INFECTIONS - Medicine for Mountaineering and Other Wilderness Activities - page 323

Hepatitis B Yellow fever

Measles Viral hemorrhagic fevers

Rubella Epidemic typhus

Tularemia

Relapsing fever

Colorado tick fever

Toxic shock

1 A macule is a flat patch of discolored skin.

2 A papule is a small, raised area of discolored skin.
3 Petechiae are small, dark red or purple spots containing blood.

The period of time between infection by HIV and the development of AIDS can be
manyyears.Duringthislatentphase,theinfectedpersonhasnosymptomsbutiscapableof
transmitting the infection by sexual contact, by blood, and from mothers to infants. Trans-
fusions of blood or blood products, injections with needles or syringes contaminated with
blood, infected mothers giving birth, and splashing contaminated blood into open wounds
are some of the ways blood can transmit the virus. On the other hand, kissing, sharing
utensils,usingthesametoilets,drinkingfromthesamecontainers,touching,andothernon-
intimate contacts donottransmit thevirusandaresafe.Personswhoareinfected withHIV
but otherwise are in good health do not need to be excluded from wilderness outings, al-
though they should inform other participants of their infection.
Blood transfusions are extremely risky in any country that does not effectively screen
blood for HIV. A traveler's clinic or the CDC can supply upto-date information. Similarly,
injections from reused syringes or needles are dangerous. The safest ways to avoid sexual
transmission of infection are abstinence or monogamous sexual relations with a person
known to be uninfected. Condoms reduce, but do not eliminate, the risk of infection.
More information is available at www.cdc.gov/hiv .