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Tropical diseases symptoms, prevention and therapy
contents
- prevention
- The hygiene bag
- water shortage
- Travel sickness and the symptoms
- The dengue fever:
- yellow fever
- vaccination
- Side effects of vaccinations
- Lassa fever
- Loa Loa
- leishmaniasis
- Hepatitis A
- diarrhea
- rabies
- course
- Other tropical diseases and their symptoms
- to eat and drink
- What belongs in the first aid kit?
- drugs
- Additional Information:
prevention
For all travel destinations: illnesses have causes, and some of these causes can be avoided.
1) About two months before departure you should inform yourself which vaccinations are prescribed in the country of destination and which are advisable. Then they should check their imf passport, which vaccines are still working, which they have to repeat and which they do not have.
Tropical diseases reach Europe. Image: Henrie - fotolia It is also about the regions that visit them and their way of traveling. For example, if you are staying in mid-range hotels in India and booking organized tours, you are unlikely to have contact with a rabies-affected dog or jackal.
On the other hand, if you are backpacking, camping, or spending the night in the open air, vaccination against rabies is highly recommended.
2) You should generally observe simple hygienic measures.
This includes:
- Boil tap water and forgo well water, if possible.
- Do not eat unpeeled fruit.
- Do without homemade ice cream.
- If possible, do not eat at street vendors.
- Wear long clothes, sleep under a mosquito net, put on mosquito hat in wetlands, use mosquito repellents.
- Wash your hands, especially before and after eating, if you were on the bus or train, touching doors or foreign objects. Most of the infection goes from hand to mouth.
- After washing, rub the skin with a cream.
- In risk areas such as the slums of major South American cities use a mask against smog and Krnakheitserreger.
- Avoid stroking stray animals or at least wash your hands thoroughly afterwards.
- Carry out sprays or powders against fleas, mites and bedbugs.
- Take your own bedding. Sleep in hotels with poor hygiene in your own sleeping bag and place a plastic bag over the bed sheet if necessary.
- Bring bathing shoes with you when you use the shower.
The hygiene bag
Small things often prevent big things. Our "cosmetic bag" already helps to slow infections.
He should contain:
- Toilet paper,
- Toothpaste and toothbrush,
- Soap,
- a cloth handkerchief (wash regularly with clean water),
- Razor and After Shave (disinfected),
- Comb (also brushes insects and parasites out of the hair),
- Sunblock,
- Skin cream (chapped skin opens the way for many pathogens).
water shortage
The most dangerous killer on tropical trips is not the tiger or the white shark, but lack of water. No danger is so underestimated! Never go without water reserves - in the wild as in the city. Never think, you already find water somewhere.
The proximity to cities is deceptive - if you were to die of thirst five kilometers from the next place, they still died of thirst.
In hot deserts we need several liters of water per day. If we are driving a car, that offers no security. Maybe the next gas station has closed, then we continue to dry out, or the car will lie with a breakdown.
Never think, "there is a river on the way". Maybe he's just not running water, or you're losing the path.
Lack of water threatens life long before, the organs fail. The fatal thing is that we lose focus and orientation just when we need them urgently to get help.
We are confused, our concentration suffers, we become impotent, the tongue swells, and we see things that do not exist.
Our urine gets dark and stinks.
We prevent water shortage by always carrying at least two liters of water with us as a true law - considerably more on trekking tours.
- We avoid sweating.
- We relocate strenuous marches and work in the night or the shade.
- We wear loose light clothes.
- We protect ourselves from wind, because wind promotes evaporation.
- We eat nothing except water-rich fruit.
- We do not drink alcohol and do not smoke.
- When we show symptoms, we never drink salt water or urine. This disturbs the osmotic balance and can lead to death.
- We cleanse the water with degermination tablets; if there is a lack of water, even the loss of fluid in the event of a small diarrhea quickly leads to death.
Travel sickness and the symptoms
The term tropical diseases does not cover all diseases that tourists encounter on long-distance trips. For example, rabies or malaria are not restricted to the tropics but are now under control in central Europe.
The dengue fever:
Aedes aegypti, a mosquito species transmits a dangerous virus called dengue fever. Tens of thousands of people in countries like Vietnam and Venezuela fell ill with it. The symptoms include severe pain in the muscles, joints and limbs. Bleeding and shock symptoms may follow.
The fever can not be cured, but only alleviated, for example, by acetaminophen - but never take aspirin, because of the risk of bleeding! In areas where the dengue fever is rampant, all measures to ward off the diurnal mosquitoes are a must: mosquito hat. Mosquito repellent sprays, and if necessary, a strong smoldering fire.
yellow fever
The yellow fever also transmit mosquitoes to humans. The virus is endemic in parts of Africa, as well as in Central and South America. In Asia and the Caribbean there is no danger, but experts fear that the virus spreads to Asia, because there are suitable hosts and vectors live here.
The mosquitoes suck on infected monkeys, then transfer the virus to other monkeys or to humans. Or they suck blood from sick people and transfer it to other people. In nature, monkeys are the main carriers, in cities people.
The transmissions of monkeys to humans usually only lead to local epidemics in forest villages. In metropolitan areas, however, the disease breaks out massively.
The incubation is 3-6 days. After transmission, the virus multiplies in the body. Those affected suffer from high fever, which also rises rapidly. In addition, there is nausea, and pain in the head like muscles. The conjunctiva inflames and the pulse slows down.
Then the symptoms disappear and those affected believe they are recovering. But now begins the second phase, in which the yellow fever affects the organs. Liver and kidneys fail, the body is poisoned. In this phase, every second patient dies.
Yellow fever also causes severe internal bleeding. Sometimes yellow fever is less severe.
No medicine helps against the disease, and medicines only relieve the symptoms.
If you are in yellow fever areas, you should definitely use repellent, sleep under mosquito nets and seek their protection especially at dusk - then the animals are active.
vaccination
A yellow fever vaccine is mandatory when entering many countries. In the process, attenuated viruses are propagated on chicken eggs - the vaccination is done with a syringe under the skin. Such a vaccination is essential when traveling to Africa or tropical America: the protection is almost 100% - and that in the case of a disease that leads to the death of every second unvaccinated.
The basic vaccination takes place at the latest ten days before entry and may only be carried out by official vaccinarians. The vaccine lasts a lifetime, but some states desire to renew it after ten years.
Side effects of vaccinations
Very rarely there are side effects. Every twentieth vaccinee reports a slight headache. In any case, the risk of catching the virus in epidemics is far more dangerous than any side effects.
Those who have no vaccine protection and were in yellow fever countries, the or the other States sometimes refuse entry.
Lassa fever
Lassa fever is a classic tropical disease because it only occurs in West Africa from Senegal to Nigeria.
A rat, Mastomys natalensis, transmits the fever when in contact with humans. Infected people then transfer it to other people.
The incubation takes 2-21 days. The disease begins with limb, muscle and headache, nausea and fatigue, and fever around 40 degrees. At first, it can easily be confused with a flu.
Body aches are an important sign of an infectious disease. Picture: detail-view-foto - fotolia After three or more days, however, the throat becomes inflamed. Those affected are now apathetic to external stimuli. The lymph nodes on the neck swell and hurt. After seven days, patches of skin spread, nodules on the face, neck and arms, later on the whole body. In addition there are abdominal pains like with a colic, the feces become pulpy to watery.
Other lymph nodes are now swelling and eating is difficult. The kidney functions are disturbed. After the seventh day, the fever lowers, but often returns full force a few days later. The mortality rate is between 50 and 90%.
There is no therapy and there is no vaccine. The only protection is to avoid contact with rats. Carry a long stick in affected countries and poke it in possible hiding places before entering or sitting down.
Loa Loa
Loa-Loa refers to a worm infestation transmitted to the brakes. The worms are nematodes of the genus Filarioidea. Loa-Loa is common in West and Central Africa.
The incubation lasts months, and usually infested feel the first complaints only after the trip. The nematodes migrate in the connective tissue of skin and mucous membranes, their larvae also in the blood vessels. The skin swells, reddens and itches.
Against Loa-Loa helps a deworming agent, diethylcarbamazine. Sufferers must go to hospital. There is no vaccine. The same protective measures against mosquitoes help with braking, but with special repellents for flies.
leishmaniasis
Leishmaniases are skin diseases that transmit mosquitoes. The so-called Orientbeule occurs in Asia, in the Middle East, around the Mediterranean, East and West Africa and in tropical America. The visceral leishmaniasis is rife from India and Pakistan through the Middle East to Central and South America.
The incubation on the skin can take months, the organ involvement is often only after years. After the stitch, a red ring appears without swelling. For this symptom, travelers should consult a doctor. Skinleishmaniasis is manifested as necrotizing skin ulcers, visceral leismaniases as a result of fever, swelling of the liver and spleen, and pain in the stomach and intestines.
Various antibiotics help. There is no vaccine. As sandflies transmit the disease, repellents and mosquito nets help.
Hepatitis A
The hepatitis A virus is found in contaminated food, for example in seafood, but also in drinks and toilets.
The virus infects the liver, it becomes inflamed and the skin turns yellow. Healthy people recover relatively quickly from the disease, but at least three out of every hundred people die in people with a weak immune system and older people.
The virus is most common in warm countries. Already in Turkey, there is a 50 times higher risk of becoming infected with the virus than in Germany. An extreme risk in tropical Africa and America, and also the south of Asia is a danger zone.
The vaccine against hepatitis A is routine - such a vaccine is almost one hundred percent effective. It is taken over by the health insurance companies.
diarrhea
The most common travel sickness is not malaria, not worm infestation or an infectious rat bite, but diarrhea. 70% of all long-distance travelers suffer such diarrhea at least once in their lifetime.
However, "traveler's diarrhea" is a collective term - it includes various infections. Coli bacteria are the usual suspects, but viruses are also possible.
The most vulnerable are travelers in India, Africa, Malaysia, Indonesia and Indochina. But also Mediterranean tourists, Japan visitors or Pacific Ocean trotters know the problem.
Most of the people who are affected also know about the trigger, because the fluid bowels usually start a few hours after a drink or a meal. Without treatment, it will last three to five days.
The diarrhea does not threaten life, but can cause significant problems. Most lenient comes from who has a hotel room with its own toilet. It becomes more difficult if the infection announces itself, if the travelers are overland on the way. Quite a few were already stuck at night in dark toilets somewhere on the Bay of Bengal, while the bus drove off without them.
Women looking for sexual adventures should be extra careful because diarrhea sometimes relieves the effect of the pill.
Prevention of diarrhea is simple but consistent: cooking food, peeling fruit, not eating at street stalls, and washing your hands.
rabies
A largely underestimated threat comes from rabies. Although the Lyssa virus is under control in Central Europe, it is a deadly threat in Africa and India: in India alone, it is estimated that 20,000 people die every year.
Rabies transmissible to humans. Image: Irina84 - fotolia With whom the disease breaks out, he (as good as) always dies. Infected animals, in Europe especially the fox, in India and Africa mostly dogs, in South America vampire bats, but also wolves, jackals and cats transmit the epidemic with their saliva.
Rabies sometimes breaks out after days, often months, and sometimes years.
Pay attention to unusual behavior of animals in affected countries. Afflicted wild animals behave unnaturally trustingly, they gasp for air, seem irritated, stagger, are emaciated or grab around. Beware of stray dogs: 99% of developing country infections are through dogs, and Indian children learn early to repel the animals with a stick.
In South America, the vampire bat of the genus Dendrobatus transmits the virus. These animals use their teeth to rasp the skin of warm-blooded animals and drink their blood. Infected bats thus transmit the virus as in dogs with a bite. A mosquito net helps against the bats.
Humans are infected by bites from sick animals. But even if a sick dog licks the skin, a small wound is enough for the virus to enter the body. The saliva of the animal may also enter the organism through the eyes, nose or mouth, when travelers rub themselves there with unwashed hands.
Beware of animal carcasses! The dead animals are also weeks after their death full of viruses. To examine a dead jackal and then drill it in the nose is a royal way to infect oneself. The Lyssa pathogen is very resistant to cold and decay.
The biggest danger, however, is not biting a sick dog, but helping a "cute puppy". The virus often infests baby dogs, and those who have scratched their arms, which is almost a part of outdoor travel, and then let their hands lick the poor animal are at great risk.
course
In the incubation period, the onset of the disease can certainly be pushed back, after the onset of the disease, it is incurable. The virus travels along the nerve tracts to the spinal cord and on to the brain. There it multiplies.
In the first phase the patients appear paranoid. You feel sick, have a fever and a headache. This is followed by spasms of the swallowing muscles, which led to the old term "water-shy" for the epidemic.
The second phase is characterized by cramps that are getting stronger. The eyes redden, the mouth dries up, the fingers writhe as in rickets, the sufferers suffer unbearable pain, their skin becomes hypersensitive; they suffer from delusions and become aggressive. Various external stimuli are torture for them. After a few days they fall into delirium and die.
There is no cure, the sufferer can only help complete rest, darkness and narcosis. They need to be isolated immediately because their saliva, urine and tears are extremely infectious.
vaccination
A vaccination should be given immediately after contact with an infected animal. All in all, patients will receive five vaccinations over a period of 28 days.
Anyone undertaking outdoor tours in risk countries should in any case get vaccinated beforehand. For endangered professions vaccination is even mandatory. This applies to foresters, hunters, zookeepers or veterinarians. Backpackers in India, Bangladesh, Vietnam, Cambodia, Bali, Nepal, China or Thailand should also take care of an impromptu before the trip. Hotel travelers do not necessarily need to be vaccinated, but should avoid the stray dogs.
A three-time vaccination within a month protects to nearly 100%. It has to be repeated next year, and again after three years.
Other tropical diseases and their symptoms
Diseases that require provision for tropical travel are also malaria, diphtheria and tetanus, polio. Tuberculosis, typhoid fever, cholera and encephalitis, as well as hepatitis B.
Malaria means bad air, and the evaporation of the swamps found the ancient Romans the cause of this fever disease. In fact, it is not the swamps themselves, but the mosquitoes that develop there from larvae that transmit the malaria.
Precaution means learning about the biotopes in which biotopes are frequent, at what time of day they swarm and pack the usual equipment for mosquitoes.
You should consult your doctor if you are taking prophylaxis. The preventive medicines for malaria have side effects similar to a flu infection, and they do not prevent infection, but usually kill the pathogens during their development.
But against the tropical malaria, which is rampant, for example, in equatorial Africa, they help only conditionally. It is often better to be treated first, if there is an infection.
Trekking tourists should always carry a dose of malaria medication in their backpack.
to eat and drink
Healthy diet prevents many illnesses, but is difficult on many routes, in dirty slums like rainforest.
An emergency ration contains, for example:
- nuts
- granola bar
- raisins
- Datteln
- purification tablets
- Sugar / glucose
- salt
What belongs in the first aid kit?
Especially trekking travelers are often dependent on themselves. Absolutely they need bandages, namely:
- Mullbinden
- plastering
- sticking plaster
- Elastic bandages
- Disposable gloves
- disinfectant
- Tweezers
- safety pins
- bandage scissors
- thermometer
drugs
Travelers should take all medications for specific ailments. Generally belongs in the medicine bag:
Anthistamingel for insect bites and sunburn, paracetamol or ibuprofen for pain and fever, diclofenac ointment for contusions and strains, anti-gastric agents, panthenol for burns, wounds and water blisters, eye drops for example Berberil for eye inflammation, Dorithricin for sore throat, silomat for cough, Simuforton against colds, ointments or powders against fungal diseases.
Even more important than medicines are:
- Water purification tablets
- Vitamin and mineral tablets, for example, vitamin C, magnesium or iron. On long trips in nature, the intake of vitamins through food may be insufficient.
- Rehydration mixture. Diarrhea leads to a loss of fluid, minerals and nutrients. The cocktail to compensate for this deficiency is especially important for children.
Home remedies and tinctures against the main ailments also help: sage for tea takes up little space, as do dried mallow, lemon peel or mint.
The rule number 1 is: Be careful with water, especially with ice. Soft drinks in bottles are not very problematic (clean the bottle if necessary from the outside), with draft beer, fruit juices or milkshakes it looks different. Tea, coffee and other hot drinks are mostly drinkable because the water was cooked.
Rule number 2 means: Pay attention to the food. Avoid seafood as well as not enough heated meat, especially hack. Is the restaurant clean, the plates and cutlery as well as the kitchen? Then that probably applies to the food. Does the kitchen boy in Delhi wash his plates one meter off the urine flow from the street wall? Then fingers away.
In general, the more extreme the tour and the more remote the route, the more travelers have to prepare to be their own doctor in an emergency.
For trips in the wild alone, cannulas and gloves are also in the pharmacy, as are antibiotics. Take care of sets that help with snoring, both against blood and nerve toxins. Ask a doctor and prepare for such trips with courses in, for example, wilderness schools. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)
Additional Information:
http://tropeninstitut.de/reiseziel/index.php
African trypanosomiasis. In: Orphanet (database for rare diseases).
Factsheet of the WHO
Information on the sleeping sickness of Doctors Without Borders
www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Tollwut.html