Travel Reference
In-Depth Information
Other Infections
A number of rare but ser- ious diseases are carried by insects and rodents, such as barton-
ellosis, Bolivian hemorrhagic fever, Chagas' disease, leishmaniasis, typhus and the
plague. Rabies is also a concern, especially in the southeastern part of the country. Do not
attempt to pet, handle or feed any animal. Any bite or scratch by a mammal, including
bats, should be promptly and thoroughly cleansed with large amounts of soap and water,
followed by application of an antiseptic such as iodine or alcohol. The local health author-
ities should be contacted immediately for possible post-exposure rabies treatment, wheth-
er or not you've been immun- ized against rabies. It may also be advisable to start an anti-
biotic, since wounds caused by animal bites and scratches frequently become infected. Or
use one of the newer quinolones, such as levofloxacin (Levaquin), which many travelers
carry in case of diarrhea.
Travelers' Diarrhea
To prevent diarrhea, avoid tap water unless it has been boiled, filtered or chem- ically dis-
infected (with iodine tablets); only eat fresh fruits or vegetables if peeled or cooked; be
wary of dairy products that might contain unpasteurized milk; and be highly selective
when eating food from street vendors.
If you develop diarrhea, be sure to drink plenty of fluids, preferably an oral rehydration
solution containing lots of salt and sugar. A few loose stools don't require treatment but if
you start having more than four or five stools a day, you should start taking an antibiotic
(usually a quinolone drug) and an antidiarrheal agent (such as loperamide). If diarrhea is
bloody, or persists for more than 72 hours, or is accompanied by fever, shaking chills or
severe abdominal pain, you should seek med- ical attention.
Environmental Hazards
Altitude Sickness
Altitude sickness may de- velop in those who ascend rapidly to altitudes greater than
2500m (8100 ft). In Bolivia this includes La Paz (altitude 4000m). Being physically fit of-
fers no protection. Those who have experienced altitude sickness in the past are prone to
future episodes. The risk increases with faster ascents, higher altitudes and greater exer-
tion. Symptoms may include headache, nausea, vomiting, dizziness, malaise, insomnia
