Hookworms! What
Are They?
| You have been strolling down the
beach in balmy Bali, or dancing all night on the sands
of Koh Samui, and what happens when you get home? Your
feet are itchy, you start wheezing and then you get the
runs, feel nauseous and all your friends avoid you
because of the excessive wind problem emanating from
your behind! What could it be, have you picked up a
passenger from your holiday?
Hookworms are hatched from eggs that live in
animal and human faeces which remain in a
shaded, moist environment. Humans can pick them
up by walking barefoot in the sand, or sometimes
sitting with their bare buttocks in the shade on
the beach!
People
travelling to Asian resort areas such as Phuket, Koh
Samui, Bali and other destinations in tropical areas are
at highest risk. The hookworm larvae penetrate human
skin and form itchy red serpiginous lines while they are
travelling under your skin. Eurrgh! Some species will
migrate through the bloodstream to the lungs, then crawl
up the airways to your mouth and are swallowed, finally
reaching your bowels to feed on blood, causing the
cough, wheeze, diarrhoea, nausea and flatulence along
the way. |
Hookworm - the parasite uses its
teeth to hold onto the wall of the gut |
How you prevent Hookworm
infection?
|
Hookworm infection can be
prevented by using appropriate footwear and by avoiding
areas of the beach that are shaded and moist. It is also
important not to eat salads or uncooked vegies that may
have been fertilized with human faecal matter that has not been washed
off.
Is it treatable?
If you are unlucky enough to have
caught hookworms, simple worm tablets and creams kill
them very easily. Visit your friendly travel medicine
provider for treatment or more information.
|
Dog hookworm travels through skin
causing an itchy line |
... prepared by
Dr Stan Khoo, Medical Director, Travel Medicine Centre
Perth
Outbreak
Information
Melioidiosis
Australia:
One person has died and three more are in intensive
care in a Darwin hospital after contracting a killer
tropical disease, prompting Northern Territory health
authorities to issue a warning to tourists and locals.
There have been 11 diagnosed cases of melioidosis this
wet season, one being a visitor who became ill after
returning home.
Melioidosis is caused by bacteria found in surface
water and mud after heavy rain; the bacteria can become
airborne, but usually enter the body through small cuts
in the skin. The incubation period for acute disease can
range from one to 21 days. Symptoms include fever,
shortness of breath, headache, confusion, boils, chest
and abdominal pain, weight loss and skin ulcers.
...
www.thetraveldoctor.com.au
Dengue Fever
Dengue Fever is the most common mosquito spread
infection amongst travellers. It can be complicated by a
tendency to easy bleeding, which requires urgent medical
attention and can be fatal. There are no tablets or
vaccines for prevention against dengue. Avoid being
bitten by mosquitoes, by using protective clothing,
repellents, permethrin-impregnated nets, room sprays
and/or mozzie coils.
In 2008, outbreaks of dengue have been reported in:
- The British Virgin Isles
- Peru: Including three cases in Lima city
- Venezuela: 221 cases in Margarita Island in
January
- Brazil: 2150 registered cases and 3 deaths in
Rio de Janeiro this year
- Australia: Two people living near Port Douglas
in Queensland (north-eastern Australia), have
contracted dengue. The most recent previous outbreak
was in 1997-1999, which saw 498 people infected.
Authorities are reminding residents to eradicate
potential mosquito breeding sites around their homes
and use mozzie repellents.
... ProMED Digest V2008 #35, 75
Cholera
- Kenya: An outbreak of cholera has seen the death
of one person and hospitalization of 70 others in
Mandera District Hospital. An outbreak alert has
also been sounded in an Internally Displaced Persons
camp in Narok (southwestern Kenya) where sanitation
is poor and food, clothing and shelter are lacking.
- Tanzania: An alert has been raised regarding a
cholera outbreak which has affected 54 residents in
Arusha (north-central Tanzania), mainly in slum
areas. Authorities have asked residents to observe
the highest standards of hygiene in order curb the
spread of disease.
- Angola: In Kwanza Sul province, the Red Cross of
Angola have been running an intensive awareness
campaign against cholera, educating residents about
the symptoms of the disease and the need to seek
medical attention swiftly. In January 2008, seven
cases of cholera were registered in the Arusha
province, with no fatalities.
- Vietnam: A recent cholera outbreak has occurred
in northern Viet Nam
- Nigeria: In the southern Delta State, many
children have been hospitalized following an
outbreak of cholera.
- Zambia: A suspected cholera outbreak has
occurred in Ipusukilo Township, Kitwe (northeast
Zambia), bordering the Katanga province of Congo DR.
The problem has arisen since residents began
drinking contaminated water from shallow wells,
following the closure of local water kiosks.
- Congo DR: In Katanga province, at least 76
people have died and nearly 3000 have been infected
this year in a severe and unseasonably early cholera
epidemic. The capital, Lubumbashi, and the nearby
mining city of Likasi have been worst hit. Many
neighbourhoods have poor sanitation and a lack of
clean drinking water, as the population has grown
massively following the arrival of mining companies.
- Mozambique: over 1000 cases have been diagnosed
since 11/07, mostly in the cities of Maputo and
Matola. New cases have also been reported in the
town of Xai Xai on the Limpopo river, and in the
Chokwe and Guija districts of the southern province
of Gaza. In the north, there have been 4-6 new cases
a day in the town of Pemba and the Pemba-Metuge
district.
- Malawi: 291 cholera cases and 9 fatalities were
reported in December/January in southern Malawi,
where flooding has increased the risk of contracting
the disease. Health authorities in Malawi are
teaching the importance of handwashing and boiling
water to people living in rural areas, to help
prevent the spread of disease.
- An effective oral cholera vaccine is available
from your travel health specialist, and has the
advantage of decreasing diarrhoea from the most
common bacterial infection, E. coli.
... ProMED Digest V2008 #30, 38, 67,
75
... prepared by Ros Fairless, RN,
Travel Medicine Centre Perth
The magical Kingdom of Bhutan
One of the most stunning trips I have recently made
was a trip to the magical Kingdom of Bhutan, the land of
the Thunder Dragon. With a spectacular Himalayan
backdrop, just stepping into Bhutan gave me an immediate
feeling of serenity.
It might be the lack of traffic noise, or
that the King has banned cigarettes, or the fact
the country has designated national parks and
protected biological corridors which span the
country from north to south and from east to
west, or the restriction in tourist numbers;
travelling in Bhutan gave me the wonderful mix
of the rush of adventure and overwhelming
relaxation and peace all at the same time.
|
 |
My partner Vicky and I were part of a small
group led by Payza, our ever smiling Bhutanese
guide, and by Sorrel Wilby, who had been there
many years ago when she made an epic trip
completely traversing the Himalayas from west to
east. We spent 9 days camping on a trek centred
on Bhutan's holiest Himalayan mountain, Jhomolhari, reaching passes 5000m above sea
level, and walking through beautiful Himalayan
forest in the Jigme Dorji national park, where
some of the rangers have had exchange training
with parks and conservation staff from Aussie
national parks.
|
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Not only did the thermals, the fleece, the down
jacket and the gloves come in handy, so did the
altitude pills. The majority of the first aid
and medical kit we brought along was also put to
good use, with the usual bouts of travellers' diarrhoea, coughs and colds,
blisters and sprains failing to dampen any of
our party's days. As you can see from the
pictures, some of the terrain and weather can
get pretty rough. The local farmers may only
have healthcare available once a month, and less
during winter, as the doctor has to walk for
three days to reach the community health post
which otherwise is left unmanned for the rest of
the month. At least the doctor has stupendous
scenery to enjoy during the 6 day foot commute
to and fro the clinic! |
 |
... written by Dr Stan Khoo, Medical
Director, Travel Medicine Centre Perth
|
Do you have a holiday
story to tell, especially one with a medical
event?
Send it to
info@travelmedicine.com.au,
and we will send you one of our mini TMA
torches to put on your key ring - a great
help when finding your lock at night.
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The Travel Medicine Alliance