This article provides you with current medical information on the prevention, recognition, and treatment of different illnesses that might affect you while you travel to South East Asia, as well as other health issues affecting travelers to high mountainous regions of the world. Information content is designed for the use of physicians and non-physicians alike. It is best to consult your travel agent or General Physician well before departure to ensure that you fulfill the immunization requirements. The immunizations you need may be greatly influenced by the nature of your trip. For example, a trip only to urban areas may require less protection than a visit also involving rural areas. Your General Physician should be able to provide more information.
This information is intended for guidance purposes only.
During the winter months, colds are probably the most common illness in South East Asian Countries, and within a few days of arriving in the cities, most people have either developed a full-blown cold or have developed the city cough. This latter malady is brought on by the dust and smog that plague these cities.
The dust can be very irritating to the eyes, nose, and throat. Some people choose to wear aspirators (face masks) or bandannas to keep out the dust. Face masks are sold in almost every pharmacies and other shops frequented by tourists. Though a cold is likely the worst thing that you'll come down with in these countries, there are quite a few other illnesses you should know about and take precautions against.
Food Poisoning: Salmonella is the most common cause of food poisoning during your travel. It is caused by a bacteria found in chickens and therefore in egg products. Fresh-cooked eggs are rarely a problem, but dishes such as cheesecake and meringue pie commonly support the growth of salmonella. It's best to avoid these two treats. The symptoms of salmonella are severe stomach cramps, diarrhea, vomiting, fever, and chills. Luckily, these all pass within 24 hours. Anti-diarrheal drugs such as codeine, Imodium, and Lomotil should never be taken if salmonella poisoning is suspected. To treat salmonella, drink as much liquid as possible.
Bacterial Diarrhea: Of all the possible causes of diarrhea, bacterial infection is by far the most common. This is caused by a proliferation of a usually harmless form of E. coli bacteria. Because E. coli has developed a resistance to the antibiotic sulfamethoxazole-trimethoprim (SMZ-TMP), which is marketed in the United States under the trade names of Septra and Bactrim, the most common way to treat bacterial diarrhea is with Norfloxacin or Ciprofloxacin (both readily available).
Amoebic Dysentery: Though this is one of the most dreaded of diseases among travelers to the tropics, amoebas can be easily treated if diagnosed. The problem is that amoebas are often difficult to detect. If left untreated, they will migrate to the liver and cause damage, so it is very important that you let your doctor know that amoebic dysentery is a possibility should you develop diarrhea after leaving these Countries. Symptoms of amoebic dysentery include abdominal pain, diarrhea (frequently with blood or pus in the stool), lethargy, and fever. The recommended treatment for amoebic dysentery is tinidazole. In the United States, where tinidazole is not available, Flagyl is the recommended drug.
Giardiasis: Another cause of long-term diarrhea, giardiasis is caused by a protozoan and is quite common. Giardiasis is spread by water and food that has been contaminated with the cysts of the giardia organism; it has an incubation period of 7 days. Therefore, if you develop diarrhea on your second or third day of Traveling South Asian Subcontinent, giardiasis is not the cause. Common symptoms of giardiasis are a violent bubbling in the intestines accompanied by pain in the upper part of the abdomen. Diarrhea may come and go and often occurs only in the morning. Should you develop diarrhea after returning home, it is important that you tell your doctor that giardiasis is a possibility. In the United States, giardiasis is usually treated with the drug Flagyl, but in south Asia, the recommended treatment is tinidazole (marketed as Tiniba).
Traveling South Asian Subcontinent??
The following vaccinations are recommended: typhoid, tetanus, diphtheria, and polio. Also, if you were born after January 1, 1957, you should make sure you have been immunized against measles. Malaria tablets (if you are visiting the Terai), the hepatitis A vaccine, and a vaccination against meningococcal meningitis are also advised.
Thing you must know
The majority of illnesses are spread by unsanitary conditions, particularly contaminated water. Consequently, it is important to take special precautions to ensure that your drinking water is safe. The best precaution is not to drink any water unless you have purified it yourself, or know that it has been boiled. Do not drink tap water; even bottled water if the seal is broken, especially out on the trekking routes, are sometimes refilled with unsafe water.
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