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Friday, 24 March, 2000, 18:39 GMT
Travelling fright: Illness abroad

The death of a British aid worker from the highly infectious tropical disease lassa fever has brought home to many the potential dangers of travel to exotic destinations.

Ian Janeck, who died at Coppetts Wood Hospital in north London, caught the virus while working in Sierra Leone.


Clintons on safari
More people are heading to exotic destinations
However, as a whole range of once inaccessible regions are opened up to British tourists, it is not just aid workers, explorers or foreign correspondents who have to guard against tropical diseases.

Sarah Long, from the Lonely Planet travel guides, says those visiting the Far East, South America and Africa should do their homework.

"Protecting your health is not the most glamorous part of travel, but it's as important as buying your ticket."


Tropical diseases transmitted by mosquitoes
Dengue fever. Viral disease. Symptoms: Headache, severe joint pain, rash. Rarely causes death.
Malaria. Disease caused by parasites in the red blood cells. Symptoms: Periodic attacks of chills and fever. Kills 1-1.5m people a year.
Yellow fever. Acute viral disease. Symptoms: Fever, jaundice, often haemorrhaging. Mortality: Up to 50% in adults, 70% in children
Lonely Planet has even launched a series of guides exclusively about travel health issues.

"You don't want to be consumed by worry, that will ruin your holiday, but so can getting ill."

Doctor Ron Behrens, senior lecturer at the London School of Hygiene and Tropical Medicine, says intrepid travellers should fear cars more than rare diseases such as Ebola.

"Infectious diseases are quite rare. Traffic accidents lead the league table of medical problems abroad. In India there are 11 times more deaths per vehicle than in the UK."

Being injured on foreign roads can lead to disease, says Dr Behrens.

"The quality of care in foreign hospitals can be quite different. Patients may be infected from contaminated blood products or instruments."

The climate, environment and insect life of certain regions can also catch travellers unawares, turning minor cuts and bites into skin sepsis.


An Ebola victim
Few travellers will encounter Ebola
"One has to be meticulous in cleaning wounds and using antiseptic. You only need one fly to land on a cut for it to get infected," says Dr Behrens.

With HIV affecting as many as one in five people in some countries, Britons abroad are advised to take extra precautions against the virus that leads to Aids.

Many of the mosquito-borne illnesses, such as malaria, yellow fever and the milder dengue fever, are relatively rare amongst UK travellers.

There are just over 1,000 annual cases of malaria contracted by British tourists.

Dr Guy Barnish, from the Liverpool School of Tropical Medicine, says these cases could be avoided.

"The few deaths attributed to malaria are caused by people not taking their anti-malarial tablets.


Mosquito
Cover up to avoid mosquitoes
"People forget to take them for the four weeks after they come home, they get flu-like symptoms, don't tell their doctors their travel history and end up being severely ill."

The best defence against the different types of mosquitoes, and the different diseases they carry, may not be medicine but common sense.

Long sleeve shirts, long trousers, mosquito nets and repellents containing a high level of "deet", could save travellers from illnesses which kill millions worldwide.

They may not ward off some of the other nasty flying insects which plague those who live in the Tropics.

The tumbu fly likes to lay its eggs in clothing. Once its larvae hatch, they burrow into the skin of their human host.


Tropical diseases
Ebola. Virus transmitted by infected blood, etc. Symptoms: fever, vomiting, diarrhoea, kidney and liver failure, internal and external bleeding. Mortality: 50-90%
Lassa fever. Viral disease transmitted by rodents, also person-to-person. Symptoms: High fever, headaches, mouth ulcers, muscle aches, heart and kidney failure, Mortality: 15%
"They create a pimple, under which you just might notice something moving," says Dr Barnish, who has endured them several times.

To coax the intruder out their air supply has to be cut off, sending them gasping to the surface of the skin.

The sand fly also saddles those it lands on with a minute parasite. People around the Tropics endure "horrific" ulcers on any uncovered part of their bodies.

Water can carry everything from diarrhoea bugs to the bacteria which causes the much-feared disease cholera.

Dr Barnish says utmost care should be taken and recommends the use of bottled water for drinking and teeth cleaning.

Even paddling in an inviting looking lake can land you up the creek.

"Schistosomiasis is a slow, debilitating infection caught from fresh water in Africa. It comes from worms which live around the human bladder and intestine."


Girl pumping water
Water can transmit many diseases
These centimetre-long worms, once released from the body, infect water snails. The second generation hatch and hunt out another human host, entering through the skin.

Maturing in the person's liver, the worms can get lost on their journey back to the bladder or intestine, causing untold damage if they reach the brain or spine.

While lassa fever is incredibly rare, with only a dozen cases in America and Europe in 30 years, keeping healthy while travelling is a growing concern.

"Understand the risks," says Dr Behrens. "The best way to avoid these problems is through your behaviour."

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See also:

23 Mar 00 | Health
Tropical virus man dies
26 Jun 98 | Medical notes
Malaria: the facts
17 Jun 99 | Medical notes
Infectious disease
24 Feb 00 | Health
Malaria secrets uncovered
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