Basics - The Rough Guide to Southeast Asia on a Budget - page 34

worms carrying diseases such as bilharzia infect
some tracts of fresh water in Southeast Asia. The
worm enters through the skin and may cause a
high fever after some weeks, but the recognizable
symptoms of stomach pain and blood in the urine
only appear after the disease is established, which
may take months or even years. At this point, some
damage to internal organs may have occurred.
Many countries in Southeast Asia have significant
AIDS problems. Condoms are available at pharma-
cies throughout the region, though the quality is
not always reliable: it's best to bring a supply with
you, take special care with expiry dates and bear in
mind that condoms don't last as long when kept in
the heat. Blood transfusions, intravenous drug use,
acupuncture, dentistry, tattooing and body piercing
are also high-risk.

against malaria, which is a very dangerous and poten-
tially fatal disease. Information regarding malaria is
constantly being updated, so it's absolutely essential
to get medical advice before you travel.
Malaria is caused by a parasite in the saliva of the
anopheles mosquito that is passed into the human
when bitten by the mosquito. There are many
strains of the disease, and some are resistant to
particular prophylactic drugs. The following are the
most common anti-malarial tablets: chloroquine
(Avloclor or Nivaquine) and proguanil (Paludrine),
mefloquine (Lariam), doxycycline (Vibramycin) and
Malarone (atovaquone-proguanil). The first three
can be bought from pharmacies, but may have to
be ordered in if you are going for a long trip, while
the final three require a prescription from your
doctor. All the malaria prevention medicines must
be started before you travel, so make sure that you
visit the doctor or pharmacy in good time. Chloro-
quine, proguanil and mefloquine should be started
a week in advance, while Malarone and doxycycline
can be taken one to two days prior to travelling. It's
absolutely essential to finish your course of anti-
malarial drugs, as there is some time delay between
being bitten and the parasites emerging into the
blood: taking all your medicine will cover the
incubation time, eliminating the risk of infection.
None of the drugs is one hundred percent
effective, and it is equally important for the preven-
tion of malaria to stop the mosquitoes biting you.
Mosquitoes are mainly active from dusk until dawn,
and during this time you should wear trousers,
long-sleeved shirts and socks, and smother yourself
and your clothes in mosquito repellent containing
the chemical compound DEET: shops all over
Southeast Asia stock it. DEET is strong stuff, and if
you have sensitive skin a natural alternative is
citronella (sold as Mosi-guard in the UK), which is
made from a blend of eucalyptus oils. At night, you
should either sleep under a mosquito net sprayed
with DEET or in a room with screens across the
windows. Accommodation in tourist spots nearly
always provides screens or a net (check both for
holes), but if you're planning to go way off the
beaten track, you can either take a net with you or
buy one locally from department stores in capital
cities. Mosquito coils - widely available in Southeast
Asia - also help keep the insects at bay.
The symptoms of malaria are fever, headache
and shivering, similar to a severe dose of flu and
often coming in cycles, but a lot of people have
additional symptoms. You will need a blood test to
confirm the illness, and the doctor will prescribe
the most effective treatment locally. If you develop

Inoculations

No compulsory vaccinations are required for entry
into any part of Southeast Asia, but health profes-
sionals strongly recommend that travellers to the
region get inoculations against the following
common and debilitating diseases: typhoid, hepatitis
A, tetanus and polio. In addition, you may be advised
to have some of the following vaccinations, for
example, if travelling during the rainy season or if
planning to stay in remote rural areas: rabies,
hepatitis B, Japanese encephalitis, diphtheria, menin-
gitis and TB. If you're only going to Hong Kong and
Macau, you may not have to get any inoculations.
If you've been in an area infected with yellow fever
during the fourteen days before your arrival in
Southeast Asia, you will need to bring your yellow
fever certificate with you to prove you've been vacci-
nated against the disease.

Malaria

All of Southeast Asia lies within a malarial zone ,
although in many urban and developed tourist
areas there is little risk (see box, p.38). Most health
professionals advise travellers on a multi-country
trip through Southeast Asia to take full precautions

TELL YOUR DOCTOR WHERE
YOU'VE BEEN
Some of the illnesses you can pick up in
Southeast Asia may not show themselves
immediately. If you become ill within a
year of returning home, tell your doctor
where you have been.