Each time I stop in at my doctor's office (a tropical disease specialist with time in Vietnam), he asks me why the hell I do what I do. Yet, he takes great pains to describe the symptoms of the many tropical diseases that await me in the Third World. His lectures usually center around the lifelong pain and debilitation that can be inflicted on travelers who inadvertently ingest an amoeba, get bitten by a mosquito or become the host for a degenerative bug. I take his advice seriously, and I am as fastidious as I can be in adverse conditions. I am very careful about what I eat and how I sleep, and I follow the rules of common sense when it comes to avoiding infection. Despite this, I have spent nights shivering and delirious, lying in puddles of my own sweat on cement floors in the Sahara desert. I pay his bill gladly and trust to the cosmos and good common sense.

With this in mind, do not assume that this chapter is the be-all end-all reference source for tropical diseases. Always confer with a specialist before taking any trip. This way, you understand the odds and the penalties and can make an educated decision on the risks involved. Secondly, always have full medical tests upon your return. This means giving a little bit of yourself to the lab to run blood, stool and urine tests. Your doctor may ask you to come back again due to the long incubation time of some of these nasties. This is not hypochondria, but common sense. Early detection will increase your odds of successful treatment.

The odds of coming down with a bug are pretty good once you leave the antiseptic Western world. If you go off on an extended trip (one month or more) you have a 60­75 percent chance that you will develop some illness or problem, most likely diarrhea. Only about one percent of travelers will pick up an infectious disease. I once thought that the locals had built up resistance to the various bugs that strike down Westerners. But once in-country, you realize what a toll disease takes on the Third World. Not only are many people riddled with malaria, river blindness, intestinal infections, hepatitis, sexual diseases and more, but they are also faced with malnutrition, poor dental care, toxic chemicals and hard environmental conditions. The World Health Organization (WHO), in a recent global survey, reported that much of the world's population dies needlessly from preventable diseases due to a lack of access to health care. Of the 52 million people who die each year, infectious diseases kill about 17 million. Infectious diseases are the leading cause of premature death in Africa and Southeast Asia, according to WHO. Of the 11 million victims who are children under the age of five, 9 million die from infectious diseases. About 70 percent of the deaths attributed to cholera, typhoid or dysentery can be blamed on contaminated food. To make matters worse, 30 new diseases have sprung up since 1976, among them AIDS and the deadly Ebola virus. Antibiotics are becoming less and less effective in treating many of these diseases, because of resistance due to their overuse.

Malaria is a very dangerous disease, affecting 500 million people worldwide and killing at least 2 million people every year. The mosquito-borne disease is found in 102 countries and threatens 40 percent of the world's population.

Over a million people in Africa are killed by malaria every year. Two million people die from it in a one-year period, according to WHO. More than 30,000 European and American travelers will come down with malaria this year.

The female Anopheles mosquito is small, pervasive and hungry for your blood, and likes to bite in the cool hours before and after sunset. As they seek out blood to nurture their own procreation, they leave the Plasmodium parasites in your blood system. The symptoms can start with a flulike attack, followed by fever and chills, then lead to failure of multiple organs and then death. In many cases, the symptoms of malaria do not start until the traveler has returned home and is in a nonmalarial zone. Remember that current chemoprophylaxis does not prevent malaria. Larium, Fansidar, and chloroquinine can lower the chances of getting malaria but do not provide any guarantee of being malaria-proof. Two of my fellow travelers (one in Africa and one in Borneo) did not realize they had malaria, because they believed that Larium would protect them from the disease. Luckily, they sought treatment in time.

Malaria is a very real and common danger in most tropical countries. Most malaria in Asian and African areas is quinine-resistant and requires multiple or more creative dosages to avoid the horrors often associated with the disease. The most vicious strain of malaria (Plasmodium falciparum) attacks your liver and red blood cells, creating massive fevers, coma, acute kidney failure, and eventually death. There are three other types of malaria in the world: Plasmodium malariae, Plasmodium vivax and Plasmodium ovale (found only in West Africa).

The Anopheles mosquito is the most dangerous insect in the world, and there are few contenders for its crown. Other biting insects that can cause you grief include the Aedes aegypti mosquito, which carries yellow fever. His kissing cousins, the Culex, Haemogogus, Sabethes and Mansonia, can give you filariasis, viral encephalitis, dengue and other great hemorrhagic fevers. Next on the list are tsetse flies, fleas, ticks, sandflies, mites and lice. We won't even bother to discuss wasps, horseflies, African killer bees, deerflies, or other clean biters.

These insects are an everyday part of life in tropical Third World countries. They infect major percentages of the local population, and it is only a matter of time and luck before you become a victim.

Prevention is rather simple but often ineffective. Protect yourself from insects by wearing long-sleeved shirts and long pants. Use insect repellent, sleep under a mosquito net, avoid swampy areas, use mosquito coils, don't sleep directly on the ground, check yourself for tick and insect bites daily and, last but not least, understand the symptoms and treatment of these diseases so that you can seek immediate treatment, no matter what part of the world you are in.

My least favorite are the helminthic infections, or diseases caused by intestinal worms. Unlike the more dramatic and deadly diseases, these parasites are easily caught through ingestion of bad water and food and cause long-term damage. Just to let you know what's out there, you can choose from angiostrongyliasis, herring worm, roundworm, schistsomiasis, capillariasis, pin worm, oriental liver fluke, fish tapeworm, guinea worm, cat liver fluke, tapeworm, trechinellosis and the ominous-sounding giant intestinal fluke (who's eating who here?). All these little buggers create havoc with your internal organs, and some will make the rest of your life miserable as well. Your digestive system will be shot and your organs under constant attack, and the treatment or removal of these nasties is downright depressing. All this can be prevented by maintaining absolutely rigid standards in what you throw or breathe into your body. Not easy since most male travelers find wearing a biohazard suit a major impediment to picking up chicks or doing the limbo.

Think of yourself as a sponge, your lungs as an air filter, and all the moist cavities of your body as ideal breeding grounds for tropical diseases. It is better to think like Howard Hughes than Pig Pen when it comes to personal hygiene.

The classic tropical diseases that incapacitated Stanley, Livingstone, Burton and Speke are the hemorrhagic fevers. Many of these diseases kill, but most make your life a living hell and then disappear. Some come back on a regular basis. It is surprising that most of the African explorers lived to a ripe old age. The hemorrhagic fevers are carried by mosquitoes, ticks, rats, feces or even airborne dust that gets into your bloodstream, and let you die a slow, demented death, as your blood turns so thin it trickles out your nose, gums, skin and eyes. Coma and death can occur in the second week. There are so many versions that they just name them after the places where you will stumble across them. Needless to say, these are not featured in any glossy brochures for the various regions. Assorted blood-thinning killers are called Chikungunya, Crimean, Congo, Omsk, Kyasanur Forest, Korean, Manchurian, Songo, Ebola, Argentinian, Hantaan, Lassa and yellow fever.

The recent outbreaks of the Hanta and Ebola viruses in the U.S. have proved that North America is not immune from these insect-, rodent- and airborne afflictions. So far, the Ebola Reston virus has only been found in monkeys sent by a Philippine supplier. All monkeys exposed to the virus were destroyed, and officials from the Centers for Disease Control reassured the public that Ebola Reston is a different virus from Ebola Zaire (now called the Democratic Republic of the Congo), the strain that killed 244 people in one outbreak. Still, experts warn that the Ebola Reston strain could mutate into a strain that is fatal to humans. The outbreak of plague in India also has travelers a little edgy about the whole concept of adventurous travel. There are real dangers in every part of the world and the more knowledgeable you are about them, the better your chances for surviving.

The quest for sexual adventure was once a major part of the joy of travel. Today, the full range of sexual diseases available to the common traveler would fill an encyclopedia. Despite the continual global publicity on the dangers of AIDS, it continues to claim victims at an alarming rate. Whorehouses around the world are thriving, junkies still share needles, and dentists in many Third World countries still grind and yank away with improperly sterilized instruments. Diseases like HIV, Hepatitis A and B, the clap, syphilis, genital warts, herpes, crabs, lice, and others that Westerners blame on the Third World, and the Third World blames on the West, are very preventable and require parking your libido. Sexually transmitted diseases are a growing health hazard. According to WHO, 236 million people have trichomoniasis and 94 million new cases occur each year. Chlamydial infections affect 162 million people, with 97 million new cases annually. And these figures don't include the increasing millions with genital warts, gonorrhea, genital herpes and syphilis. The highest rates for sexually transmitted diseases are in the 20­24 age group, followed by 15­19 and 25­29. In many countries, more than 60 percent of all new HIV infections are among the 15­24 age group.

How do you avoid sexually transmitted diseases, some people ask? Well, keeping your romantic agenda on the platonic side is a good start. The use of condoms is the next best thing. Realistically the chances of catching AIDS through unprotected sex depends on frequency and type of contact. People infected by blood transfusions, prostitutes, frequent drug users, hemophiliacs, homosexuals, and the millions of people who will get HIV this year from heterosexual sex will continue to make HIV a growing danger.

Your chance of getting Hep B if you leave the U.S. is only 5 percent unless of course you go for a tattoo at the smack jabbers rusty needle convention in the Golden Triangle (and have unprotected sex afterwards with a Thai junkie hooker). All macho bullshit aside, men and women are at equal risk and health workers are at a very high risk when working in Third World countries. Carrier rates among the population in some undeveloped countries are as high as 20 percent of the total population. Many travelers get Hep B without engaging in any high risk activities because the virus can survive outside the body for prolonged periods. Infection can occur when any infected material comes in contact with mucous membranes or broken skin. Hepatitis A is a viral infection of the liver transmitted by the fecal, oral route through direct contact with infected people, from water, ice, shellfish, or uncooked food. Symptoms for Hep A include fever, loss of appetite, dark urine, jaundice, vomiting, aches and pains and light stools. You usually get Hep A in Third World countries with poor sanitation. It is easy to prevent with simple vaccination using one of the two vaccines available. For proper protection the vaccine requires an initial shot (good for three months) and then repeated doses to protect longer term.

DP fan and reader Dr. Susan Hou sent us a polite, but firm letter demanding that we expand information on this very easy to catch and very easy to prevent disease. We quote the good doctor (who has knocked around enough to earn a DP shirt):

"The majority of people with symptomatic Hepatitis B infection don't die, but spend a month wishing they would. One percent develop fulminate (Webster's: developing or progressing suddenly) disease and die of liver failure. (On the bright side, if you get back to the United States before getting sick, fulminate liver failure moves you to the top of the liver transplant list). Five to ten percent of people become chronic carriers which means they can infect other people. For women this includes 85 percent of the children they carry who don't get treated. Thirty percent of chronic carriers have ongoing liver disease (chronic active hepatitis). Many progress to cirrhosis and require liver transplants (but start out lower on the transplant list). People with chronic active hepatitis develop liver cancer at a rate of 3 percent per year. The bad news if you get a liver transplant, Hepatitis B is usually still in your body and infects the new liver."

The vaccine for Hepatitis B is 90 percent effective after three doses. See your doctor or a local health clinic for more information before you travel.

Perhaps the most dangerous and publicized disease is AIDS. It strikes right at the heart of American phobia­­pain for pleasure. AIDS is the terminal phase of HIV (Human Immunodeficiency Virus). HIV is usually the precursor to AIDS, and then the victim succumbs to death by cancer, pneumonia and other afflictions that attack the weakened human immune system. AIDS has roughly a nine-year incubation period.

Initially brushed aside as "the gay plague" or an "African disease," AIDS has in the last few years become the biggest killer of young American men and women. Washington, D.C. has the nation's highest AIDS rate, far higher than even New York or San Francisco, according to statistics released by the Centers for Disease Control and Prevention. The 1995 D.C. rate was 185.7 AIDS cases per 100,000 residents. Puerto Rico was second with a rate of 70.3 cases per 100,000, followed by New York, Florida and New Jersey. Nationwide, the rate of AIDS cases is 27.8 cases per 100,000. The CDC says that AIDS is spreading more among women and minorities now, while the epidemic among homosexual white men has slowed. Women accounted for 19 percent of all AIDS cases among adults and adolescents nationwide. A growing number of children are being orphaned by AIDS, which has become the leading cause of death among women of childbearing age in the United States, according to a study in the Journal of the American Medical Association. Experts project that about 144,000 children and young adults will have lost their mothers to AIDS by the year 2000. Blacks are six times more likely to have AIDS than whites and twice as likely to have AIDS as Hispanics.

As sobering as the U.S. statistics are, the rate of deaths caused by AIDS in other countries is alarming. The number of AIDS cases worldwide reported to the World Health Organization by governments reached 1,025,073 by January 1995. WHO said that chronic underreporting and underdiagnosis in developing countries means the actual figure is probably more than 4.5 million. More than 70 percent of the estimated cases were in Africa, 9 percent in the United States, 9 percent in the rest of the American hemisphere, 6 percent in Asia, and 4 percent in Europe. The statistics include only people with active cases of AIDS or those who have died from the disease.

An estimated one million Latin Americans could have AIDS by the turn of the century, according to the Pan American Health Organization. The group says HIV is increasing among women in the Caribbean and Central America and it is expected to increase rapidly, particularly in areas where injection drug use is prevalent. There are currently 2 million HIV-infected people in Latin America and the Caribbean. According to Italy's statistics institute, ISTAT, AIDS has become as big a killer in Italy as road accidents. An estimated 4370 Italians died from AIDS last year, compared to 6000 deaths on the roads. For young males between 18 and 29 in Italy, AIDS has overtaken drugs as the second leading cause of death. ISTAT estimates that the number of HIV-infected Italians is at least 100,000. AIDS is also on the increase in smaller countries. WHO estimates that at least 400,000 or one percent of Myanmar's citizens are infected with HIV. A high number of injection drug users, social tolerance of prostitution and large amounts of cross-border trade with nearby nations make Myanmar's populace more vulnerable. Condoms are also costly and rarely used in Myanmar, exacerbating the problem.

Ministry of Health statistics show that more than 100,000 residents of Zimbabwe have died of AIDS-related causes in the past decade. Another 100,000 or one percent of the country's population is expected to succumb to AIDS in the next year and a half. AIDS is expected to slow population growth, lower life expectancies and raise child mortality rates in many of the world's poorer countries over the next 25 years, according to a report by the U.S. Census Bureau.

By the year 2010, a Ugandan's life expectancy will decline by 45 percent to 32 years-down from 59 years projected before AIDS. A Haitian's life expectancy will fall to 44 years, also down from 59 years. Life expectancy in Thailand will drop from a projected 75 years to 45. By the year 2010, Thailand's child mortality rates are expected to increase from the current 20 deaths per 1000 children born to 110 deaths. In Uganda, the jump will be from 90 deaths to 175 deaths out of every 1000 children born. In Malawi, it will soar from 130 to 210 deaths per 1000. Overall, premature death rates in those countries will double by 2010 compared with 1985 levels.

In 16 countries­­the African nations of Burkina Faso, Burundi, Central African Republic, Congo, Cote d'Ivoire, Kenya, Malawi, Rwanda, Tanzania, Uganda, Congo, Zambia and Zimbabwe, plus Brazil, Haiti and Thailand­­AIDS will slow population growth rates so dramatically that by 2010, there will be 121 million fewer people than previously forecast. Thailand's population will actually fall by nearly one percent because of AIDS deaths.

Many travelers are quite surprised to find themselves coming down with measles or mumps while traveling. Unlike the U.S., which has eradicated much of the childhood and preventable viruses through inoculation, the rest of the world is more concerned about feeding than vaccinating their children. The recent outbreak of plague in India is a good example of what you should watch out for. Whooping cough, mumps, measles, polio and tuberculosis are common in Third World countries. (Measles claimed the lives of 1.1 million in 1995.) Although some of the symptoms are minor, complications can lead to lifelong afflictions. Make sure you are vaccinated against these easily preventable diseases.

But don't just run off to be the next bubble boy and spend the rest of your life in a hermetically sealed dome. For travelers, these diseases are relatively rare and avoidable. To put the whole thing in perspective, the most common complaint tends to be diarrhea, followed by a cold (usually the result of lowered resistance caused by fatigue, dehydration, foreign microbes and stress). The important thing is to recognize when you are sick versus very sick. Tales of turn-of-the-century explorers struck down by a tiny mosquito bite are now legend. Malaria is still a very real and common threat. Just for fun, bring back a sample of local river water from your next trip and have the medical lab analyze it. You may never drink water of any kind again.

This is not to say that as soon as you get off the plane you will automatically be struck down with Ebola River fever and have blood oozing out from your eyes. You can travel bug-free and suffer no more than a cold caused by the air conditioning in your hotel room. But it is important to at least understand the relative risks and gravity of some diseases.

The diseases listed on the following pages are important, and you should be conversant with both symptoms and cures. Please do not assume that this is medical advice. It is designed to give you an overview of the various nasties that possibly await you.

Tropical countries are the most likely to cause you bacterial grief. Keep in mind that most of these diseases are a direct result of poor hygiene, travel in infected areas and contact with infected people. In other words, stay away from people if you want to stay healthy. Secondly, follow the common sense practice of having all food cooked freshly and properly. Many books tell you to wash fruit and then forget to mention that the water is probably more filled with bugs than the fruit. Peel all fruits and vegetables, and approach anything you stick in your body with a healthy level of skepticism and distrust. If you are completely paranoid, you can exist on freeze-dried foods, Maggi Mee (noodles), fresh fruit (peeled, remember) and tinned food.

It is considered wise to ask local experts about dangers that await. If you do not feel right for any reason, contact a local doctor. It is not advisable to enter a medical treatment program while in a developing country. There are greater chances of you catching worse afflictions once you are in the hospital. Ask for temporary medication and then get your butt back to North America or Europe.

Remember that the symptoms of many tropical diseases may not take effect until you are home and back into your regular schedule. It is highly advisable that you contact a tropical disease specialist and have full testing done (stool, urine, blood, physical) just to be sure. Very few American doctors are conversant with the many tropical diseases by virtue of their rarity. This is not their fault, since many tourists do not even realize that they have taken trips or cruises into endemic zones. People can catch malaria on a plane between London and New York from a stowaway mosquito that just came in from Bombay. Many people come in close contact with foreigners in buses and subways and on the street from Los Angeles to New York. Don't assume you have to be up to your neck in Laotian pig wallows to be at risk. Many labs do not do tests for some of the more exotic bugs. Symptoms can also be misleading. It is possible that you may be misdiagnosed or mistreated if you do not fully discuss the possible reasons for your medical condition. Now that we have scared the hell out of you, your first contact should be with the Centers for Disease Control in Atlanta.

Dr. Susan Hou recommends that readers leave behind (or take extra) medical supplies for clinics or doctors when they travel. It is a good rule never to give medication, pills or even first aid materials directly to sick people since most do not know the correct usage or are aware of side effects. She also suggested giving blood (you can bring your own 18 gauge needle), but don't give blood at high altitude.

This list is a simple and incomplete checklist of what to ask your doctor about when planning your trip. The best single source in the world for information on the various bugs and germs is the Center for Disease Control available on the web (http://www.cdc.gov), by phone (404) 639-3311 or reprinted in book form. (See the Health/Security section at the back of the back of the book.) Always consult with a doctor before traveling to Third World countries, before taking medication and to ensure proper precautions are taken. If you are sick within a country, it is wise to have supplementary medical treatment and or evacuation insurance.

African Sleeping Sickness

(African Trypanosomiasis)
Found: Tropical Africa.
Cause: A tiny protozoan parasite that emits a harmful toxin.
Carrier: Tsetse fly. Tsetse flies are large biting insects about the size of a horsefly found in East and West Africa.
Symptoms: Eastern trypanosomiasis: two­31 days after the bite recurrent episodes of fever, headaches and malaise. Can lead to death in two to six weeks.Western trypanosomiasis: produces a skin ulcer within five to 10 days after being bitten. The symptoms then disappear in two to three weeks. Symptoms reappear six months to five years after the initial infection, resulting in fevers, headaches, rapid heartbeat, swelling of the lymph glands located in the back of the neck, personality changes, tremors, a lackadaisical attitude, and then stupor leading eventually to death.
Treatment: Suramin (Bayer 205), pentamidine (Lomodine), melarasoprol (Mel B)
How to avoid: Do not travel to infested areas, use insect repellent, wear light-colored clothing, and cover skin areas.

 

AIDS (Acquired Immune Deficiency Syndrome)

Found: Worldwide.
Cause: Advanced stage of HIV (Human Immunodeficiency Syndrome), which causes destruction of the natural resistance of humans to infection and other diseases. Death by AIDS is usually a result of unrelated diseases which rapidly attack the victim. These ranges of diseases are called ARC (AIDS-related complex).
Carrier: Sexual intercourse with infected person, transfusion of infected blood, or even from infected mother through breast milk. There is no way to determine if someone has HIV, except by blood test. Male homosexuals, drug users and prostitutes are high-risk groups in major urban centers in the West. AIDS is less selective in developing countries, with Central and Eastern Africa being the areas of highest incidence.
Symptoms: Fever, weight loss, fatigue, night sweats, lymph node problems. Infection by other opportunistic elements such as Karposi's sarcoma and pneumonia are highly probable and will lead to death.
Treatment: There is no known cure.
How to avoid: Use condoms, refrain from sexual contact, and do not receive injections or transfusions in questionable areas. Avoid live vaccines such as gamma globulin and Hepatitis B in developing countries.

 

Amebiasis

Found: Worldwide.
Cause: A protozoan parasite carried in human fecal matter. Usually found in areas with poor sanitation.
Carrier: Entamoeba histolyica is passed by poor hygiene. Ingested orally in water, air or food that has come in contact with the parasite.
Symptoms: The infection will spread from the intestines and causes abscesses in other organs such as liver, lungs and brain.
Treatment: Metronidazole, iodoquinol, diloxanide furoate, paromomycin, tetracycline plus chloroquinine base.
How to avoid: Avoid uncooked foods, boil water, drink bottled liquids, be sure that food is cooked properly and peel fruits and vegetables.

 

Bartonellosis (Oroya Fever, Carrion's Disease)

Found: In valleys of Peru, Ecuador and Colombia.
Cause: Bartonella bacilliformis, a bacterium.
Carrier: Sandflies that bite at night.
Symptoms: Pain in muscles, joints and bones along with fever occurring within three weeks of being bitten. Oroya fever causes a febrile fever leading to possible death. Verruga peruana creates skin eruptions.
Treatment: Antibiotics with transfusion for symptoms of anemia.
How to avoid: High boots, groundsheets, hammocks and insect repellent.

 

Brucellosis (Undulant Fever)

Found: Worldwide.
Cause: Ingestion of infected dairy products.
Carrier: Untreated dairy products infected with the brucellosis bacteria.
Symptoms: Intermittent fever, sweating, jaundice, rash, depression, enlarged spleen and lymph nodes. The symptoms may disappear and go into permanent remission after three to six months.
Treatment: Tetracyclines, sulfonamides and streptomycin.
How to avoid: Drink pasteurized milk. Avoid infected livestock.

 

Chagas' Disease (American Trypanosomiasis)

Found: Central and South America.
Cause: Protozoan parasite carried in the feces of insects.
Carrier: Kissing or Assassin bugs (Triatoma insects or reduviid bugs). Commonly found in homes with thatched roofs. It can also be transmitted through blood transfusions, breast milk and in utero.
Symptoms: A papule and swelling at the location of the bite, fever, malaise, anorexia, rash, swelling of the limbs, gastrointestinal problems, heart irregularities and heart failure.
Treatment: Nifurtimox (Bayer 2502).
How to avoid: Do not stay in native villages; use bed netting and insect repellent.

Cholera

Found: Worldwide; primarily developing countries.
Cause: Intestinal infection caused by the toxin Vibrio Cholerae O group bacteria.
Carrier: Infected food and water contaminated by human and animal waste.
Symptoms: Watery diarrhea, abdominal cramps, nausea, vomiting and severe dehydration as a result of diarrhea. Can lead to death if fluids are not replaced.
Treatment: Tetracycline can hasten recovery. Replace fluids using an electrolyte solution.
How to avoid: Vaccinations before trip can diminish symptoms up to 50 percent for a period of three to six months. A threat in refugee camps or areas of poor sanitation. Use standard precautions with food and drink in developing countries.

 

Chikungunya Disease

Found: Sub-Saharan Africa, Southeast Asia, India, Philippines in sporadic outbreaks.
Cause: Alphavirus transmitted by mosquito bites.
Carrier: Mosquitoes who transmit the disease from the host (monkeys).
Symptoms: Joint pain with potential for hemorrhagic symptoms.
Treatment: None, but symptoms will disappear. If hemorrhagic, avoid aspirin.
How to avoid: Standard precautions to avoid mosquito bites: Use insect repellent and mosquito nets, and cover exposed skin areas.

 

Ciguatera Poisoning

Found: Tropical areas.
Cause: Ingestion of fish containing the toxin produced by the dinoflagellate Gambierdiscus toxicus.
Carrier: 425 species of tropical reef fish.
Symptoms: Up to six hours after eating, victims may experience nausea, watery diarrhea, abdominal cramps, vomiting, abnormal sensation in limbs and teeth, hot-cold flashes, joint pain, weakness, skin rashes and itching. In very severe cases victims may experience blind spells, low blood pressure and heart rate, paralysis and loss of coordination. Symptoms may appear years later.
Treatment: There is no specific medical treatment other than first aid. Induce vomiting.
How to avoid: Do not eat reef fish (including sea bass, barracuda, red snapper or grouper).

 

Colorado Tick Fever

Found: North America.
Cause: Arbovirus transmitted by insect or infected blood.
Carrier: The wood tick (Dermacentor andersoni); also through transfusion of infected blood.
Symptoms: Aching of muscles in back and legs, chills, recurring fever, headaches, eye pain, fear of brightly lit area.
Treatment: Since symptoms only last about three weeks, medication or treatment is intended to relieve symptoms.
How to avoid: Ticks are picked up when walking through woods. Wear leggings, tall boots and insect repellent.

 

Dengue Fever (Breakbone Fever)

Found: South America, Africa, South Pacific, Asia, Mexico, Central America, Caribbean.
Cause: An arbovirus transmitted by mosquitoes.
Carrier: Mosquitoes in tropical areas, which usually bite during the daytime.
Symptoms: Two distinct periods. First period consists of severe muscle and joint aches and headaches combined with high fever (the origin of the term "break bone fever"). The second phase is sensitivity to light, diarrhea, vomiting, nausea, mental depression and enlarged lymph nodes.
Treatment: Designed to relieve symptoms. Aspirin should be avoided due to hemorrhagic complications.
How to avoid: Typical protection against daytime mosquito bites: using insect repellent with high DEET levels, wearing light-colored long-sleeve pants and shirts.

 

Diarrhea

Found: Worldwide.
Cause: There are many reasons for travelers to have the symptoms of diarrhea. It is important to remember that alien bacteria in the digestive tract is the main culprit. Most travelers to Africa, Mexico, South America and the Middle East will find themselves doubled up in pain, running for the nearest stinking toilet and wondering why the hell they ever left their comfortable home.
Carrier: Bacteria from food, the air, water or other people can be the cause. Dehydration from long airplane flights, strange diets, stress and high altitude can also cause diarrhea. It is doubtful you will ever get to know your intestinal bacteria on a first name basis, but Aeromonas hydrophila, Campylobacter, jejuni Pleisiomonas, salmonellae, shigellae, shielloides, Vibrio cholerae (non-01), Vibrio parahaemolyticus, Yersinia enterocoliticia and Escherichia coli are the most likely culprits. All these bugs would love to spend a week or two in your gut.
Symptoms: Loose stools, stomach pains, bloating, fever and malaise.
Treatment: First step is to stop eating and ingest plenty of fluids and salty foods; secondly, try Kaopectate or Pepto Bismol. If diarrhea persists after three to four days, seek medical advice.
How to avoid: Keep your fluid intake high when traveling. Follow common sense procedures when eating, drinking and ingesting any food or fluids. Remember to wash your hands carefully and frequently, since you can transmit a shocking number of germs from your hands to your mouth, eyes and nose.

 

Diphtheria

Found: Worldwide
Cause:The bacterium Corynebacterium diptheriae, a producer of harmful toxins that is usually a problem in populations that have not been immunized against diphtheria.
Carrier: Infected humans can spread the germs by sneezing, or contact.
Symptoms: Swollen diphtheritic membrane which may lead to serious congestion. Other symptoms are pallor, listlessness, weakness and increased heart rate. May cause death due to weakened heart or shock.
Treatment: Immunization with the DPT vaccine at an early age (three years) is the ideal prevention; treatment with antitoxin, if not.
How to avoid: Avoid close contact with populations or areas where there is little to no vaccination program for diphtheria.

 

Ebola River Fever

Found: Among local populations in Congo.
Cause: A very rare but much publicized affliction.
Carrier: Unknown, but highly contagious. In 1989 the virus was found in lab monkeys in Reston, Virginia. The monkeys were quickly destroyed. Outbreaks in the Congo and Central Africa are a risk.
Symptoms: The virus is described as melting people down, causing blood clotting, loss of consciousness and death.
Treatment: None.
How to avoid: Unknown.

 

Encephalitis

Found: Southeast Asia, Korea, Taiwan, Nepal, Eastern CIS countries and Eastern Europe.
Cause: A common viral infection carried by insects.
Carrier: The disease can be carried by the tick or mosquito. The risk is high during late summer and fall.The most dangerous strain is tickborne encephalitis transmitted by ticks in the summer in the colder climates of Russia, Scandinavia, Switzerland and France.
Symptoms: Fever, headache, muscle pain, malaise, runny nose and sore throat followed by lethargy, confusion, hallucination and seizures. About one-fifth of encephalitis infections have led to death.
Treatment: A vaccine is available.
How to avoid: Avoid areas known to be endemic. Avoid tick-infested areas such as forests, rice growing areas in Asia (mosquitoes) or areas that have large number of domestic pigs (tick carriers). Use insect repellent. Do not drink unpasteurized milk.

 

Filariasis (Lymphatic, River Blindness)

Found: Africa, Central America, Caribbean, South America, Asia.
Cause: A group of diseases caused by long, thin roundworms carried by mosquitoes.
Carrier: Mosquitoes and biting flies in tropical areas.
Symptoms: Lymphatic filariasis, onchocerciasis (river blindness), loiasis and mansonellasis all have similar and very unpleasant symptoms. Fevers, headaches, nausea, vomiting, sensitivity to light, inflammation in the legs including the abdomen and testicles, swelling of the abdomen, joints and scrotum, enlarged lymph nodes, abscesses, eye lesions that lead to blindness, rashes, itches and arthritis.
Treatment: Diethylcarbamazine (DEC, Hetrazan, Notezine) is the usual treatment.
How to avoid: Avoid bites by insects with usual protective measures and insect repellent.

 

Flukes

Found: Caribbean, South America, Africa, Asia.
Cause: The liver fluke (Clonorchis sinensis) and the lung fluke (Paragonimus westermani) which lead to paragonimasis.
Carrier: Carried in fish that has not been properly cooked.
Symptoms: Obstruction of the bile system, along with fever, pain, jaundice, gallstones, inflammation of the pancreas. There is further risk of cancer of the bile tract after infection.Paragonimasis affects the lungs and causes chest pains.
Treatment: Paragonimasis is treated with Prazanquantel. Obstruction of the bile system can require surgery.
How to avoid: To avoid liver flukes do not eat uncooked or improperly cooked fish-something most sushi fans will decry. Paragonimasis is found in uncooked shellfish, like freshwater crabs, crayfish and shrimp.

 

Giardiasis

Found: Worldwide.
Cause: A protozoa Giardi lamblia that causes diarrhea.
Carrier: Ingestion of food or water that is contaminated with fecal matter.
Symptoms: Very sudden diarrhea, severe flatulence, cramps, nausea, anorexia, weight loss and fever.
Treatment: Giardiasis can disappear without treatment, but Furazolidone, metronidizole, or quinacrine HCI are the usual treatments.
How to avoid: Cleanliness, drinking bottled water, and strict personal hygiene in eating and personal contact.

 

Guinea Worm Infection (Dracontiasis, Dracunculiasis)

Found: Tropical areas like the Caribbean, the Guianas, Africa, the Middle East and Asia.
Cause: Ingestion of waterborne nematode Dracunculus medinensis.
Carrier: Water systems that harbor Dracunculus medinensis.
Symptoms: Fever, itching, swelling around the eyes, wheezing, skin blisters and arthritis.
Treatment: Doses of niridazole, metronidazole or thiabendazole are the usual method. Surgery may be required to remove worms.
How to avoid: Drink only boiled or chemically treated water.

 

Hemorrhagic Fevers

Some of the more well-known hemorrhagic fevers are yellow fever, dengue, lassa fever and the horror movie­caliber Ebola fever. Outbreaks tend to be localized and subject to large populations of insects, or rats. Don't let the exotic-sounding names lull you into a false sense of security; there was a major outbreak in the American Southwest caused by rodents spreading the disease.

Found: Worldwide.
Cause: Intestinal worms carried by insects and rodents.
Carrier: Depending on the disease, it can be transmitted by mosquitoes, ticks and rodents (in urine and feces).
Symptoms: Headache, backache, muscle pain and conjunctivitis. Later on, the thinning of the blood will cause low blood pressure, bleeding from the gums and nose, vomiting and coughing up blood, blood in your stool, bleeding from the skin and hemorrhaging in the internal organs. Coma and death may occur in the second week.
Treatment: Consult a doctor or medical facility familiar with the local disease.
How to avoid: Avoid mosquitoes, ticks, and areas with high concentrations of mice and rats.

 

Hepatitis, A, B, Non-A, Non-B

Found: Worldwide.
Cause: A virus that attacks the liver. Hepatitis A, Non-B and Non-A can be brought on by poor hygiene; Hepatitis B is transmitted sexually or through infected blood.
Carrier: Hepatitis A is transmitted by oral-fecal route, person-to-person contact, or through contaminated food or water. Hepatitis B is transmitted by sexual activity or the transfer of bodily fluids. Hepatitis Non-A and Non-B are spread by contaminated water or from other people.
Symptoms: Muscle and joint pain, nausea, fatigue, sensitivity to light, sore throat, runny nose. Look for dark urine and clay-colored stools, jaundice along with liver pain and enlargement.
Treatment: Rest and a high-calorie diet. Immune Globulin is advised as a minor protection against Hepatitis A. You can be vaccinated against Hepatitis B.
How to avoid: Non-A and Non-B require avoiding infected foods. Hepatitis B requires avoiding unprotected sexual contact, unsterile needles, dental work and infusions. Hepatitis A requires proper hygiene and avoiding infected water and foods.

 

Hydatid Disease (Echinococcosis)

Found: Worldwide.
Cause: A tapeworm found in areas with high populations of pigs, cattle and sheep.
Carrier: Eggs of the echinococcosis.
Symptoms: Cysts form in organs in the liver, lungs, bone or brain.
Treatment: Surgery for removal of the infected cysts. Mebendazole and albendazole are used as well.
How to avoid: Boil water, cook foods properly and avoid infected areas.

 

Leishmaniasis

Found: Tropical and subtropical regions.
Cause: Protozoans of the genus Leishmania.
Carrier: Phlebotomine sandflies in tropical and subtropical regions.
Symptoms: Skin lesions, cutaneous ulcers, mucocutaneous ulcers in the mouth, nose and anus, as well as intermittent fever, anemia and enlarged spleen.
Treatment: Sodium stibogluconate, rifampin, and sodium antimony gluconate. Surgery is also used to remove cutaneous and mucocutaneous ulcers.
How to avoid: Use insect repellent, a ground cover when sleeping and bed nets, and cover arms and legs.

 

Leprosy (Hansen's Disease)

Found: Africa, India and elsewhere
Cause: The bacterium Mycobacterium leprae that infects the skin, eyes, nervous system and testicles.
Carrier: It is not known how leprosy is transmitted, but direct human contact is suspected.
Symptoms: Skin lesions, and nerve damage that progresses to loss of fingers and toes, blindness, difficulty breathing and nerve damage.
Treatment: Dapsone, rifampin and clofazimine.
How to avoid: Leprosy is a tropical disease, with over half the cases worldwide occurring in India and Africa. There is no known preventive method.

 

Loaisis

Found: West and Central Africa.
Cause: The loa loa parasite.
Carrier: Chrysops deer flies or tabanid flies in West and Central Africa.
Symptoms: Subcutaneous swellings that come and go, brain and heart inflammation.
Treatment: Diethylcarbamazine.
How to avoid: Deerflies are large, and their bites can be avoided by wearing full-sleeved shirts and thick pants. Hats and bandannas can protect head and neck areas.

 

Lyme Diseases

Found: Worldwide
Cause: A spirochete carried by ticks.
Carrier: The Ixodes tick, found worldwide and in great numbers during the summer. Ticks are found in rural areas and burrow into skin to suck blood.
Symptoms: A pronounced bite mark, flulike symptoms, severe headache, stiff neck, fever, chills, joint pain, malaise and fatigue.
Treatment: Tetracyclines, phenoxymethylpenicillin or erythromycin if caught early. Advanced cases may require intravenous penicillin.
How to avoid: Do not walk through wooded areas in the summer. Check for ticks frequently. Use leggings with insect repellent.

 

Malaria

Malaria is by far the most dangerous disease and the one most likely for travelers to pick up in Third World countries. Protection against this disease should be your first priority. As a rule, be leery of all riverine, swampy or tropical places. Areas such as logging camps, shantytowns, oases, campsites near slow moving water, and resorts near mangrove swamps are all very likely to be major areas of malarial infection. Consult with a local doctor to understand the various resistances and the prescribed treatment. Many foreign doctors are more knowledgeable about the cure and treatment of malaria than domestic doctors.

Found: Africa, Asia, Caribbean, Southeast Asia, the Middle East.
Cause: The Plasmodium parasite is injected into the victim while the mosquito draws blood.
Carrier: The female Anopheles mosquito.
Symptoms: Fever, chills, enlarged spleen in low-level versions; plasmodium falciparum, or cerebral malaria, can also cause convulsions, kidney failure and hypoglycemia.
Treatment: Chloroquinine, quinine, pyrimethamine, sulfadoxine and mefloquine. Note: Some people may have adverse reactions to all and any of these drugs.
How to avoid: Begin taking a malarial prophylaxis before your trip, as well as during and after (consult your doctor for a prescription). Avoid infected areas and protect yourself from mosquito bites (netting, insect repellent, mosquito coils, long-sleeve shirts and pants) especially during dusk and evening times.

 

Measles (Rubeola)

Found: Worldwide.
Cause: A common virus in unvaccinated areas.
Carrier: Sneezing, saliva and close contact with infected or unvaccinated humans.
Symptoms: Malaise, irritability, fever, conjunctivitis, swollen eyelids and hacking cough appear nine to 11 days after exposure. Fourteen days after exposure, the typical facial rash and spots appear.
Treatment: Measles will disappear, but complications can occur.
How to avoid: Vaccination or gamma globulin shots within five days of exposure.

 

Meliodosis

Found: Worldwide.
Cause: An animal disease (the bacillus Pseudomonas pseudomallei) that can be transferred to humans.
Carrier: Found in infected soil and water, and transmitted through skin wounds.
Symptoms: Various types, including fever, malaise, pneumonia, shortness of breath, headache, diarrhea, skin lesions, muscle pain and abscesses in organs.
Treatment: Antibiotics such as tetracyclines and sulfur drugs.
How to avoid: Clean and cover all wounds carefully.

 

Meningitis

Found: Africa, Saudi Arabia.
Cause: Bacteria: Neisseria meningitis, Streptococcus pneumoniae and Haemophilus influenzae. Children are at most risk. There are frequent outbreaks in Africa and Nepal.
Carrier: Inhaling infected droplets of nasal and throat secretions.
Symptoms: Fever, vomiting, headaches, confusion, lethargy and rash.
Treatment: Penicillin G.
How to avoid: Meningococcus polysaccharide vaccine. Do not travel to areas where outbreaks occur (the Sahel from Mali to Ethiopia) in the dry season.

 

Mumps

Found: Worldwide.
Cause: A virus found worldwide. Common in early spring and late winter and in unvaccinated areas.
Carrier: Infected saliva and urine.
Symptoms: Headache, anorexia, malaise, and pain when chewing or swallowing.
Treatment: Mumps is a self-inoculating disease. There can be complications which can lead to more serious lifetime afflictions.
How to avoid: Vaccination (MMR).

 

Plague

Found: India, Vietnam, Africa, South America, the Middle East, Russia.
Cause: A bacteria (Yersinia pestis) that infects rodents and the fleas they carry.
Carrier: Flea bites that transmit the bacteria to humans. Ticks, lice, corpses and human contact can also spread the disease.
Symptoms: Swollen lymph nodes, fever, abdominal pain, loss of appetite, nausea, vomiting diarrhea, and gangrene of the extremities.
Treatment: Antibiotics like streptomycin, tetracyclines and chloramphenicol can reduce the mortality rate.
How to avoid: Stay out of infected areas, and avoid contact.

 

Poliomyelitis (Polio)

Found: Worldwide.
Cause: A virus that destroys the central nervous system.
Carrier: Occurs through direct contact.
Symptoms: A mild febrile illness that may lead to paralysis. Polio can cause death in 5 to 10 percent of cases in children and 15 to 30 percent in adult cases.
Treatment: There is no treatment.
How to avoid: Vaccination during childhood with a booster before travel is recommended.

 

Rabies

Found: Worldwide.
Cause: A virus that affects the central nervous system.
Carrier: Rabies is transmitted through the saliva of an infected animal. Found in wild animals, although usually animals found in urban areas are most suspect: dogs, raccoons, cats, skunks, and bats. Although most people will automatically assume they are at risk for rabies, there are only about 16,000 cases reported worldwide. The risk is the deadly seriousness of rabies and the short time in which death occurs.
Symptoms: Abnormal sensations or muscle movement near the bite, followed by fever, headaches, malaise, muscle aches, tiredness, loss of appetite, nausea, vomiting, sore throat and cough. The advanced stages include excessive excitation, seizures and mental disturbances leading to profound nervous system dysfunction and paralysis. Death occurs in most cases four to 20 days after being bitten.
Treatment: Clean wound vigorously, injections of antirabies antiserum and antirabies vaccine. People who intend to come into regular contact with animals in high-risk areas can receive HDCV (human diploid cell rabies vaccine) shots.
How to avoid: Avoid confrontations with animals.

 

Relapsing Fever

Found: The louseborne version is found in poor rural areas where infestation by lice is common.
Cause: Borrelia spirochetes.
Carrier: Lice and ticks. Ticks are found in wooded areas and bite mainly at night.
Symptoms: The fever gets its name from the six days on and six days off of high fever. Other symptoms include headaches, muscle pains, weakness and loss of appetite.
Treatment: Antibiotics.
How to avoid: Avoid infected areas, and check for ticks.

 

Rift Valley Fever

Found: Egypt and East Africa.
Cause: A virus that affects humans and livestock.
Carrier: Mosquitoes, inhaling infected dust, contact with broken skin and ingesting infected animal blood or fluids.
Symptoms: Sudden one-time fever, severe headaches, muscle pain, weakness, sensitivity to light, eye pain, nausea, vomiting, diarrhea, eye redness and facial flushing. Blindness, meningitis, meningoencephalitis and retinitis may also occur.
Treatment: Seek medical treatment for supportive care.
How to avoid: Avoid contact with livestock in infected areas; protect yourself against mosquito bites.

 

River Blindness (Onchocerciais)

Found: Equatorial Africa, Yemen, the Sahara and parts of Central and South America.
Cause: The roundworm Onchocerca volvulus.
Carrier: Transmitted by blackflies found along rapidly flowing rivers.
Symptoms: Itching, skin atrophy, mottling, nodules, enlargement of the lymph nodes, particularily in the groin, and blindness.
Treatment: Invermectin or Diethylcarbamazine(DEC), followed by suramin, followed by DEC again.
How to avoid: Insect repellant, long-sleeve shirts and long pants. Avoid blackfly bites.

 

Rocky Mountain Spotted Fever

Found: Found only in the Western Hemisphere.
Cause: A bacterial disease transmitted by tick bites.
Carrier: Rickettsial bacteria are found in rodents and dogs. The ticks pass the bacteria by then biting humans.
Symptoms: Fever, headaches, chills, and rash (after fourth day) on the arms and legs. Final symptoms may include delirum, shock and kidney failure.
Treatment: Tetracyclines or chloramphenicol.
How to avoid: Ticks are found in wooded areas. Inspect your body after walks. Use insect repellent. Wear leggings or long socks or long pants.

 

Salmonellosis

Found: Worldwide.
Cause: A common bacterial infection; Salmonella gastroenteritis is commonly described as food poisoning.
Carrier: Found in fecally contaminated food, unpasteurized milk, raw foods and water.
Symptoms: Abdominal pain, diarrhea, vomiting, chills and fever usually within eight to 48 hours of ingesting infected food. Salmonella only kills about one percent of its victims, usually small children or the aged.
Treatment: Purge infected food, replace fluids. Complete recovery is within two to five days.
How to avoid: Consume only properly prepared foods.

 

Sandfly Fever (Three-day Fever)

Found: Africa, Mediterranean.
Cause: Phleboviruses injected by sandfly bites.
Carrier: Transmitted by sandflies, usually during the dry season.
Symptoms: Fever, headache, eye pain, chest muscle pains, vomiting, sensitivity to light, stiff neck, taste abnormality, rash and joint pain.
Treatment: There is no specific treatment. The symptoms can reoccur in about 15 percent of cases, but typically disappear.
How to avoid: Do not sleep directly on the ground. Sandflies usually bite at night.

 

Schistosomiasis (Bilharzia)

Bilharzia is one of the meanest bugs to pick up in your foreign travels. The idea of nasty little creatures actually burrowing through your skin and lodging themselves in your gut is menacing. If not treated, it can make your life a living hell with afternoon sweats, painful urination, weakness and other good stuff. There is little you can do to prevent infection, since the Schistosoma larva and flukes are found where people have fouled freshwater rivers and lakes. Get treatment immediately, since the affliction worsens as the eggs multiply and continue to infect more tissues. About 250 million people around the world are believed to be infected.

Found: Worldwide.
Cause: A group of parasitic Schistosoma flatworms (Schistosoma mansoni, Schistosomajaponicum and Schistosoma haematobium) found in slow moving, tropical freshwater.
Carrier: The larvae of Schistosoma are found in slow moving waterways in tropical areas around the world. They actually enter the body through the skin and then enter the lymph vessels and then migrate to the liver.
Symptoms: Look for a rash and itching at the entry site, followed by weakness, loss of appetite, night sweats, hivelike rashes, and afternoon fevers in about four to six weeks. Bloody, painful and frequent urination, diarrhea. Later victims become weaker and may be susceptible to further infections and diseases.
Treatment: Elimination of S. mansoni requires oxamniquine and praziquantel. S. japonicum responds to praziquantel alone, and Schistosoma haematobium is treated with praziquantel and metrifonate.
How to avoid: Stay out of slow moving freshwater in all tropical and semitropical areas. This also means wading or standing in water.

 

Syphilis

Found: Worldwide.
Cause: A spirochete (Treponema pallidum) causes this chronic venereal disease, which if left untreated progresses into three clinical stages.
Carrier: Syphilis is spread through sexual contact and can be passed on to infants congenitally.
Symptoms: After an incubation period of two to six weeks, a sore usually appears near the genitals, although some men and women may not experience any symptoms. Some men also experience a scanty discharge. A skin rash appears in the second stage, often on the soles of the feet and palms of the hands. It may be accompanied by a mild fever, sore throat and patchy hair loss. This rash generally appears about six weeks after the initial sore. The third phase of the disease may develop over several years if the disease is left untreated and may damage the brain and the heart or even cause death.
Treatment: Antibiotics are used to treat syphilis, and infected people should abstain from sex until treatment ends. Blood tests should be performed again in three months after the round of treatment. Sexual partners need to be tested and treated. Victims of syphilis should also be tested for other sexually transmitted diseases.
How to avoid: Abstain from sexual activities or use a latex condom.

 

Tainiasis (Tapeworms)

Found: Worldwide.
Cause: A tapeworm is usually discovered after being passed by the victim.
Carrier: Ingestion of poorly cooked meat infected with tapeworms.
Symptoms: In advanced cases, there will be diarrhea and stomach cramps. Sections of tapeworms can be seen in stools.
Treatment: Mebendazole, niclocsamide, paromomysi and praziqunatel are effective in killing the parasite.
How to avoid: Tapeworms come from eating meats infected with tapeworm or coming into contact with infected fecal matter.

 

Tetanus (Lockjaw)

Found: Worldwide.
Cause: A bacteria caused by the bacteria Clostridiium tetani.
Carrier: Found in soil and enters body through cuts or punctures.
Symptoms: Restlessness, irritability, headaches, jaw pain, back pain and stiffness, and difficulty in swallowing. Then within two to 56 days, stiffness increases with lockjaw and spasms. Death occurs in about half the cases, usually affecting children.
Treatment: If infected, human tetanus immune globulin is administered with nerve blockers for muscle relaxation.
How to avoid: Immunization is the best prevention, with a booster recommended before travel.

 

Trachoma

Found: Common in Africa, the Middle East and Asia.
Cause: A chlamydial infection of the eye, which is responsible for about 200 million cases of blindness.
Carrier: Flies, contact, wiping face or eye area with infected towels.
Symptoms: Constant inflammation under the eyelid that causes scarring of the eyelid, turned-in eyelashes and eventual scarring of the cornea and then blindness.
Treatment: Tetracyclines, erythromycin, sulfonamide, surgery to correct turned-in lashes.
How to avoid: It is spread primarily by flies. Proper hygiene and avoidance of fly-infested areas are recommended.

 

Trichinosis

Found: Worldwide.
Cause: Infection of the Trichinella spiralis worm.
Carrier: Pig meat (also bear and walrus) that contain cysts. The worm then infects the new hosts' tissues and intestines.
Symptoms: Diarrhea, abdominal pain, nausea, prostration and fever. As the worm infects tissues, fever, swelling around the eyes, conjunctivitis, eye hemorrhages, muscle pain, weakness, rash and splinter hemorrhages under the nails occur. Less than 10 percent of the cases result in death.
Treatment: Thiabendazole is effective in killing the parasite.
How to avoid: Proper preparation, storage and cooking of meat.

 

Tuberculosis

Found: Worldwide.
Cause: A disease of the lungs caused by the Mycobacterium tuberculosis bacteria or Mycobacterium bovis.
Carrier: By close contact with infected persons (sneezing, coughing) or, in the case of Mycobacterium bovis, contaminated or unpasteurized milk.
Symptoms: Weight loss, night sweats and a chronic cough usually with traces of blood. If left untreated, death results in about 60 percent of the cases after a period of two and a half years.
Treatment: Isoniazide and rifampin can control the disease.
How to avoid: Vaccination and isoniazid prophylaxis.

 

Tularaemia (Rabbit Fever)

Found: Worldwide.
Cause: A fairly rare disease (about 300 cases per year) caused by the bacteria Francisella tularnesis passed from animals to humans via insects.
Carrier: The bite of deerflies, ticks, mosquitoes and even cats can infect humans.
Symptoms: Fever, chills, headaches, muscle pain, malaise, enlarged liver and spleen, rash, skin ulcers and enlargement of the lymph nodes.
Treatment: Vaccination is used. Streptomycin primarily. Tetracycline and chloramphenicol are also effective.
How to avoid: Care when handling animal carcasses, removal of ticks and avoidance of insect bites.

 

Typhoid Fever

Found: Africa, Asia, Central America.
Cause: The bacterium Salmonella typhi.
Carrier: Transmitted by contaminated food and water in areas of poor hygiene.
Symptoms: Fever, headaches, abdominal tenderness, malaise, rash, enlarged spleen. Later symptoms include delirium, intestinal hemorrhage and perforation of the intestine.
Treatment: Chloramphenicol.
How to avoid: Vaccination is the primary protection, although the effectiveness is not high.

 

Typhus Fever

Found: Africa, South America, Southeast Asia, India.
Cause: Rickettsia.
Carrier: Transmitted by fleas, lice, mites and ticks found in mountainous areas around the world.
Symptoms: Fever, headache, rash and muscle pain. If untreated, death may occur in the second week due to kidney failure, coma and blockage of the arteries.
Treatment: Tetracyclines or chloramphenicol.
How to avoid: Check for ticks, avoid insect bites, attend to hygiene to prevent lice and avoid mountainous regions.

 

Yellow Fever

Found: Africa, South America.
Cause: A virus transmitted by mosquito bites.
Carrier: The tiny banded-legged aedes aegpyti is the source for urban yellow fever, and the haemogogus and sabethes mosquito carries the jungle version.
Symptoms: In the beginning, fever, headaches, backaches, muscle pain, nausea, conjunctivitis, albumin in the urine and slow heart rate. Followed by black vomit, no urination and delirium. Death affects only 5 to 10 percent of cases and occurs in the fourth to sixth day.
Treatment: Replace fluids and electrolytes.
How to avoid: Vaccination is mandatory when entering or leaving infected areas.