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Travel Tips - Medical Advice
Quick Links - Cholera| Hepatitis | Malaria | Dengue | Diarrhoea| Meningococcal meningitis
An alien environment and new living conditions often tend to throw one’s health in disarray. Here’s a list of diseases you need to guard yourself against while travelling in India. Given the plethora of precautions enlisted, you might feel worried as to if it is worth making the trip at all. But rest assured, most of the travellers journey across India suffering nothing more than a customary stomach upset this land of heat and dust bestows. But as a popular on-the-road adage in India goes, “Safety is Better than Cure”. We advice that you contact your doctor or Travel Clinics allowing at least three weeks before the date of travel, for all medical advice.
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Water Worries
avoid untreated drinking water, always buy mineral water.
If purchasing bottled water from roadside stalls, dodgy-looking shops, or small towns, check the seal on the cap and investigate the bottle for any signs of tampering.
be on your guard against any food product that is washed with water or has had water added to it like ice.
carry a small cloth or napkins so that you can remove any and all water from anything that is going to go into your mouth
Use bottled water when you brush your teeth
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Fast Facts
- We strongly recommend that you vaccinate yourself against Polio, Tetanus, Typhoid, Cholera, Hepatitus A and Malaria.
- Ensure you carry a good mosquito repellent.
- If travelling in the sun, drink lots of liquids all day with a little sprinkled salt. Contrary to popular belief, dehydration once set in, cannot be remedied by just drinking more water – the lost salts need to be replenished as well.
- "Delhi belly"- An unfortunate reaction to unfamiliar rich and spicy foodstuffs that can overwhelm the system.Causes symptoms ranging from slight discomfort and "the runs" to extreme cases of nausea, fever, and delirium. To avoid this adjust slowly move on to spicy foods in small doses. Be on your guard about where you eat; if you have any fears at all, stick to the upmarket restaurants, usually those in five-star hotels
- Carry high-SPF sunscreen and use it liberally. It's also advisable to wear a hat or cap during the day.
Some diseases you need to protect yourself from are as follows:
Cholera : This diarrhoeal disease can cause rapid dehydration and death. Cholera is caused by a bacteria, Vibrio cholerae. It's transmitted from person to person by direct contact (often via healthy carriers of the disease) or via contaminated food and water. It can be spread by seafood, including crustaceans and shellfish, which get infected via sewage. Cholera exists where standards of environmental and personal hygiene are low. Every so often there are massive epidemics, usually due to contaminated water in conditions where there is a breakdown of the normal infrastructure. The time between becoming infected and symptoms appearing is usually short, between one and five days. The diarrhoea starts suddenly, and pours out of you. It's characteristically described as 'ricewater' diarrhoea because it is watery and flecked with white mucus. Vomiting and muscle cramps are usual, but fever is rare. In its most serious form, it causes a massive outpouring of fluid (up to 20L a day). This is the worst case scenario – only about one in 10 sufferers get this severe form. It's a self-limiting illness, meaning that if you don't succumb to dehydration, it will end in about a week without any treatment. You should seek medical help urgently; in the meantime, start re-hydration therapy with oral re-hydration salts. You may need antibiotic treatment with tetracycline, but fluid replacement is the single most important treatment strategy in cholera. Prevention is by taking basic food and water precautions, avoiding seafood and having scrupulous personal hygiene. The currently available vaccine is not thought worthwhile as it provides only limited protection for a short time).
Hepatitis: The symptoms in all forms of this illness include fever, chills, headache, fatigue, feelings of weakness and aches and pains, followed by loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-coloured faeces, jaundiced (yellow) skin and yellowing of the whites of the eyes. Hepatitis A is transmitted by contaminated food and drinking water. Seek medical advice, but there is not much you can do apart from resting, drinking lots of fluids, eating lightly and avoiding fatty foods. Hepatitis E is transmitted in the same way as hepatitis A; it can be particularly serious in pregnant women. Hepatitis B is spread through contact with infected blood, blood products or body fluids, for example through sexual contact, unsterilised needles (and shaving equipment) and blood transfusions, or contact with blood via small breaks in the skin. The symptoms of hepatitis B may be more severe than type A and the disease can lead to long-term problems such as chronic liver damage, liver cancer or a long-term carrier state. Hepatitis C and D are spread in the same way as hepatitis B and can also lead to long-term complications. There are vaccines against hepatitis A and B, but there are currently no vaccines against the other types. Following the basic rules about food and water (hepatitis A and E) and avoiding risk situations (hepatitis B, C and D) are important preventative measures).
Malaria: This serious and potentially fatal disease is spread by mosquito bites and is very common in India. If you are travelling in endemic areas it is extremely important to avoid mosquito bites and to take tablets to prevent this disease. Symptoms range from fever, chills and sweating, headache, diarrhoea and abdominal pains to a vague feeling of ill-health. Seek medical help immediately if malaria is suspected. Without treatment malaria can rapidly become more serious and can be fatal. If medical care is not available, malaria tablets can be used for treatment. There is a variety of medications such as mefloquine, Fansidar and Malarone. You should seek medical advice, before you travel, on the right medication and dosage for you. If you do contract malaria, be sure to be re-tested for malaria once you return home as you can harbour malaria parasites in your body even if you are symptom free. Travellers are advised to prevent mosquito bites at all times.
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To prevent mosquito bites
wear light-coloured clothing
wear long trousers and long-sleeved shirts
use mosquito repellents containing the compound DEET on exposed areas (prolonged overuse of DEET may be harmful, especially to children)
avoid perfumes and aftershave
Use a mosquito net impregnated with mosquito repellent (permethrin)
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Dengue fever: The Aedes aegypti mosquito, which transmits the dengue virus, is most active during the day, and is found mainly in urban areas, in and around human dwellings. Signs and symptoms of dengue fever include a sudden onset of high fever, headache, joint and muscle pains, nausea and vomiting. A rash of small red spots sometimes appears three to four days after the onset of fever. Severe complications do sometimes occur. You should seek medical attention as soon as possible if you think you may be infected. There is no vaccine against dengue fever
Diarrhoea: The first thing to bear in mind when diarrhea or nausea strike is that your body is trying to cleanse itself, so only use an anti-diarrhea medication (like Imodium) if you are desperate -- about to embark on a long train journey, for example. Ideally, you should plan a few days of rest and cut back on all food except plain basics (a diet of boiled rice and bananas is ideal), and drink plenty of boiled water (or black tea) or bottled water with rehydration salts. If your tummy trouble doesn't clear up after 3 to 4 days, consult a physician -- you may be suffering from something more serious: a protozoa (amoeba or giardia) or a viral or bacterial infection.
Remember that uncooked vegetables or fruit can be hazardous if washed in water that has not been boiled, so peel all your own fresh fruit and avoid salads. Unless you're in an upmarket hotel, don't eat fruit that has already been cut -- any water on the knife or on the skin of the fruit is likely to seep into the flesh. Be wary of undercooked meats -- they may harbor intestinal worms -- and stay away from pork unless you're in a five-star hotel.
Meningococcal meningitis: This occurs in trekking areas only. Not every headache is likely to be meningitis. There is an effective vaccine available which is often recommended for travel to these areas. Generally, you're at pretty low risk of getting Meningococcal meningitis, unless an epidemic is ongoing, but the disease is important because it can be very serious and rapidly fatal. You get infected by breathing in droplets coughed or sneezed into the air by sufferers or, more likely, by healthy carriers of the bacteria. You're more at risk in crowded, poorly ventilated places, including public transport and eating places. The symptoms of meningitis are fever, severe headache, neck stiffness that prevents you from bending your head forward, nausea, vomiting and sensitivity to light, making you prefer to stay in darkness. With meningococcal meningitis, you may get a widespread, blotchy purple rash before any other symptoms appear. Meningococcal meningitis is an extremely serious disease that can cause death within a few hours of you first feeling unwell. Seek medical help without delay if you have any of the symptoms listed earlier, especially if you are in a risk area.), typhoid (Contaminated water and food can cause typhoid fever, a dangerous gut infection. Medical help must be sought. In typhoid's early stages, sufferers may feel they have a bad cold or flu on the way, as early symptoms are headache, body aches and a fever that rises a little each day until it is around 40°C (104°F) or more. The victim's pulse is often slow relative to the degree of fever present - unlike a normal fever where pulse increases. There may also be vomiting, abdominal pain, diarrhea or constipation. In the second week, the high fever and slow pulse continue, and a few pink spots may appear on the body; trembling, delirium, weakness, weight loss and dehydration may occur. Complications such as pneumonia, perforated bowel or meningitis may occur. The fever should be treated by keeping victims cool and giving them fluids (watch for dehydration). Ciprofloxacin, 750mg twice a day for 10 days, is good for adults. Chloramphenicol is recommended in many countries. The adult dosage is two 250mg capsules, four times per day. Children between eight and 12 years old should have half the adult dose; for younger children one-third the adult dose)
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