between sunset and sunrise.
The early symptoms of malaria are fever, fatigue, headache and myalgia. Also diarrhea,vomiting and coughing and shortness of breath can occur after effection. An attack of malaria can be very similar to flu.
Should you protect yourself or not?
You can protect yourself from malaria in several ways: by swallowing pills (with possible side-effects) and/or anti-mosquito measures.
Again, it’s a personal matter. Ask your doctor for advice on this, be at least good informed by people with the proper knowledge and experience.
Read more about the preparations of my cycle-tour from Rotterdam to Singapore.