Basics - The Rough Guide to Southeast Asia on a Budget - page 36

Giardia can be identified by foul-smelling wind
and burps, abdominal distension, evil-smelling
stools that float, and diarrhoea without blood
or pus. Don't be over-eager with your diagnosis
though, and treat it as normal diarrhoea for at least
24 hours before resorting to flagyl antibiotics.

and cause infection. Bloodsucking leeches can be a
problem in the jungle and in fresh water. Get rid of
them by rubbing them with salt, though anti-tick
treatments also work. Apply DEET or Dettol to the
tops of your boots and around the lace-holes.
Specially woven leech socks are also available to
buy in specialist travel shops back home and often
locally in leech-infested areas; recommended for
the squeamish.
Southeast Asia has many species of both land
and sea snakes , so wear boots and socks when
hiking. If bitten , the number one rule is not to
panic. Stay still in order to slow the venom's entry
into the bloodstream. Wash and disinfect the
wound, apply a pressure bandage as tightly as you
would for a sprain, splint the affected limb, keep it
below the level of the heart and get to hospital as
soon as possible. Scorpion stings are very painful
but usually not fatal; swelling usually disappears
after a few hours.
If stung by a jellyfish , the priority treatment is to
remove the fragments of tentacles from the skin -
without causing further discharge of venom -
which is most easily done by applying vinegar to
deactivate the stinging capsules. The best way to
minimize the risk of stepping on the toxic spines
of sea urchins, sting rays and stone fish is to wear
thick-soled shoes, though these cannot provide
total protection; sea-urchin spikes should be
removed after softening the skin with a special
ointment (like Tiger Balm), though some people
recommend applying urine to help dissolve the
spines. For sting-ray and stone-fish stings, alleviate
the pain by immersing the wound in very hot water
- just under 50°C - while waiting for help.
Rabies is transmitted to humans by the bite of
infected animals; tetanus is an additional danger
from such bites. All animals should be treated with
caution, particularly monkeys, cats and dogs. Be
extremely cautious with wild animals that seem
inexplicably tame, as this can be a symptom. If you
do get bitten, scrub the wound with a strong
antiseptic and then alcohol and get to a hospital as
soon as possible. Do not attempt to close the
wound. The incubation period for the disease can
be as much as a year or as little as a few days; once
the disease has taken hold, it will be fatal.

Viruses
The frequency with which travellers suffer from
these infectious diseases makes a very strong case
for inoculation (see p.37). Hepatitis A is a water-
borne viral infection spread through water and
food. It causes jaundice, loss of appetite, and
nausea and can leave you feeling wiped out for
months. Seek immediate medical help if you think
you may have contracted it. Havrix is a vaccination
against hepatitis A, which can last for over 20 years
provided you have had a booster 6-12 months
after your first jab. You can also vaccinate against
hepatitis B , which is transmitted by bodily fluids
during unprotected sex or by intravenous drug use.
Cholera and typhoid are generally spread when
communities rely on sparse water supplies. The initial
symptoms of cholera are a sudden onset of watery,
but painless, diarrhoea. Later, nausea, vomiting and
muscle cramps set in. Cholera can be fatal if adequate
fluid intake is not maintained. Copious amounts of
liquids, including oral rehydration solution, should
be consumed and medical treatment should be
sought immediately. Like cholera, typhoid is also
spread in small, localized epidemics. Symptoms can
vary widely, but generally include headaches, fever
and constipation, followed by diarrhoea. Vaccination
against typhoid is recommended for all travellers to
Southeast Asia.

Bites and stings
The most common irritations for travellers come
from tiny pests and the danger of infection is to or
via the bitten area, so keep bites clean. Fleas , lice
and bed bugs (see box, p.35) adore grimy sheets,
so examine your bedding carefully, air and beat the
offending articles and then coat yourself liberally in
insect repellent. Scabies, which cause severe itching
by burrowing under the skin and laying eggs, might
affect travellers who stay in hill-tribe villages.
Ticks are nasty pea-shaped bloodsuckers that
attach themselves to you if you walk through long
grass. A dab of petrol, alcohol, Tiger Balm or insect
repellent, or a lit cigarette, should make them let
loose and drop off; whatever you do, don't pull
them off, as their heads can remain under the skin,

Medical resources for travellers

AUSTRALIA AND NEW ZEALAND
Travellers' Medical and Vaccination Centre T 1300 658 844,
W traveldoctor.com.au. Lists travel clinics in Australia, New Zealand
and South Africa.