SERIOUS HEALTH PROBLEMS THAT CAN AFFECT TRAVELERS

ALTITUDE SICKNESS

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Everest climber
in the old days
Altitude Sickness may be a problem in high-elevation areas, Acute Mountain Sickness (AMS, altitude sickness) causes fluid to form in the brain and lungs and kills by causing the brain to swell and hemorrhage inside the skull. Many people die of it every year, and there is no rhyme or reason to who it strikes (sometimes fat smokers are unaffected while athletes get sick). Describing altitude sickness, one mountain climber told the Washington Post, “You feel terrible, your head is pounding, your body failing, you can’t think, you can’t move. I was fit, but I couldn’t lift my head on my shoulders.”

The effects of the low oxygen on body tissues are noticeable above 3,500 meet (11,480 feet) and marked above 5,000 meters (16,400 feet)." Symptoms include headaches, nausea, vomiting, lightheadedness, lassitude, breathlessness, anorexia, fatigue, insomnia, swelling of hands, feet, or face, and decreased urine output. People with severe AMS have difficulty breathing with minimal activity, feel extremely tired, and have a dry cough. When the disease becomes more advanced the victims have bubbly breathing, cough up fluid or blood, feel confused and become bluish in color.

Above 12,000 feet a swelling of the brain called HACE (high altitude cerebral edema) may occur. The first symptom of this disease is a severe headache, hallucinations, stumbling walk, drowsiness and faulty judgement (which can make self-diagnosis difficult). Brain damage and death can occur quickly.

The only cure for AMS or HACE is to descend to a lower elevation quickly. If you experience any of the aforementioned AMS symptoms, descend immediately, the more you don't want to the more imperative it is that reach you lower elevations, even if it is rainy night.

Hypothermia

Hypothermia occurs when the body loses heat faster than it can generate it and the body temperature drops. The combination of wet clothing, cold temperatures, wind and exhaustion can cause the temperature to drop very quickly. Symptoms include numb skin, shivering, slurred speech, irrational behavior, lethargy, muscle cramps, and sudden bursts of energy.

As a precaution against hypothermia, or cold in general, people should wear a waterproof jacket or outer shell, preferably made from a waterproof material such as Gortex, and underneath that wear multiple layers of warn clothing, including silk, wool or artificial fibers that move water from away from the body. It is also important to wear a warm hat because so much heat is lost through the head.

The treatments for hypothermia include getting the victim into warm, dry clothes, seeking shelter, drinking hot liquids and eating high-calorie and easy-to-digest food. If possible get the victim into a sleeping bag, preferably with an other person Don't place the victim near a fire or rub them down.

Dehydration

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Dehydration is a serious problem in the desert and hot places. It is possible to die in less than four hours in the wrong part of the desert at the wrong time. It goes without saying to bring lots of water, at least 5 liters per person a day, and have access to shade. To avoid heat exhaustion and heat stroke stay in shade as much as possible, get enough salt, replace electrolytes with fruit juices or prepared drinks that replace the salts you lose, stay out of the sun and don't do strenuous exercise after 10:00am and before 4:00pm.

If a person loses a gallon of water and doesn't replace any of it, he experiences dehydration: parchment skin, dizziness, fatigue, loss of appetite, a low fever, and irritability.

When the temperature in the desert rises near 120̊F a person's pulse speeds because the body can not dispel the warmth. If a person loses two gallon of water and doesn't replace any of it, he can't stand up; his tongue swells and thickens; swallowing is difficult; moving, even crawling becomes impossible; the outer layers of skin tighten, darken and split. Eventually the liver and kidneys begin to fail. As the body temperature rises, the central nervous system can no longer control the heart rate and breathing. The person slips into a coma and dies.

One resident of the Sahara told National Geographic, "Two years a friend of mine got lost here for nine days. By the time we found him, his face was black. We could not tell who he was. Not until we got some water into him and he regained consciousness a few days later could he speak his name. We were all shocked."

Heat Exhaustion and Heat Stroke

Water acts as a coolant. Your body loses it through perspiration, digestion and urination. If you consume less water than you use you risk overheating and this can have dangerous consequences. The first signs of trouble are often are heat cramps. If the condition get worse it can progress to heat exhaustion and then heat stroke.

Heat cramps are the least dangerous of heat-related conditions. They serve as a warning that more serious things might happen if your body isn’t cooled down with some water or shade. The symptoms include cramps, muscle twitching, and lightheadedness.

Heat exhaustion is a serious condition. It is characterized by severe fatigue, headaches, confusion, nausea, weak pulse, cold clammy skin, and giddiness.

Heat stroke is a very dangerous and potentially fatal condition characterized by a high body temperature and no sweating. People with heat stroke need immediate hospitalization; in the meantime keep them cool with wet towels.

When in a hot place drink lots of water (carry at least 5 liters per person per day), replace lost salt and electrolytes with fruit juices or prepared drinks or rehydration salts (salt and sugar), don't do strenuous exercise after 10:00am and before 4:00pm, and stay in the shade.

Vector-Borne Diseases

Vector-borne diseases are human illnesses caused by parasites, viruses and bacteria that are transmitted by vectors (usually mosquitos, ticks, lice or blood-sucking insects). Every year there are more than 700,000 deaths from diseases such as malaria, dengue, schistosomiasis, human African trypanosomiasis, leishmaniasis, Chagas disease, yellow fever, Japanese encephalitis and onchocerciasis.

The burden of these diseases is highest in tropical and subtropical areas, and they disproportionately affect the poorest populations. Since 2014, major outbreaks of dengue, malaria, chikungunya, yellow fever and Zika have afflicted populations, claimed lives, and overwhelmed health systems in many countries. Other diseases such as Chikungunya, leishmaniasis and lymphatic filariasis cause chronic suffering, life-long morbidity, disability and occasional stigmatisation.

Distribution of vector-borne diseases is determined by a complex set of demographic, environmental and social factors. Global travel and trade, unplanned urbanization, and en The following table is a non-exhaustive list of vector-borne disease, ordered according to the vector by which it is transmitted. The list also illustrates the type of pathogen that causes the disease in humans.

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Malaria distribution

Malaria

20110306-malaria cdc freeborniwithlogo.jpg malaria mosquito Malaria is a disease caused by single-cell parasitic protozoans that are transferred to humans by particular kinds of mosquitos. The word “malaria” is derived from the Italian words “mala aria” , which means "bad air" and is based on the mistaken belief in the past that the disease was caused by bad swamp air. [Source: Michael Finkel, National Geographic, July 2007]

According to World Health Organization figures between 300 million and 500 million people are infected annually by the disease worldwide. It is endemic in 106 nations, threatening half the world’s population. Twice as many people die of it than a generation ago.

Malaria is the world's deadliest disease and the world's number one parasitic killer. It kills an estimated 1 million to 3 million people a year. About 90 percent of the victims are children under 5 in poor countries in Africa. A child dies of malaria every 12 to 30 seconds and about 25 percent of all childhood deaths in the Third World are the result of malaria.

Dysentery

Dysentery is a nasty disease characterized by diarrhea with blood and mucus and painful abdominal cramps. There are two kinds: 1) Bacillary dysentery, the most common variety, is foul and painful but usually goes away after a few days. 2) Amoebic dysentery, caused by an amoeba, is much more serious, long-lasting and difficult to treat. Shigellosis, a diarrheal diseases caused by a bacterium, causes severe dysentery but usually goes away abut a week.

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amebiasis life cycle

See Food and Water Precautions, Treatment for Severe Diarrhea, Above..

Bacillary dysentery appears suddenly and is characterized by nausea, painful cramps and diarrhea. It can be treated effectively treated with antibiotics (usually tetracycline or bactrim).

Amoebic dysentery appears more gradually and if left untreated can cause permanent intestine damage. If you notice blood in your stool for two or three days in a row seek medical attention immediately. The most commonly prescribed medicine to treat amoebic dysentery is Flagyl (metronidazole), an antibiotic and antiparasitic that is given in dozes of six tablets per day for seven days. Flagyl is also used to treat giardia and sleeping sickness. It has many adverse side effects.

Dengue Fever

Dengue fever is a nasty, viral disease transmitted by the “Aedes” mosquito, usually the “ Aedes aegypti” , the same mosquito that often carries yellow fever. Sometimes called "breakbone fever" or "break-heart" because of the intense pain it can produce, the disease is characterized by sudden onset of fever; intense pounding, frontal headaches; aching bones and joints; nausea and vomiting; and a feeling of being too sick to eat anything. Other symptoms include severe sweats, symptoms: eye pain, rash, chills, and excruciating chest pains. Tests foe dengue rely on the presence of antibodies, which can take up to a week to develop.

Dengue fever is found in 100 countries and kills about 20,000 people annually. Nine out of 10 people who get dengue fever don’t even feel it or get a mild case in which they feel something akin to a slight flu. People who get full-blown dengue fever are sick for a week or more. Many patients have a rash, which appears 3 to 5 days after the onset of the disease, and experience severe emotional and mental depression during the recovery period. Most cases of the disease are benign and self-limiting although convalescence may take a long time.

A few people with dengue fever suffer gastrointestinal bleeding. Fewer still suffer brain hemorrhages. In about 1 percent of cases dengue fever can cause a severe and often fatal hemorrhagic disease called dengue hemorrhagic fever (DHF) that occurs when capillaries leak and the circulatory system collapses.. Those that die of dengue fever often get DHF hemorrhaging in the final stage of the sickness. Failing to realize they are infected, they go don’t get treatment soon enough and lose blood plasma and go into shock after the initial fever passes. Some victims die within 10 hours of developing serious symptoms if they don’t get appropriate treatment.

Hepatitis

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hepatitis virus
Hepatitis is a viral disease that affects the liver. There are at least six known kinds of hepatitis (A, B, C, D, E and F). Hepatitis A, hepatitis B and Hepatitis C (which wasn't even identified until 1989) are relatively common in some places. Hepatitis D and hepatitis E are very rare. Hepatitis may be infectious or noninfectious. Six or seven virus are usually responsible for the infectious versions although other viruses, parasites, fungi may cause it.

Hepatitis is debilitating disease that can last for months. It often creeps up slowly (between 15 to 50 days, usually around 25 days), peaks, sometimes with pronounced symptoms, and fades away slowly. leaving victims feeling weak and tired for a long time.

Hepatitis A is contacted from contaminated water and hepatitis B is contacted from infected blood or bodily fluids. Both diseases can be very serious and debilitating and often include jaundice (yellowing of the skin and the whites of the eyes). Immunizations, consisting of a series of shots given over several weeks, are available for both diseases. If you are getting these shots for traveling make sure you get them well advance of your departure date.

Hepatitis generally begins with mild symptoms that may or may not become severe. Hepatitis can go on a long time and cause considerable damage before people realize they have it. Early symptoms include a slight fever, achy joints, abdominal pain, lethargy and aversion to cigarette smoke. One telltale sign of hepatitis is urine that is deep orange in color regardless of how much liquid has been consumed (if you think you may have hepatitis drink a lot of water, if you urine is still really orange or yellow see a doctor).

Rabies

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rabies bullet
Rabies is an infectious fatal disease transmitted by a bite from infected animals, which includes dogs, bats, and raccoons, and varies from place to place. Rabies is an extremely painful disease. It works its way through the nervous system, beginning around the bite, and causes painful muscles spasms, especially around the throat and eats away at the brain and causes insanity. Victims usually die of hydrophobia (paralysis of the breathing muscles).

According to the World Health Organization (WHO) about 50,000 people die of rabies every year, including 17,000 in India, 2,000 in China and 300 in the Philippines (2004). The disease is usually transmitted by dogs but also carried by other mammals. Human to human transmission has only occurred during organ transplants.

Untreated rabies is almost always fatal. In 2004, a 15-year-old girl bitten by an infected bat at a church in Wisconsin became the first known person to survive rabies without a vaccination. After she was bitten she did not seek immediate medical and made her first visit to a month after she was bitten when she began displaying rabies symptoms such as periods unconsciousness, double vision, slurred speech and weakness in her left arm. The teenager spent 11 weeks in the hospital. Because the disease had advanced to a stage that immunization was pointless she was treated with coma-inducing drugs to protect her brain and a cocktail of drugs to protect her nervous system and boost her immune system, with the goal being to protect her brain while the disease ran its course in the body.

Schistosomiasis

Schistosomiasis (bilharziasis or bilharzia) is caused by a blood fluke (a tiny worm also called a flatworm) that goes through a complicated life cycle utilizing a species of freshwater snail. After maturing inside a human host, adult flukes pair for life and produce thousands of eggs that damage organs and are discharged in urine and feces. The larvae that hatch from the eggs work their way into the snails that in turn produce large number of larvae capable of penetrating human skin. The flukes lives in the veins, bladder and large intestine of their human hosts and borrow molecules form their hosts to wear on their surfaces so the hosts’ immune system can't recognize them as alien.

Schistosomiasis is found in rural and suburban areas in 71 countries in Asia, Africa and Latin America (where it first arrived in the bodies of slaves). Globally, 200 million , or one in about 30 people, have the schistosomiasis parasites in their bodies. The WHO estimates that a quarter of million people died from it every year in sub-Saharan Africa alone.

Schistosomiasis is painful. Infection often occurs two to three weeks after exposure to the contaminated water. Symptoms include fever, lack of appetite, weight loss, abdominal pain, weakness, headaches, joint and muscle pain, diarrhea, nausea and coughing. Rarely, the central nervous system is involved. Chronic infections can cause disease of the lungs, liver, intestines and/or bladder and enlargements of the spleen and liver and bloody diarrhea and urine.

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schistosomiasis life cycle

Snake and Scorpion Bites

Snakes and scorpions are mainly active at night. Bites from scorpions are often painful but rarely dangerous although some species can be dangerous. Snakes bites are generally a much more serious matter. Wearing thick boots is good preventative measure. Snakes and scorpions sometimes rest in shoes and clothes. It is a good idea to carefully shake your clothes and shoes before you put them on. There are antivenim for most poisonous snakes but they are not always available. If you are really concerned you may want to bring snake anti-venom and scorpion anti-venom for the snakes and scorpions you might encounter. These sometimes need to be refrigerated.

Image Source: Centers for Disease Control and Prevention cdc.gov/DiseasesConditions

Text Sources: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services; World Health Organization (WHO) fact sheets; National Geographic, New York Times, Washington Post, Los Angeles Times, The New Yorker, Time, Reuters, Associated Press, AFP, Lonely Planet Guides and various websites books and other publications.

Last updated May 2022


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