HEPATITIS A

This infection has been known to occur throughout the world – from the sophisticated Western world to the hyper endemic areas of Africa, Asia and South America.

It is a viral infection of the liver and it is generally transmitted through food and water.  Outbreaks have been linked to water, ice and shellfish – and to the consumption of salads, fruits and other foods pre-washed with contaminated water.

Patients usually become jaundiced with nausea, vomiting and joint pains that may last many weeks – while the patient is bed resting.  It can be effectively prevented by a series of two injections, six months apart, to give immunity for ten years.

HEPATITIS B

This is a viral infection of the liver – which is contracted in the same way as the AIDS virus.  In much of Africa, South America, China and Southeast Asia the level of chronically infected people comprises between 5% and 15% of the population.

This disease may eventually lead to liver cancer.

Sexual transmission is highly efficient – as is percutaneous transmission from needle sharing, blood transfusions and traditional medical procedures (acupuncture and tattooing). Three doses of vaccine constitute the complete series of immunisation.  The first two doses are usually given one month apart with the third dose about six months later.  A further booster every five years is recommended.

Vaccination is advised for travellers likely to engage in sexual or needle-sharing activities or those that may have to undergo dental or medical procedures while away.

HEPATITIS E

MALARIA

•  It is estimated that up to 2,7 million people die from malaria every year. Malaria occurs in almost all of sub-Saharan Africa . In South Africa only in the low altitude areas ( below 1000 metres) in the northern part of the country. ( Mpumalanga , Northern Province , north-eastern KwaZulu-Natal ). Occasionally limited focal transmission may develop in the Northwest and Northern Provinces along the Molopo and Orange Rivers .

Infections are very seldom contracted outside the malarious areas and are then possibly a consequences of the importation of infected mosquitoes by motor/air/rail transport.The female anopheles mosquito that carries the malariaparasite transmits the disease through her bite. The mosquito generally feeds between dusk and dawn, both indoors and outdoors. Bites may be minimised by the following:

•  Apply a mosquito repellent to the exposed parts of your body (Wet wipes containing DEET).

•  Use mosquito nets in high risk areas.

Flu-like symptoms after returning from a malarial area must get immediate attention. Any person returning from a malarial area with these symptoms should immediately consult a doctor and mention that they have been exposed to malaria. Other symptoms include body pain, diarrhoea and vomiting. The usual incubation period for malaria is 14 days but it can take as little as a week to manifest itself – and as long as two months in some cases.

In South Africa malaria transmission is seasonal. During dry seasons the number of mosquitoes may be fewer – often rendering precautionary measures against mosquito bites sufficient – antimalarial drugs are then necessary.

Use of mosquito nets and insect-repellents (as well as ‘cover-all' clothing at sunset/night/dawn) will reduce the risks quite considerably.

Malaria incidence in this country has been shown to be associated with climatic conditions (temperature and rainfall) – as well as influx from neighbouring countries.

Note that no precautionary measures are 100% effective.

BILHARZIA

A blood fluke infection with adult male and female worms living in certain veins of the patient over a life-span of many years.

These are several forms of blood flukes – and mixed infections are sommon.

The distribution in South Africa includes KwaZulu-Natal and virtually the entire country north of Johannesburg – extending into Botswana , Zimbabwe and Mozambique . Small areas of infection alsooccur near port Elizabeth and East London . In some endemic areas like Mpumalanga nearly 100% of rural school children are infected.

This infection is acquired from contact with water containing free-swimming larval forms which have developed in snails.The bilharzias life-cycle involves the release of the ora in human urine (haematobium) directly into natural surface waters – or in faeces (mansoni) which is then washed by rain into nearby surface waters. In the water, the ora hatch and eventually enter a suitable snail where development takes place.

Eventually fork-tailed larvae emerge and avtively penetrate through healthy intact skin of people swimming or wading in the water.

An immediate consequence of infection might be ‘swimmer's itch' which usually occurs on the day of exposure and then subsides within a few days. People who have never had the infection previously might develop katayama fever between 2 weeks and 2 months of infection. This presents with a fever, Diarrhoea, cough and swollen lymph nodes.

A third stage of blood in the urine and severe fever follows.

Severe liver complications and bladder cancer may result with chronic infections.

The only prevention for travellers is to avoid bathing or swimming in contaminated lakes and rivers.

CHOLERA

This is caused by a bacteria and will usually cause profuse watery stools and vomiting. Rapid dehydration may follow which may lead to the patient's death within a few hours. The mode of transmission is primarily through ingestion of water contaminated with faeces or vomits of patients or, to a lesser extent, faeces of carriers. It is often associated with flooding, poor water supplies and/or poor sanitation.

Cholera can be prevented by an oral vaccine dissolved in water. It's effectiveness is from six months to two years.

ELEPHANTISIS

A mosquito-borne disease where repeated infections cause severe deformities – occurring in tropical areas. There is no vaccination.

DENGUE FEVER  

A severe mosquito-borne disease which occurs in most of tropical Asia – characterised by abnormal blood clotting. A sudden onset of high fever is accompanied by vomiting, headache and abdominal pain.

Outbreaks have occurred in the Philippines , Burma , Thailand , Indonesia , Malaysia , Singapore , Vietnam , Sri Lanka , India , Cuba and northern Australia .

No vaccine exists at present so insect-repellents are strongly advised.

JAPANESE ENCEPHALITIS

INDEMNITY:  This information is offered without charge to potential travellers.  It is NOT intended as a complete list of all the risks encountered at these (or other) destinations.  Consultation with a qualified doctor at a travel clinic is recommended. Travelsafe Clinic is not responsible for any infection/illness resulting from the use of the information at this site or in any of our published brochures.