Hep A and Hep B injections

[alypaly]

DS2 is travelling to costa rica with the school in summer. It is recommended that he has hep A and i was wondering about hep B as it is our decision and he is doing alot of sporting activities.

He is also going on a night bat tour..do they have rabies?

He needs to exchange bodily fluids to get Hepatitus B. Only you know whether that seems likely. Hep. A is a lot easier to catch, and might be advisable... though I would have thought Costa Rica would be low risk for it (high standard of living there).

I can't believe a school tour would go see the bats if there was even a low risk of anyone getting bit. I wouldn't worry about rabies.

Hep B not really essential unless he is living/working with the local community and going off the beaten track.

Bats can carry rabies - the vaccine doesn't prevent rabies per se, it just buys you time until you can get medical treatment.

He might want to think about having typhoid and may well need antimalarials.

Have a look here for more info.

Also he should have a travel health consultation with the practice nurse about a month before he goes (longer if he needs rabies vaccine).

I wouldn't do Hep A. Why not send him along for some gamma globulin just before travel.

I definitely wouldn't do Hep B either for the reasons mentioned above. It's so unlikely. And he's probably not going to get bitten by a rabid bat. Most bats aren't rabid and most bats don't land on you and bite you. Also the absolute best best best malaria protection is bite prevention. Malarials will give you a false sense of security. Loads of roll on, loads of mosbito clothing stickers, long socks, long trousers, sleeves down.

Re hepatitis B: this can be caught by exposure to blood during contact sports, and not necessarily by sexual exposure. Even then, the vaccine is very safe so again I can't understand why the OP is being advised against it. There's a combined vaccine against A and B.

@Sidge re rabies: Of course the vaccine protects you against the disease! Why wait until you get bitten and then have to have high titre immune globulin injected into the bite site plus 6 months of not knowing whether it has been effective or not? And let's not forget the far higher risk from dog- or cat-bites rather than bats.

Antimalarials should still be taken if travelling in the risk areas indicated. Mosquitoes are perfectly capable of biting through trousers and socks; as I can relate from experience.

Musukebba - I didn't write very clearly. (Trying to reply quickly before shooting off to do the school run isn't a good idea!) What I meant was that the vaccine isn't a complete prevention against rabies - of course it is hugely valuable but if a traveller is bitten/scratched/licked then they still need urgent medical attention which will involve treatment with further rabies vaccine. The person can't assume that having had the vaccine pre-travel is treatment/prevention enough.

I would still recommend rabies for some travellers, and I would also recommend Hep A (and B) for many travellers. Immunoglobulins aren't routinely given now pre-travel as we have effect vaccines.

I would also highly recommend malarial prophylaxis as well. Whilst bite avoidance is essential and should always go hand in hand with antimalarials there is a place for them. I think people forget malaria kills.

been to nurse today and she has given him hep A and hep B but dont think she has mentioned typhoid. Will ring again tomorrow to find out as it keeps saying that he should have it on all the websites ive been on. Does anyone know which website the NHS uses for advice

ring your GP and ask the practice nurse - they will know exactly what is advisable to have and what isnt.

Wouldn't bother with either personally.

well the nurse is half the problem....one said one dosage regime and another said something completely different. Has anyone else had the typhoid injection for costa rica

I haven't but I know someone who caught typhoid despite having the jab. I don't think you have the herd immunity to help, so much higher chance of it not working.