Travel Reference
In-Depth Information
bronchitis and pneumonia, which may need to be treated with antibiotics. Seek medical
help in this situation.
No vaccine offers complete protection, but the influenza vaccine is highly recommended
for travellers to China and Tibet, and is good for up to one year.
Amoebic Dysentery
Caused by the protozoan
Entamoeba histolytica,
amoebic dysentery is characterised by a
gradual onset of low-grade diarrhoea, often with blood and mucus. Cramping abdominal
pain and vomiting are less likely than in other types of diarrhoea, and fever may not be
present. It will persist until treated and can recur and cause other health problems.
You should seek medical advice if you think you have giardiasis or amoebic dysentery,
but where this is not possible, tinidazole or metronidazole are the recommended drugs. The
better option of the two is tinidazole, which is not easily obtained in Tibet. If you are going to
be travelling in high mountain areas, it's a good idea to keep your own stock with you.
Cholera
This is the worst of the watery diarrhoeas. Outbreaks are generally widely reported, so you
can avoid problem areas. Fluid replacement is the most vital treatment: the risk of dehydra-
tion is severe, as you may lose up to 20L a day. Seek medical advice if you think you may
have this disease. If there is a delay in getting to hospital, begin taking doxycycline.
Giardiasis
Known as giardia, giardiasis is a type of diarrhoea. It's relatively common in Tibet and is
caused by a parasite,
Giardia lamblia,
present in contaminated water. Many kinds of mam-
mals harbour the parasite, so you can easily get it drinking 'pure mountain water', or even
brushing your teeth with contaminated water. Symptoms include stomach cramps, nausea,
a bloated stomach, watery, foul-smelling diarrhoea and frequent gas. Giardiasis can appear
several weeks after you have been exposed to the parasite. The symptoms may disappear
for a few days and then return; this can go on for several weeks. Treatment is with tin-
idazole, 2g in a single dose for one to two days.
Environmental Hazards
Acute Mountain Sickness
Acute mountain sickness (AMS; also known as altitude sickness) is common at high eleva-
tions; relevant factors are the rate of ascent and individual susceptibility. The former is the
