There have, in addition, been cases of substitution of inert materials for active drugs. With the following precautions and advice you should keep as healthy as usual. Make local enquiries about health risks if you are apprehensive and take the general advice of European, Australian or North American families who have lived or are living in the area.

Before you go
Take out medical insurance. You should also have a dental check-up, obtain a spare glasses prescription and, if you suffer from a long-standing condition, such as diabetes, high blood pressure, heart/lung disease or a nervous disorder, arrange for a check-up with your doctor who can at the same time provide you with a letter explaining details of your medical disorder. Check the current practice for malaria prophylaxis (prevention) for the countries you intend to visit.

Vacctination & immunization
Visiting the peninsula's west coast does not require any medical precautions other than some insect repellent. Those travelling to national parks, rural areas and to Sabah and Sarawak are advised to have vaccinations against cholera, typhoid and polio, hepatitis A, tetanus and Japanese encephalitis. Smallpox vaccination is no longer required. Neither is cholera vaccination, despite the fact that the disease occurs, but not at present in epidemic form. Yellow fever vaccination is not required either, although you may be asked for a certificate if you have been in a country affected by

Yellow fever immediately before travelling to Southeast Asia.
Infection hepatitis This is less of a problem for travellers than it used to be development of two extremely effective vaccines against the A and B form of the disease. It remains common, however, in Laos. A combined hepatitis A and B vaccine now licensed and has been available since 1997 - one jab covers both diseases

Typhoid (monovalent) One dose followed by a booster 1 month later. Immunity from this course 23 years. An oral preparation is also available.

Poliomyelitis this is alive vaccine generally given orally but a full course consists of three doses with a booster in tropical regions every 3-5 years.

Tetanus one dose should be given, with a booster at 6 weeks and another at 6 month. Ten yearly boosters thereafter are recommended.

Meningitis and Japanese B encephalitis (JVE) There is an extremely small risk of these rather serios diseases; both are seasonal and vary according to region. Meningitis can occur in epidemic form; JVE is a viral disease transmitted from pigs to man by mosquitoes, For detail of the vaccinations, consult a travel clinic.

Children should, in addition to the above, be properly protected against diphtheria, whooping cough, mumps and measles. Teenage girls, if they have not had the disease, should be given a rubella (German measles) vaccination. Consult your doctor for advice on BCG inoculation against tuberculosis: the disease is still common in the region.

Basic supplies
You my find following item useful to take with you from home: suntan cream, insect repellent, flea powder, Mosquito net, coils or tablets, tampons, condoms, contraceptives water sterilizing tablets, anti-malaria tablets, anti-infective ointment, dusting powder for feet travel sickness pills, antiacid tablets, anti-diarrhoea tablets, sachets of rehydration salts, a first aid kit and disposable needles (also see page 59)

Further information
Information regarding country-by-country malaria risk can be obtained from the world health organization (WHO) or in Britain from the Ross Institute, London School information - Keppel St, London WCIE 7HTwhich also publishes a highly recommended book the preservation of Personal Health in Warm Climates. I he In Atlanta, Georgia, USA will provide equivalent information. The organization MASTA (Medical Advisory Service for Travellers Abroad) also based at the London School of Hygiene and Tropical Medicine (T020-7631M08) will provide up-to-date country-by-country information on health risks. Further information on medical problems overseas can be obtained from Travellers Health: How to Stay Healthy Abroad, edited by Richard Dawood (Oxford University Press, 1992). This revised and updated edition is highly recommended especially to the intrepid traveller. A more general publication, with hints on health and much more besides, is John Hatt's The Tropical Traveller (Penguin, 1993).

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