Local Health Conditions

rabies

This is a fatal viral infection found throughout South America and parts of Asia. Many animals can be infected (such as dogs, cats, bats and monkeys) and it's their saliva that is infectious. Any bite, scratch or even lick from a warm-blooded, furry animal should be cleaned immediately and thoroughly. Scrub with soap and running water, and then apply alcohol or iodine solution. Medical help should be sought promptly to receive a course of injections to prevent the onset of symptoms and death.

schistosomiasis (bilharzia)

This disease is carried in fresh water by tiny worms that enter through the skin and attach themselves to the intestines or bladder. The first symptom may be tingling and sometimes a light rash around the area where the worm entered. Weeks later, a high fever may develop. A general unwell feeling may be the first symptom, or there may be no symptoms. Once the disease is established, abdominal pain and blood in the urine are other signs. The infection often causes no symptoms until the disease is well established (several months to years after exposure), and damage to internal organs is irreversible. Avoid swimming or bathing in freshwater where bilharzia is present. Even deep water can be infected. If you do get wet, dry off quickly and dry your clothes as well. A blood test is the most reliable test, but it will not show positive until a number of weeks after exposure.

dengue fever

Unlike the malaria mosquito, the Aedes aegypti mosquito, which transmits the dengue virus, is most active during the day and is found mainly in urban areas, in and around human dwellings. Signs and symptoms of dengue fever include a sudden onset of high fever, headache, joint and muscle pains, nausea and vomiting. A rash of small red spots sometimes appears three to four days after the onset of fever. Severe complications do sometimes occur. You should seek medical attention as soon as possible if you think you may be infected. A blood test can indicate the possibility of dengue fever. There is no specific treatment. Aspirin should be avoided, as it increases the risk of haemorrhaging. There is no vaccine against dengue fever.

malaria

This serious and potentially fatal disease is spread by mosquito bites and is endemic in most countries of the region (the exceptions being Singapore and Brunei). If you are travelling in endemic areas it is extremely important to avoid mosquito bites and to take tablets to prevent this disease. Symptoms range from fever, chills and sweating, headache, diarrhoea and abdominal pains to a vague feeling of ill-health. Seek medical help immediately if malaria is suspected. Without treatment malaria can rapidly become more serious and can be fatal. If medical care is not available, malaria tablets can be used for treatment. There is a variety of medications such as mefloquine, Fansidar and Malarone. You should seek medical advice, before you travel, on the right medication and dosage for you. If you do contract malaria, be sure to be re-tested for it once you return home, as you can harbour malaria parasites in your body even if you are symptom-free. To help prevent mosquito bites: wear light-coloured clothing; wear long trousers and long-sleeved shirts; use mosquito repellents containing the compound DEET on exposed areas (prolonged overuse of DEET may be harmful, especially to children, but its use is considered preferable to being bitten by disease-transmitting mosquitoes); avoid perfumes and aftershave; use a mosquito net impregnated with mosquito repellent (permethrin) - it may be worth taking your own. Impregnating clothes with permethrin effectively deters mosquitoes and other insects.

cholera

This diarrhoeal disease can cause rapid dehydration and death. Cholera is caused by a bacteria, Vibrio cholerae. It's transmitted from person to person by direct contact (often via healthy carriers of the disease) or via contaminated food and water. It can be spread by seafood, including crustaceans and shellfish, which get infected via sewage. Cholera exists where standards of environmental and personal hygiene are low. Every so often there are massive epidemics, usually due to contaminated water in conditions where there is a breakdown of the normal infrastructure. The time between becoming infected and symptoms appearing is usually short, between one and five days. The diarrhoea starts suddenly, and pours out of you. It's characteristically described as 'ricewater' diarrhoea because it is watery and flecked with white mucus. Vomiting and muscle cramps are usual, but fever is rare. In its most serious form, it causes a massive outpouring of fluid (up to 20L a day). This is the worst case scenario - only about one in 10 sufferers get this severe form. It's a self-limiting illness, meaning that if you don't succumb to dehydration, it will end in about a week without any treatment. You should seek medical help urgently; in the meantime, start re-hydration therapy with oral re-hydration salts. You may need antibiotic treatment with tetracycline, but fluid replacement is the single most important treatment strategy in cholera. Prevention is by taking basic food and water precautions, avoiding seafood and having scrupulous personal hygiene. The currently available vaccine is not thought worthwhile as it provides only limited protection for a short time.