Introduction: Dangers&Annoyances in Tibet(2-1)

Local Health Conditions

Vaccinations for diptheria and tetanus are usually combined and are recommended for everyone. After an initial course of three injections (usually given in childhood), boosters are necessary every 10 years.

Step 1: Dangers&Annoyances in Tibet(2-2)

The vaccine for Hepatitis A (eg, Avaxim, Havrix 1440 or VAQTA) provides long-term immunity (possibly more than 10 years) after an initial injection and a booster at six to 12 months. Alternatively, an injection of gamma globulin can provide short-term protection against hepatitis A - two to six months, depending on the dose given. It is not a vaccine, but is ready-made antibody collected from blood donations. It is reasonably effective and, unlike the vaccine, it is protective immediately, but because it is a blood product, there are concerns about its long-term safety. Hepatitis A vaccine is also available in a combined form, Twinrix, with hepatitis B vaccine. Three injections over a six-month period are required, the first two providing substantial protection against hepatitis A.

Step 2: Dangers&Annoyances in Tibet(2-3)

China (although not so much Tibet) is one of the world's great reservoirs of hepatitis B infection. This disease is spread by contact with blood or by sexual activity. Vaccination involves three injections, the quickest course being over three weeks with a booster at 12 months.

This serious, easily transmitted disease is still prevalent in many developing countries, including China. Everyone should keep up to date with this vaccination, which is normally given in childhood. A booster every 10 years maintains immunity.

Step 3: Dangers&Annoyances in Tibet(2-4)

Officially there is no rabies in Tibet. All the same, there are an awful lot of rabid-looking dogs about. Recent surveys by the Chinese indicate that instances of rabies may have occurred in Qinghai, which borders Tibet. Vaccination should be considered if you are spending a month or longer in Tibet, especially if you are cycling, handling animals, caving or travelling to remote areas, and for children (who may not report a bite). Pretravel rabies vaccination involves having three injections over 21 to 28 days. The vaccine will not give you 100% immunity, but will greatly extend the time you have for seeking treatment. If someone who has been vaccinated is bitten or scratched by an animal they will require two booster injections of vaccine, while those not vaccinated will require more.

Step 4: Dangers&Annoyances in Tibet(2-5)

The risk of tuberculosis (TB) to travellers is usually very low, unless you will be living with or closely associated with local people in high-risk areas. As most healthy adults do not develop symptoms, a skin test before and after travel to determine whether exposure has occurred may be considered. A vaccination (BCG) is recommended for children and young adults living in these areas for three months or more.

This is an important vaccination to have in Tibet where hygiene standards are low. Available either as an injection or oral capsules. A combined hepatitis A-typhoid vaccine was launched recently but its availability is still limited - check with your doctor to find out its status in your country.