Himalayan Social Ecology (Oct.)

Eating and Drinking--Basic Rules

1. Drink only bottled or treated water.  When buying bottled water, make sure that the bottle has not been tampered with. This is the most important rule.
2. Watch out for "hidden" sources of contaminated water, such as ice. Hot beverages (tea, coffee, cocoa) and commercial soft drinks are generally safe.
3. Wash your hands before eating (soap or sanitizer).  This is especially important since Indian meals are often eaten with the (right) hand (although one usually gets a spoon too).
4. Cooked food should be fresh and hot. If it doesn't taste good, DON'T EAT IT.
5. Do not buy cooked food from street vendors unless you see it come out of the smoking-hot oil with your own two eyes.
6. Fresh fruits and vegetables must be peeled. Peel it, cook it, or forget it.
7. If you hold a fruit in your hand to eat it (such as a mango), DO NOT lick the juice from your fingers. Trust me on this one :-)
8. Don't panic if you get Delhi Belly.  It will be unpleasant for a day or so, but after that your system will have gained greater local immunity.  Taking antibiotics at the first sign of trouble will will kill your intestinal flora and set you up for further distress. 

Immunizations

For up-to-date medical advice, check the Indian Travel Page at the Center for Disease Control (both links should be active, the latter is the CDC's main page). Aside from recommending multiple immunizations, the Travel Page also talks about simple preventive measures (as above). If you want complete peace of mind, by all means get all the immunizations, but you still have to watch what you eat and drink.

Though I am not an MD, the immunizations I most highly recommend are Hepatitis A, typhoid, and tetanus.  It's not that the other diseases are less serious, but they are more easily managed with precautions (e.g.,  avoid animal bites, which can transmit rabies). The first two are spread by contact with an infected person, most commonly through contaminated food. My "mild" case of Hep A in 1990 left me sick for months, and even most people make a complete recovery, this is not something anyone wants to catch.  Note: At least in the past, the Hep A vaccine came in 2 doses administered 6 months apart, so plan accordingly.  India has high typhoid infection rates (which can be spread by asymptomatic carries such as the notorious "Typhoid Mary"), and although it responds to antibiotics, it is a nasty disease.  If your system is robust consider getting the oral typhoid vaccine (4 pills, taken one every other day); this uses a live virus and is more effective the injected vaccine.  You can get a tetanus booster shot (and perhaps Hep A) at most County Public Health Offices.  Many large hospitals also have Travel Medicine clinics at which you can consult with doctors and get the necessary immunizations.

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