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Common problems encountered when travelling

(Adapted from Manson’s Tropical Disease, 21st ed, Gordon Cook et al)

 

Sunburn

The closer you go to the tropics the stronger the sun becomes. We advise you regularly apply a high factor sun protection and avoid direct sun exposure between 10 am and 3 pm. Sun burn can be very painful and in worst cases can cause second/third degree burns. Children are particularly susceptible to sun burn and should not be exposed to direct UV light.

 

Heat Stroke

This is when the core body temperature rises due to heat, exercise or fever.

Symptoms include headaches, drowsiness, confusion, collapse and fits.

If not appropriately treated heat stroke can be fatal.

 

Accidents

Fatal accidents are two to three times higher in developing countries compared to Western countries.

 

Strategies to reduce the risk of accidents:

  • Know the local medical emergency system
  • Avoid alcohol before driving or swimming
  • Carefully select swimming areas and avoid dangerous spots (e.g rifts, under currents, sharks, pollution, contaminated waters, etc)
  • Use seat belt or helmet whenever possible with the vehicle
  • Select safe cars rather larger vehicles when possible
  • Avoid riding on motorcycles
  • Avoid small, non-scheduled aircraft
  • Avoid travelling at night in remote areas
  • Employ a local driver, experienced in the area

 

Traveller’s Diarrhoea

It is very common, usually acquired in the first or second week of the trip.

It starts with abdominal cramps, profuse watery diarrhoea and occasional vomiting.

Recovery is usually complete after 5-7days.

Good hygiene measure with eating proper cooked food and bottled water when available will drastically reduce the risk of acquiring it.

A short course of antibiotics can help reduce the symptoms and shorten the time of the infection.

Ask your doctor or nurse for more advice.

 

Dysentery

Usually it is more severe than the traveller’s diarrhoea, contracted in areas with poor sanitation through contaminated water and foods.

Symptoms are diarrhoea with mixed fresh blood in the stools, abdominal pains, fever and lethargy with dehydration. In some severe cases blood poisoning.

It is advisable to seek medical advice when acquired.

Usually good hygiene measures will avoid getting this infection and if properly treated individuals recover well.

For more information ask your doctor or nurse in our clinic.

 

 

 

Mosquito Transmitted Diseases

Preventing mosquito bites is the key to avoid contracting severe tropical disease in particular malaria and yellow fever.

 

  • Use long sleeves clothes mainly in evening or on expeditions.
  • Use mosquito propellants on clothes and exposed skin.
  • Use impregnated bed nets when rough sleeping or camping.
  • Use air conditioned rooms with closed windows when available.
  • Smoke or spray mosquito propellant room before sleeping in evening.
  • Malaria preventative tablets to take before, during and after trip.
  • Yellow fever vaccine when required.

 

 

Malaria

Life threatening disease which is transmitted by mosquito bites. It is characterised by high fever, headaches, muscle and joint aches and seizures and can lead to death if not treated urgently. The disease can start several days to several months after the mosquito bite. Malaria prevention tablets if taken appropriately will protect you from having the life threatening symptoms. Usually the tablets are started just before your trip and up to 2 to 4 weeks on return, depending on the type of treatment.

 

Yellow Fever

This is a serious disease transmitted by mosquito bites.

Symptoms include fever, jaundice (yellow skin), diffuse bruising and internal bleeding.

Most travellers who contract yellow fever unfortunately do not survive.

However there is an effective vaccination against yellow fever which protects travellers for up to 10 years.

The vaccine has side effects which are thankfully rare.

When travelling to certain countries you must have a valid yellow fever certificate if you have transited in a previous yellow fever endemic country.

In our travel clinic we can advise you on whether you will need the vaccination and/or certificate.

We can also provide a ‘certificate of exemption’ if you have a specific health condition which the yellow fever vaccine could affect.

 

Dengue Fever

Transmitted following a mosquito bite in a endemic area.

It is a viral infection with similar symptoms of a bad flu.

It can be followed by a chronic fatigue syndrome.

In some rare cases it causes life threatening internal bleeding.

There are no tablets or vaccines to prevent it.

 

Japanese Encephalitis

Mosquito transmitted virus mainly endemic in south Asia but can be found around the tropics.

Symptoms such as fever, severe headache, confusion and chronic fatigue are linked with them.

It can be a life threatening condition.

In the UK there is a vaccine available but unlicensed.

 

 

 

 

Tick Transmitted Diseases

 

Tick Born Encephalitis

Viral infection transmitted by tick bites. It is endemic in continental Europe, Scandinavia, Russia and Northern America.

There are several strains of this virus. In Europe the strain can cause symptoms of fever headache and chronic fatigue and is rarely life threatening whereas strains in Russia and the Americas can be cause symptoms of fits, coma occasionally leading to death.

There is a vaccine available in the UK for the European and Russian strain and some North American strains

 

Lyme Disease

Chronic infection transmitted by the tick bite, starts with a characteristic rash at the site of the inoculation (erythema migrans) and chronic low grade fever associated with persistent tiredness.

The condition is easily diagnosed with the rash or blood tests and a course of antibiotics can get rid of it.

 

Other Insect Bites

may carry other types of disease or strong allergic reactions (bees, wasps, hornets, scorpions, etc)

 

 

 

 

Other Bites

 

Snake bites

Some snakes can be seriously venomous and you will need to clean the wound urgently, place a tourniquet (with belt or shirt) proximally to the bite and seek expert advice for an antidote.

 

Animal bites

Can transmit all type of infections, it is important to seek immediate medical advice and decide whether rabies vaccine should be given.

 

If you are planning to go on a backpacking holiday or to work with animals it is advisable to receive a preventative immunisation against rabies.

 

 

 

 

 

Vaccination Preventable Diseases

 

Yellow Fever

(see above)

 

Hepatitis A

Viral infection transmitted by food or contaminated water, usually in endemic countries with a poor sanitation.

Shellfish are often incriminated in particular where they are harvested off coastlines adjacent to sewage outlets.

Contaminated fruits or vegetables are known to transmit the virus.

Symptoms start as malaise, fever, muscle and joint aches, followed then by jaundice (yellow skin).

Recovery is usually slow and could take up to several months with symptoms of chronic tiredness.

The infection is rarely lethal.

There is a reliable vaccine which can give a full immunity for up to 2 to 10 years.

 

Hepatitis B

Contagious disease. Most symptoms will start with flu like symptoms associated with severe joint pains, occasionally a red itchy rash followed by jaundice (yellow skin). The liver is affected which could gradually lead to cirrhosis (scarring of the liver) and liver cancer.

The mortality is quite high and the progression of the disease is slow and rather invalidating.

Most areas at risk are south-east Asia, China, equatorial Africa, Oceania and South America followed by Eastern Europe, around the Mediterranean, India subcontinent and the Middle East.

There is a very safe hepatitis B vaccine which gives full protection for up to 10 years.

 

Typhoid (enteric fever, typhoid fever)

Bacterial infection transmitted mainly by contaminated food and water.

Countries with a poor sanitation system are likely to be endemic. If untreated the mortality rate is high.

There is a safe and reliable vaccine available to protect against the disease.

Confirmed cases are usually treated with antibiotics and most patients have a full recovery following the treatment.

 

Meningitis

It is a serious and rapid bacterial infection with a high mortality rate.

There are several strains which vaccines could protect from.

 

Note: Pilgrims travelling to the Hajj, in Saudi Arabia, will have to provide proof of vaccination on entry, as a meningitis vaccination is mandatory.

 

Tetanus, Diphtheria & Polio

Most people in the UK and in Western Europe are vaccinated and the immunity lasts for 10 years.

If you are not sure whether it has been more than 10 years since you last were vaccinated we suggest you receive a booster which will cover you for a following 10 years.

 

Flu Virus Immunisation

Seasonal flu appears across the world it is a highly contagious virus which spreads in the air by thin microscopic droplets from coughs and sneezing by infected individuals.

It is also spread by contaminated surfaces.

 

It is usually a mild disease but patients with chronic diseases are more vulnerable to the virus’ infection.

 

Pandemic flu such as the Swine flu can cause much more serious symptoms and could be as aggressive to young and healthy adults. Vaccines are available.

 

 

 

 

Sexual Transmitted Diseases (STD's)

Travelling abroad can be exciting and it is sometimes easily forgotten that you must always protect yourself from sexual transmitted diseases such as:

  • Chlamydia
  • Gonorrhoea
  • Hepatitis B
  • HIV

Don’t forget the rules of safe sex and it is advisable to get condoms with the British or European kite mark.

 

 

 

 

 

 

 

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