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West Nile Disease

West Nile Disease


“People really should not be worried about it, but there is no harm being aware of it.”

Professor Chris Curtis, Professor of Medical Entomology at the London School of Hygiene.

“Over here in the UK there has been a case of birds being discovered with West Nile antibodies, but there are still no human cases in the UK.”

Annette Lee, who is studying West Nile disease at Harvard.

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What is it West Nile disease?

West Nile virus is spread through the bite of an infected mosquito. The mosquito can become infected after biting an infected bird and this can then be transmitted from the bird to humans.There is no evidence to suggest that West Nile virus can be spread from person to person or animal to person.

Where am I at risk?

The West Nile virus was first discovered in the West Nile area of Uganda in 1937.It is prevalent in North America, where two thirds of the East coast states have had cases. There has even been a case in California.

There have also been cases in Israel, Africa and Asia and parts of Eastern Europe.

There was a UK case of a bird with the antibodies of the West Nile virus, but there have been no human cases.

What are the symptoms?

The patient can incubate the disease for up to a fortnight after being bitten.Many of the people who become infected will have either no symptoms or mild flu-like symptoms, which last a couple of days.

These can range from fever, headache and body aches to skin rashes on the trunk of the body and swollen lymph glands.

But more serious cases, less than 1% of those who become infected, can result in severe illness such as West Nile encephalitis or meningitis and sometimes lead to death.

Out of about 1,000 people who became infected in Europe recently there were about 40 deaths.

How do I protect myself?

Scientists have developed a vaccine for the disease and it was due to start human trials in late 2002.But as yet there is no vaccine for travellers to use so the best way to protect yourself is to avoid being bitten by a mosquito.

The mosquitoes which carry this disease bite at dawn, dusk and early evening, so if you are travelling to an area where the disease is prevalent you should either stay indoors, or wear long sleeved shirts and long-trousers and wear insect repellent.

People travelling with young children should ensure that they use a specially prepared insect repellent, rather than the adult version.

This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Sars

    Sars


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    What is Sars?

    Sars stands for Severe Acute Respiratory Syndrome. It is a new illness that emerged in the Far East early in 2003, first in southern China, then spreading to Hong Kong, Vietnam, Singapore, Canada and more than 20 other countries.It is believed to be caused by a new strain of Corona virus - a family of viruses which has been linked to the common cold.

    By the middle of April, it had killed more than 150 people worldwide and infected more than 3,000 more.

    What are the symptoms, and how is it treated?

    The most obvious symptoms of Sars are breathing problems. Patients develop a high temperature (more than 38 degrees), dry cough, and severe respiratory symptoms follow swiftly.Some patients need to be put on a ventilator to keep them breathing while their bodies fight the infection. Four in every hundred people who develop Sars do not survive.

    Most of those who have died have been older, or had pre-existing health problems which increased their vulnerability - but some younger, healthy people have died.

    Patients suspected of having Sars are given a combination of antibiotics and antiviral drugs, which have produced an improvement in some patients, although their precise effectiveness is uncertain.

    There is no vaccine for the virus that causes Sars, although a diagnostic test has been developed.

    How can I catch it?

    The virus appears to be transmitted less easily than conventional influenza - although the resulting illness can become more severe.It appears to be passed on by “close contact” with an infected person, perhaps carried in large droplets thrown out when the infected person sneezes or coughs.

    There has been concern about transmission within passenger aircraft. The latest advice suggests that those at risk of infection would need to be seated within a couple of rows of the infected person, with no evidence of risk to people sitting elsewhere on the plane.

    People in the Far East have attempted to protect themselves by wearing face masks - it is uncertain how much genuine protection these offer against the virus.

    Should I avoid any particular areas?

    The areas worst hit by Sars are Hong Kong, and the Guangdong province of southern China.In late March 2003, the World Health Organization advised people to restrict non-essential travel to Hong Kong or Guangdong. The UK government agreed with this advice. This was only intended to be temporary advice until outbreaks in these locations were under control.

    Travellers should check the websites of the World Health Organization and, in the UK, either the Health Protection Agency or Foreign and Commonwealth Office for the latest advice.

    All travellers to areas heavily affected by Sars should be aware of this and take account of the problem in their travel plans. Some countries have been screening passengers arriving from Sars-hit areas for early signs of the illness.

    I have some of these symptoms. What should I do?

    If you have recently returned from South East Asia and suffer from any of the following symptoms - sudden onset of fever (>38° C), together with respiratory symptoms such as cough, sore throat, shortness of breath or difficulty breathing within 10 days of return, please contact your doctor’s surgery or, in the UK, phone NHS Direct on 0845 4647.
    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Traveller’s diarrhoea

    Traveller’s diarrhoea


    “Traveller’s diarrhoea is one of the more important causes of infectious problems in travellers and occurs in up to 60% of travellers visiting tropical regions.”

    Dr Ron Behrens, senior lecturer in travel medicine at the London School of Hygiene & Tropical Medicine and consulant at the Hospital for Tropical Diseases, in London.

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    What is Traveller’s diarrhoea?

    Traveller’s diarrhoea is one of the most common illnesses for tourists going to tropical climates. As many as 60% of all travellers suffer some form of diarrhoea, sometimes dubbed “Delhi Belly” or “Montezuma’s revenge”.These can range from diarrhoea to nausea and vomiting and usually last about two or three days.

    Patients usually self-treat, but experts say cases can be cleared up much quicker if sufferers take antibiotics.

    About 10% of all cases are serious and people with long-term symptoms should seek specialist advice.

    All patients with traveller’s diarrhoea are advised to ensure they replace lost fluids with fluids and rehydration tablets.

    My doctor said I have giardia, what is it?

    Giardia and cryptosporidium are intestinal illnesses caused by the protozoan parasites affecting the gastrointestinal tract of humans and animals. They are shed in faeces and can remain dormant for long periods.They are particularly difficult to remove from water systems.

    Infections may be asymptomatic, or may cause diarrhoea, nausea, abdominal cramps, fever, vomiting and headaches. Most people will recover within several weeks, but individuals with weakened immune systems, such as HIV/AIDS or cancer patients, may be unable to remove the parasites from their systems and can suffer debilitating illness and even death.

    How can I avoid giardia?

    Carefully wash your hands after toilet visits; dispose of sewage wastes carefully to avoid contaminating surface water or groundwater and ensure you never drink untreated water from spring, streams or lakes.
    My doctor says I have typhoid - what is it?

    Typhoid and paratyphoid are also spread through contaminated water and food. They are recognised by the sudden onset of sustained fever, severe headache, nausea and severe loss of appetite.There can be fatalities in 10% of cases, but this can be reduced to less than 1% with the right antibiotics.

    There are about 17 million cases of typhoid each year globally and about 600,000 deaths.

    How did I get typhoid?

    Typhoid is transmitted by food and water contaminated by the faeces and urine of patients and carriers.Polluted water is the most common source of typhoid. In addition shellfish taken from sewage contaminated beds and vegetables fertilized by faeces and then eaten raw are also sources of contamination.

    There is a vaccine that can protect against typhoid, but it will not protect against paratyphoid.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Rabies

    Rabies


    “Once within the brain rabies progresses to cause an encephalitis or inflammation of the brain, which leads onto the classical symptoms of rabies. Once these have occurred it is impossible to cure the disease.”

    Dr Ron Behrens, senior lecturer in travel medicine at the London School of Hygiene & Tropical Medicine and consulant at the Hospital for Tropical Diseases, in London.

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    What is rabies?

    Rabies is an encephalitis, or brain disease, which is caused by the rabies virus.It is a fatal condition caused after being bitten by an infected animal, usually a rabid dog or a bat.

    There is a vaccination against the disease, but once symptoms of rabies have developed the condition is almost always fatal - and the few people who have survived have suffered serious long-term disabilities.

    Which countries am I most at risk?

    Most countries of the world have rabies and there are only a few, including Britain, the Antarctic and Australia, which have been declared rabies free.But anyone bitten by a bat in the UK should still seek medical advice.

    The last case of rabies in the UK was in November 2002, when a conservation worker was bitten by a rabid bat.

    But there have been no cases in the UK of rabies being transmitted by a dog over the last 100 years.

    Travelling in developing countries is the most risky, particularly the more remote areas, as clinics do not always have supplies of the vaccine. The vaccine can be successful after a person has been bitten, if it is taken early enough.

    What are the symptoms?

    Rabies affects the central nervous system.Initial symptoms can include anxiety, headaches and fever. As the condition progresses the patient will have spasms of their swallowing muscles, a fear of water and respiratory failure will set in.

    How can I avoid rabies?

    Travellers going to countries where rabies is endemic are advised to have the rabies vaccine. This is a safe and effective jab and should be considered by anyone who is bitten or scratched by a warm blooded animal in a country with rabies.Travellers abroad are advised to steer clear of animals, particularly stray or unattended dogs.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Malaria

    Malaria


    “Through dusk to dawn one has to use anti-mosquito measures. These are actually more important than taking other measures because obviously if you don’t get bitten you don’t get infected.”

    Dr Ron Behrens, senior lecturer in travel medicine at the London School of Hygiene & Tropical Medicine and consulant at the Hospital for Tropical Diseases, in London.

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    What is Malaria?

    Malaria is a parasitic infection of the blood and is transmitted through bites from mosquitoes.It kills over a million people worldwide each year and is second only to tuberculosis in its impact on world health.

    The disease is present in 90 countries and infects one in 10 of the world’s population at some point in their lives.

    Three-quarters of all malaria cases are in sub-Saharan Africa where it is a main cause of death and a major threat to child health.

    How can I avoid it?

    Avoiding being bitten by mosquitoes is the best way of avoiding malaria.Keeping arms and legs covered by clothing in the evening; applying DEET repellent creams and sleeping under a special mosquito net are the best ways of discouraging insect bites.

    But travellers should also ensure that they have the appropriate anti-malarial drugs for the specific region to which they are travelling.

    Can I protect myself before I travel?

    Travellers can help to cut their risk by taking anti-malarial drugs before they leave on their trip.Travellers should contact their GP at least a month before travel to get advice about which particular drugs to take for the areas that they are travelling to.

    The tablets, which are taken in either daily or weekly doses, need to be started before travel and continued for up to a month after return from the malarial zone.

    How likely am I to survive malaria?

    If spotted and treated quickly malaria can usually be completely cured.Most UK travellers do survive a bout of malaria after a 10-20 day illness. Many of those who die do so because the disease has not been spotted early enough.

    The death rates are high in areas of sub-Saharan Africa, where medical expertise and malarial drugs are limited.

    What symptoms should I look out for?

    It is vital that anyone getting “flu-like symptoms” after the first week in a malarious region and for up to a year after returning home should mention this to their GP so that he can organise a test for malaria.Symptoms of the disease include flu-like illness, diarrhoea, joint pains and fever.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Lyme disease

    Lyme disease


    “Deer are no longer killed at such a rate as they used to be and now they come into people’s backyards more. Deer is one of the animals in which the organism, which causes the disease, naturally lives.”

    Professor Chris Curtis, Professor of Medical Entomology at the London School of Hygiene and Tropical Medicine.

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    How would I get Lyme disease?

    Lyme disease is caused by a bacteria, called Borrelia burgdorferi, and is transmitted to humans through the bites of a tick.The ticks are found either on animals such as deer and mice, or they jump onto the human when they brush past them in tall grass, shrubs or low trees.

    Where am I most at risk?

    America, particularly the forested areas of New England, has the most cases of Lyme disease - here the numbers of those infected run into hundreds of thousands each year.Russia is also quite badly affected. But there are also cases of Lyme disease in the UK. Doctors usually see a few hundred cases of it each year.

    And recent climate changes have been blamed for an increase in the infection.

    What are the symptoms?

    There are a variety of symptoms linked to Lyme disease. The first is an expanding rash or bruise which starts at the bite mark, usually a week after the person has been bitten.It can appear as either a single red blotch, or as a “bullseye” shape with a widening ring around its central point.

    The mark can feel warm to the touch, but might not itch or cause pain.

    After the rash appears sufferers may also start to suffer joint pains, fever, fatigue, stiff neck and facial paralysis or tingling as the bacteria starts to spread around the body.

    More serious symptoms can include severe headaches, painful arthritis, joint swelling and heart problems.

    Some patients even suffer mental disorders such as short term memory loss and difficulty concentrating.

    But if the disease is caught early enough it can be treated with antibiotics, although later stage Lyme does not respond as well.

    What should I do to protect myself?

    Anyone in an area where Lyme disease is thought to be prevalent should check themselves regularly to ensure that they have not been bitten.Ticks can attach themselves anywhere on the body, but prefer creases like the armpit, groin or back of the knee.

    Walkers should wear light coloured clothing and gardeners’ light gloves, so they can see the ticks.

    The ticks spread their disease slowly, so the quicker they are spotted the less chance there is of someone becoming infected.

    The best way to remove a tick is by tweezers, although you should be careful to pull the tick out directly without jerking or twisting it. Antiseptic should then be put on the wound.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Leishmaniasis

    Leishmaniasis


    “You hear some horrific stories about misdiagnosis and mistreatment, because most practitioners in this country and most in Europe have never seen it and very few have ever heard about it. So they will identify it as all sorts of other things than leishmaniasis.”

    Professor Richard Ashford, professor of parasite and vector biology at the Liverpool School of Tropical Medicine.

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    What is it?

    Leishmaniasis is a parasitic disease spread through bites from sandflies.It affects about 12 million people globally, most of them in south or central America, Africa and the Middle East.

    There are three sorts of leishmaniasis, which vary in severity.

    The most dangerous is “visceral leishmaniasis”, which is also known as black fever. This is nearly always fatal if it is left untreated.

    It spreads into the spleen, bone marrow and liver and attacks and destroys the immune system.

    Another type, “mucocutaneous leishmaniasis”, produces disfiguring lesions which destroy the mucous membranes of the nose, mouth and throat.

    “Cutaneous leishmaniasis” tends to cause sores on the skin. Some people have had up to 100 and these can vary in size from 2cm to 3cm in diameter.

    How can I avoid it?

    As the disease is spread by the sandfly the best way to avoid it, is to avoid getting bitten.The sandfly bites mainly at night so travellers should use a good insect repellent, they should also sleep under insect nets with a very fine mesh.

    Leishmaniasis is prevalent in about 90 tropical and subtropical countries around the world.

    What do I do if I get it?

    Anyone suffering from the symptoms of leishmaniasis, who has just returned from an area in which it is prevalent, should contact their GP immediately.It is vital that people going to their doctor tell him where they have been travelling so that he can make an accurate diagnosis.

    What is the treatment?

    The treatment involves a series of about 30 days worth of injections, using a toxic drug to kill the parasite. The patient has to stay in hospital for the duration of their treatment.
    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Legionnaires’ disease

    Legionnaires’ disease


    “It is hard to protect yourself because it is one of those diseases that you can’t see, you can’t feel and you can’t touch.”

    Dr Carol Joseph, public health scientist at the Public Health Laboratory Service.

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    What is it?

    Legionnaires’ disease is a rare form of pneumonia, which is also called Legionellosis.It was named after the first outbreak, which occurred in an American hotel, which was hosting a convention of the Pennsylvania Department of the American Legion.

    It is generally contracted by inhaling mists from water sources like showers, whirlpool baths and cooling towers which have become infected with the bacteria.

    The most common cause of the disease is contaminated air conditioning systems; it cannot be passed from one person to another.

    What are the symptoms?

    Legionnaires’ has an incubation period of between two to 10 days.The first symptoms are similar to flu - headaches, muscle pain and a general feeling of being unwell.

    These progress to high fever, the chills, nausea, vomiting and diarrhoea.

    On the second or third day the patient usually gets a dry cough and sometimes chest pains and they may have difficulty breathing.

    Some patients also suffer from confusion; disorientation; hallucination and a loss of memory. Some also get pneumonia.

    Will I die?

    Legionnaires’ disease does have a high fatality rate of about 5% to 15%. But if the disease is caught early enough the prognosis is better and patients are able to be treated with antibiotics.Those with chronic diseases such as diabetes, cancer or serious kidney problems are extremely vulnerable if they catch the disease. Smokers and alcoholics are also more vulnerable.

    How can I protect myself?

    If you are concerned about making your hotel water supply as safe as possible, one way to do this is to run the taps in the bathroom for a few minutes with the bathroom door closed. When the steam has settled you can then use the bathroom taps. This gets rid of air bubbles in the pipes which may harbour the bug.Hotels should regularly check the systems themselves, but sometimes rooms can be left unoccupied for some time.

    Firms and buildings should also ensure that they carry out good engineering practices and regularly check the operation and maintenance of air and water handling systems.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Hepatitis B

    Hepatitis B


    “The disease is prevalent in many developing parts of the world and about a third of the population are carriers of the disease.”

    Dr Ron Behrens, senior lecturer in travel medicine at the London School of Hygiene & Tropical Medicine and consulant at the Hospital for Tropical Diseases, in London.

    Useful Weblinks

    What is it?

    Hepatitis B is a virus that can cause a potentially dangerous infection of the liver.The infection is spread through blood-to-blood infection and through unprotected sex.

    It is the ninth most common cause of death worldwide, killing about two million people a year.

    In Europe alone about one million people become infected each year.

    What are the symptoms?

    The incubation period before the symptoms start to develop can be anything between six weeks and six months.In about a third of cases people with the disease will show no symptoms; in the second third the illness will cause mild flu-like symptoms with headache, fever loss of appetite, nausea and vomiting.

    But in the rest of cases the illness can be very severe with patients developing abdominal pain, diarrhoea and jaundice.

    In the most severe cases patients will develop rapid liver failure, which may need a life-saving liver transplant.

    How can I avoid Hep B?

    The disease is most common in the Far East, the Middle East, Africa and Southern Europe.But travellers can also protect themselves by avoiding unprotected sex, by not sharing contaminated needles and ensuring that any tattoos, body piercing or acupuncture are only carried out in reputable salons.

    Should I get the vaccination?

    There is an effective vaccine, available from GPs and travel clinics, which can protect travellers from Hepatitis B infection.Vaccination is usually advised if a member of your family or household becomes infected with the virus. Hepatitis B is considered an occupational hazard for healthcare workers, the emergency services and the police.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


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    Hepatitis A

    Hepatitis A


    “The older you become the more serious the infection. In a very small proportion, about less than 1%, people become so severely ill that they actually have liver failure and a very small proportion actually can die from this disease.”

    Dr Ron Behrens, senior lecturer in travel medicine at the London School of Hygiene & Tropical Medicine and consulant at the Hospital for Tropical Diseases, in London.

    Useful Weblinks

    What is Hepatitis A?

    Hepatitis A is a viral infection of the liver. It is estimated to affect up to 10 million people worldwide each year and is spread through contaminated food and water.The virus is found in the faeces of an infected person and is spread through poor hygiene, such as failing to wash your hands after going to the toilet.

    What are the symptoms?

    The incubation period before symptoms develop is usually a month.Symptoms can vary from no signs of illness, to a flu-like illness, jaundice, headache, fever, loss of appetite, nausea and vomiting.

    Children getting the disease will seldom become ill and once infected will carry a life-long immunity against the disease.

    The older a person is, the more serious the disease can be. About one per cent of people with Hepatitis A will suffer from liver failure and some of these people will die.

    Where am I most at risk?

    The area where travellers are most at risk of contracting Hepatitis A is the Indian sub-continent, although there are also some cases from South-East Asia, Africa and South America.
    How can I protect myself?

    There is a highly effective vaccine against Hepatitis A, which is available from GP surgeries and travel clinics. This is recommended for travellers going to high-risk countries.Travellers should try and avoid the disease by ensuring a high level of personal hygiene, avoiding raw or inadequately cooked salads, vegetables, unpasteurised milk and shellfish and checking whether the tap water is safe to drink.

    This information is for guidance only, and the immunisations recommended may vary widely depending on the nature of your visit. Consult your doctor for advice.


    If you found this page useful, consider linking to it.
    Simply copy and paste the code below into your web site (Ctrl+C to copy)
    It will look like this: Hepatitis A


    More Relevant Topics:
  • Metabasis, Roche in hepatitis C deal
  • Hepatitis B
  • Hep C test for walking blood banks
  • Travel Health - North Africa
  • Travel Health - Western Europe
  • Travel Health - South East Asia
  • Travel Health - East Asia
  • Travel Health - India Sub Continent
  • Travel Health - South Africa
  • Travel Health - Central Africa