Travel Reference
In-Depth Information
combination with Johnson's Baby Oil to minimize
skin irritation. The most effective mosquito repel-
lents - worth looking out for before you leave
home - contain
DEET
(diethyl toluamide). DEET is
strong stuff, so follow the manufacturers' instruc-
tions, particularly with use on children. If you have
sensitive skin, a natural alternative is citronella or, in
the UK,
Mosi-guard Natural
, made from a blend of
eucalyptus oils (though still use DEET on clothes
and nets). Wear long-sleeved shirts and trousers,
shoes and socks during the times of day when
mosquitoes are most active. You should also sleep
under a sheet and, crucially, use a
mosquito net
.
Nets for hammocks (
mosqueteiro para rede
) are
reasonable and easily available in Amazonian cities
and towns. Mosquito coils also help keep the
insects at bay.
and quick diagnosis is vital. Remember that the
incubation period
means that the symptoms may
only appear after you return home - make sure to
tell your doctor where you've been if you get a
fever shortly after your return home.
Rabies
Though the government has had great success in
containing the disease in recent years,
rabies
does
exist in Brazil - feral dogs (which should not be
petted) in the cities and bats in the Amazon are the
biggest dangers. If you are bitten or scratched,
wash the wound immediately with soap and
running water for five minutes and apply alcohol or
iodine. If possible try to see whether the animal
itself has any rabies symptoms. Seek treatment
immediately - rabies is fatal once symptoms
appear, and you may also need to get a tetanus jab.
If you're going to be working with animals or
planning a long stay, especially in rural areas, you
should consider a rabies
vaccination
beforehand.
Although this won't give you complete immunity, it
will give you a window of 24-48 hours to seek
treatment and reduce the amount of post-exposure
vaccine you'll need if bitten.
Prevention and treatment
When taking
preventive tablets
it's important to
keep a routine and cover the period before and
after your trip with doses; doctors can advise on
which kind to take. As resistance to chloroquin-
based drugs increases, mefloquin, which goes
under the brand name of Lariam, has become one
of the most recommended prophylactics for travel-
lers to Brazil. This can have very strong psychiatric
side effects, though, and its use is controversial.
The websites
W
cdc.gov/travel/regionalmalaria and
W
fitfortravel.nhs.uk are useful resources, giving
advice on risk areas in Brazil and the best methods
of protection.
Malaria has an incubation period of around two
weeks. The first
signs of malaria
are remarkably
similar to flu - muscle and joint pains and weakness
that last for a day or two before the onset of malaria
fever proper - and may take months to appear: if
you suspect anything, go to a hospital or clinic
immediately. You will need immediate treatment
and a blood test to identify the strain.
Malaria treatment
is one public-health area
where Brazil can take some credit. Dotted in
malarial parts of the Amazon are small malaria
control posts and
clinics
, run by the anti-malaria
agency SUCAM - ask for the
posto da SUCAM
. They
may not look like much, but the people who staff
them are very experienced and know their local
strains better than any city specialist. Treatment in a
posto
is free, and if you do catch malaria you should
get yourself taken to one as quickly as possible;
don't shiver in your hammock and wait for it to
pass. If in a city and you get the same symptoms
(a fever and the shakes), make sure you get a blood
test right away; you'll get your results in a few hours
Yellow fever
Getting a
yellow fever vaccination
, which offers
protection for ten years, is recommended for most
regions outside of Fortaleza, Recife, Rio de Janeiro,
Salvador and São Paulo (see
W
cdc.gov/travel for
more details). This viral disease is transmitted by
mosquitoes and can be fatal, but is extremely rare
even in places where it is endemic. Symptoms
include headache, fever, abdominal pain and
vomiting, and though victims may appear to
recover, without medical help they may suffer from
bleeding, shock and kidney and liver failure. While
you're waiting for help, it is important to keep the
fever as low as possible and prevent dehydration.
In the Amazon
Given the remoteness of many parts of the
Amazon
and the prevalence of insects and snakes,
health care takes on a special significance. If you are
trekking through forest or savannah, long trousers
are a good idea, and it is vital to wear good boots
that protect your ankles from snake bites, chiggers
(mites) and scorpions. You should never trek alone.
Snakes
are timid and, unless you're unlucky, only
attack if you step on them. Many of the most
