- Yellow Fever ( 30,000 deaths yearly world wide)
Cause
Transmitted by a virus Areas Effected
Nearly all cases occur in African countries near the equator and in tropical parts of South America.Symptoms
Initial symptoms are usually flu-like and include headache‚ fatigue‚ fever‚ nausea‚ vomiting‚ and constipation. Severe symptoms include jaundice and hemorrhagic fever. Fatal in 23% of cases with severe symptoms. People who recover are immune for life. Prevention
Vaccination recommended before traveling to endemic areas. Vaccinations required for entry into certain countries. Vaccine not usually recommended for pregnant women‚ infants‚ nursing mothers‚ immunocompromised patients‚ or patients with history of thymus gland disease. Treatment
SUPPORTIVE ONLY
- Typhoid Fever and Parathyroid Fever(Enteric Fever)
Cause
Bacterial infection (salmonella typhi) in contaminated water or food. Can be spread by flies. Areas Effected
Can occur in any region where food or water is contaminated. Outbreaks common after natural disasters in poor countries. Tends to occur in urban areas. Symptoms
Initial flu-like symptoms and low-grade fever that increases every day for a week or more. In the second stage‚ fever stabilizes at 103 - 104 CB0F. "Pea soup" diarrhea or constipation can develop. Untreated‚ disease can last up to 4 weeks and is fatal in 10% of patients. After symptoms end‚ the patient is still infectious. Prevention
Vaccinations recommended for travelers visiting high-risk countries for more than four weeks. Drink bottled water. Take same precautions as for traveler's diarrhea. Treatment
Antibiotics can be used. Fluid replacement and nutrition maintenance is critical. Even when symptoms have resolved‚ patients may be contagious until bacteria is eliminated.
- Tuberculosis
Cause
Bacterial infection spread through air by coughing or sneezing. Also has been passed in unpasteurized milk. Areas Effected
High rates found in Africa‚ Asia‚ Central and Eastern Europe (including former Soviet Union)‚ Latin America. Symptoms
Symptoms may occur months after exposure: Coughing‚ weight loss‚ fever‚ night sweats. Can spread from lungs to central nervous system‚ genitourinary system‚ bones and joints. Prevention
BCG vaccine available for children in developing countries. Not routinely used for travelers. Long-term travelers may benefit with TB testing. Consider screening children who return from developing countries. Treatment
Multiple drugs for 6 months or longer.
- Schistosomiasis
Cause
Schistosoma parasitic worms live off a specific snail in fresh water contaminated with feces. Areas Effected
Lake swimming in sub-Saharan Africa is a particular hazard for schistosomiasis in travelers. Other countries: Brazil‚ Puerto Rico‚ St. Lucia‚ Egypt‚ Southern China‚ the Philippines‚ and Southeast Asia. Symptoms
Within days‚ itchy skin or rash. Within 1 - 2 months‚ fever chills‚ cough‚ muscle aches. Can be mild‚ but also can damage liver‚ kidneys bladder‚ intestines‚ or central nervous system. Prevention
Do not swim or wade in fresh water in countries where schistosomiasis occurs. Boil drinking water for 1 minute. Heat bath water to 150 CB0F for 5 minutes. Treatment
Praziquantel (Biltricide) or oxamniquine (Vansil). Reports of resistance have raised concern.
- Rabies (Fatality rate 100 percent if not treated immediately. Number of human cases is increasing in many parts of the world.)
Cause
Virus transmitted from exposure to saliva from an infected animal (even from licking). Dogs are main carriers but all mammals susceptible Areas Effected
Worldwide except Antarctica (some specific countries are rabies free). Symptoms
Disease is nearly always fatal once symptoms develop. Prevention
Vaccine is available and recommended for travelers who intend to work with animals or are likely to come in contact with animals in countries where the rabies virus is common. Immunization does not eliminate the need for treatment after exposure to the virus. Treatment
Complicated and may not be available in developing countries. Therefore PREVENTION is important, especially for children. Long-term travelers to developing countries should consider pre-exposure prophylaxis.Immunoglobulins after bites‚ vaccine if not previously vaccinated (previously vaccinated travelers only require booster vaccine‚ but no immunoglobulins). Clean the wound with soap and water‚ and iodine if possible‚ immediately after bite. If symptoms develop‚ supportive treatments only.
- Plague
Cause
Bacteria carried by rodents and transmitted by fleas. Areas Effected
Most plagues are transmitted by handling infected animals. However‚ the Indian pneumonic plague is airborne. Human plague reported in recent years in Africa‚ South East Asia‚ parts of South American and the US. Recently been reported in India‚ Vietnam and Zambia. Risk generally in rural mountainous areas. Symptoms
Swollen and tender lymph nodes‚ fever‚ chills‚ headache‚ malaise‚ prostration‚ and gastrointestinal symptoms. Can be fatal without treatment. Prevention
Use insect repellents and avoid handling any animals. Adults traveling to countries with plague outbreak may consider preventive antibiotics. Children may take sulfonamides. Treatment
Antibiotics‚ particularly streptomycin. Alternatives include gentamicin‚ tetracyclines‚ chloramphenicol.
- Poliomyelitis (Polio)
Cause
Viral infection transmitted in contaminated water or food. Areas Effected
Most developing countries in Africa‚ and parts of Asia Symptoms
Symptoms in small children can be mild and flu-like. More likely to be serious in older children and adults. Symptoms include severe fever‚ headache‚ stiff neck and back‚ deep muscle pain. Can lead to paralysis and can be fatal. Prevention
Universal immunization required. All babies should receive vaccination as part of standard vaccine schedule‚ with booster at 4 -6 years of age. Booster needed for adults traveling to developing country. Inactivated polio vaccine (IPV) is used. Treatment
Treatments only for symptoms. Can be complicated.
- Leishmaniasis
Cause
Parasitic disease transmitted by a sand fly. Areas Effected
Found in 88 countries around the world. Symptoms
Most common forms cause skin sores and mouth and nose ulcers‚ sometimes disfiguring. Organ infection can involve spleen‚ liver‚ and bone marrow. Prevention
No vaccine available. Treatment
Treatment is difficult. Certain medications for treatment are only available trhough the CDC. Antimony-containing drugs (meglumine antimonate‚ Glucantime; sodium stibogluconate‚ Pentostam) for organ infection; also pentamide isethionate (Pentam 300)‚ amphotericin B (Fungizole). Fluconazole is also effective for skin sores.
- Meningococcal Disease
Cause
Bacterial infection in the fluid and membranes covering the brain and spinal cord. Spread through coughs‚ sneezes Areas Effected
WORLDWIDE! The so-called meningitis belt (countries extending across sub-Sahara Africa from Nigeria to Somalia). Symptoms
Fever‚ chills‚ headache‚ stiff neck‚ rash caused by bleeding into the skin‚ and vomiting. Can also cause pneumonia and loss of limbs. Particularly dangerous for children Prevention
Vaccines (including boosters for previously vaccinated individuals) for travelers in the meningitis belt and other areas with outbreaks. Vaccine now recommended as standard for all children 11 - 12 years of age and entering college freshmen living in dorms and not previously vaccinated. Treatment
Early administration of antibiotics is essential.
- Malaria
Cause
Parasite transmitted by Anopheles mosquitoes. Areas Effected
The world's number one infection‚ and nearly entirely preventable. Found in every tropical or subtropical country in the world. Nearly all cases occur in African countries near the equator and in tropical parts of South America.Symptoms
Initial symptoms are flu-like‚ with possible nausea and vomiting. The skin may appear yellow. Without prompt treatment‚ can be fatal. Typically develops 10 - 30 days following exposure. Symptoms can occur up to a year or more after exposure. People who have been in malarial countries should report fever or other symptoms plus travel information to their doctor even months after they return. Prevention
No vaccine‚ should focus on minimizing exposure to mosquitoes and "mosquito-proofing" living and sleeping accommodations. Many parasites are resistant to chloroquine.
Alternative drugs include atovaquone-proguanil‚ mefloquine‚ and doxycycline. Malarone causes fewer side effects than other drugs. Lariam should not be used by people with history of psychiatric disorders. Doxycycline can cause photosensitivity (skin sensitivity to light)‚ and it cannot be taken by children or pregnant women. Treatment
Immediate treatment is important‚ but the appropriate treatment depends on the traveler's destination. There is widespread resistance to standard anti-malaria drugs such as chloroquine or primaquine. Alternative drugs include quinine‚ atovaquone/proguanil (Malarone)‚ doxycycline‚ mefloquine (Lariam)‚ hydrochloroquine‚ or derivatives of artemisinin.
- Leptospirosis
Cause
Exposure to bacteria from the urine of animals by swimming or bathing in contaminated fresh water. Areas Effected
Tropical and subtropical countries pose highest risk. Symptoms
High fever‚ severe headache‚ diarrhea‚ and eye inflammation. In severe cases‚ can develop internal bleeding and liver and kidney damage. Prevention
Avoid water activities where leptospirosis occurs.Treatment
Antibiotics (as early as possible).
- Hepatitis A
Cause
Viral infection transmitted in contaminated water or food. Areas Effected
Worldwide. Highest risk in developing nations‚ particularly where sanitation is poor and cholera and typhoid are prevalent. Symptoms
Nausea and vomiting‚ decreased appetite‚ itching‚ extreme fatigue‚ jaundice‚ fever‚ and abdominal pain. Serious complications are rare‚ but recovery may take 6 - 9 months. Prevention
Wash hands after using the bathroom. Two vaccines are available as well as combination vaccine for hepatitis A and B. Vaccination recommended for travel to any nation where risk is intermediate or high. Immunity from vaccine may develop more slowly in elderly people. CDC recommends vaccination 4 weeks before travel. HepA vaccine is recommended for all children at age 1 Treatment
No specific treatment for acute hepatitis. Abstain from alcohol and sexual contact. Avoid dehydration. Keep own eating and cooking utensils separate from others.
- Hepatitis B
Cause
Viral infection transmitted through contaminated blood‚ or through sex or sharing needles with an infected person. Can be passed from cuts‚ scrapes‚ and other breaks in the skin. Areas Effected
Common in Southeast Asia‚ Africa‚ the Middle East‚ islands of the South and Western Pacific‚ the Amazon region of South America‚ and the Mediterranean. Symptoms
Flu-like mild symptoms. Sometimes rash‚ aching in joints. Symptoms usually appear 4 - 24 weeks after exposure but can occur long after initial infection. Often no symptoms‚ but even patients with symptoms can remain chronically infected with the virus. Prevention
Several vaccines are now available‚ including a combination vaccine (Twinrix) for hepatitis A and B. Vaccination recommended for all children and for travelers to developing countries. Treatment
Treatment of symptoms.
- Encephalitis
Cause
A number of different viruses carried by mosquitoes. Areas Effected
Worldwide risk although higher in some regions than others. High-risk areas include China and Korea‚ India‚ Southeast Asia Symptoms
Can be mild to life threatening. Brain swelling produces symptoms that include headache‚ neck stiffness‚ confusion‚ irritability‚ fever‚ weakness‚ dizziness‚ tremors‚ seizures‚ and paralysis. Serious symptoms include lethargy‚ delirium‚ coma‚ and even death. Prevention
The vaccine for Japanese encephalitis (Je-Vax) is recommended only if travelers are visiting rural areas in high-risk Asian countries for more than 30 days. Vaccine for tick-borne encephalitis is available in Europe Treatment
Symptomatic treatment only.
- Dengue Fever
Cause
Virus transmitted by mosquitoes. Areas Effected
Can occur in any tropical or subtropical country. Greater risk in cities than in the country. Present in over 100 countries world-wide‚ putting some 2.5 billion people at risk. Recent cases verified in the Florida Keys! Increasing Prevalence! Here is a link to a CDC-HealthMap Collaboration Dengue Fever Case Map Symptoms
A person can get very sick when infected with the virus the first time –BUT if infected with a second strain, patient can have hemorrhagic disease and with in about a week (if not sooner) the patient will die. Here is what happens to a patient who has Dengue Hemorrhagic Disease – Explanation taken from the CDC website - " characterized by a fever that lasts from 2 to 7 days, with general signs and symptoms consistent with dengue fever. When the fever declines, symptoms including persistent vomiting, severe abdominal pain, and difficulty breathing, may develop. This marks the beginning of a 24- to 48-hour period when the smallest blood vessels (capillaries) become excessively permeable ("leaky"), allowing the fluid component to escape from the blood vessels into the peritoneum (causing ascites) and pleural cavity (leading to pleural effusions). This may lead to failure of the circulatory system and shock, followed by death, if circulatory failure is not corrected. In addition, the patient with DHF has a low platelet count and hemorrhagic manifestations, tendency to bruise easily or other types of skin hemorrhages, bleeding nose or gums, and possibly internal bleeding. " Prevention
No vaccine has been developed. vaccine requires protection against mosquito bites‚ particularly at dawn and dusk.Treatment
Blood transfusions‚ fluids‚ pain killers. (Aspirin‚ ibuprofen‚ or other NSAIDs should not be used‚ but acetaminophen is okay.)
- Cholera
Cause
Bacterial infection transmitted in contaminated water or food. Areas Effected
Outbreaks occur in many developing countries with poor sanitation. More common in warm months. Symptoms
Perfuse‚ watery diarrhea‚ abdominal pain‚ and vomiting lasting 1 - 3 days. In severe cases‚ profound dehydration can be fatal. Prevention
Risk to travelers is considered low‚ and the vaccines are not produced in the U.S. or required for international travel. Treatment
Consume as much purified water with electrolytes as possible. Tetracycline and oral hydration salts usually effective within 48 hours. Consume as much purified water as possible.
- Chagas' disease (American Trypanosomiasis)
Cause
Parasite transmitted by infected Reduviid bugs. Areas Effected
South and Central America Increasing Prevalence!. Now also seen in some parts of the US (southern states). Symptoms
In the acute stage‚ symptoms can include a skin lesion‚ fever‚ loss of appetite‚ lymph node swelling‚ spleen and liver enlargement‚ and inflammation of the walls of the heart. Symptoms that may occur years or decades later include dementia‚ weakening of the heart‚ dilation of digestive tract‚ weight loss. Prevention
Avoid buildings made of mud‚ adobe‚ and thatch‚ which can harbor the reduviid bug.Treatment
Complicated
- African sleeping sickness (African Trypanosomiasis)
Cause
Parasite transmitted by tsetse fly bite. Areas Effected
Rural Africa‚ between latitudes 15 degrees N and 20 degrees S.Symptoms
Symptoms may include fever‚ chills‚ headache‚ fluid accumulation in hands and feet‚ sleepiness‚ lethargy‚ and convulsions. Without treatment‚ the sickness is fatal. Prevention
Flies are attracted to dark‚ contrasting colors. Flies are not affected by insect repellents. Treatment
Pentamidine and suramin for early stages. Rimantadine under investigation. Melarsoprol and eflornithine for second stage. Nifurtimox being tested‚ shows great promise in combination with eflomithine.
