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Blog Words : Wanderlust health advice | 15 June

Weekly travel health update: India, Vietnam, Bangladesh

Weekly round-up of the world's travel health news from Nomad including malaria in India, rabies in Vietnam, anthrax in Bangladesh and more

This health advice is provided by Nomad, who offer Wanderlust visitors 10% off equipment online and in store including 10% off vaccinations. See the Nomad website for more details.

India – Malaria

Even before the onset of the monsoon, Maharashtra has recorded over 28,000 cases of malaria. From January to April this year (2011), 28,400 people were found positive for malarial infection -- an increase of over 8,000 cases as compared to the corresponding period last year (2010) when 20,091 cases were reported. With 16,833 positive cases and 11 deaths due to malaria in the last four months, Mumbai continues to bear the highest burden of the disease in the state followed by Thane (709 cases) and Kalyan (182 cases).

Climactic conditions with temperature up to 30 degrees C and a humidity level above 70% are favourable for mosquito-breeding. Such conditions prevailed on most days in the last four months in Mumbai.

Advice to travellers

Travellers to the affected area should seek expert advice before they travel regarding the most suitable form of malaria tablets for their trip and medical history. They should ensure that they take the tablets as advised or they will not work as well. Malaria tablets are approximately 90–95% effective when taken properly, so bite avoidance should also be adhered to. Always wear 20-50% DEET on all exposed skin, sleep under a mosquito net and wear long clothing to protect you. Malaria carrying mosquitoes generally bite between sunset and sunrise.

India – Anthrax

An anthrax scare has gripped Orissa's tribal dominated Kandhamal, as at least 12 people, including children, were affected by the dreaded disease in Tumudibandh block of the district. The condition of two of the 12 patients where the disease surfaced three days ago, was stated to be critical, both the patients were admitted to hospital at Tumudibandha, and the rest of the affected people were being treated at their houses in isolated rooms, as the disease is highly contagious.

Advice to travellers

Anthrax is a bacterial illness that usually affects the skin, but may also affect the gastrointestinal tract or lungs. It is spread by infected animals either through eating infected animals or contact with their hides, wool, hair, bone or carcasses. Anthrax does not spread from person to person. Depending on the type, symptoms can include lesions, nausea, vomiting, and altered mental state and can be fatal. Prevention of anthrax is dependent upon the control of the disease in livestock and on disinfecting, washing and scouring imported animal products. Vaccination is available but normally only considered for those at risk from inhalation of spores in an occupational or military setting. Travellers should avoid contact with animals and potentially contaminated meat in affected areas.

Vietnam – Rabies

An outbreak of rabies among domestic dogs has been reported from northern Lao Cai province. The Animal Health Department for the province has reported that 26 individuals have been bitten by rabid dogs in the last two months.

Advice to travellers

Travellers are advised to consider a pre-travel Rabies vaccine, this consists of a course of three vaccines administered over the course of 21–28 days; this removes the need for Rabies Immunoglobulin in the event of an injury. Animal contact should be avoided wherever possible and in the event of contact with animal saliva any wound should be thoroughly washed with soap and water and Iodine or Alcohol applied. Medical advice should be sought as soon as possible even if vaccinated with a full course of Rabies vaccine.

Phillipines – Schistosomiasis

A total of 99 persons from Palo, Leyte, have fallen ill due to schistosomiasis, a parasitic disease that is spread by contact with contaminated water. The patients were from the 33 barangays, which was one of the areas in Leyte that were hit by floods on 16 and 17 March (2011). The floods that hit Palo last March were confirmed as the cause of the spread of the infection. The patients may have waded in flood waters which were populated with snails, the intermediate host of cercaria, the parasitic larvae that cause the disease.

Advice to travellers

Schistosomiasis is a parasitic infection, caught through contact with infected water especially in areas where the water contains numerous freshwater snails, which may carry the parasite.

On contact with humans, the parasite burrows into the skin, matures into another stage, and then migrates to the lungs and liver, where it matures into the adult form.

Symptoms vary with the species of worm and the phase of infection but can cause a range of symptoms and if left untreated can cause chronic disease. There is no vaccine available so travellers should ensure they seek advice before travel and should avoid skin contact with fresh water in endemic areas, for example ponds, lakes and rivers. Swim only in protected swimming pools or safe sea water. Avoid drinking infected water. Wear protective footwear when walking in soil, especially if damp or water logged.

Congo – Chikungunya virus

An outbreak of chikungunya virus infection has been reported from the southern districts of Brazzaville. More than 480 cases of chikungunya have been recorded in a short period of time and the virus has been laboratory confirmed in all samples tested.

Advice to travellers

Chikungunya is spread by daytime biting mosquitoes normally from sunrise to sunset and is more common in urban areas. There is no vaccine available and therefore insect bite avoidance is essential.

Cameroon – Cholera

The long running cholera outbreak in Cameroon has now affected 9 out of 10 regions of the country. Almost 7,718 cholera cases and 256 deaths have been recorded. Charity organisations have deployed community volunteers to seven operational regions across the country. The Centre region is the worst affected with 2,558 cholera cases.

Advice to travellers

Precautions should be taken to ensure good food, water and personal hygiene.

Hand washing is very important and the use of an alcohol based hand gel is recommended where soap and water are not readily available.

If planning to visit for a long time or travelling into affected areas, travellers should consider vaccination. Vaccination involves two drinks given one to six weeks apart.

More like this

For more travel health stories see our health news pages

For travel health articles check our Dr Jane Wilson-Howarth's features here

More information on Malaria can be found here: Malaria Q and A

Just a scratch? Check out our rabies feature for more information on the disease... More