Oh, Gnats! Peru Vaccination & Healthcare Prep (Part I: Mosquitoes)

I spent the morning with the terrific travel medicine specialist at Penn Travel Medicine Center at University of Pennsylvania. Be forewarned: they don't take insurance. The consultation ($95) was about an hour, and worth every minute. What an education! I'll do a couple of posts on what I learned-- though, I must confess, I paid closest attention to what applied to me. Individual circumstances and choices will vary widely. (Go see your own doctor, this isn't medical advice, you know the drill.)

First, go prepared: Fill out the forms they provide in advance. Bring your vaccination record and your itinerary: Your altitude (locations visited, duration of time spent in each) will determine a lot of your treatment plan.

I'll start with the mosquitoes. (See my other posts [Healthcare prep Posts II and III] for Altitude Sickness and Montezuma's Revenge.)

MOSQUITO-BORNE ILLNESS

What to expect: Mosquitoes thrive under 2,000 feet. We'll be in Puerto Maldonado, in the Amazon basin, for two or three days, at sea level. 

NIGHTTIME MOSQUITOES (i.e. "aggressive at night") transmit Yellow Fever [Vaccination recommended, $175] and Malaria [Rx recommended]. The Malaria treatment [Rx] varies by cost and elements of treatment. Speak to your doctor. I'll be taking Malarone (something like $7 a pill and considered expensive, 96% effective). You take it two days ahead of travel, and continue through seven days after completing travel. Check to see if your lodge has mosquito nets, screens in the windows. Our does. I think. 

DAYTIME MOSQUITOES (i.e. "aggressive during daytime") transmit Dengue Fever, Chikungunya, and Zika. There's no vaccination or Rx for these; you simply attempt to prevent with insect spray and smart clothing. (Crossed fingers.)

What to try: Preventative measures are essential.

• Clothing is your first line of defense: long sleeves, long pants, long socks UNDER pants. See that photo above? Hear me when I say LONG PANTS.
• Insect Repellent: Get 20-35% Deet, Long-Acting (10-12 hours)—One container will be fine for our three days. Spray directly on skin. (If you get anything not long-acting, or at a lower %, you will be spraying constantly.) In addition: get Permethrin—Insect repellant that ONLY goes on clothing, never ON SKIN. 
• Mosquito netting (sleeping): Great tip: Bring a couple of rubber bands in case nets get holes.

What to try: For swelling or a severe histamine reaction, they recommend Benadryl or OTC cream.

When to worry:  If you have flu-like symptoms (fever, cough, or joint pain), you must follow up with your doctor.

A note: Zika is in the news nearly every day here. I must confess that I carelessly waved away the Zika talk. Childbearing-age women: beware and pay attention. 

I won't describe here what happens if you contract one of these illnesses-- and at this time, that's not a huge concern (focus?) of mine. Here, in New Jersey, we fuss and take a good number of precautions for any basic Pine Barrens hike or camping trip--not with mosquitoes, but with ticks. So, I'm pretty used to adapting.

Next time: Traveler's Diarrhea and Altitude Sickness.