Fit for life: No needle, will travel?

Nick Walker asks whether there are safe and effective alternatives to inoculation

Typhoid, rabies, meningococcal meningitis, yellow fever: the shopping list of vaccinations required by the long-haul traveller makes depressing reading. And that's even before the bills come in. Typhoid, pounds 18; polio, pounds 8; hepatitis A, pounds 28. The list goes on, costs mount.

For more and more travellers, homeopathy seems to offer a tempting alternative. "There's been a huge increase in interest over the past 10 years," confirms Tony Pinkus, chief pharmacist at Ainsworth's homeopathic chemists in London, who has some 50 people a day inquiring about holiday remedies, around 15 of whom ask about homeopathic inoculation. "There is a great British problem with vaccinations. I think a lot of people see it as over-the- top and any drug treatment as bad per se."

Chrissy Sorrel, for instance, became pregnant just before a short trip to the Far East last year. "I was very worried about the effects of inoculations on the baby - particularly the typhoid jab - so I went to a homeopath. I took a remedy which covered me for everything I needed on my trip. I was fine, but I spent a lot of time talking to my homeopath and my doctor before I left, so maybe it was just luck."

Mr Pinkus says the desire to avoid the needle is one of the main attractions of alternative inoculations, but price is another. For pounds 5.85, Mr Pinkus can provide a personally tailored pill containing a minute dose of medicine from the original vaccine greatly diluted, which covers, say, tetanus, polio, typhoid and hepatitis, the four major diseases that those travelling out of Europe should be protected against. He cautions that the effect can be short-lived and remedies need to be taken regularly during the protection period.

Homeopathic "vaccinations" are very different from alternative remedies for illness, but Mr Pinkus says homeopathic immunisation is the logical extension of curing like with like.

"Homeopathy does view traditional vaccination and immunisation as something of a blunderbuss approach," he says. "It is applying homeopathic principles in a very crude manner. Prevention is simply following the logic of the basic principles of homeopathy - that like can cure like, and so like can prevent like."

That is the theory. Still, Mr Pinkus admits: "This is not an area in which there has been any research. The evidence seems to be more experiential."

Dr Paul Clarke is medical director of the Medical Advisory Service for Travellers Abroad. "There is no statistical evidence. There is always good anecdotal evidence of people who have travelled all over and never had a bit of trouble, but until I see something published in a respected medical journal, I will remain doubtful."

So what do both systems offer? Traditional immunisation works by one of two methods. The first, administered by injection, introduces an impotent form of the disease organism directly into the body so that antibodies are created which will fight any potentially harmful future infection. The second, ingested orally, requires taking a small dose of the live organism, so that the body then produces antibodies.

Homeopathic immunisation usually requires the oral ingestion of a highly diluted form of the virus or bacterium. The exact mechanism of how this works is unclear, although practitioners claim it"actively stimulates the immune system in some way". Dr Clarke is doubtful: "It's very difficult to see how a very small dose of broken-down bacteria, which I can only presume is how this is working, can gain access through the gut wall - a very tough barrier - to produce antibodies."

There are those within the practice who argue that homeopathy has an important role for travellers. In his book, The World Traveller's Manual of Homeopathy, Colin Lessell "strongly recommends" homeopathic techniques in five circumstances.

First, where the conventional technique has been proved to have little effect, such as the cholera vaccine. Second, when travel plans are made at the last minute.Third, when there is no traditional technique available (such as in remote places). Fourth, where there are strong medical reasons against orthodox immunisation, such as pregnancy, or in the case of travellers with damaged or weak immune systems. Fifth, when the person refuses a conventional injection.

Still, even Mr Lessell would not recommend the total elimination of conventional techniques. Dr Ron Behrens is a consultant at the Hospital of Tropical Diseases in London. "As far as I am aware, there is no other way of protection without using the immune system. Indeed, people shunning orthodox anti-malaria treatment could be putting their lives at risk."

Moreover, Enid Seagall of the British Homeopathic Association concurs."Those who are using homeopathy regularly have probably got quite strong immune systems anyway ... but to entirely reject orthodox medicine is perhaps taking an unnecessary risk."