Thursday 30 June 2011

Disease Focus- Bilharzia


 
So you are on holiday and Lake Malawi looks cool, refreshing and inviting, but should you swim in it? The simple answer is no. Fresh water sources such as Lake Malawi are infected with parasites that cause Schistosomiasis, otherwise known as Bilharzia and swimming should be avoided if you don't want to become infected with this parasite. So however inviting the water looks - Don't be tempted to swim in it.



The inviting waters of Lake Malawi should be avoided.

What is Schistosomiasis?

Bilharzia is caused by infestation by a type of flatworm, or fluke (parasite). Fluke larvae are released by freshwater snails. These larvae penetrate the human skin and mature into adults. Adult worms live for many years in mesenteric or vesicular veins. They release ova which cause scarring of the bladder and rectum.

Where can I catch Bilharzia?

Bilharzia is caught through swimming or showering/ bathing with water fresh from lakes or rivers. Bilharzia mainly affects people in developing countries Africa, South America, and less so in the Middle and Far East .People from the UK become infested only when visiting tropical countries. About half of all those who swim in Lake Malawi test positive for Bilharzia on their return.  

Symptoms

'Swimmer's itch' develops where the parasite enters the skin, and is often the only symptom noticed.
Other possible symptoms include muscle pain, headache, diarrhoea, fever, vomiting, coughing, a burning sensation when passing urine, passing urine more frequently and blood in the urine.

How can I prevent catching Bilharzia?

The infection can be avoided by not swimming, paddling, wading, washing or drinking water in tropical lakes, rivers, canals or freshwater pools (that haven’t been chlorinated) . Swimming pools that have been chlorinated and well maintained pose no risk. There is no vaccination or medication that can be taken to prevent infestation.

How is Bilharzia treated?

If exposure has occurred, seek medical advice. Infestation is treated with medication (Praziquantel ) to kill the parasite.
Untreated Bilharzia may cause life-threatening urinary system or liver damage, bladder tumours and bowel cancer.

What should I do if I have returned from a trip and been swimming in a fresh water source in an endemic area?

You should seek advice from your GP who will refer you to an infectious disease or tropical medicine specialist for treatment.


Remember, you should always seek travel advice from your nurse or GP before you plan an overseas trip to ensure you have the correct vaccinations and malaria tablets if required for your destination.


Friday 17 June 2011

Disease Outbreaks Updates

Avian Flu Egypt - 16 June 2011
Five cases of human infection with Avian influenza (Bird Flu) have been reported to World Health Organisation (WHO) by the Egyptian Ministry of Health. All cases were aged 40 years and younger, 3 cases have died and 2 cases are recovering. All cases had exposure with poultry suspected to have Avian Flu.

Advice for Travellers: avoid visiting live animal markets and poultry farms. Avoid eating undercooked poultry. Wash hands regularly before eating or use an alcohol hand gel.

E Coli Germany 10 June 2011
Germany has reported an increase in cases of Escherichia Coli. The outbreak has been going on since May 2011 and a total of 759 cases have been reported to date. 21 cases have been fatal and a total of 2229 cases of bloody diarrhoea have also been reported. E Coli is spread through eating or drinking contaminated food or water. The most likely source of this outbreak has been through consumption of bean sprouts.  

Advice for Travellers: there is no vaccine available to prevent E Coli, therefore travellers should practice strict food and water hygiene precautions and avoid consuming bean sprouts. If you have recently returned from Germany and are experiencing E Coli symptoms: bloody diarrhoea, cramping and pain - seek urgent medical attention.

Polio Chad - 10 June 2011
65 case of wild polio virus type 1 and 3 cases of wild polio virus type 3 have been reported to date in 2011

Advice for travellers to Chad:
Make sure you have received a full primary course of Polio vaccination in childhood and if it is over 10 years since your last booster ensure you are vaccinated before travel. Polio is spread through contaminated water - make sure you drink only boiled or bottled water from a safe source.

Avian Flu Cambodia - 10 June 2011
One case of human infection with Avian influenza (Bird Flu) has been reported to WHO by the Cambodian Ministry of Health. The 7 year old child died and all 6 cases reported in 2011 in Cambodia have been fatal. The child was from Prasat village, Prasat commune Kampong Trabek district, Prey Veng Province and had been exposed to sick poultry.

Advice for Travellers: avoid visiting live animal markets and poultry farms. Avoid eating undercooked poultry. Wash hands regularly before eating or use an alcohol hand gel.

Avian Flu Indonesia - 3 June 2011
One case of human infection with Avian influenza (Bird Flu) has been reported to WHO by the Indonesian Ministry of Health. The 1 year old child from the North Jakarta District recovered. The child had been exposed to poultry when visiting a local market with her father who was buying chickens.

Advice for Travellers: avoid visiting live animal markets and poultry farms. Avoid eating undercooked poultry. Wash hands regularly before eating or use an alcohol hand gel.

References

World Health Organisation http://www.who.int/csr/don/en/
Nathnac http://www.nathnac.org/

Tuesday 7 June 2011

Planning your holiday- Tips to stay safe and healthy on your travels

Vaccinations and Travel Health
When planning an overseas trip it is advisable to consult your doctor or travel clinic at least six weeks prior to your departure. Many vaccinations such as rabies and hepatitis b, require more than one dose, so allow plenty of time before your trip to complete the necessary immunisations.
Malaria is spread through the bite of an infected mosquito and is present in many parts of the world. If you are travelling to a malarial area you will need to take anti malarial tablets. A useful website that shows worldwide malaria maps is FitForTravel  Mosquitoes spread other diseases, such as Dengue fever and it is important to avoid mosquito bites during the day and at night. It is recommended that you sleep under an impregnated mosquito net and use a DEET based repellent on any exposed skin.

Sun Care
Sunburn and heatstroke can ruin a trip. To avoid this follow these useful tips:
  • Use a high factor sunscreen 25 SPF or more and apply frequently, especially after swimming
  • Avoid going out in the hottest part of the day between 11 am and 3 pm
  • Use protective clothing and hats; this is particularly important for children.
  • Drink plenty of fluids and be aware that alcohol can dehydrate you.

Staying safe
With all the recent unrest in many countries it is advisable to register with LOCATE. You can register your details online at LOCATE In the event that there is a natural disaster or unrest in the country you are visiting, the FCO will be aware of your presence in the country and be able to assist you in the event of an emergency.

Jane Bell RGN
Nurse Director Sussex Travel Clinic