dangers

[MIKETM]

Maybe I can get some free info on Tropical diseases prior to me heading down to the area, (Central America), for a trip? Someone can give me the basics of Malaria? I know the mosquito bit, I took my nursing level Micro. How 'bout, are there any helmenthic infections that are quite common? Is it true that consuming spicy food will help fight Helmenthic infection? Is it still possible to get Cholera from swimming in the water? Is there a vaccine for cholera? How about reversal agents for some of these bites that we may come in contact. Treat the symptoms---------------just curious

[tangent]

don't know about cholera, but sent this in reply to a friends request last week....

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http://www.nasar.org/library/response_1995-spring_sarlog.shtml

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search for "malaria" - it will return hundreds of hits. There are a couple
of WHO manuals in the 70-80 page range on managing severe malaria and
malaria microscopy as well as chapters of others on vector (moscito)
control.

http://www.helid.desastres.net/

some titles:
Management of Uncomplicated Malaria and the Use of Antimalarial Drugs for
Protection of Travellers

Management of Severe and Complicated Malaria - A Practical Handbook (WHO -
OMS, 2000, 69 p.)

Emergency Vector Control after Natural Disaster (PAHO-OPS, 1982, 112 p.):
Part II: Control measures for specific vectors: Chapter 6: Anopheline
vectors of malaria

Guidelines on the Use of Insecticide - Treated Mosquito Nets for the
Prevention and Control of Malaria in Africa (WHO - OMS, 1997, 88 p.)

Basic Malaria Microscopy (part I and II) (WHO - OMS, 1991, 72 p.)
-------------
malaria
· Known strain of malaria for which refugees have no immunity esp.
falciparum malaria

· Stagnant, standing water
· Destroy mosquito breeding areas, larvae, and adult mosquitoes through
environmental measures (fill small depressions in terrain, proper garbage
management, clearing of bushes, etc.) Use insecticide spraying as a last
resort (specialist advice required)
· Ensure adequate drainage of site to eliminate breeding areas
· Distribute mosquito netting with or without impregnated insecticide
· Chemoprophylaxis of vulnerable groups (specialist advice required)
· Adequate treatment of malaria cases

[RESQDOC]

http://www.paho.org/Selection.asp?SEL=TP&LNG=ENG&CD=BDISPRVCT

http://www.cdc.gov/travel/

http://www.astmh.org/q&a/websites.html

More Later.

[RL]

Hey Mike,

I've been down that way a few times on mission trips, usally in some fairly outback kind of places. Lariam was the anti-malarial drug of choice. Taken as a prophylactic once a week: one week before, during and 4 weeks after the trip. Use some 30% DEET bug juice when the skeeters are out. Also, your can bring some Permethian (sp?) spray to treat clothes and mosquito netting.

Some countries require Yellow fever shots. Visit the CDC site for details on country specific requirements as well as general travel information.

Get the Hep A and B series. The Hep A is a two shot series; the first shot, at least four-six weeks before travel, imputes a 100% (theoreticaly) protection for, I believe, a year; the second shot, 6 months after the first provides 100% protection for life. The Hep B is a three shot series starting 4-6 weeks before travel. First shot, second shot a month later and the third 6 months after the first. One shot provides 90% immunity for life, the whole series 100% for life. The vector for Hep A is food/water and Hep B bodily fluids. Hepatitis is nothing to fool around with.

Typhoid and tetnus are recommended. The oral Typhoid is good for 5 years and the shot is good for two years. Also Diptheria. A DPT shot covers a lot of ground.

The main thing is don't drink the water. Most areas, except the smaller villages, will have bottled water available. Make sure the cap seal has not been broken as local entrepeneurs have been known to refill bottles with local water. Be cautious of ingesting water unintentionaly: while showering, brushing teeth, ice in drinks, fresh fruit washed with local water, etc, etc.

I don't remember doing much in the way of Cholera other than avoiding the water.

The only real medical problem we had was a couple people got Histoplasmosis, a fungal type infection ingested into the lungs from poultry droppings, I believe. The primary symptoms were malaise and high fever. The doctors here in the Atlanta area had a hard time diagnosing it and one guy like to died. Normally Histoplasmosis is not that big of a deal, except when it breaks out from the lungs and becomes systemic; then the Merck manual says it has a 90% mortality rate if untreated. The place we were at had a lot of chickens walking around the 'kitchen'. Roosting on the plateware and such.

Double check this information because it is all from my memory and my wife will vouch that that leaves something to be desired; find the CDC site.

[RESQDOC]

MikeTM,

For your purposes, here are the short answers. Read your info packet too. For your particular trip to Belize:

1. Malaria prophylaxis definitely recommended. Chloroquine (Aralen) 500mg once weekly, start 1 week before, continue through trip and a full 4 weeks after. Lariam and other stronger meds not needed for this AO. Contact me about getting this. Treat field clothes with permethrin. Use repellent.
2. Vaccinations, Tetanus, Hep A series, Hep B series. I assume your Tetanus & B are current. Contact me about the A. No other vaccinations needed. Cholera not endemic in the water, and no significant risk where you will be. Water safe to drink, etc. Don't worry about Typhoid.
3. Parasites always a risk but don’t eat uncooked protein, don’t walk around barefoot, don’t sleep on the jungle floor and you will be fine. Spicy food? Maybe. A single tablet of Vermox gets all the common intestinal parasites in Belize, should you manage to acquire.
4. Antivenin is in place, courtesy me.
5. Histo and similar a scant risk in the caves, very, very low risk. Because of the time I spend there I got a Rabies series, again very, very low risk so I wouldn’t bother unless you want.
6. Don’t get bit. Don’t get lit. Don’t get hit. Don’t do “it”. Don’t eat shit. A years worth of tropical medicine training right there.


_________________
Do No Harm. Do Know Harm.