Basics - The Rough Guide to South America on a Budget - page 31

ALTITUDE SICKNESS
If you don't take care, altitude sickness, known locally as soroche , can seriously affect your trip.
The most common symptoms are headache , nausea and dizziness , but when climbing
at high altitude (above 2400m), symptoms can lead to more serious conditions such as
HAPE (high altitude pulmonary oedema) or HACE (high altitude cerebral oedema), when
medical attention should be sought immediately.
Soroche can affect anyone regardless of physical fitness. The key is to allow a few days to
acclimatize when you arrive in a high-altitude region. When hiking, ascend slowly and follow the
rule “sleep low and hike high” (sleep at a lower altitude than you ascended to that day), which
allows your body time to recover. Drink plenty of water and eat light food, including carbs. Avoid
alcohol and caffeine and, most importantly, pace yourself. Don't attempt to climb a mountain like
Cotopaxi or Chimborazo after just a few days at 2800m in Quito - you need a couple of days
above 2500m, then a couple more above 3500m before climbing over 4000m. If you are hiking as
part of a tour and not dealing well with the altitude, alert your guide. Better to turn back than risk
your health. In the Andean region locals swear by “mate de coca” - coca leaf tea - as a cure.

A much more likely nuisance when visiting
wilder areas is the itchy bites given by tiny black
sand flies or painful bites of ants and ticks. Hairy
caterpillars are also capable of giving nasty stings
similar to burns.

Intestinal problems

Common illnesses such as traveller's diarrhoea can
be largely avoided by steps such as washing your
hands before eating and drinking bottled water.
Unpasteurized dairy products and all un-refrigerated
food should be avoided and fruit and vegetables
should be washed and peeled. Take care with
shellfish, lettuce and ice. If you do fall ill, rest and
replace the fluids you have lost by drinking plenty
of water and an oral rehydration solution. A home-
made option is 1tsp salt and 8tsp of sugar in 1 litre
of water. An anti-diarrhoeal tablet can usually
alleviate symptoms.
Other than diarrhoea that usually lasts no more
than a few days there are a number of more serious
problems that you can encounter on your travels.
Cholera , for example, is an acute infection with
watery diarrhoea and vomiting; dysentery has
similar symptoms but includes bleeding. If your
diarrhoea persists for a week and your symptoms
include a chill or fever or bleeding, or if you are too ill
to drink, seek medical help. Typhoid is also a problem
in the poorest, most rural areas and is transferred
through food or water. Symptoms include fever,
headache and occasionally a bleeding nose or spotty
rash. Seek medical advice immediately - the fever
can be easily treated with antibiotics but is serious
if not caught early.
To avoid problems, always use bottled water,
even for cleaning your teeth. Avoid buying food
from street vendors unless the food is piping hot,
and think carefully about swimming in lakes and
rivers. If bottled water isn't available, there are
various methods of treating water: boiling for a
minimum of five minutes is the most effective
method. Filtering alongside chemical sterilization

Mosquito-borne diseases
Malaria prevention is two-fold; in addition to
avoiding mosquito bites as detailed above, travellers
should be sure to take a prescription anti-malarial
drug, typically malarone (usually the best option),
chloroquine or doxycycline - consult with a doctor
before taking any. These should generally be started
several weeks before you travel, and the full course
must be completed which means continuing to take
them after leaving a malaria zone. Symptoms can
occur any time up to a year after travel, so it's impor-
tant to inform your doctor about your travel history.
Yellow fever is a serious disease carried by mosqui-
toes, which, like malaria, can be avoided by vacci-
nation and taking sensible precautions against insect
bites. It is present in most of South America except
the far south. You'll need to show a certificate if travel-
ling from one endemic country to another (although
you won't always be asked for it, it's best to have one
anyway). The following countries are considered the
greatest risk areas: Bolivia, Brazil, Colombia, Ecuador,
Peru and Venezuela.
Dengue fever is also mosquito-borne and there is
no vaccine. The mosquitoes carrying the virus tend to
live near stagnant water so it's more of a problem in
poor areas. It has become a serious health issue in
Brazil, Bolivia, Paraguay and Argentina, but is present
in most countries in South America. Symptoms
include high fever and aching limbs. Drink fluids, take
paracetamol and seek medical attention immediately.