Considering traveling to a tropical destination to escape the cold winter weather or maybe a festive spring break trip? Here’s some information on what to know about Hepatitis and Malaria, which are two of the more common and potentially serious illnesses encountered abroad.
As always consult the CDC (www.cdc.gov) or your primary care provider before traveling to any destination to see what vaccinations or prophylactic medications are recommended for that particular area.
Hepatitis A and B
In actuality ALL adults should be vaccinated for Hep A and B (not just those traveling abroad) and especially gay men (more so those who engage in oral/rectal sex). Despite the popular notion, Hep A and B are not tropical-born diseases – Hep A can be transmitted anywhere that the food is not properly prepared (including the United States), and Hep B can be transmitted through sexual intercourse with an infected person or sharing infected needles.
The signs and symptoms of both types of Hepatitis include: Jaundice (yellowing of the skin), fatigue, abdominal pain, loss of appetite, nausea, diarrhea and fever. There are presently only vaccines for Hep A and Hep B but there are many other forms of the Hepatitis virus including Hep C, and the much more rare types of Hep D and Hep E. The cost of Hepatitis vaccine varies but in general it costs around $100 for each vaccine (most insurance companies now cover the cost of Hepatitis vaccination).
Hepatitis A vaccine is give in two doses over a six month period and provides lifelong protection. Hepatitis B is a series of three doses given over a six month period. Even if you can’t get in all of the doses of Hep A or B vaccine before your trip, just having one or two doses does offer some protection.
Malaria
Although eradicated in the U.S. in 1951, malaria is still a huge problem in many tropical regions of the world including Africa, Asia, the Middle East, Central and South America, parts of the Caribbean (primarily Hispaniola and the Dominican Republic) and the Yucatan areas of Mexico.
As many as 500 million infections and 1 million deaths worldwide occur from malaria, and as many as 1,200 Americans who travel to tropical regions become sick with malaria annually, and of those an average 13 die each year. The parasite that causes Malaria is passed by the females of certain breeds of mosquitoes in infected areas, and it takes seven days for all forms of the parasite that causes Malaria to incubate, so any symptoms that occur before the seven day window are generally not considered to be Malaria. Symptoms of Malaria include fever, chills, muscle aches, abdominal pain, diarrhea and vomiting.
In general the Center for Disease Control recommends using a mosquito repellent that contains DEET. Other precautions include using sprays that kill air-born insects that contain pyrethroid-type insecticides and the use of mosquito netting.
Fortunately malaria is preventable using chloroquine phosphate for prophylaxis beginning one to two weeks before travel and continuing for two to four weeks after returning. In countries where a chloroquine resistant strain of malaria exists, other drugs like Larium, Malarone or Doxycycline may be used. Larium has been associated with nightmares and psychosis in approximately one in 10,000 people, but the risk of this side effect is far less than the risk of developing Malaria if traveling to a part of the world where Malaria is endemic.
Pregnant women, children, the elderly, and persons with impaired immune systems due to chronic diseases that impair the immune system such as AIDS or diabetes are at greater risk of complications or even death from malaria and should consult a travel medicine specialist before embarking to any country with endemic malaria.
Unfortunately having HIV can increase the risk of developing Malaria and make it much more difficult to treat, so it is imperative to seek medical advice and begin prophylactic treatment well in advance. It is important to note than even with prophylactic treatment with drugs to prevent Malaria that it can still be possible to contract the disease and any signs or symptoms of fever or diarrhea seven days after being in a part of the world with known Malaria is cause to immediately seek medical care.
For more information about malaria and other tropical diseases please consult the CDC online at www.CDC.gov.