The Travel Doctor

The Travel Doctor
      

Common Health Issues

Malaria

There are several infections spread by mosquitoes and other bugs, including dengue fever (day-biting mosquitoes), yellow fever, Japanese encephalitis and tick typhus. But malaria is by far the most important to consider while travelling.

There are four strains of malaria. One of them, Plasmodium falciparum, may be fatal if treated improperly or not early enough. This same strain has developed resistance to several antimalarial medications. That being said, malaria is usually preventable and, when necessary, a treatable infection.

The following personal measures will make a difference:

  • Limit outdoor exposure from dusk until dawn and cover up
  • Use an insect repellent containing DEET (e.g. Muskol <30%)
  • Sleep under an insect net at night

Antimalarial medications are used to lower your risk of becoming ill with malaria. There are several good antimalarials and the correct one for you depends on factors such as your destination, age, medical history and the duration of your trip.

Antimalarials are usually effective when taken properly. All medications may have side effect. The most common are listed below:

  • Chloroquine -(used only in chloroquine sensitive areas (bad taste, GI upset); taken weekly
  • Mefloquine (Lariam) - take with lots of food and water, not alcohol (GI upset, dizziness, insomnia, vivid dreams, anxiety); taken weekly
  • Doxycline - take with lots of food and water (GI upset, photo sensitivity, yeast infections); taken daily
  • Atovaquone/proguanil (Malarone) - GI upset; taken daily

Remember, malaria should be a preventable disease. But also remember, no antimalarial is perfect. Should you develop a fever while you are away, or upon your return, see a doctor. It could be malaria.

Traveller's Diarrhea

Diarrhea is the most common problem for travellers to the tropics. Your chance of developing diarrhea depends upon:

  • Your destination
  • The precautions you take
  • Your style of travel
  • LUCK!

In general, it is a good idea to follow the words of Montezuma himself: 'boil it, bottle it, peel it, cook it, or forget it!' Beer, carbonated drinks, bottled water, tea and coffee should be OK. Avoid uncooked vegetables and fruits that might be washed in local water. Ice cubes are not to be trusted!

Other methods of purifying your water is iodine, Pristine or water purifiers and filters.

The most important aspect of the treatment of diarrhea is fluid replacement with clear fluids or electrolyte solutions such as Gastrolyte or ORS. Immodium, in small quantities, will help "slow down" your bowels and may make you feel more comfortable. Because acute traveller's diarrhea is usually caused by a bacterium, and antibiotic such as Cipro or Zithromax might also speed up your recovery, especially in more severe cases.

REMEMBER: Travel expands the mind and loosens the bowels

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