Tropical diseases

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There are a number of Tropical diseases that present a health risk to travellers that are not present in their own countries. This article is meant as a travellers introduction to the more common aspects of the subject.

Hot humid environments provide ideal conditions for a number of diseases, or their vectors, to survive and spread. Some of these are transmitted by insects, others are water borne or may be carried by foods, often in meat. A number are transmitted by human contact.

Simple precautions -- vaccinations, condoms, mosquito nets and insect repellents, and taking care with food and drink -- can greatly reduce the risks.

	tropical diseases Travel Guide : 1 Before travelling 1.1 Legal requirements 1.2 Health requirements 1.3 Information sources 2 Disease by vector 2.1 Insects 2.2 Water (or contaminated food) 2.3 Food 2.4 Others

Before travelling

Legal requirements

Many governments require visitors entering, or residents leaving, their countries to be vaccinated for a range of diseases. These requirements may often depend on what countries a traveller has visited or intends to visit. For example, if you have visited Africa then other countries may require evidence of Yellow fever vaccination before letting you in.

If you are bringing prescription medicine with you, carry a copy of the prescription.

Health requirements

For much travel, especially to tropical or "third world" countries, additional vaccinations or other precautions such as anti-malarial medication may be necessary.

Before starting your travels you should consult a doctor with experience in the field of travel medicine. You should do this at least 8 weeks before you plan to leave, to give time for vaccinations.

Information sources

There are many sources of additional information for travelers:

• US government, Centre for Disease Control (http://www.cdc.gov/travel/index.htm)
• International Soviety for Travel Medicine (http://www.istm.org/) has an index of travel medicine clinics
• World Health Orgainisation (http://www.who.int/ith/en/) has a downloadable book, written for doctors

Disease by vector

Insects

• Mosquitoes
  • Malaria - Treatments available
  • Yellow fever - Vaccine available
  • Dengue - causes high fever, headache, joint and muscle pain and may in some cases lead to a severe hemorrhagic fever. Occurs in many tropical countries.
  • Filariasis
  • Encephalitis
  • West Nile virus
  • Ross River virus and possibly others

• Lice or mites
  • Ricketsial Infections - cause a broad range of diseases. Symptoms often include fever, headache and malaise as well as a rash. Antibiotic treatment is available.
    • Rocky Mountain spotted fever
    • Cat-scratch disease
    • Q fever - transmission by contact with soil and dust contaminated with carcasses from goat, sheep, and cattle and probably also by unpasteurized milk
    • (Epidemic) Typhus - transmitted by the human body louse

• Others
  • Chagas disease

Water (or contaminated food)

• Cryptosporidiosis/Cryptosporidium/Crypto. Found worldwide, this disease is an untreated and chlorine treated water risk. It can even be spread if an infected person bathes in a treated public swimming pool. It causes diarrhea, cramps and fever. Last about 10 days but feces carry infection for weeks. Prevention by avoiding mouth coming into contact with infected water or fecal matter and maintaining scrupulous toilet and bathing hygiene after being infected to prevent reinfection of self or others. There is no cure. Prevented by boiling all drinking water, including tap water, in infected areas.
• Hepatitis A. Can be spread by food contaminated with feces (unwashed hands), on which it can remain infectious for days. Symptoms may not appear for a month after infection, and may continue for as long as six months. Hepatitis A is common almost everywhere but the "first world" (Western Europe, North America, Australia, New Zealand). (see map in the US CDC FAQ (http://www.cdc.gov/ncidod/diseases/hepatitis/a/faqa.htm) A vaccine is available. Hepatitis A vaccine does not protect against hepatitis B at all, nor will hepatitis B vaccine protect against hepatitis A.
• Typhoid fever. Caused by the bacterium Salmonella enterica Typhi. It causes high fever, headache, malaise as well as other symptoms and is a general health problem in all less developed countries. Transmission is by contaminated food and water, especially in rural areas. A vaccination is available but offers no absolute safety, so the best options are precautions with what you drink & eat. See also http://www.cdc.gov/travel/diseases/typhoid.htm.
• Cholera. Causes watery diarrhea - is a common cause of death in children. There is a vaccine, and evidence of vaccination may be required at some borders, but it is not very effective.
• Dysentery. Reputedly the most common traveller's health problem. It can have many causes.

There are many other diseases that cause food poisoning.

Food

• Meat
  • Trichinosis - a tapeworm - from eating improperly cooked infected meats, particularly pork.
  • Hydatids - another tapeworm - from eating improperly cooked infected meats, particularly sheep/mutton. Can also be spread by dogs that have been eating infected meat.
  • BSE - Not a tropical disease, as such, but has been an issue in the United Kingdom and some other first world countries.
• Unpastuerized dairy products can transmit several diseases, including tuberculosis

Others

• Avian Influenza. A viral infection normally affecting birds but the Avian Influenza A virus has also been found in some human infections. Current outbreaks among animals occurred in South-East Asia (Cambodia, China, Indonesia, Laos, Malaysia, Thailand, and Vietnam). The disease is transmitted to humans by contact with infected birds (esp. poultry) and their excrements and may cause serious disease. Precautions include avoiding contact to wild birds and their excrements (as fas as this is possible...). There is no vaccination available in the moment.
• Hepatitis B and C. Can be spread by entry of blood or bodily fluids from an infected person into the body, such as through sexual contact, sharing of hypodermic needles, or blood transfusion or organ donation (theoretically, if screening were not performed). Unlike Hepatitis A, "Hepatitis B is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, coughing, sneezing or by casual contact" (US CDC FAQ (http://www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.htm)) A vaccine is available to prevent Hepatitis B, but no vaccine is available to protect against Hepatitis C.
• HIV (AIDS virus). Originally believed to come from tropical Africa after humans ate infected wild food, possibly monkey. HIV is transmitted in the same ways as hepatitis B. It can be controlled by expensive drugs, but not cured. Abstinence or monogamy, safe sex, and an absolute ban on needle-sharing are wise precautions in any country of the world.
• Influenza. The common Flu kills an estimated 36,000 Americans each year, and results in 200,000 hospitalizations per year. (CDC Flu Page (http://www.cdc.gov/flu/about/disease.htm)) As a general precaution an annual vaccination is often recommended for the latest strains prevalent in the countries you are visiting. Avian influenza infection appears frequently in the news because it could be a source for new influenza strains to which no one has immunity and which have the potential to evolve to cause deadly epidemics. However, from the traveler's perspective the personal risk from avian influenza is extremely low. Travelers should obey recommendations on contact with poultry as a matter of civic duty, to prevent spreading the avian disease to birds in other countries.
• Lassa fever. An acute viral illness that occurs in West Africa. In areas of Africa where the disease is endemic (that is, constantly present), Lassa fever is a significant cause of morbidity and mortality. While Lassa fever is mild or has no observable symptoms in about 80% of people infected with the virus, the remaining 20% have a severe multisystem disease. Lassa fever is also associated with occasional epidemics, during which the case-fatality rate can reach 50%.
• Polio. Causes paralysis and nerve damage - easily preventable by an oral vaccination that should normally be given in early childhood. Although polio was nearly eradicated in recent years, it is currently experiencing a resurgence in several nations, so travelers should be sure that they have received proper vaccination and boosters.
• SARS. Severe Acute Respiratory Syndrome - Caused by a common Corona virus that apparently crossed species and was highly infectious. Only a problem if undiagnosed travelers travel and spread the disease. Its control is an example of how unidentified (new) diseases are able to be controlled by simple but obnoxious public health measures.
• Tuberculosis. A third world disease due to poverty and poor health care. Can occur in first world countries where the health care system makes treatment expensive - generally responds to antibiotics but mis/incomplete treatment in some countries means antibiotic resistant strains are also problem.

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