This page contains
useful information for travelers to tropical destinations and people
involved in outdoor activities.g(It
features subjects like adventure, travel tips, indigenous culture, survival
skills, wildlife and plants and more...)
Ailment
Prevention
Treatment
Malaria
Prevent mosquito
bites (use
deet-containing insect repellent, treat clothing with permethrin,
sleep under a mosquito net.)
Prophylactic medicines
:
mefloquine, chloroquine, proguanil, plus-minus Fansidar standby in
Central and South Americas. (check locally for resistant strains of
the plasmodium).
mefloquine, chloroquine, proguanil,
quinine, quinidine, artemisinin (qinghaosu) and derivatives.
Prevent sand fly
bites (same measures as in malaria prevention).
For visceral leishmaniasis (kala
azar) and severe cutaneous and mucocutaneous leishmaniasis,
intravenous sodium stibogluconate (Pentostam) 20 mg/kg daily for
30-40 days is usually curative.
For mild cutaneous leishmaniasis
,
dapsone 100 mg twice daily for 6 weeks, or Ketoconazole 600 mg daily
for 28 days has been shown good results.
Amebiasis
Good hand washing,
boil/filter water, cook food well, avoid fly-contaminated foods.
metronidazole(flagyl)
750 mg three times a day for 10 days, followed by iodoquinol 650 mg
three times a day for 20 days.
Giardiasis
Good hand washing,
boil/filter water, cook food well, avoid anal-oral contact.
metronidazole (flagyl)
500 mg three time a days for 7 days; quinacrine (atabrine) 100 mg
three times a days for 7 days (not available in the United States);
tinidazole (Fasigyn) (not available in the U.S.) 2 gm daily for 1-3
days; furazolidone (furoxone) (not available in the U.S.) 100 mg
four time daily for 7 to 10 days.
Schistosomiasis
Avoid contaminated water
(fresh water), chlorinated water and sea water is safe. Heat bath
water to above 50 degree C or 122 degree F for more than five
minutes, or stand water more than 48 hours in a container.
For Schistosoma mansoni
and S. hematobium, praziquantil (Biltricide) is curative in a single
dose of 40 mg/kg. For S. japonicum and S. mekongi, praziquantel 60
mg/kg is given in three divided doses 6 hours apart. Dexamethasone
is a useful adjunct in the treatment of acute neuroschitosomiasis.
Traveler’s Diarrhea
Disinfecting techniques for
water and food, food hygiene, may consider prophylaxis with
medications.
For watery
(non-bloody) diarrhea, fluid hydration is usually sufficient; for
bloody diarrhea, need to start antibiotic or antiparacitic medicine
in addition to prevention of dehydration. Antibiotic choices include
Cipro 500 mg twice daily for 1-3 days; floxin 400 mg twice daily for
1-3 days; furazolidone(furoxone) 100mg 4 times daily for 1-3 days
for bacterial infection and for 7-10 days for giardiasis;
trimethoprim/sulfamethoxazole DS 1 tab twice daily for 3 days,
combing with loperamide increases effectiveness; metronidazole
(Flagyl) 500 mg three times daily for 5-7 days for giardiasis.
Good hygiene, disinfections
of food and water, vaccine, or immunoglobulin.
No cureagainst
the virus of hepatitis, but symptoms often disappear after a few
weeks to several months. Vaccination is available for hepatitis A
and B (and thus can help prevent hepatitis D as well).
Only supportive therapy for dehydration from diarrhea and vomiting,
no cure. Avoid alcohol and food heavy on the liver.
Hepatitis B
Good hygiene, disinfections
of food and water, vaccine, condomsduring
intercourse, avoid unscreened blood transfusion.
Only supportive
therapy for dehydration from diarrhea and vomiting; interferon may
be useful in chronic hepatitis B, but no cure for either acute or
chronic hepatitis B.
Keep wounds dry and clean,
wash wounds with clean saline for disinfections.
Antibiotics—topically or
orally.
Chagas Disease
Avoid assassin (a.k.a.
kissing, ruduviid) bugs which hide in the adobe hut structure
(thatched roof and mud walls); avoid blood transfusion in Latin
America.
Acute illness
can be shortened with nifurtimox, but the side effects can be
severe. No treatment for chronic disease.
Other cure in the acute stage can be done with Benznidazol or
Ragonil
Cholera—caused by Vibrio cholerae
Disinfect food
and water, avoid raw or undercooked food or seafood (especially
ceviche); vaccines are not recommended by WHO.
Fluid re-hydration,
antibiotics (Cipro 1 gm as single dose, Floxin 800 mg as single
dose, doxycycline, tetracycline, or furazolidone)
Dengue fever
Avoid mosquito bites.
There is no cure fordengue
fever, but usually all symptoms disappear after a week.Supportive
treatment with rest, fluid re-hydration, and pain medication.
Filariasis (one type of roundworm)
--lymphatic filariasis (bancroftian or malayan filariasis) and
subcutaneous filariasis (onchocerciasis—a.k.a. river blindness) and
loiasis
Avoid mosquitoes, flies
(especially black flies in Latin America, and red flies in Africa),
and biting midges; prophylaxis with diethylcarbamazine (DEC) either
weekly or monthly to prevent loiasis or lymphatic filariasis. There
is no prophylactic drug for onchocerciasis. Do not use DEC if have
previously been exposed to filariasis until treated and cleared of
parasites.
Diethylcarbamazine (hetrazan)
or high-dose ivermectin (200 micrograms/kg) for lmphatic filariasis;
ivermectin (150 micrograms/kg every 6 months for 1 year, then
annually for 5 years) for onchoceriasis; diethylcarbamazine (75mg/kg
total, but start with ¼ tablet per day and slowly work up to 3
tablets 3 times a day over a 3-week period to avoid anaphylactic
reaction from destruction of the worms.) or ivermectin (400
microgram/kg) as a single dose for loiasis.
Typhoid Fever—caused by Salmonella
typhi
Disinfect food and water,
good hygiene, avoid contact with infected individuals, vaccines
(oral or the new one-dose injectable)
Antibiotics (Cipro,
Floxin, ampicillin, trimethoprin/sulfamethoxazole, ceftriaxone, and
chloramhenicol)—start self-treatment with antibiotic and see medical
consultation if infection suspected.
Tropical ulcer
Avoid having
open wounds, cleanse wound with saline if present, keep wound dry
and clean.
Antibiotic powder (not
ointment) to keep wound clean and dry.
Dehydration
Oral Rehydration Therapy:
Add 1 tsp of salt and 2-3 tsp of sugar or honey
to 1 liter of water.
Mix 8 oz. of fruit juice with 3 cups (24 oz.)
of water, and add 1 tsp of salt.
Mix together: 1 liter clean water, ½ tsp table
salt, ¼ tsp salt substitute (provide potassium chloride), ½ tsp
baking soda (provide bicarbonate), and 2-3 tbsp of table sugar, or 2
tbsp of honey or Karo syrup. If cannot obtain baking soda or salt
substitute, use 1 tsp of table salt per liter of solution.
Steps of dehydration treatment technique:
vigorously drink 3-6 liters or more of full-strength oral
re-hydration solution over 2-4 hours. Don’t stop as soon as thirst
is quenched—drink enough to restore urine output.
After re-hydration, start eating if not vomiting, and continue
to drink fluids to maintain hydration. The best fluids are dilute
fruit juices and water. If not able to eat, use half-strength oral
re-hydration solution (ORS) as a maintenance fluid.
If watery diarrhea continues after re-hydration, prevent
recurrent dehydration by drinking 8-12 oz. of full-strength ORS
after each watery stool. Continue to eat and also consume water as
thirst dictates.
Start antibiotic for traveler’s diarrhea as soon as possible.
Use easy-to-digest starches as starting foods—salted crackers,
lightly salted oatmeal, rice cereal, lightly salted rice or noodle
soups, etc. BRAT diet (banana, rice, apple sauce, and toast) is also
good. Advance diet as allowed to cooked meats and vegetables, and
then normal diet.
