Travel Reference
In-Depth Information
Mosquito-borne diseases
Given the prevalence in Cambodia of serious
diseases spread by mosquitoes, including multi-
resistant
malaria
, it is important to
avoid being
bitten
. Mosquito nets often aren't provided in guest-
houses and hotels, so it's worth bringing your own.
Wearing long trousers, socks and a long-sleeved
top will reduce the chances of being bitten.
Insect
repellents
containing DEET are the most effective,
although you may want to consider a natural alter-
native such as those based on citronella.
that and be cautious with ice, which is often cut up
in the street from large blocks and handled by
several people before it gets to your glass (though
in Western restaurants it will probably come from
an ice-maker).
Stomach complaints
The most common travellers' ailment is
upset
tummy
. Travellers'
diarrhoea
often occurs in the
early days of a trip as a result of a simple change
in diet, though stomach cramps and vomiting
may mean it's food poisoning. If symptoms
persist for more than a couple of days, seek
medical help as you may need antibiotics to clear
up the problem.
Most diarrhoea is short-lived and can be
handled by drinking plenty of fluids and avoiding
rich or spicy food. Activated charcoal tablets help
by absorbing the bad bugs in your gut and usually
speed recovery; they're sold across the counter at
pharmacies, but it's worth bringing some with you
from home. It's often a good idea to rest up for a
day or two if your schedule allows. In the event of
persistent diarrhoea or vomiting, it's worth taking
oral rehydration salts
, available at most pharma-
cies (or make your own from half a teaspoon of
salt and eight teaspoons of sugar per litre of
bottled water).
Unless you're going on a long journey, avoid
taking Imodium and Lomotil. These bung you up
by stopping gut movements and can extend the
problem by preventing your body expelling
the bugs that gave rise to the diarrhoea in the
first place.
Malaria
Malaria
is prevalent year-round and throughout
the country - with the exception of Phnom Penh,
Siem Reap and the area immediately around the
Tonle Sap lake. More than 40,000 cases were
reported in 2013, and almost 70,000 in 2012.
Malaria is contracted from the night-biting female
anopheles
mosquito, which injects a parasite into
the bloodstream. Chills, fevers and sweating ensue
after an incubation period of around twelve days,
often along with aching joints, a cough and
vomiting, and the symptoms repeat after a couple
of days. In Cambodia the dangerous
falciparum
strain of the disease predominates; if untreated, it
can be fatal.
Before you travel, it is important to take advice on
a suitable
prophylaxis
regime, as a course of
antimalarial medication needs to be started in
advance of arriving in a risk area.
Malarone
(atovaquone/proguanil) and
doxycycline
are the
two most frequently prescribed antimalarials for
Cambodia.
Mefloquine
(aka Larium) is also
sometimes recommended, but has the drawback of
well-publicized side effects and may not be
effective in western and northern provinces close
to the Thai border thanks to the presence of meflo-
quine-resistant malaria in these areas. Note that
taking antimalarials doesn't guarantee that you
won't contract the disease, a fact that reinforces the
need to avoid being bitten.
Emergency treatment
for falciparum malaria is
600mg of quinine sulphate, taken three times a day
for three days, followed by a single dose of three
Fansidar tablets once the quinine course is
completed. These tablets are available over the
counter at pharmacies throughout Cambodia, but if
you suspect malaria you should still see a doctor for
a diagnostic blood test.
Dysentery and giardiasis
If there is blood or mucus in your faeces and you
experience severe stomach cramps, you may have
dysentery, which requires immediate medical
attention. There are two forms of the disease, the
more serious of which is
amoebic dysentery
. Even
though the symptoms may well recede over a few
days, the amoebae will remain in the gut and can
go on to attack the liver; treatment with an antibi-
otic, metronidazole (Flagyl) is thus essential. Equally
unpleasant is
bacillary dysentery
, also treated
with antibiotics.
Giardiasis
is caused by protozoa usually found in
streams and rivers. Symptoms, typically watery
diarrhoea and bad-smelling wind, appear around
two weeks after the organism has entered the
system and can last for up to two weeks. Giardiasis
can be diagnosed from microscope analysis of stool
samples, and is treated with metronidazole.
Dengue fever
Outbreaks of
dengue fever
occur annually in
Cambodia with 37 deaths reported in 2009. Spread
