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Before departure, all long-term travelers should undergo an extensive medical and dental examination. Travelers should anticipate that they will need care at some point during their stay, and they should plan where they will get it and how they will pay for it. Those traveling for work or with an organization (such as a university or the Peace Corps) may have a predetermined source of care; other travelers should identify a source in advance. Long-term travelers should also determine if they will need supplemental travel health insurance and evacuation insurance.
In some countries, travelers are likely to encounter counterfeit or low-quality medications. Because the pills and packaging may be nearly indistinguishable from their legitimate counterparts, travelers should consider bringing a supply of their routine medications (antihypertensive or antihyperlipidemic drugs, for example) from the United States
The World Health Organization (WHO) recommends these vaccinations for travellers to India (as well as being up to date with measles, mumps and rubella vaccinations) :
Adult diphtheria and tetanus Single booster recommended if none in the previous 10 years. Side effects include sore arm and fever.
Hepatitis A Provides almost 100% protection for up to a year; a booster after 12 months provides at least another 20 years’ protection. Mild side effects such as headache and sore arm occur in 5% to 10% of people.
Hepatitis B Now considered routine for most travellers. Given as three shots over six months. A rapid schedule is also available, as is a combined vaccination with Hepatitis A. Side effects are mild and uncommon, usually headache and sore arm. In 95% of people lifetime protection results.
Polio In 2007 polio was still present in India. Only one booster is required as an adult for lifetime protection. Inactivated polio vaccine is safe during pregnancy.
Typhoid Recommended for all travellers to India, even if you only visit urban areas. The vaccine offers around 70% protection, lasts for two to three years and comes as a single shot. Tablets are also available, however, the injection is usually recommended as it has fewer side effects. Sore arm and fever may occur.
Varicella If you haven’t had chickenpox discuss this vaccination with your doctor.
These immunisations are recommended for long-term travellers (more than one month) or those at special risk:
Japanese B Encephalitis Three injections in all. Booster recommended after two years. Sore arm and headache are the most common side effects. Rarely, an allergic reaction comprising hives and swelling can occur up to 10 days after any of the three doses.
Meningitis Single injection. There are two types of vaccination: the quadravalent vaccine gives two to three years’ protection; meningitis group C vaccine gives around 10 years’ protection. Recommended for long-term backpackers aged under 25.
Rabies Three injections in all. A booster after one year will then provide 10 years’ protection. Side effects are rare – occasionally headache and sore arm.
Tuberculosis (TB) A complex issue. Adult long-term travellers are usually recommended to have a TB skin test before and after travel, rather than vaccination. Only one vaccine given in a lifetime.
Dangers & annoyances
Contaminated food & drink
In past years, some private medical clinics have provided patients with more treatment than necessary to procure larger payments from travel insurance companies – get a second opinion if possible. In the late 1990s, several travellers were killed in a dangerous food scam in Agra and Varanasi after being fed food spiked with bacteria by restaurants linked to dodgy clinics. This scam has thankfully been quashed, but there’s always the chance it could reappear.
Most bottled water is legit, but always ensure the lid seal is intact and check that the bottom of the bottle hasn’t been tampered with. Crush plastic bottles after use to prevent them being misused later, or better still, bring along water-purification tablets or a filtration system to avoid adding to India’s plastic-waste mountain
As India is a developing nation, visitors need to take special precautions against illnesses not normally encountered at home. A trip to a doctor or travel clinic is recommended well in advance of your departure date to ensure that you receive all the necessary immunizations and medications.
In particular, the following common health issues should be addressed.
This very common travel ailment is encountered by many travelers and usually results from the consumption of contaiminated food & water. Some people also find that their stomachs and intestines don't appreciate the change in diet or spicy food. It's a good idea to always carry Oral Rehydration Salts, as well as anti-diarrhea medicine (such as Immodium) in case you have to travel and won't have access to a toilet.
Malaria and Dengue Fever
Both of these diseases are transmitted by mosquitoes and are most problematic in areas where there is stagnant water for mosquitoes to breed, particularly during and just after the monsoon season. They can produce some very nasty flu-like symptoms and fever. The mosquitoes that transmit the diseases are different types -- malaria carrying ones usually bite at night, while the dengue fever carrying "tiger striped" mosquitoes bite during the day (particularly during the very early morning).
Hepatitis A and B
Hepatitis is virus that affects the liver. Hepatitis A is contracted by ingesting contaminated food and water, while Hepatitis B is spread through blood and bodily fluids.
This bacterial disease is usually transmitted by food or water that’s contaminated with the feces of an infected person. It produces extremely high fever, sweating, vomiting, and diarrhea.
Tetanus is a bacterial disease from spores in the earth and animal dung, which enter the body though open cuts. It produces stiff muscles and spasms.