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Mr. Bee had a doctor’s check-up recently, and told his doc that he was travelling to Costa Rica. She was very familiar with the country so she gave him Tetanus-Diphtheria and Hepatitis A vaccinations, along with prescriptions for Chlroquine (an anti-malaria medicine), and a Vivotif Berna (a typhoid vaccine).
I then did a little research and came across MD Travel Health, which recommends all the above meds for people travelling to Costa Rica. I got my Tetanus and Hep A vaccines a couple years back, so I’ll just ask my doctor for anti-malaria and thyphoid prescriptions.
People on travel messageboards also recommend that you take the prescription drugs Cipro or Levaquin, which treat traveller’s sickness aka diarrhea. I had a friend plagued with a horrible case of traveller’s sickness when he visited Europe some years back, and it almost ruined his entire trip. Will good old Imodium AD will be enough? I’ve taken the stuff before (diarrhea seriously hits me at the most inopportune times) and it really works! I’ve purchased the economy size for this trip. 
Are you getting any vaccinations for an international honeymoon? Or do you have any vaccine suggestions for international destinations you’ve travelled to?
I caught a nasty, violent stomach bug in Acapulco some years ago. I’m a seasoned traveler who spent months in rural areas of the Middle East, eating with the Bedouin in their tents, and never got sick there. In the Acapulco Hyatt I got seriously ill within three days–even though I was very careful, didn’t drink the water, no ice cubes, no unpeeled fruit, etc.–and had to cut my vacation short and fly home. I was supposed to go work on an archaeological survey in the interior after my beach vacation, but I never made it there. My doctors never figured out what it was, as it wasn’t common traveler’s diarrhea or Monteczuma’s Revenge, and I didn’t come up with any parasites they could find. However, I was sick for *months,* and I still have bad acid reflux to this day, which I never had before that. I think it permanently altered my stomach. Also, a couple of coworkers of mine went to Costa Rica last year and came home sick from the traveler’s trots. So–bring some Cipro! Take some every other day as a precaution. A little bit of extra Cipro won’t hurt you, and it could help.
Cipro and Levaquin are actually antibiotics, not anti-diarrheals. If the doc is saying to take them to prevent traveler’s diarrhea, it’s probably becuase you’ll likely be exposed to foreign bacteria which cause diarrhea. When you are infected with bacteria and get diarrhea, it’s becuase the bacteria are producing toxins. Your body naturally tried to rid you of the toxins before they are toxic. Hence, you are always going, which turns into diarrhea. If you get infected and you take immodium AD, that’s just “stopping you up” and you are keeping the toxins inside you. This can actually do more damage as the toxins are bottled up and have time to work their magic.
Before taking Immodium AD, talk to the doctor about it. Cipro is quite a strong antibiotic to jtake jsut in case. I’m not sure about Levaquin, but isn’t that an anti-malarial?
Anyway, talk to the doctor about it.
Have a fantastic trip, and don’t drink the water. brush your teeth with bottled water!
I gotta comment on this and making sure you know what kinds of vaccines to get. I am a tropical biologist and have travelled to some countries where they are more important than others. It is generally a good idea to have tetanus and hepatitis shots if you do not completely isolate yourself in an antiseptic bubble.
I work in Costa Rica every so often and I am getting married there early next year. I tell people that the Caribbean coast north of Limon is the region that is tagged for malaria (and it has not been prevalent in a long time). You need to be more careful of Dengue in that region and the best way to do that is with insect repellent if you are in the jungle. I am getting married just south of there and am not concerned with it. When you give blood in the U. S. the nurses taking your information ask about your travel history and they ask what part of the country you have visited because you cannot blanket a whole country as having malaria issues if it is just a region.
The water is safe to drink. Food poisoning in Costa Rica is as common as it is in the U. S. if you are not eating from mom and pop street vendors all the time. The only time I got food poisoning in Costa Rica was from an upscale Moroccan restaurant and consider it a fluke on par with getting food poisoning in an upscale Moroccan restaurant in any big U. S. city. Basically, prepare yourself for tummy issues no matter where you travel because you are eating food you are not used to since you are not cooking it yourself.
The only reason I got a typhoid vaccine was because I had a funky travel schedule at one point that had me in Costa Rica for a couple of months, then directly to Panama and then I had to go up to Montreal for a conference and I did not want any issue with immigration in Canada due to my lengthy stay in Central America.
I am coming off really forward in this e-mail because of the anti-malarial recommendation. These drugs have psychological side-effects for some people. A number of friends and myself who have worked in countries and regions with real malaria problems sometimes stay away from anti-malarials if we need all our facilities and cannot afford to go “crazy” while we are working.
I like that you are doing so much research as to what you need, but I also recommend contacting your resort or other local information outlet to ask what they suggest you be prepared with health wise in terms of vaccines, etc.
wow thanks everyone for all the great advice!! there is actually a very, very low risk for malaria in the area we’re travelling to (manuel antonio). i’m told it’s a bit higher risk in the popular Arenal area (but still low there too).
I am a bit of a hypochondriac with a better safe than sorry mentality, and I guess if Mr. Bee is going to take the meds I thought that I should too.
I’ll definitely do a little more research before stocking up on all these meds.
Cipro and Levaquin are very similar-in the same class of drugs. In my pharmacy classes, we learned that Traveler’s diarrhea is caused by a toxin producing e.coli. You may take the immodium as long as you do not have a fever and/or the diarrhea is not bloody. Levaquin is a good drug to take if you are going to take one, but preventative antibiotics are not recommended. If you want to, you can take pepto bismol or another bismuth subsalicylate product to prevent the diarrhea. Make sure you don’t get dehydrated above all!
I am also going to bring up a very random subject here about insect repellent and Dengue. There are two major strains recognized in Asian countries and Latin-American countries. My father is Panamanian so I have Latin-American blood in me and am mindful of how I can be affected even though I was born and raised in the U. S. Anyway, due to globalization, the strains of the Asian Dengue is now in Latin-America and in places like El Salvador people do not have the natural immunity to this strain and some of the poorer regions have major health issues due to this.
I am writing this because I know there are a lot of Asian participants on weddingbee and I do not know how the Latin Dengue affects the auto-immune response of people with immunity to the Asian strains of the disease. So, wear your insect repellent. Don’t wear too much DEET though. Be mindful of the mosquitoes. This is just my personal hypochondriac concern because I have not read any studies of Asian visitors to Central America but the thought crossed my mind when I heard about the health issues of El Salvadorean citizens.
You can e-mail me at my “name” at gmail if I can help you with any more questions.
I’ve used this website for travel/immunization concerns:
http://www.cdc.gov/travel/
In regards to anti-malaria meds..I never knew it could have funky psychologial side-effects..wow
I’ve been on those meds for each time I’ve flown out to a country w/ malaria mosquitoes and never experienced any “craziness” - sounds scary actually.
I’m going to Costa Rica in May and I will not be taking the anti-malarial drugs. For me, the numerous side effects out weigh the small chance of contracting malaria. I plan on just wearing lots of mosquito repelent. I’ve already had the HepA/B vaccinations but other than that I’m not getting any more vaccs or drugs.
Just to chime in on the Cipro thing- it generally is not a good idea to take antibiotics without having an infection in the first place. This is how bacteria that are resistanct to anti-biotics develop and this is becoming a huge problem.
I should post an insect repellent I recommend. People use DEET, but it is a harsh chemical and should be used in low dose because people can have chemical reactions. Some products can be 90% DEET and I have even seen a 100% DEET product from the UK. I use the Ultrathon 3M because of the protein capsulate formula and the 34% DEET content
http://www.rei.com/online/store/ProductDisplay?storeId=8000&catalogId=40000008000&productId=12413848&parent_category_rn=4500560&vcat=REI_SEARCH
Natural insect repellents can be good too but need to be reapplied a lot. I also travel with Burts Bees repellent.
Hope this helps. You ladies have provided me with such inspiring wedding ideas that I am only trying to give back to a community that I like checking in on from time to time
Agreed with bunnybride 100%
Having your Hep vaccines is required for going to college in the US these days, so it’s not a Costa Rica specific thing, it’s a good idea to have period, no matter where you live or travel.
Anti-malarial drugs are pretty harsh and totally not necessary for a trip to Costa Rica. The cdc is often over-reactant with their travel recommendations, as is their job, don’t get me wrong. But be mindful that they are preparing for worst case scenario with you going to the malaria region, drinking water from the street and licking the ground which I’m guessing you’re not likely to do.
Taking antibiotics without an infection is pretty irresponsible for doctor’s to be suggesting in my opinion. My nephew had/has a horrible bacterial infection that is resistent to 90% of antibiotics out there. He’s been in and out of the hospital since with pneumonia about 6 times in the last year until they finally found antibiotic that would treat it. It happened to be an anti-malarial antibiotic and if those are being used as preventative antibiotics instead of treatment, there may come a day when they won’t work for what my nephew had.
Just my two cents sorry, I get pretty emotional about that stuff. Costa Rica is my homeland after all and I’d hate for people to come away thinking it was a scarry place to go.
Just went to CR on my honeymoon. We did not have any vaccinations or take any special medicine with us (besides Benadryl). You should be fine.
Agree with PP on the quality of water and produce based on our experience there.
While I agree that the CDC is overly cautious and you may not absolutely need all of the vaccinations/medications they recommend, I always heed their advice. Malaria, typhoid, yellow fever, and many other diseases and infections common to developing countries are gnarley and serious. Even if your chances are low (1-2%), would you really want to be the anomaly?
Not to scare anyone, but many of the cheaper anti-malarials (cholorquine in particular) have been known to cause hair-loss. Last year my fiance and I traveled to a region of Panama resistant to cholorquine, so we had to take Malarone at around $20/pill. Malarone has the least # of side effects. It was expensive but I say better safe than sorry.
On our honeymoon to Vietnam and Cambodia in October, we plan to take Malarone again.
You can take the pills with you, in case of emergency, but please don’t dose yourself with anti-biotics unless you really need to. Build up your immune system beforehand with natural things, like OJ.
On my trip to Mexico as a student, the people who put iodine in their water, brushed with bottled water, never ate anything that wasn’t at a restaurant, etc. got sick. Those of us who ate food at vendors off the street, ignored iodine but drank bottled water, and weren’t overly concerned with wash water were fine.
Also, know your reactions to vaccines before you get them. I have a history of allergic reactions to them (and, yes, you can go to college without them — you just have to have a good reason not to get them).
Isn’t immodium a liquid? Can you bring an economy sized bottle?
fran - they’re just pills that you can buy over the counter.
You can pack the Immodium in your checked baggage. There are plenty of places to buy stuff in San Jose and big cities. Personally I love shopping at Mas por Menos when I land for toiletries and booze because they have good deals there.
unrelated comment….
will you be posting winners soon for the “favorite memory” contest…
i’m excited to see if who won the t-shirts…
thanks.
I would bring a prescription to treat traveler’s diarrhea, just in case. We went to Vietnam and Cambodia on our honeymoon and I got sick the last day of the trip. Nothing over the counter worked and I was very happy to have the prescription on our long flight home. I only took it once I got sick and it cleared whatever I had caught right up. We went to a clinic that specialized in travel medicine before our trip to get all our shots and they gave us the prescription, which we filled and then took the meds with us. We also took Malarone for the short time we were in high risk areas and had no side effects.
Also as a scientist and someone who has lived in Costa Rica, I would 2nd (3rd? 5th?) the no malaria pills, but only because the ‘risky’ areas are nowhere near where you will be.
Dengue fever is a big concern, but since you are not going to the Atlantic coast or Nicaragua, you should be fine if you wear bug spray.
Also, Costa Rica has great (and cheap) medical care and facilities, so if you should need help while there, you should be in good hands.
Keep in mind that for some women, Cipro and other antibiotics can CAUSE yeast infections as a side effect. You really don’t want a yeast infection on your honeymoon! If you’re planning to bring an antibiotic with you, I’d also plan to bring a package of Monistat or get a prescription filled for Diflucan.
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Mrs. Bee, New York Age and Occupation: 29, Weddingbee Publisher Fiance's Age and Occupation: 33, Internet Engagement Date: May 7, 2004 Wedding Date: March 5, 2005 Venue: Westside Loft, New York About Me: Yes, my name really is Bee! I love my blogging, wikis, and tabasco sauce!
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