Survival Guide - Morocco - page 1017

Symptoms and effects Initially, usually fever or a pink rash on the abdomen. Septicaemia (blood poison-
ing) may also occur.
Prevention Typhim Vi or typherix vaccine. In some countries, the oral vaccine Vivotif is also available.
Yellow Fever
Travellers arriving in Morocco from a yellow-fever-endemic area need to show proof of vaccination before
entry.
Spreads There is a small risk of yellow fever, borne by mosquitoes, in rural Chefchaouen province between
May and October.
Symptoms and effects Muscle aches, fever, headache, nausea and vomiting subside after a few days, fol-
lowed in up to a quarter of cases by anaemia, liver inflammation, hepatitis, jaundice and kidney damage.
Most patients who also experience bleeding from the nose, mouth and stomach (leading to blood in vomit
and faeces) die in a short space of time.
Prevention The risk is so small that the World Health Organization does not recommend vaccination. It
must be given at a designated clinic, and is a live vaccine so must not be given to immuno-compromised or
pregnant travellers.
Traveller's Diarrhoea
Causes Strains of travel - unfamiliar food, heat, long days and erratic sleeping patterns - can all make your
body more susceptible to an upset stomach.
Prevention Water is generally safe to drink in cities, but elsewhere you should only drink treated water. Eat
fresh fruits or vegetables only if they are cooked or if you have washed or peeled them yourself. Buffet
meals, which may have been kept sitting warm for some time, can be risky; food should be piping hot.
Meals freshly cooked in front of you (like much street food) or served in a busy restaurant are more likely to
be safe. Be sensible, but not paranoid: food is one of the treats of visiting Morocco, so don't miss out.
Hygiene Pay close attention to personal hygiene. Many Moroccan meals are eaten with the hand, so always
wash before eating and after using the toilet. Even the smallest restaurant will have a sink, but soap is less
common, especially at cheap hotels. Antibacterial hand gel, which cleans without needing water, is useful.
Treatment Drink plenty of fluids, and preferably an oral rehydration solution; pharmacies stock these inex-
pensive sels de réhydration orale . Avoid fatty food and dairy products. A few loose stools don't require
treatment, but if you start having more than four or five a day, take an antibiotic (usually a quinolone drug)
and an anti-diarrhoeal agent (such as loperamide). If diarrhoea is bloody, persists for more than 72 hours,
and is accompanied by fever, shaking, chills or severe abdominal pain, seek medical attention.