Travel Reference
In-Depth Information
MALARIA
Malaria is transmitted by mosquito bites, usually between dusk and dawn. High-spiking
fevers may be accompanied by chills, sweats, headache, body aches, weakness, vomit-
ing or diarrhea. Severe cases may lead to seizures, confusion, coma and death.
Malaria pills are recommended for rural areas in the provinces of Bocas del Toro, Dar-
ién and Kuna Yala. For Bocas del Toro, chloroquine is taken once weekly in a dosage of
500mg, starting one to two weeks before arrival and continuing through the trip, and for
four weeks after departure. In the Darién and Kuna Yala, there are chloroquine-resistant
mosquitoes. Your options there are mefloquine, the milder doxycycline, or Malarone.
Protecting yourself against mosquito bites is the best prevention. If you develop a fever
after returning home, see a physician, as malaria symptoms may not occur for months.
RABIES
In Panama, rabies is transmitted mainly by vampire bats. If you are bitten by any animal,
thoroughly wash the wound and visit a doctor to determine whether or not further treat-
ment is necessary.
TYPHOID
Caused by ingestion of food or water contaminated by
Salmonella typhi
, fever occurs in
virtually all cases. Other symptoms may include headache, malaise, muscle aches, dizzi-
ness, loss of appetite, nausea and abdominal pain. Either diarrhea or constipation may
occur. Possible complications include intestinal perforation or bleeding, confusion, deliri-
um or, rarely, coma.
The vaccine is usually given orally but is also available as an injection. The treatment
drug is usually a quinolone antibiotic such asciprofloxacin (Cipro) or levofloxacin (Leva-
quin).
YELLOW FEVER
A life-threatening viral infection, yellow fever is transmitted by mosquitoes in forested
areas. Flu-like symptoms include fever, chills, headache, muscle aches, backache, loss of
appetite, nausea and vomiting. Some patients enter a second, toxic phase, which can
lead to death.
Vaccination is recommended for travelers visiting Chepo, Darién and the Kuna Yala.
TRAVELER'S DIARRHEA
To prevent traveler's diarrhea avoid untreated tap water, eat fresh fruit or vegetables that
are cooked or peeled, and be highly selective when eating food from street vendors.
If you develop diarrhea, 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
