Travellers need strong vigilance against malaria and typhoid fever
17th January 2013
In recent years more and more Brits have become fed up of the freezing cold temperatures over the winter season and many even decide to jet off to sunnier climates and areas such as the Tropics, where necessities to stave off the cold such as electric blankets, hot water bottles and a piping hot brew are simply not required! Upon arriving back in the UK though, what would you do if you begin to feel unwell after a week or two of being back? In these instances, symptoms such as muscular aches/pains, diarrhoea, vomiting and a high temperature are commonly (and usually incorrectly) blamed on simple problems such as seasonal flu or food poisoning from out-of-date food or a dodgy takeaway meal. In fact, some of these symptoms are not too dis-similar to those suffered by over a million Brits recently with the norovirus epidemic which is still rife in many areas. However, if you are feeling slightly under the weather after a visit to tropical regions such as West Africa, Southeast Asia, India, the Caribbean, etc., then it could be a cause for concern and something more serious than just a seasonal flu or food poisoning. The findings of one particular study, published online yesterday in the American Journal of Tropical Medicine and Hygiene, have suggested that travel illnesses such as malaria and typhoid ought to be discussed with your GP following a visit to a tropical climate. In addition though, Medical Specialists Pharmacy strongly advise that these and many other travel illnesses such as traveller’s diarrhoea and dengue also be discussed, before travelling to your destination where there may be a high risk of such diseases.  To prevent contracting malaria, there are numerous antimalarial medications available from Medical Specialists for anybody visiting a country of risk. These include Doxycycline, Paludrine and Malarone – with the latter also able to treat the disease if you should get it. University of Oslo researcher Mogens Jensenius, MD, PhD, and his team looked at the GeoSentinel surveillance network database to attain an incredible 15 years worth of information; this comprising of data contained on 82,825 returning travellers from Europe, North America, Israel, Japan, Australia and New Zealand. All had requested treatment for different health problems from June 1996 through to August 2011. It was ascertained that 4.4% (3,655) of these people had contracted either malaria, typhoid fever, or another type of deadly tropical disease. In total, 13 deaths were documented from the 3,655 patients and 10 of these were due to malaria. Malaria was actually the most prevalent of the tropical diseases, seen in 76.9% of the diagnoses. The disease is caused by the Plasmodium parasite. The parasite is passed on to humans through the bites of infected female mosquitoes. Symptoms include muscular pain, headaches, diarrhoea, vomiting, severe sweats and chills and a fever of 38C (100.4F) or more.   The second most common tropical disease was typhoid fever. Caused by the Salmonella typhi bacterium, it is an infection that may spread through the body after the person consumes food or water that has been contaminated with a small amount of infected faeces or urine. Symptoms include stomach pain and rashes in the first week of illness. During the second week, the sufferer will likely experience a worsening of symptoms that can include abdominal pain, weight loss and a fever that increases in temperature to about 39–40C (103–104F). Both conditions are fatal without a prompt diagnosis and treatment; however those who contract malaria are more likely to die than those who contract typhoid fever, which can be treated in merely a few days with antibiotics. Surprisingly, not one of the 80,000 had caught the often-fatal Ebola virus – one of the top-feared diseases in travellers due to its 90% fatality rate. ‘Ebola haemorrhagic fever’ as it is also known, occurs mainly via outbreaks within remote villages in Central and West Africa that are close to tropical rainforests. Researcher Mogens Jensenius commented on the findings in the study, stressing just how serious the issue of tropical diseases is. He said: “While diagnosis and treatment of malaria and typhoid fever and many other tropical diseases have improved greatly over the years, people still can die from them if they are not treated quickly after their symptoms begin. Doctors and nurses in Western countries need to be vigilant in considering these potentially life-threatening tropical infections in recently-returned travellers with fevers, and identify and treat them quickly.”