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Home
> Travel >
Travel
Tips
Travel
Health:
Some
of the common health problems that most travellers
face in arid zones like U.A.E are traveler's Diarrhea
and Skin Disorders. This section tells you some
recommended ways to prevent these kind of diseases.
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Traveler's
Diarrhea
Travelers'
diarrhea (TD) typically causes four or five loose
or watery stools per day and vomiting may occur.
It typically lasts three or four days, but about
14% of cases last longer -- in rare cases more than
three months. It is rarely life threatening. It
usually occurs within the first week but may develop
at any point, including after returning home. Studies
show that 50% of tourists travelling to developing
countries develop diarrhea. High-risk destinations
include most of the developing countries of Latin
America, Africa, the Middle East, and Asia. Intermediate
risk destinations include most of the Southern European
countries and a few Caribbean islands. (Of note,
about 25% of tourists who recently visited Jamaica
experienced traveler's diarrhea.) Low risk destinations
include Canada, Northern Europe, Australia, New
Zealand, the United States and a number of the Caribbean
islands. The most common bacterial causal agent
is Escherichia coli (E. coli), but other bacteria
and a number of parasites (usually Giardia lamblia
or Entamoeba histolytica) and, less commonly, the
rotavirus may also cause the problem. In about 10%
to 50% of cases, the cause is unknown.
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Prevention
of Diarrhea.
The old adage, if you can't cook it, boil it
or peel it, then forget it! still applies and could
help prevent many common illnesses associated with
international travel. Even ice cubes can cause infection,
and only carbonated bottled water should be used
for brushing teeth and drinking. If carbonated water
is not available or the traveler is not carrying
a portable water filter, tap water can be treated
by boiling it for ten minutes or by adding one iodine
tablet to a quart of water 30 minutes before drinking
it. The organism cyclospora causes a severe form
of traveler's diarrhea that can be prevented only
by boiling water -- not by purifying it. Heated
food should be hot to the touch and eaten promptly.
Beware of sliced fruit that may have been washed
in contaminated water; as a rule of thumb, travelers
should peel and wash all fresh fruits and vegetables
themselves. Also avoid dairy products, raw or undercooked
meat and fish. |
| Taking
two tablets of Pepto-Bismol four times a day before
and during international travel can help prevent
diarrhea. It should not be taken for more than three
weeks. It should be noted that both aspirin and
Pepto-Bismol share the active ingredient salicylate.
People allergic to aspirin, pregnant women, and
those who have ulcers or other bleeding disorders,
kidney disease, or gout should not take Pepto-Bismol
without consulting a physician. Children under three
or children and adolescents with flu or chicken
pox should not take it. Many medications interfere
with salicylate. Side effects of Pepto-Bismol include
ringing in the ears and black stools and tongue.
(Lomotil and Imodium, two common drugs used to treat
diarrhea, are not effective in preventing traveler's
diarrhea; Lomotil may even increase the risk for
it.) |
| Although
antibiotic regimens can prevent diarrhea while traveling,
using antibiotics as a prophylactic (preventive)
measure can trigger adverse drug reactions, development
of superinfections, and can contribute to the widespread
bacterial resistance to many antibiotics. They are
also not effective against parasites or viruses
and may give travelers a sense of false security.
Thus prophylactic antibiotics are not generally
recommended unless the traveler has an underlying
medical condition or a trip that would be utterly
ruined by a change in schedule due to the brief
illness. For travelers at high risk for diarrhea,
one study found that a single dose of the antibiotic
ciprofloxacin was as effective as the three-to-five
day antibiotic regimen currently in use. |
| A
vaccine for the rotavirus is now available. An oral
vaccine that kills the E. coli bacteria is showing
promise and vaccines against other common diarrhea-causing
bacterial are also in development. Interesting research
indicates that an enzyme found in the stems of pineapples
may also protect travelers against the bacteria.
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Treatment
of Diarrhea with Fluid Replacement
If diarrhea develops, the preferred treatment is
a combination of fluid and electrolyte replacement
and antibiotics. Parents with small children should
bring commercial oral rehydration solutions (e.g.,
Pedialyte, Lytren, Ricelyte). Products using rice
flour may work slightly faster, but within 12 hours
all are equally effective. If the child finds the
taste unpleasant, adding a half-teaspoon of Jell-O
or Kool Aid to sweeten the solution does not appear
to reduce its benefits. An alternative is a recipe
that calls for two glasses of fluid: the first containing
8 oz. of fruit juice, 1/2 tsp. of honey or corn
syrup, and a pinch of salt; the second filled with
8 oz. of purified or carbonated water and 1/4 tsp.
of baking soda. The traveler should drink alternately
from each glass until the thirst is quenched. Adding
a soluble fiber supplement and eating as soon as
possible helps the intestine to absorb water and
is beneficial for children and adults. Foods that
help slow diarrhea include rice, wheat, potatoes,
corn, and chicken. Contrary to popular advice, adding
some milk (but not soymilk) to these foods may help
many children. Children should not drink apple juice,
colas, or sports beverages, which do not contain
the proper balance of salts and sugar. Parents should
seek medical help immediately if the child appears
to be dehydrated. Early symptoms include agitation
and severe indications are listlessness and a weak
pulse. |
Treatment
of Diarrhea with Medications.
Antimotility agents, such as loperamide (Imodium),
diphenoxylate (Lomotil) and opiates (e.g., paregoric,
tincture of opium, and codeine), provide prompt
but temporary symptomatic relief by reducing muscle
spasms in the gastrointestinal tract. Patients with
high fever or with blood in the stool should not
use antimotility agents. Nor should they be used
in children under the age of two, and they should
be discontinued in anyone if symptoms persist beyond
48 hours. |
Antibiotics
are effective for diarrhea with three or more loose
stools that develops in an 8-hour period, especially
if associated with nausea, vomiting, abdominal cramps,
fever, or blood in the stools. Taking a single dose
of an antibiotic such as ofloxacin (Floxin) plus
an antimotility agent (usually Imodium) often provides
relief within 24 hours for many patients. Other
antibiotics used for diarrhea include ciprofloxacin
(Cipro) and norfloxacin (Noroxin). Trimethoprim-sulfamethoxazole
(Bactrim), which had fallen out of favor because
of resistant bacteria, has now been shown to be
very effective against the severe diarrhea caused
by cyclospora. Antibiotics should not be used for
nausea and vomiting when diarrhea is not present.
Because these are prescription drugs, travelers
at risk should obtain them before they depart and
should receive directions for self-treatment while
abroad; in general, the dose is one tablet every
12 hours for 5 days. Although self-treatment is
generally effective, patients who develop fever
or bloody diarrhea should consult a doctor immediately.
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| Preventing
Skin Disorders |
An
estimated 3% to 10% of travelers experience some
skin problem related to their trip, particularly
when traveling to tropical and subtropical areas.
Everyone should avoid episodes of excessive sun
exposure, particularly during the hours of 10 AM
to 4 PM when sunlight pours down 80% of its daily
dose of damaging ultraviolet radiation. Reflective
surfaces, such as water, sand, concrete, and white-painted
areas should be avoided. Clouds and haze are not
protective. High altitudes increase the risk for
burning in shorter times compared to sea level and
low altitudes. Sunscreens and sunblocks, used generously,
are important, but they should not be relied on
for complete protection. Wearing sun-protective
clothing is equally important and protects even
better than sunscreens.
Everyone, including children, should wear hats with
wide brims. Overexposure to the sun is the most
common problem, but other skin disorder may also
develop. Berloque dermatitis resembles sunburn but
is caused by a sunlight reaction to chemicals in
certain tropical fruits. Botfly eggs implanted into
the skin by mosquitoes cause cutaneous myiasis.
The affected area has a small hole and becomes prickly
and swollen. Hikers are at increased risk for insect
bites from ants, spiders, or fleas, which can causing
itching, burning, and red bumps. A number of fungal
infections can occur in warm and damp climates,
such as sporotrichosis (causes ulcerated areas),
tinea nigra (causes the palms and soles to darken),
and piedra (causes stony bumps on the hair shaft).
Creeping eruption is a particularly unpleasant skin
disorder caused by larvae from dog and cat feces
deposited on beaches. The larvae cause red, fluid-filled
bumps that usually create a continuous track as
it moves under the skin. It is treated with oral
medications. |
Prevention
of Diarrhea. The old adage, if you can't cook it, boil
it or peel it, then forget it! still applies and could
help prevent many common illnesses associated with international
travel. Even ice cubes can cause infection, and only carbonated
bottled water should be used for brushing teeth and drinking.
If carbonated water is not available or the traveler is
not carrying a portable water filter, tap water can be
treated by boiling it for ten minutes or by adding one
iodine tablet to a quart of water 30 minutes before drinking
it. The organism cyclospora causes a severe form of traveler's
diarrhea that can be prevented only by boiling water --
not by purifying it. Heated food should be hot to the
touch and eaten promptly. Beware of sliced fruit that
may have been washed in contaminated water; as a rule
of thumb, travelers should peel and wash all fresh fruits
and vegetables themselves. Also avoid dairy products,
raw or undercooked meat and fish.
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