Traveling in the Tropics
When traveling in the tropics, be sure to drink a lot of liquids to avoid dehydration. Drink enough to maintain a clear urine
In developing countries, consider all water as unsafe even in large hotels and restaurants. Vaccines protect against some waterborne illnesses, but they are never foolproof. Drink only from unopened bottled water or water that you have treated yourself. Avoid ice, since freezing does not kill microbes. Do not use tap water to brush teeth and do not swallow water while in the shower.
Water Purification Methods
You can purify water to make it drinkable. In all cases, if the water is not clear, you should first filter it through a clean cloth or coffee filter. Then disinfect it using one of the following methods (in order of preference):
- Method 1:
Boil water fast for 5 minutes, put in clean containers, cover and let cool.
- Method 2:
Add 5 drops of 2% tincture of iodine per litre of water (10 drops if the water is cloudy), shake vigorously, then let sit for 30 minutes.
N.B.: This method is contraindicated for pregnant and breastfeeding women, people who are allergic to iodine, or those with thyroid disease.
- Method 3:
Add 2 drops of bleach per litre of water (4 drops if the water is cloudy), shake vigorously, then let sit for 30 minutes. This technique is not as effective as method 2.
If none of these methods is possible, you can buy a glass with a disinfecting filter. When used according to the manufacturer's instructions, this glass will effectively purify water.
Drink only pasteurized milk. If it is not pasteurized, treat it yourself by following this method: bring milk to a boil, remove from heat, remove the skin that formed on the surface and refrigerate quickly.
Food can be contaminated by insects, water, unhygienic handling, or unsanitary conditions. Follow these measures to reduce the risk of gastric or intestinal problems:
- Wash your hands often, especially before handling food.
- Eat light meals.
- Avoid: vegetables and fruits washed with water that has not been purified; food from street vendors; foods made with unpasteurized dairy products (including pastries and creams); meat, fish, or vegetables that are not fully cooked; shellfish in general; any food that has been left at room temperature or in the sun.
- Choose: vegetables and fruits that have been peeled, freshly squeezed, or cooked; whole vegetables and fruits that are in good condition and have been thoroughly washed with disinfected water; fresh, well-cooked foods served immediately after cooking; pasta, nuts, and cereals; canned (UHT - Ultra High Temperature) or powdered milk reconstituted with drinkable water; unopened bottled beverages.
In some tropical areas - e.g., Florida, Caribbean, Hawaii, Australia - reef fish may become contaminated by eating an algae that contains a toxin known as ciguatoxin. This toxin, which has no taste and cannot be destroyed by cooking, causes a debilitating kind of food poisoning in humans known as ciguatera.
To reduce the risk of ciguatera, avoid eating large carnivorous, white-flesh fish that live near corals and reefs (including barracuda, grouper, seabass, puffer fish, king fish, serran, amberjack and snapper) since they are more likely to be contaminated with this toxin.
Sweating, shivering, nausea, vomiting, cramps and diarrhea may appear within a day of eating contaminated fish. A few days after that, you may experience extreme fatigue, weakness, insomnia, muscle and joint pain, blurred vision or temporary loss of sight, tingling, temperature reversal. These symptoms can last weeks or even months. Even though there is no known treatment, the condition is rarely fatal.
Avoid eating any of the above-mentioned predatory fish. Eat only small fish that can fit entirely on your plate (head and tail included) or ones that were caught in open sea.
|Swimming in the Ocean
Don't touch anything directly when swimming in the ocean. Be especially careful of sharp coral that sometimes cause skin irritation. Also watch out for jellyfish and crab.
- When on the beach, don't sit directly on the sand. Always use a chair, a mat, or a beach towel.
- Wear beach shoes or sandals.
- If you have a skin irritation caused by contact with a jellyfish or coral, splash some vinegar on it and then rub with sand. If the irritation doesn't subside, consult a physician.
|Swimming in Fresh Water
Fresh water in tropical regions may be contaminated by microscopic parasites that cause a disease called schistosomiasis or bilharziosis. These parasites can penetrate unbroken skin within 10 minutes and then travel into the bloodstream and to organs. Symptoms include itching and urticaria (hives). To prevent this infection:
- Avoid swimming, washing, or wading in ponds, rivers, lakes, and ditches.
- Do not be influenced by local residents swim in fresh water; they are likely to already be contaminated.
- Never drink fresh water.
- If you come in contact with fresh water, dry yourself quickly and vigorously with a dry cloth.
- Swim only in well-maintained swimming pools and the ocean. And make sure no sewage is being spilled into the ocean within 1 kilometre.
|Insects, Spiders, and Scorpions
Insects, especially mosquitoes, often carry diseases so do your best to avoid getting bitten. Mosquitoes thrive in rural areas, particularly during the rainy season. Most mosquitoes bite between dusk and dawn, and rarely during the day. They are attracted by dark clothing, heat and perfume. Spider and scorpion bites are painful but are not usually dangerous. If you are bitten, take an antihistamine and/or an analgesic and apply cold compresses.
When visiting a rural area in the tropics, consider the following precaution:
- Wear loose, light clothing.
- Use an insect repellent that contains DEET (wash it off as soon as you don't need it anymore).
- Hang mosquito netting around your bed at night.
- Don't leave your clothes and shoes on the floor and shake them out before putting them back on.
- If you hang your clothes outside to dry, iron them with a hot iron (especially along the seams) to destroy any eggs or larvae that insects might have deposited.
In some developing countries, you are more at risk of being in a road accident than of getting a tropical disease. Road signals are often scarce and sometimes confusing, vehicles may be in poor condition, and road maintenance and driving methods may not be up to the mark.
- Always be extremely prudent while driving or walking.
- If you travel with young children, bring their car seats.
- At night, do not take roads that you are not very familiar with.
|Sexually transmitted infections (STIs) and blood-borne infections
Sexual tourism is dangerous. Casual sex puts you at risk of contracting a sexually transmitted infections (STIs) and blood-borne infections, including the human immunodeficiency virus that causes acquired immune deficiency syndrome (HIV-AIDS). While on vacation, drinking too much alcohol and the relaxed atmosphere can precipitate intimate relations. Be sure to take precautions.
Some of the STIs and blood-borne infections that thrive abroad are resistant to classic antibiotic treatments. And there still is no cure for AIDS.
STIs and blood-borne infections are transmitted during unprotected sex (vaginal, anal, or oral). Avoiding sexual contact with occasional partners remains the best preventive measure. However, if you do have sex, ALWAYS use a lubricated latex or polyurethane condom or a dental dam. Buy them before you leave, since the quality of condoms in foreign countries may be doubtful.
The AIDS virus is transmitted by contact with sperm or vaginal secretions during unprotected sex where penetration is involved. It is also transmitted by blood, when contaminated needle or material is shared. However, AIDS cannot be transmitted during usual social contacts and daily activities.
In addition to STIs prevention measures:
- In developing countries, refuse any injection or transfusion unless you are in a life-or-death situation.
- Bring a supply of sterile needles and syringes for injection (carry a medical certificate of explanation from your physician). If you need an injection, demand that your own material be used or that the material used be sterile.
- Do not have your ears pierced or get a tattoo unless you are absolutely sure that the material used is sterile.
Malaria is a disease transmitted by the Anopheles mosquito, which looks similar to those seen in Canada. Only the female carries the parasite responsible for malaria and it usually only bites between dusk and dawn. The Anopheles thrives primarily in rural areas, below 2,500 metres, during warm or rainy seasons. Each year, about 200 million people are infected by malaria worldwide and 1 to 2 million die from it.
Malaria can be transmitted by a single mosquito bite, but direct person-to-person transmission is not possible. You can get malaria more than once and there is no vaccine available.
Malaria causes attacks of high fever, shivering, intense sweating, and general malaise. Infected persons should seek immediate medical care. Attacks appear 1 to 6 weeks after the person has been bitten, which means that symptoms may appear only after you have returned home. Episodes may also reappear several years after the initial infection.
When you are traveling in a country where malaria is endemic, protect yourself by taking a preventive medication. Since this medication is available only by prescription, see a physician before you leave.
No medication can offer foolproof protection against malaria. When you reach your destination, do what you can to avoid getting bitten. When possible, avoid outdoor activities during the evening, at night, and at sunrise. During these periods, also avoid perfume and aftershaves and wear light-colored long pants and long sleeves. Apply a DEET-based insect repellent, with a concentration of no more than 35 percent, on all exposed skin. If your bedroom mosquito screens are in poor conditions, ask for bed netting and secure it tightly under your mattress.
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Essential information for a safe trip
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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.