As an increasing number of destinations worldwide open their arms to international travellers, which infectious diseases could you be exposed to?

Dengue Fever

Locations: Caribbean, Central and South America, Western Pacific Islands, North Australia, South and South-East Asia, West and Sub-Saharan Africa.

This mosquito-spread virus can be found in many parts of the world and with no treatment or vaccine available yet, your only protection is to cover up and use insect repellent to keep the mosquitoes at bay. This species of mosquito, Aedes aegypti, bites throughout the day. Symptoms can take up to two weeks to develop and are flu-like, including fever, headache, nausea, vomiting and pain in the eyes, muscles and joints, and generally last for one week.

There are four different serotypes of the dengue virus, all of which are now found globally and whilst infection with one can give you immunity to that type in the future, infection with a second, third of fourth serotype can lead to more severe illness than the first exposure — such as Dengue hemorrhagic fever.

Schistosomiasis

Locations: Africa, the Middle-East, and some parts of South America, the Caribbean and South-East Asia.

Freshwater snails carry the schistosoma parasitic worm that causes this disease — also known as bilharzia. The snails release the worms’ larvae into contaminated freshwater rivers, lakes, ponds or wetlands, which then penetrate through skin, such as the soles of your feet.

According to the World Health Organization (WHO), the worm is endemic in 52 counties where water is contaminated with the feces of people infected with the worm, which contains parasitic eggs. Symptoms can take up to two months to develop and whilst some people never develop symptoms, others experience fever, chills, cough, and muscle aches within two months of infection. The extent of symptoms depends on the amount of parasite you have inside your body.

You can evade infection by avoiding swimming in freshwater and by heating water if needed for bathing. There is no vaccine available, but there is an effective and fast-acting treatment: The drug praziquantil will kill parasites within one to two days of treatment.

Malaria

Locations: Africa, Central and South America, parts of the Caribbean, Asia, and the South Pacific.

Malaria is a parasitic disease spread by the bite of the female Anopheles mosquito. Symptoms include high fevers, shaking chills and flu-like illness, and if untreated malaria can progress to severe illness and even death. The WHO estimates there were 207 million cases of malaria in 2012.

No licensed malaria vaccine exists but preventative anti-malaria drugs are available and recommended for people traveling to endemic regions. A range of options is available, from weekly to daily pills. Wearing long clothing, regular use of repellants and sleeping in air-conditioned rooms or under insecticide-treated bed nets can help avoid bites. But if despite all this you still get infected, an effective treatment is available.

Yellow Fever

Locations: Tropical regions of Africa and South America.

The Aedes aegypti mosquitoes continue to wreak their havoc with the yellow fever virus, which can cause fever, chills, headache, backache and muscle aches. About 15% of people infected develop serious illness that can lead to bleeding, shock, organ failure and sometimes death. Some people become jaundiced, which is where the “yellow” comes from. The WHO estimates there are 200,000 cases of yellow fever each year, with 90% of them occurring in Africa.

As there is no treatment, the main method of protection is from a vaccine, which travelers need to receive at least 30 days before travel to get lifelong protection against the virus. If you are a seasoned traveler you will be familiar with the need to prove your vaccination with the yellow card provided after your injection, as countries with the disease, as well as those harboring this mosquito species, aim to prevent the disease spreading or entering their population. If traveling to remote locations, it might be wise to keep that card firmly inside your passport.

Tuberculosis

Locations: Africa, Asia, Eastern Europe

A third of the world’s population is thought to be infected with tuberculosis (TB), which is the second greatest infectious cause of death globally (after HIV/AIDS). TB can occur in a “latent” state where people carry the bacteria without developing the disease itself. TB occurs in nearly every country but infections are more concentrated in developing countries, particularly in Asia, Africa and Eastern Europe.

This airborne disease is spread from person to person and infects mainly your lungs but can spread to other parts of the body.

There is a vaccination available but its protection in adults is limited. Its greatest protection is in young children yet to be exposed to the TB bacteria. Symptoms include a prolonged cough, weakness, tiredness, weight loss and night sweats. If diagnosed, TB is treatable and curable with an extensive course of antibiotics. However, drug-resistant forms of the disease have emerged globally.

Travelers’ Diarrhea
Locations: Highest risk in Indian subcontinent, North Africa and the Middle East, sub-Saharan Africa and South America.

This is a collective term for diarrhea caused by a range of bacteria, viruses or protozoa.

Transmission is generally through consuming contaminated food or water and though symptoms are usually mild, infections can ruin a vacation or business trip, causing dehydration, weakness and general inconvenience from numerous trips to the bathroom. It can be avoided by sticking to bottled water, making wise food choices and regularly washing your hands, as your immune system simply isn’t ready for those new, exotic micro-organisms.

Ebola

Ebola has now reached 5 countries in West Africa in the largest outbreak to date.

Ebola has now reached 5 countries in West Africa in the largest outbreak to date.

Location: Guinea, Liberia, Sierra Leone, Nigeria, DR Congo, (Senegal has had an isolated case).

As of March 2014 this once remote and easily contained disease has gained international recognition. To date the current outbreak of Ebola Viral Disease (EVD) has reached five countries and those traveling to affected regions are advised to be aware of the symptoms, which include fever, rash, diarrhea, vomiting and red eyes. Alongside these symptoms, internal and external bleeding are also signs of the disease, which spreads from person to person by contact with infected body fluids, such as saliva, semen or blood. Small outbreaks continue to occur in the Democratic Republic of Congo.

Ebola has no licensed vaccine or treatment and has fatality rates of up to 90% in infected people — but the virus requires very close contact with body fluids to be transmitted and is easily avoided with regular hand-washing and protective clothing — and avoiding contact with bodily fluids.

Typhoid Fever

Locations: Africa, Asia, the Caribbean and Central and South America. Highest risk in South Asia.

This bacterial disease is spread by contaminated food and water and the resulting fever can be life threatening. Symptoms begin as high fevers, weakness, stomach pains, headache, and loss of appetite. Travelers should get vaccinated before travel but as the vaccine only protects 50%-80% of recipients it’s wise to be careful about your choice of food and drink.

As with travelers’ diarrhea, stick to bottled water and avoid unpeeled fruit and vegetables, street food (as delicious as it may look) and ice in drinks. Typhoid fever can be treated with antibiotics but drug-resistant bacteria have begun to emerge so perhaps avoid that cucumber in your salad or that icy cocktail in the sunshine.

Lyme Disease

Locations: North America, Europe, Asia.

Lyme disease is mainly found in the northeastern, north central, and Pacific coastal regions of North America. It is caused by bacteria which spread through the bites of infected black leg ticks.

Symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If untreated the infection will spread to the joints, heart and nervous system. So when wandering through the wilderness be sure to protect yourself with insect repellant. But as infected ticks need to be attached for 36-48 hours or more before the Lyme disease bacterium can be transmitted, effective spotting and removal of ticks from your body will also prevent you from getting infected.

If caught early the disease is treatable with antibiotics.

Hepatitis A

Location: Most of the developing world.

The Hepatitis virus has many forms (A, B, C and D) but Hepatitis A is the one most travelers should be aware of as it spreads through contaminated water and uncooked food. The disease is closely linked to unsafe water, inadequate sanitation and poor personal hygiene and is one of the most frequent causes of foodborne infection.

There is a safe and effective vaccine available against the virus, which most travelers are advised to have, but again, wise food and drink choices are recommended to avoid the resulting liver disease and potentially severe illness. Symptoms include fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine and jaundice. WHO estimates show 1.4 million cases of Hepatitis A each year. There is no treatment for the disease other than rehydration and supportive treatment for the weeks or months of recovery time required.

New research suggests using two types of polio vaccine is more effective than using just one. The research team found administering an injection of the inactivated polio virus (IPV) alongside the oral dose of activated poliovirus vaccine (OPV) boosts patients’ immunity. It’s hoped the findings could help speed up the eradication of polio reports expat health.org

Currently, the oral vaccine is leading the battle against polio but this new research from India may change the way we fight the virus. The findings, which World Health Organisation calls “truly historic”, will potentially lead to a total eradication of the disease which is now widespread in only three countries.

Fighting polio has been one of the greatest global health success stories. As recently as 1988 there were 350,000 cases of polio in 125 countries. Once the worldwide vaccination programme was launched in 1988, the number of cases fell dramatically to just 291 in 2012. Polio is currently widespread in only three countries – Nigeria, Pakistan, and Afghanistan.

The disease is spread through contact with infected faeces and the oral vaccine is currently the preferred prevention method as it’s cheap and protects digestive tract from lower transmission of the virus. The injected vaccine works largely in the bloodstream. However, the protection offered by the oral vaccine wanes over time, so repeated doses are needed.

In this latest study, reported in Science Magazine, doctors tested the two vaccines on 1,000 children in northern India. The use of both types of vaccine lowered transmission and infection. “They both have an important role to play in the eradication programme,” said Professor Nick Grassly, co-author of the study.

The use of the IPV is more effective as a booster than multiple doses of the OPV, according to the study. However, the biggest challenge facing health workers, is not which vaccine to use, but accessing children in conflict zones.

The Korean government aims to tackle high smoking rates by doubling the cost of cigarettes.
South Korea is looking at doubling the cost of cigarettes in a bid to lower the smoking rate, reports the BBC. Under the proposed changes, the price of a packet of cigarettes would go up to 4,500 won (€3.35), the price is currently 2,500 won (€1.87).

South Korea has one of the highest male smoking rates among OECD member countries. About 41% of men smoke, according to the Organisation of Economic Cooperation and Development, this is higher than the 26% average reports expat health.org

The proposal, which would come into effect next year, is designed to lower the overall smoking rate (23%), which is also higher than the OECD average of 21%. The last increase in price was in 2004 when it went up by 500 won and the smoking rate fell 15%, reports Korean news agency Yonhap.

There have been many studies which appear to confirm a link between raising the price of cigarettes and a drop in the smoking rate. Researchers agree that a 10% increase in prices results in a 3-5% reduction in cigarette consumption.

Reports from Yonhap also said tobacco manufacturers would be required to print graphic warnings on packaging, and some types of advertising would be banned. General warnings on packaging were introduced in 1976, with graphic warnings originally introduced in 2007.

The South Korean government hopes the price increase will generate an estimated 2.8 trillion won in tax revenue. The opposition have already called it a “deceitful move” which will impact low-income earners as they smoke more than other population groups.

In April this year South Korea’s health agency launched a lawsuit against three of the largest tobacco manufacturers including the local arm of Philip Morris International, to offset the cost of treating smoking-related illness.

British military engineers and medics are being sent to Sierra Leone to help fight the world’s largest-ever outbreak of Ebola reports the BBC World News.

They will set up and run a treatment centre near the capital Freetown.

The World Health Organization says more than 2,000 people have now died in the outbreak in West Africa.

Last week, the charity Medecins Sans Frontieres called for a global military intervention in the region.

It said the global response to the outbreak had been “lethally inadequate” with countries turning their back on West Africa and merely reducing the risk of Ebola arriving on their shores.

The UK has announced it will build a centre with 50 beds for people in Sierra Leone and 12 beds for healthcare workers who become ill.

The proposed site will be surveyed this week, with the healthcare worker section of the facility scheduled to be running within eight weeks.

Yesterday, President Obama said the US military would set up isolation units and provide security for public health workers.

International Development Secretary Justine Greening said: “The scale of the problem requires the entire international community to do more to assist the affected countries which is why the UK is working with the government of Sierra Leone to build a new medical treatment facility near their capital Freetown.

“When it is up and running it will enable the UK to provide medical care for local and international health workers, as well as treatment for the wider population.”

The UK government has committed £25m to tackling the outbreak, including running trials for an Ebola vaccine.

The charity Save the Children will eventually take over management of the treatment centre.

Its chief executive, Justin Forsyth, said: “Ebola threatens thousands of people’s lives across West Africa and could set back development many decades.

“The key to combating this epidemic is backing front line health workers and underpinning a fractured health system in Sierra Leone.

“Without urgent action to assist medics, many more children and their families will suffer and die from this most appalling and tragic disease.”