People travel to hot countries not only for vacation. Businessmen, labor migrants, embassy staff, and Ukrainian soldiers in UN peacekeeping forces – all of them fall into the "risk group". European governments are most concerned about their citizens visiting Asia, Africa, and South America, where infectious diseases are most prevalent.
Natural sources of diseases such as plague and cholera exist almost worldwide, but it so happens that microorganisms deadly to humans thrive (and reproduce) best in hot tropical and subtropical climates. Therefore, for centuries, the East and South have generously "gifted" Europe with pathogens of the most terrible diseases.
Today it is hard to imagine that just a few decades ago, in the 1920s, influenza epidemics claimed thousands of lives. Scientists have conquered many diseases, but new ones keep emerging. Some of them, such as AIDS or Ebola fever, are incurable.
To protect citizens and prevent the spread of infectious diseases, all major airports in most countries have epidemiological control services. And they do not work in vain. At Moscow's Sheremetyevo Airport, for example, in 2000, doctors identified 53 (!) cases of imported dangerous diseases from abroad.
Another effective way to combat the introduction of infections is mandatory vaccinations when traveling to an endemic country and other preventive measures. The main center developing methods and means of combating overseas epidemics in the former USSR remains the Martsinovsky Institute of Medical Parasitology and Tropical Medicine in Moscow. Its materials and recommendations are used by doctors in all CIS countries, including Ukraine.
• After returning from an exotic country, if health problems arise, you should definitely consult a specialist. Only a professional infectious disease specialist can make a correct diagnosis and prescribe appropriate treatment. Do not neglect the services of an infectious disease specialist, even if you feel perfectly healthy after the trip. After all, some diseases may only manifest over time.
Viral diseases are, of course, the most frightening thing one can bring from the tropics, as they can also harm others. For the traveler themselves, food poisoning caused by unfamiliar or poor-quality food can be no less dangerous. But – let's take it in order.
WATCH OUT, INFECTION!
Viral and infectious diseases that can be acquired in warm regions are divided into two groups. One includes those for which preventive medications are used, and the other includes those that can be avoided on your own. The latter are less dangerous but occur much more frequently. For example, in Turkey and Egypt, there is a high risk of contracting amoebic dysentery and other diseases whose source is water contaminated with sewage.
Probably the most severe disease spread this way is cholera. The cholera bacterium enters the human body when swallowing water while swimming, drinking, through dishes and clothing, as well as through food that is not heat-treated (milk, raw fruits, salads, etc.). After an incubation period (from several hours to 5 days), the first symptoms appear: severe toxicosis (nausea, vomiting, headache) and gastrointestinal upset. See a doctor as soon as you suspect something is wrong: a favorable outcome is only possible with inpatient treatment in a hospital. Self-medication can only worsen the situation. Previously, those traveling abroad were vaccinated against cholera, but this practice has now been discontinued.
Cholera outbreaks have been reported in Turkey, India, Indonesia, Iran, Iraq, Afghanistan, Laos, Bolivia, Guatemala, Brazil, Honduras, Mexico, Nicaragua, Peru, El Salvador, Angola, Nigeria, Guinea, Ghana, Burundi, Somalia, Chad, Uganda, Tanzania, and Sierra Leone, and in recent years also in a number of coastal regions of Ukraine.
Water contaminated with sewage can be a source of hepatitis A infection. This is, of course, not the most severe form of hepatitis; it usually does not become chronic, but still – who wants to damage their own liver?
Avoiding cholera, hepatitis, and dysentery is simple – you just need to follow basic hygiene rules: thoroughly wash hands before eating and preparing food, as well as after using the toilet; drink only boiled or factory-bottled water (use the same water to wash fruits and vegetables); buy food only in stores.
One of the most severe viral diseases widespread in countries with tropical and subtropical climates is yellow fever. Outbreaks of this disease have been reported in nearly fifty countries (almost all countries in Central and South America are at risk; the most dangerous are countries in Tropical Africa). Yellow fever is difficult to treat – one in four cases ends in death.
The first symptoms appear within 3-6 days: headache, high fever, rash. Then the disease affects the kidneys and liver, leading to jaundice and kidney failure. The only way to avoid yellow fever is to get vaccinated beforehand (the yellow fever vaccine, by the way, is the only mandatory vaccination for Ukrainian citizens when visiting countries in Africa and Latin America). It can be obtained at the clinic of the Central City Hospital in Kyiv (1 Mechnikova Street, room 26; tel. (044) 294-55-14), but first you will need to purchase the vaccine (manufacturer: Aventis-Pasteur, Kyiv, 59 Frunze Street; cost – 65 hryvnia). Moreover, the vaccination can only be done on the day the vaccine is purchased. The vaccine is intended for two people, but you cannot split it yourself – this must be done by a doctor.
For vaccination, you must appear no later than 10 days before departure, bringing your passport and a health certificate from the clinic at your place of registration (the certificate must indicate that there are no contraindications to vaccination). Immunity against yellow fever after vaccination lasts for ten years.
No less insidious than yellow fever is malaria. Science knows four forms of it, the most serious of which is tropical malaria (it is very difficult to treat and without prompt medical intervention can lead to death). The incubation period for different forms of this disease ranges from one week to three years. The first symptoms of the disease are fever, headache, weakness, profuse sweating, and chills.
Malaria is widespread in many countries with hot climates, and its tropical variety is in Africa. To avoid contracting malaria, you need to take special medications, and you must start taking them a week before departure. The most common antimalarial drug is *delagil* (chloroquine) (1 tablet per day). However, in some countries, malaria pathogens are resistant to delagil. In this case, you need to take *metakelfin* or *fansidar* (one tablet per week for 6 months, subsequently replaced with delagil). The dosage of antimalarial drugs for children should be prescribed by a doctor. These drugs are freely sold in pharmacies (a pack of delagil – 30 tablets – costs about 12 hryvnias).
Doctors advise that after arriving in the destination country, you should consult with the embassy doctor about the need and procedure for malaria prevention, and after returning home, inform your local doctor about your arrival. By the way, you need to take antimalarial drugs for another four weeks after returning.
Unfortunately, to protect oneself from malaria, chemoprophylaxis alone is not enough. The vector of all forms of malaria is mosquitoes (bites of sandflies are usually harmless). Tropical mosquitoes, like their domestic relatives, prefer damp shady places during the day and come out to hunt at night, and then neither noise nor bright city lights bother them. In the evening, you must wear clothing that covers most of your body. Given that in the evening the temperature in 'such distant' places exceeds 30 degrees, this is not very pleasant.
Do not forget about repellents – substances that repel insects (the traditional Vietnamese 'star' may not be enough). There are many other modern (though often not cheap) means of protection against bites: lotions, creams, aerosols, and alcohol solutions. Repellents should be applied to the skin, and it is also advisable to impregnate clothing with them (wardrobe items made of natural fabrics, as a rule, do not suffer from chemicals). Do not allow repellents to get into your eyes or mouth, onto mucous membranes or damaged skin! The duration of action of repellents depends on the environment: the higher the temperature and humidity, the shorter the duration (from 30 minutes to several hours). Repellents should be washed off with soap and water, never using sponges or washcloths.
Living quarters should be treated every evening with an aerosol containing synthetic pyrethroids (the main thing is not to forget to treat the screens on doors and windows with the aerosol). Instead of aerosols, you can use electric fumigators and mosquito coils. After that, you need to ventilate the room for half an hour, without removing the mosquito nets (so as not to poison yourself). It would not be superfluous to also protect sleeping areas with a separate mosquito net.
In some countries, including India, Vietnam, Mozambique, Zimbabwe, and Madagascar, cases of plague have been reported in recent years. Bubonic plague, characterized by enlarged lymph nodes, can be contracted from rodents or infected fleas. If you do not see a doctor immediately, complications such as pneumonic plague may occur (in which case the person can also infect others). Nowadays, both bubonic and pneumonic plague are treatable if medical attention is sought promptly.
But if all the above-mentioned diseases are treatable one way or another, then HIV infection, the final stage of which is AIDS, leads to death. Recall that the best way to protect against AIDS is abstinence, abstinence, and again abstinence. Also remember that AIDS is transmitted through blood and blood products. In underdeveloped countries, there is almost no system for controlling donor blood, so it would not be superfluous to stock up on disposable syringes. By the way, this measure is not redundant in any case, because through blood you can contract not only AIDS.
The greatest danger of AIDS is that it spreads unnoticed, and no epidemiological surveillance can detect it. If you suspect you have AIDS, it is best to get tested (in Kyiv, this can be done at the 'trust office', 38/2 Chernihivska Street (Levoberezhna metro station).
Recently, many of our tourists who love hot countries and are already tired of hotels and manicured beaches are being attracted to various 'wild' coastal spots. This approach is, of course, very romantic, but far from safe. In a number of tropical regions, a migrating larva lives in the coastal sand, which happily moves into a human at a convenient opportunity. To avoid such 'pleasant' company, you will have to deprive yourself of the pleasure of warming up on the sand without a mat or lounger and walking along the shore barefoot. You cannot place clothing on the sand either.