Travel Reference
In-Depth Information
Pharmacies and
medical treatment
Most standard drugs are available in pharmacies
( farmácias ), which you'll find everywhere - no
prescriptions are necessary. A pharmacy will also
give free medical advice, and they're a good first
line of defence if you fall ill.
If you are unlucky enough to need medical
treatment in Brazil, forget about the public
hospitals - as a foreigner, you have virtually no
chance of getting a bed unless you have an infec-
tious disease, and the level of health care offered by
most is poor. You can get good medical and dental
care in private hospitals and clinics: North
Americans will think it fairly inexpensive, but
Europeans used to state-subsidized health care may
not. A doctor's visit will cost on average R$100-160,
and drugs are relatively cheap. Hotels in big cities
will have lists of English-speaking doctors ; ask for a
médico . Outside the larger centres, you will
probably have to try out your Portuguese. Any
Brazilian doctor will also understand - although not
necessarily speak - Spanish.
fever, tiredness, muscle and joint pains (especially in
the fingers), and nausea and vomiting. There is
currently no cure for dengue, so it is likely that you
will feel pretty grim for a week or so even with
treatment, and you should be aware that some of
its complications can be dangerous. The same
precautions against mosquito bites outlined in the
section on malaria (see p.41) apply here too; the
difference is that the dengue mosquito comes out
during the day rather than at night.
There is one dangerous form of dengue, hemor-
rhagic dengue , which kills hundreds of people a
year in Brazil. Tourists tend not to get it, since you
almost always need to have had a previous attack
of dengue to be vulnerable to it. It is particularly
dangerous to children. If dengue-like symptoms are
accompanied by bleeding from the nose, ears or
gums, highly bloodshot eyes, blood in your vomit
or urine or a pin-prick red rash, get yourself to a
private hospital fast.
Diarrhoea, dysentery
and giardia
Diarrhoea is something everybody is likely to get
at some stage, and there's little to be done except
drink a lot (not alcohol) and bide your time. You
should also replace salts, preferably by taking oral
rehydration salts (one after each episode), or by
mixing a teaspoon of salt and eight of sugar in a
litre of purified water. You should seek help if you
can't keep any fluids down at all (sucking ice cubes
can be a good way to stay hydrated).
If your diarrhoea contains blood or mucus, the
cause may be dysentery or giardia. With a fever, it
could well be caused by bacillic dysentery and
may clear up without treatment. Nevertheless, a
course of antibiotics such as ciprofloxacin is
advised. It is best to consult a doctor or pharmacist
about which antibiotic to take as different bugs
may be resistant locally, and you should avoid
taking Loperamide (Imodium) if at all possible. Note
that these drugs also destroy “gut flora” that help
protect you. Once your symptoms have disap-
peared you may be a bit intolerant to milk, spicy
food and alcohol, and it is a good idea to stick to
small, bland meals.
Similar symptoms without fever indicate
amoebic dysentery , which is much more serious,
and can damage your gut if untreated. The usual
cure is a course of metronidazole (Flagyl), an
antibiotic that may itself make you feel ill, and
should not be taken with alcohol. Similar
symptoms, plus rotten-egg belches and farts,
Chagas' disease
Chagas' disease is endemic in parts of the
Northeast and the Amazon . Although it is di cult
to catch, it can lead to serious heart and kidney
problems that appear up to twenty years after
infection. The disease is carried in the faeces of
beetles that live in the cracks of adobe walls, so if
sleeping in an adobe hut, make sure nothing can
crawl into your hammock; either use a mosquito net
or sling the hammock as far from walls as you can.
The beetle bites and then defecates next to the spot:
scratching of the bite will rub in the infected faeces,
so before scratching a bite that you know wasn't
caused by a mosquito, bathe it in alcohol . If you are
infected, you will have a fever for a few days that will
then clear up as if nothing untoward happened.
Though the disease can be treated in its early stages,
it becomes incurable once established. If you travel
through a Chagas area and get an undiagnosed fever,
have a blood test as soon as possible afterwards.
Dengue fever
Dengue fever , a viral disease transmitted by
mosquito bites, is increasingly common in all
Brazilian cities. It is highly seasonal, peaking in the
southern hemisphere summer (Dec-April). The
symptoms are debilitating: light but persistent
 
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