Jungle trekkers be wary of Malaria
Sound advice about travel-related diseases
- Published: 23/08/2011
- Newspaper section: Life
Planning to have a jungle holiday? If so, there are some precautions you should take to ensure that you enjoy the trip and are free of travel-related illnesses, in particular maladies that may come from your adventure.
According to Dr Pratap, people contract malaria, an infectious disease, with the bite of an infective female anopheles mosquito (or yung kon pong). Occasionally, the ailment can also be transmitted by blood transfusion, organ transplantation, needle sharing and syringes contaminated with infected blood.Unlike a cold or flu, malaria doesn't spread from person to person. In other words, people cannot get malaria from normal contract with malaria-infected person.
This insect-borne fever is especially prevalent in tropical countries including Thailand. The areas of potential risk to malaria in Thailand are along the border provinces, particularly in hilly and forested areas as well as rivers and streams. Provinces where the highest incidence of malaria is found are Kanchanaburi, Chanthaburi, Trat, Sa Kaeo, Ratchaburi, Tak, Chumphon, Prachuap Khiri Khan, Songkhla, Narathiwat, Ranong, Yala and Mae Hong Son.
Apart from the usual characteristics of chill, a fever and sweating, patients with malaria may exhibit other symptoms including fatigue, headache, muscle pains, vomiting and loss of appetite. They may be associated with anemia and jaundice, yellow colouring of the eyes and skin. The symptoms can develop as early as a week after the exposure but, in some cases, it may take months or years.
"Malaria is curable if a patient receives accurate diagnosis and prompt treatment. It can be treated effectively early in the course of illness. Delay in treatment can lead to serious or even fatal outcomes," Dr Pratap said. As malaria in Thailand is the multi-drug-resistant strain, anti-malaria drugs aren't recommended. Travellers should avoid over-the-counter anti-malaria drugs.
"The drug may have unwanted side effects. The best advice to prevent malaria is to avoid getting bitten by mosquitoes. Consult a doctor right away if you develop a fever or illnesses right after returning from a jungle trip and tell him or her of your travel. Malaria may be suspected and considered," the doctor said.Another common ailment that travellers may carry back from jungle travel is scrub typhus. Less-well known, the disease is transmitted by some species of chigger (rai on) which can be found in areas of scrub vegetation where rodents live. This mite-borne infectious disease can also be prevalent in such areas as riversides, rainforests and mountain deserts. It's quite common in the rainy season.
People with high occupational risks for the illness include patrol soldiers and police, farmers, wildlife professionals and forest navigators.
Cases of scrub typhus have been found in all regions of Thailand. "While the disease is common, especially in northern Thailand, it is often under-reported," said Dr Pratap.
When bitten by infected chiggers, travellers may develop symptoms including fatigue, high fever, heavy headache, cough and red eyes. Some patients may develop a nasty rash."The bite of chigger, in particular, may leave black eschar, (similar to a cigarette burn injury) in some patients, and it is up to the doctor to make the diagnosis," Dr Pratap said.
If the condition's left untreated properly, the patient may experience a high fever for a couple of weeks. After that, the body may heal itself in some cases. Unfortunately, complications may mean the inflammation of vital body parts, including lung tissue, known as pneumonitis, brain (encephalitis) and heart muscle (myocarditis), that may lead to death in some patients. To confirm precise diagnosis of the disease, patients need to have blood and laboratory tests."With the use of antibiotics, the illness can be effectively treated," Dr Pratap stressed. "Travellers should wear clothes that cover most of the body, in particular the lower part, to help prevent the bite."
When having a jungle holiday, the doctor continued, it's possible for long-term travellers to be bitten by land leeches.
"When feeding, they release an anesthetic so that a host or person will feel numb. One easy way of removal is to use a fingernail or flat object to break the seal of the oral sucker at the anterior end of the leech, then repeat with the posterior end and strike it away," Dr Pratap said.
The bite of a leech normally doesn't pose a threat. However, bacteria, viruses and parasites from previous blood sources may linger on in a leech and be retransmitted to humans. And some people may suffer severe allergies from leech bites that require urgent medical care.
Trekkers, meanwhile, may often feel the need to walk barefoot, which puts them at a potential risk of infection by hookworm that live in animal faeces. The mouth of the worm has sharp hook-shaped teeth that pierce the skin of the human host.
One important thing: don't underestimate the risk of leptospirosis (the so-called "wee rat problem") that can be contracted through exposure to the urine of infected animals including rats, particularly in inundated areas.
ALL ABOUT FEVER
The Hospital for Tropical Diseases provides basic travel advice, treatment of tropical and travel-related diseases, pre- and post- tropical screening, etc. In addition, the hospital has launched an around-the-clock fever clinic where patients can receive consultation about - and treatment for - fever."Dengue haemorrhagic fever is the most common illness among children. At the clinic, we're able to provide a diagnosis of the ailment within 24 hours," Dr Pratap said.
SAFE TRAVEL
To help keep healthy on your trip and have a pleasant stay, take these travel precautions :- Learn more about the diseases that are commonly recognised in the country or province where you plan to travel. Also, review current travel notices.
- Travellers should visit either a personal physician or a travel health clinic 4-6 weeks before departure in order to allow for your vaccines to take effect.
- Bring enough supplies of all medications with clear labelling. First-aid supplies include sunblock, topical (skin) disinfectants, bandage materials, insect repellent, antifungal foot powder, devices or supplies to purify or filter water, pain relievers, antibiotics, oral rehydration solution, antimotion sickness medication and antihistamines.
- If you have certain allergies or chronic medical conditions, wear a medical alert bracelet.
- Don't sleep with the window open. When sleeping outdoors, use a bed net, with edges tucked in under the mattress.
- Wear long sleeves and long pants, preferably of light colour. A hat and shoes (rather than sandals) can also help protect you from insect bites.
- Contact with mosquitoes can be reduced by applying effective mosquito repellent.
- A screened bedroom should be sprayed with insecticide before use.
- Stay away from areas containing rodent burrows or nests. Never handle sick or dead animals.
- Don't drink tap water unless it has been boiled, filtered or chemically disinfected.
- Don't eat fruit or vegetables that you don't peel or cook.
- Avoid cooked food that is no longer hot or has been left for a long time at room temperature.
- Skip raw or undercooked meat and fish.
คำศัพท์ที่น่าสนใจ
jungle trekkers คนชอบเที่ยวป่าเขา
precautions ข้อควรระวัง
to contract สัมผัส
an infectious disease โรคติดต่อ
prevalent มีอยู่ทั่วไป
area of potential risk พื้นที่เสี่ยงภัย
symptom อาการที่แสดงอก
the exposure การสัมผัส
anemia and jaundice โรคตัวเหลืองซืด
allergy โรคภูมิแพ้
anterior and posterior ด้านหน้าและด้านหลัง
chronic เรื้อรัง/เป็นมานานไม่ยอมหาย
ailment อาการเจ็บป่วย
mosquito repellent ยาไล่ยุง
animal faeces อุจจาระสัตว์
land leeches ตัวทากดูดเลือด
inflammation อาการอักเสบ
physician หมอรักษา
to take effect มีผลเกิดขึ้น
labelling ฉลากยา
to feel numb รู้สึกชาไปทั่วตัว
to pose a treat ก่ออันตราย/ภัยให้เกิดขึ้น
disinfectant ยาฆ่าเชื้อ
mucus เมือกน้ำลาย
syringes เข็มฉีดยา
to secrete พ่นออกมา/ปล่อยออกมา
acute รุนแรง/ร้ายแรง
diagnosis ตรวจวิเคราะห์โรคภัย
pre and post ก่อนและหลัง
to walk barefoot เดินเท้าเปล่า
to develop a nasty rash มีผื่นแดงๆ
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