免疫 [Ref. 1, 2]

Vaccinations:

Hepatitis A, Typhoid, Yellow fever, Measles, mumps, rubella (MMR), Tetanus-diphtheria.

Medications (“/” means “or”):

1.    Ciprofloxacin (Cipro)/levofloxacin (Levaquin)

2.    Mefloquine/Atovaquone/proguanil (Malarone)

Food and water precautions

Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, and sea bass.

All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.

If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

Insect and tick protection

Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accomodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.

Swimming and bathing precautions

Avoid swimming, wading, or rafting in bodies of fresh water, such as lakes, ponds, streams, or rivers. Do not use fresh water for bathing or showering unless it has been heated to 150 degrees F for at least five minutes or held in a storage tank for at least three days. Toweling oneself dry after unavoidable or accidental exposure to contaminated water may reduce the likelihood of schistosomiasis, but does not reliably prevent the disease and is no substitute for the precautions above. Chlorinated swimming pools are considered safe.

General advice

Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity. Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.

Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.

Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.

机票：Expedia订的TAM，纽约-圣保罗-Manaus， 12.24-31的往返票，连税$795.30。

Travel Signature: 从学校的ISO拿，提前三天。根据每年忙闲时段，办理所需时间有差异。

签证：

1.    使领馆地址（Brazilian Consulate in the US）

2.    Boston地区所需材料（Tourist VISA for non-US citizens）

住宿：           Ararinha Jungle Hotel

Packages:    Gero 或者 Eco-discovery

携带的物品：

1.      湿纸巾、面巾纸、药品、First Aid Kit、防蚊水($4.79x2+5.69)、防晒用品($10.99)、洗漱用品、食品袋；

2.      休闲短裤、拖鞋、内衣、袜子；

3.      温区生活携行具(65L)、迷彩服帽($36.99+36.99)，高帮作训靴($71.99)、腰带、强光手电($6.99)、电池($4.99)、指北针($5.99),雨具；

4.      、相机及附件、脚架、电脑、U盘、插座转接头、镜头纸、手机、手表；

5.      疫苗接种证明、护照、I-20、地址电话簿、纸笔、钱(含少量零钱)、机票、LP书($23.99+26.99)、打印资料；

6.  可选(我没带)：剃须刀、备用眼镜、刀、打火机、哨子、茶叶、游泳衣裤、吊床、小礼品。

需要购买的物品：

1.      CD、明信片。

出发前

1.    Re-confirm the flight at least 72 hours prior to scheduled departure (888-235-9826).

Schedule:

12/24/2008

1.    MBTA Redline (05:45 AM)

2.    Luckystar Bus (3rd floor, South Station bus terminal)(06:45 AM)

3.    Bowery/Canal St., J Line – Broadway Junction, J/A line – Howard Beach JFK Airport, A Line, -- AIRTRAIN

4.    Terminal 4, JFK, NY (05:40 PM)

12/25/2008 (Ref. LP Brazil page 278, 287, 301)

1.    São Paulo-Guarulhos International Airport – Bus (R$27)/Taxi(R$75) to city center (06:45 AM)

2.    Walking tour

3.    Sao Paulo (07:00 PM) – Rio de Janeiro – Manaus (12:50 AM)

Contact Information:

Geraldo Mesquita: +55-92-9983-6273 (cell), 021-92-9983-6273, 3232-4755 (office)

References:

1.       http://www.mdtravelhealth.com/destinations/samerica/amazon_river.html

2.       http://wwwn.cdc.gov/travel/destinationBrazil.aspx

3.       The Amazon: Amazonian Brazil, Bolivia, Peru, Ecuador, Colombia, Venezuela and the Guianas

4.       Brazil (Lonely Planet)

5.       http://www.amazonfilms.org/