Tanzania with young kids

[mamaLHK]

I'm considering a trip to Tanzania with our 6 year old son. I've been there several times (I love it there and can't wait to go back!) and yet now with a young child I am much more nervous than before. We would be going on (probably to Tarangire, Ngorongoro, Serengeti), spending some time with friends who live in villages in the Arusha region and also spending some time at an orphanage in the Arusha region. We may be going to Dar as well but I am not sure.

I have a few meds/vaccine questions that I find hard to find answers to elsewhere (hard to distinguish main stream med advice vs. true necessity).

One is malaria meds. Do people recommend taking (and giving to kids) preventative meds, and if so what kind? I used to take Larium but now I'm quite against it for psychiatric side effects. I think when ex-pats live over there long term they dont take preventative meds and then treat when they get it, but what do people recommend with a 6 year old who would be over there for some time between 3 weeks and maybe 3 months?

Next is yellow fever. I've done all but the final 4-6 year booster vaxes with my son, so I do vax but prefer not to. From what I have seen there have not been any cases of yellow fever in Tanzania in the last few years, but I am not positive.

What about Typhoid? I dont know much about this one. Anything else I should think about taking/giving?

Finally, if we work out the proper precautions is this a reasonably safe trip for a young one? For instance, I've read all this stuff about malaria progressing quickly in young kids, even gastrointestinal illnesses being much harder on kids. I dont want to put ds at (too much) risk, but at the same time I so want to go back there. I am nearing (or at) the end of my child bearing years and I might want to try for another child when we return, so I dont have the option of waiting a few more years for the trip (because then I might have a 1 year old!).

Thanks for any thoughts you might have! (Oh, and if anyone has any recs on good medical care in the region to know about that would be appreciated.)

[RomanGoddess]

Hi,
We live in Madagascar (inland) so some of your questions are pertinent to us as well.

There is no malaria in inland madagascar but there is on the coast. When we visit the coast, we do NOT take the preventative stuff (I wouldn't be able to give it to the baby anyway and I'm breastfeeding so don't want to take it myself). We do be careful in the evening between 5 and 7 PM - stay indoors, long sleeves and pant legs if we are outdoors, and citronella repellent on clothes and skin (even on baby). Malaria is entirely treatable. Just make sure that AS SOON AS your boy says he is not feeling well or has any fever at all, you get him to a dispensary for testing ASAP. The test is routine,the answer is immediate, the treatment is quick and the malaria goes away immediately as long as you treat it right away.

For the typhoid vaccine - typhoid is a treatable disease. You take antibiotics and it goes away. You do not get it from other people. You get it from contaminated food - it's a form of salmonella poisoning. If you will be eating at hotels or at friends' places, you are probably fine without the vaccine. The only reason to get the vaccine is that typhoid, though treatable, is pretty awful to have. It can be pretty violent (though not fatal) for children. Mind you, with the vaccine, you sometimes get a "mini-typhoid" which is also not so pleasant, so if you can avoid the vaccine on the grounds that you won't be eating in any unhygenic places, you are going to be careful about what you eat (no raw eggs or meat, don't eat food on the streets), and it's a treatable disease, great.

I'm not sure that yellow fever is treatable. You need to look that one up. The vaccine is not required here so we never got it. I have a feeling that it might not be and I think the disease is carried by mosquitos (although maybe I'm confusing it with dengue fever). Plus check whether the US will let you back in the country if you have been Africa without having been vaccinated for yellow fever.