Travel Reference
In-Depth Information
Rabies
Rabies is spread by receiving the bites or licks of an infected animal on broken skin. It's
always fatal once the clinical symptoms start (which might be up to several months after
an infected bite), so postbite vaccination should be given as soon as possible. Postbite
vaccination (whether or not you've been vaccinated before the bite) prevents the virus
from spreading to the central nervous system. Animal handlers should be vaccinated, as
should those travelling to remote areas where a reliable source of postbite vaccine isn't
available within 24 hours. Three preventive injections are needed over a month. If you
have not been vaccinated you'll need a course of five injections starting 24 hours or as
soon as possible after the injury. If you have been vaccinated, you'll need fewer postbite
injections, and have more time to seek medical help.
Schistosomiasis (Bilharzia)
This disease is spread by flukes (minute worms) that are carried by a species of freshwater
snail. The flukes are carried inside the snail, which then sheds them into slow-moving or
still water. The parasites penetrate human skin during paddling or swimming and then mi-
grate to the bladder or bowel. They're passed out via stool or urine and could contaminate
fresh water, where the cycle starts again. Paddling or swimming in suspect freshwater
lakes or slow-running rivers should be avoided. There might be no symptoms; there might
be a transient fever and rash; and advanced cases might have blood in the stool or in the
urine. A blood test can detect antibodies if you might have been exposed, and treatment is
then possible in specialist travel or infectious-disease clinics. If not treated the infection
can cause kidney failure or permanent bowel damage. It's not possible for you to infect
others.
Tuberculosis (TB)
TB is spread through close respiratory contact and occasionally through infected milk or
milk products. BCG vaccination is recommended for those likely to be mixing closely
with the local population, although it gives only moderate protection against TB. It's more
important for long stays than for short-term stays. Inoculation with the BCG vaccine isn't
available in all countries. It's given routinely to many children in developing countries.
The vaccination causes a small permanent scar at the site of injection, and is usually given
in a specialised chest clinic. It's a live vaccine and should not be given to pregnant women
or immunocompromised individuals.
TB can be asymptomatic, only being picked up on a routine chest X-ray. Alternatively,
it can cause a cough, weight loss or fever, sometimes months or even years after exposure.
