Medical Considerations

Points to consider

Going to China as a caver is a bit different from being on the normal tourist trail, and it presents some out of the ordinary medical concerns. Hiking through the brush we've encountered leeches, ticks, and snakes. In the caves we've seen millipedes, large bat colonies, and even a poison arrow frogs. Streamways are often polluted with animal or human waste. It's well nigh impossible to avoid mosquito bites while camping, and sometimes etiquette demands that you drink or eat local food of dubious origins. Make sure that your doctor is aware of these special circumstances. This page gives an overview of our experience of health issues associated with caving expeditions to China; you should always consult your doctor, not this page, for medical advice.

That said, despite everything, the worst you're likely to suffer is a recurring bout of diarrhoea.

Vaccinations

The following are recommended for caving in China.  This certainly isn't authoritative, but it's meant to be a good starting point.  Please consult your own doctor.

  • Hepatitis A
    • 2 shots over 6 months.
  • Hepatitis B
    • 3 shots over 6 months.
  • Typhoid
    • 1 shot.
  • Tetanus
    • Booster every 10 years.
  • Diphtheria
    • Same as tetanus.
  • Measles, Mumps, Rubella.
    • 1 booster in adulthood.
  • Rabies
    • 3 shots over 30 days.
    • Considering the number of bats we've seen in China, and the frequency with which packs of snarling dogs are encountered in rural areas, we'd highly recommend this one.
    • This may no loger be relevant relevant, but from "Expedition Medicine and Histoplasmosis in Guangxi" , Cave Science, August 1990:

      "Rabies vaccine is now available on an ordinary general practitioner's prescription costing the recipient just 2.60 GBP for two doses instead of 40 GBP when privately ordered. This is a new and not yet well publicized development and can save money for expeditions."

  • Japanese B Encephalitis
    • 3 shots over 30 days. You're not supposed to travel for 10 days after each shot. Americans may find that their HMO is reluctant to pay for this one.

Here are some links you might find useful:
CDC on East Asia

Malaria

Malaria is a concern mostly in the summer in low-lying areas. Yunnan is considered a risk area, as are the costal and southern regions of Guangxi province such as Jingxi. Note, most malaria pills need to be taken 2 days to 2 weeks before entering the infected area, and then continued for about a month afterwards, so consult your doctor well in advance of leaving for China.

Note that most anti-malaria drugs are unsuitable for use at high altitudes (some of the caves in Yunnan are at over 4000m above sea level).

The Center for Disease Control says [April 9, 2001]:

"China: Risk in rural areas only of the following provinces: Hainan, Yunnan, Fuijan, Guangdong, Guangxi, Guizhou, Sichuan, Xizang (in the Zangbo River Valley only), Anhui, Hubei, Hunan, Jiangsu, Jiangxi, Shandong, Shanghai, and Zhejiang. In provinces with risk, transmission only occurs during warm weather. North of latitude 33° N, transmission occurs July to November; between latitude 33° N to 25° N, transmission occurs May to December; south of latitude 25° N, transmission occurs year-round. Note: Travelers to cities and popular tourist areas, including Yangtze River cruises, are not at risk, and do not need to take antimalarial drugs. Hong Kong S.A.R. (China): Urban areas: No risk. Limited risk in extremely rural areas of the S.A.R."

More info:
CDC's Malaria Page

First Aid and Prescription Drugs

Everyone should bring a personal first aid kit as well as their own malaria drugs. Many things can be bought in China, although finding them can be a bit of a hassle. If you're traveling in the summer, don't forget a DEET based mosquito repellant.

A first aid kit might include: plasters, iodine, gauze bandage, gauze pads, ibuprofen, paracetamol, lip balm, sunscreen, vaseline, talcum powder, small scissors, triangular bandage, tweezers, mosquito repellant, antihistamine crème.

Health Insurance

Americans may find that their HMO covers medical evacuation and other medical expenses whilst traveling.; check before investing in costly travel insurance. If you're a Brit, Rob had good luck with the British Mountaineering insurance. James has insurance through the BCRA.

BCRA Insurance: This is great for Brits, and horrible for residents of the US.
Patriot Travel Health Insurance: Overseas emergency evac, etc. for Americans. It has a rider to cover certain sports.