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This is a rough guide to not contracting all manner of scary diseases on your travels. We reckon that would put a bit of a damper on the trip. Seriously, though, there are some truly horrific diseases out there that you might not be familiar with. We’re certainly not trying to scare you into not travelling, but we readily admit to trying to scare you (with good reason) into forking out for all your vaccinations, no matter how many nights in hostels you could pay for with the cash equivalent. We would point out that this is not necessarily comprehensive, and requirements vary depending on how long you’re going for, so please contact your doctor as well to be sure. But this is a good starting point. Read on...
Typhoid
An unpleasant disease spread through humans by unsanitary conditions. If you’re going somewhere where the standard of cleanliness isn’t very high, you may be at risk. Typhoid will give you a fever in its first stage, which will eventually lead to listlessness and clouding of consciousness. The second stage involves severe problems with your digestive system, usually resulting in harsh diarrhoea, while your pulse is very high and weak. It can last about 4 to 5 weeks, and is treated in hospital by antibiotics. You tend to show your first symptoms between 1 and 3 weeks after you contract it. As this disease is spread by unsanitary conditions, the most likely places you will contract it are the poorer countries in Asia, Africa, Central and South America.
The shot itself needs to be taken at least ten days before you travel, and you are recommended to have a booster every three years. You can have a combined shot of Typhoid and Hepatitis A to prevent excess holes in your arms, although the Hep A bit will only last a year. If you are pregnant, you may wish to not have this shot, and it is unadvisable to give it to a child of under 18 months. If you have recently had a feverish illness you should wait until you are fully recovered from it to get a Typhoid shot.
Hepatitis A
Hep A is a disease that inflames the liver. Like Typhoid, Hep A is spread through unsanitary conditions and passed on by humans. The symptoms begin with loss of appetite, nausea, aching muscles and a mild fever. Smokers will often find that they lose their taste for cigarettes. After this, skin and whites of eyes tend to get a bit jaundiced, and your urine goes darker. After this, the recovery process generally kicks in, and the whole thing will most often last about 2 or 3 weeks, although serious cases can last a couple of months. There is a tiny, tiny chance that if you contract Hep A then it can lead to liver failure and, ultimately, death. But there is no specific treatment – with plenty of rest and a balanced diet, you should recover fully. And if you do get it, once you’ve recovered, you’ll never get it again!
You should have your Hep A shot at least 2 weeks before you travel, and it will last a year. You can either get it as a combined shot with Typhoid, or a combined shot with Hep B. The Hep A + B combination needs to be taken in 3 doses, which can be done as late as 3 weeks before you travel. Children under a year old should not have the Hep A vaccination, and pregnant women should not have the vaccine unless they are at a severe risk of getting it.
Diphtheria
This one’s nasty. Diphtheria still has a surprisingly high mortality rate. The focal point for the bacteria that cause Diphtheria is the throat, nose and larynx. The bacteria multiply here, cause a severe throat inflammation and can coat the back of your throat to cause suffocation. The symptoms usually develop 2 to 5 days after you’ve contracted the disease, and often begin with a sore throat and difficulty breathing. If the disease infects the skin, you can come out in crusty scabs. As the disease progresses, if it isn’t caught in time, it will affect the heart and nervous system, which can result in an irregular heartbeat and paralysis.
It can be treated in hospital with anti-toxins and antibiotics. It is passed from human to human, and can be carried and passed by humans who never exhibit any symptoms. You can catch this anywhere in the world, although it is most common in poor or densely populated areas.
If you were born and brought up in Britain, chances are you were vaccinated against it from birth, and then received at least one booster at school, and usually one just before you left. This one is reckoned to be good for another ten years. This means that if you are over 26 years of age you should consider having another booster before you travel, which should be done at least 3 months before your departure.
TBs
TB (Tuberculosis) used to be one Europe’s biggest killers, until the 1940s when some effective medicines were developed and the mortality rates pushed down. TB is a disease of the lungs, and so the most well-known symptom is coughing up blood, which occurs at an advanced stage of the disease. However, it can spread through the blood to all other organs of your body. Other symptoms include exhaustion, weakness, fever, appetite loss and night sweats. Treatment for TB can take 6 to 12 months, involving a cocktail of antibiotics. If not followed strictly, treatment can fail. TB is mostly found in Africa below the Sahara desert, and in South East Asia, although it does still occur everywhere.
As of 2005, the TB vaccine (commonly known as BCG vaccine) is no longer given to children as a matter of course. The BCG vaccine is generally considered to last throughout your lifetime. If you have had the injection, you will probably have a scar on one of your shoulders. If you are travelling to a high risk area and have not had your BCG vaccination, you may wish to consider getting it. That said, you can take basic precautions by avoiding contact with people who are exhibiting signs of a persistent cough in high risk areas. You are more likely to contract TB if your immune system is weak, so make sure you eat well and exercise to stay as healthy as possible, and if you do develop a cough that lasts a few weeks, consult a doctor.
Hepatitis B
This is another strain of the Hepatitis liver infection, except that this one can turn chronic, particularly in young children. Hep B is passed through the blood, and is most commonly spread by infected needles/syringes, sexual contact and from pregnant women to their children during the delivery. It can, in some cases, also be passed by kissing and sharing toothbrushes. In those that the liver inflammation does turn chronic, the liver will swell and, in some cases, develop cirrhosis, leading to liver failure. The symptoms begin in the same way as Hep A: loss of appetite, nausea, aching muscles and a mild fever, followed by jaundice and darker urine. When the disease turns chronic, unfortunately there are not many more symptoms to help distinguish it, although one is occasional pressure or pain below the right ribs due to the enlargement of the liver. It’s very treatable, but needs to be caught in time, and preferably not when the liver fails.
You should get this vaccination at least a month before you travel. If you choose not to get it, then make sure that you avoid sharing needles, razors and toothbrushes, don’t get any tattoos done in dodgy places and use condoms during sex.
Rabies
Rabies is well known for being a fatal disease – in fact there have only ever been half a dozen known instances of humans surviving rabies once it has started showing symptoms. It is passed within warm-blooded mammals by blood and saliva. In Europe it is most commonly transmitted by foxes, in Asia by monkeys and in countries in which the fox population is controlled and pets vaccinated, by bats. So far, Australia, New Zealand and Japan have had no known cases of rabies, which explains their very strict policies on importing animals. If you have been bitten by a rabid animal there is still only a one in six chance that you will develop rabies. The disease enters the nervous system through the blood and heads up for the brain. The symptoms start with fever, vomiting, headaches, loss of appetite and pain at the actual location of the bite. At this point, the important symptom is a great deal of salivation, which is infected. After this, the disease develops and can lead to paralysis, fear of water (rabies is also known as hydrophobia), anxiety, delirium, confusion and hyperactivity. As the brain is affected at this point, aggression is also a symptom, and this is when the patient may attack and bite with no provocation, and pass on the disease. Once symptoms are showing, there is almost no chance of recovery.
However, the news is not all bad. The rabies vaccine, while not protecting you entirely, buys you more time if you are bitten. The first thing to do is wash the wound thoroughly with as much water as possible. You will still need to have a post-bite vaccine, but this treatment is less extensive than if you have not had a pre-bite vaccine, and does not need to be done with quite the same urgency, although must still be treated as soon as possible. The Rabies vaccine is a series of three shots taken over a month, and should be completed at least a month before travel. Some people have reported contracting fevers from the rabies shots that last a matter of hours. Whether you choose to get the vaccination in up to you – if you are travelling in India or areas of Asia where monkeys are constantly hanging around humans, you may wish to. If you are spending time in a country where you would find it hard to get quickly to medical treatment, e.g. trekking and camping in mountains, or travelling in a country whose medical facilities you would be reluctant to use, e.g. Cambodia, you may wish to have the vaccine to be on the safe side. But it is highly unlikely that you will be bitten if you avoid stray animals, and so just being cautious may be enough.
Meningococcal Meningitis
This is not a common vaccination, and you may only need it from time to time. Without getting too medical about it, basically this vaccine produces antibodies that will fight any meningococcal bacteria that enter your system that would cause meningitis. Certain parts of Africa are at risk from this, and certain countries in the Middle East demand a certificate of this vaccination before allowing you to enter the country.
This vaccine should not be used on very young children, those with a feverish illness, and those with an immune deficiency such as HIV. It is reported to produce certain side-effects in some people. These include headaches, fever, exhaustion and sleepiness. It also rarely causes an allergic reaction.
Yellow Fever
Known as Yellow Fever because of the yellow colour your skin turns from jaundice (because of the added Hepatitis which accompanies the disease), this is a serious viral infection passed on my mosquitoes, usually in tropical environments. It moves in an epidemic, and has a high mortality rate. You can show symptoms of the disease 3 to 16 days after you contract it, and they tend to involve high fevers, violent headache, muscular pain, upset stomach and loss of fluid. Yellow Fever has no treatment – doctors can only treat the symptoms and attempt to keep the fluid level as high as possible. In serious cases, Yellow Fever can lead to internal bleeding and kidney failure.
Yellow Fever is limited to Africa and South America. It is technically possible for it to spread to Asia, and as such, certain areas of Asia insist that you have had the vaccine against Yellow Fever before entering the country from Africa or Latin America.
Vaccination against Yellow Fever is agreed to last about ten years, and there are certain high risk areas that insist you have it before entering the country, along with Asia. Check with your doctor and local Embassy what the state of play is before attempting to travel to Africa or South America. You must have this vaccine at least 10 days before travelling.
Japanese B Encephalitis
This is another mosquito transmitted viral disease, most commonly found in rural areas of East Asia. It causes an inflammation of the brain, can easily lead to brain damage and has a high mortality rate. It tends to be spread by pigs and wild birds, and so it is most common in rural/farmland areas. The time from becoming infected to developing symptoms is about 4 to 16 days. Early symptoms of the disease becoming severe are headaches, fever and exaggerated reflexes, and then the symptoms move on to loss of consciousness, possibly even a coma. This could result in brain damage. There are no current treatments for Japanese B Encephalitis, and so doctors treat the symptoms.
The vaccine for this is a series of three shots, taken over a 28 day period. This gives you protection for a year, but if you have a booster a year later you will be protected for another 3 years. You should continue to protect yourself against mosquito bites, as the vaccine is not 100% effective, and there are reports of allergic reactions, so you should stay near medical care for a few days afterwards. You should have the vaccine at least a month before travelling.
It is generally supposed that you don’t need this vaccine unless a) you will be travelling in a high-risk area for more than a few weeks, or b) you think you will be tramping through rice fields or pig farms.
Tick-Bourn Encephalitis (Lime Disease)
Ticks, as most people know, are very unpleasant little creatures that stick their heads under the surface of your skin and start to drink your blood. In doing so, they swell up. If you try to pull them out their bodies can snap off, leaving their heads under your skin to get infected. As if this isn’t bad enough, some ticks carry Lime Disease, which can have even more unpleasant effects. The most common symptoms are drowsiness, headaches, fever, swollen lymph glands and joint and muscle pain. A sign to look out for is the circular area around the tick bite getting redder and bigger. In serious conditions which have become complicated, the central nervous system is affected, and you might suffer from back pain, numbness or meningitis, and could even lead to dementia. If you think the situation has got to this point you should go to hospital immediately. Lyme disease can also lead to inflammation of the heart, occasionally to heart failure.
Ticks usually live in forests, often on the bodies of deer, so if you find that you have a little black dot under your skin after tramping through some forests, you need to get it out. Lyme disease can take ages to manifest itself, but once it shows up in symptoms, it can be treated by antibiotics.
There is a vaccine for Lyme disease which is sometimes recommended if you are travelling in forested areas known to harbour ticks. The vaccine is given in 3 doses, and sometimes has side effects such as, muscle pain, fevers, rashes and headaches. You can do much to minimise your risk of being bitten by a tick – if you are spending lots of time walking through forests and high-growing shrubs, you can wear long trousers, tucked into your socks, to protect your legs, which are the obvious target.
We hope this information isn’t too scary – it just helps to be prepared before you travel. Of course the chances of you catching any of these diseases is minimal if you take the basic precautions, but it good to be aware of the symptoms in case you do think you might need to go to hospital. Some of these shots are pretty expensive, but as we said at the beginning, better to pay up. You can’t buy your health back once it’s gone too far.
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