Health: Sick notes

"And ninthly," said the doctor from the Medical Advisory Service for Travellers Abroad (Masta), "you might consider an injection for Japanese B Encephalitis."

Friends had already warned me that the biggest deterrent to going on a tropical holiday wasn't the fear of disease but the recommended immunisation programme (which, depending upon where you live, can cost anything up to pounds 60).

The prospect of contracting any one of nine diseases during my holiday to India was worry enough. But since all, bar one, require an inoculation injection, not only would I run out of limbs (and both buttocks) but also there was little doubt I was going to suffer pain in this country irrespective of what I caught in India.

Dr Peter Barrett, senior medical advisor to Masta, continued his account of the extent of the outbreak of Japanese B encephalitis. Somehow I knew that the impact of a virus designed by the Japanese wasn't going to be same as, say, Spanish flu.

In fact, the latest death toll had reached 28 in the Kerala state of India - the very region I had planned to visit. "No tourists yet, just locals," said the doctor trying to reassure me.

I made an appointment to see the nurse at my surgery. By negotiation ("I promise not to go anywhere that might bring me in contact with yellow fever"), I managed to cut my quota to three jabs - hep A, typhoid and polio. The nurse didn't mention Japanese B; neither did I. Instead, I decided to change my plans and visit one of the other equally alluring, but less infected, parts of India.

Apart from the yellow fever vaccine, I had also ducked out of rabies (two or three jabs recommended before departure) and hepatitis B, neither of which are compulsory but recommended for 100 per cent safety. I managed to convince the nurse I was still covered for TB and tetanus.

Having established I was travelling with a male companion the nurse went on to treat me to the de rigueur holiday Aids lecture. It was the second one in a week. The subject had already been more than adequately covered by my girlfriend in her lecture on the many ways you could die from being unfaithful on holiday.

What I hadn't noticed was that the nurse had managed to staple a pack of condoms between two health guide pamphlets which she slipped me as I was leaving. At home these were discovered by my girlfriend who used them as evidence of my real motive for going on holiday. I had the Aids lecture again.

For the sake of a fortnight's holiday in the sun I had already been pricked all over, treated to a succession of increasingly gruesome India health horror stories and spent a month on the rack being mentally tortured by my girlfriend. But my own holiday anxieties pale into insignificance when I heard some of the inquiries Masta has to deal with. One woman who contacted Masta wanted to know whether restricting herself to drinking gin and tonic in India would give her protection against malaria. She reasoned that because quinine, a treatment for malaria, is contained in tonic water a regular dose of G&Ts would ward off any malaria threat.

Dr Barrett was quick to advise her against such a course of treatment. "She would have had to drink such a vast quantity that the last thing she would be worried about would be malaria."

Last year's media reports of a bubonic plague epidemic in India led to an almost hysterical response by holidaymakers which jammed Masta's helplines for three days. "At first, we were advising people to avoid too close contact with people in very crowded places. There was some concern that there could have been bubonic spread through coughing and sneezing," said Dr Barrett.

For me a repetition of any Black Death epidemic would have been the last straw but the doctor assured me the outbreak had died down. He also suggested that I concentrate on an illness almost unavoidable for first- time travellers to India - Delhi belly.

Dr Barrett had recently suffered an attack of Montezuma's revenge in Mexico and so knew what he was talking about. "It can wreck people's holidays," he warned. He recommends a drug called ciprofloxacin the effects of which he describes as "absolutely wonderful". If you take it as soon as you get your first bout, says Dr Barrett, it's an almost guaranteed cure. But of course I know now the only guaranteed cure to a holiday illness is staying at home.

Masta provides 24-hour personal healthcare advice to travellers on 0891 224 100. For queries about malaria, call 0891 600350.