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Health
& Safety - Vaccinations:
There's nothing like updating vaccinations to make you
feel like a human pin cushion. I remember one such visit several
years ago when, after several shots, the nurse turned to me
and said "Well, I think we've more or less filled
this arm up. Perhaps it's better we continue on the other
arm.' Fortunately, our visit to the George Washington
University Travel Clinic was a fairly painless affair as most
of our vaccinations are still up-to-date from previous travels.
Even still, we didn't leave totally unscathed. Here’s
a brief summary of the immunizations and medications we have
for the expedition. All descriptions are provided by
masta.org.
Hepatitis A: This is a viral disease which
affects the liver. Symptoms include fever, chills, weakness,
loss of appetite, nausea and abdominal discomfort, followed
within a few days by jaundice (yellowing of the skin and the
whites of the eyes). The urine may become dark and the stools
pale. Many infections, particularly in children, are mild.
Occasionally, jaundice may be severe and liver failure may
occur. In adults, up to 2% of cases are fatal. In general,
severity of the disease increases with age. Past infection
with hepatitis A gives life-long immunity. The disease is commonly
associated with eating and drinking contaminated food and water.
Outbreaks are often linked to raw or undercooked shellfish
and raw vegetables. The disease occurs worldwide, but is more
common in developing countries with poor sanitation and overcrowding.
Hepatitis
B: This is a viral infection affecting the liver. Symptoms
include loss of appetite, nausea,
abdominal pain and sometimes a rash, joint pain and jaundice.
The urine may become dark and the stools pale. Children under
1 year of age usually have no symptoms but virtually all such
children become carriers of the disease for life. About 5%
of adult sufferers will go on to become carriers. Hepatitis
B carriers can infect other people and are at risk of death
from liver disease/cancers years after the initial infection.
Hepatitis B is transmitted through exposure to infected blood
and body fluids. It may be acquired from infected blood transfusions,
contact with unsterilized medical equipment and by unprotected
sexual intercourse.
Meningitis (Meningococcal
Serogroups A, C, Y, W-135): This is a bacterial infection affecting the tissues
lining the brain and spinal cord. Symptoms include fever, intense
headache, nausea, stiff neck, inability to tolerate bright
light and fine blotchy rash. If not treated early, the disease
may be fatal within hours. Cases occur worldwide. An area of
particularly high incidence, especially during the dry season,
exists in the sub-Saharan region of Africa known as the “meningitis
belt”. Meningococcal meningitis can occur in epidemics,
especially where large crowds gather. The bacteria are transmitted
by droplets or direct contact with carriers or infected persons.
Carriers are those who have the bacteria present in their nose
and throat but do not become infected with the disease themselves.
Polio
(Oral): Polio is a viral infection. The World Health
Organization has initiated a global polio eradication program
but some countries are still reporting new cases (e.g. India,
Nigeria, Pakistan and Afghanistan). The initial symptoms are
fever, headache and vomiting as the virus multiplies in the
gut. The virus then invades the blood and nervous system. Paralysis
occurs in less than 1 in 100 cases of infection, this risk
increases with age. The virus is spread from person to person
through either mucous from the nose and throat or by contamination
of food/drink with infected feces.
Rabies: Rabies is a viral
disease primarily affecting animals but humans can also be
infected. The virus travels from the site of entry (the bite
or scratch) via the nerves to the brain and spinal cord and
eventually spreads to the salivary glands. Symptoms start with
itching and tingling at the site of the healed bite and then
rapidly progresses to include headache, fever, spreading paralysis,
confusion and aggression and hydrophobia (fear of water). It
may take many weeks or months for symptoms to develop although
it is usually 2-8 weeks (but can in rare circumstances be a
short as 4 days). Unfortunately, once symptoms have developed,
rabies is fatal.
Rabies can be transmitted in a number of ways
to humans. Dog bites are by far the most common source of infection.
A scratch to the skin, a lick on a fresh skin break or contact
of the infected saliva with intact mucous membranes may also
transmit rabies. Cats, bats, foxes, skunks, raccoons, monkeys
and many other animals can also be infected with this virus.
Animals may be infectious for five days before they develop
symptoms.
Tetanus: Tetanus is caused by a bacteria which releases
a powerful toxin into the body. Symptoms include jaw stiffness
(lock-jaw), and difficulty swallowing. The toxin also causes
severe and very painful muscle spasms. These spasms may interfere
with breathing and lead to death. Tetanus spores are present
worldwide in soil and may be introduced into the body during
injury through a puncture wound, burn or trivial, unnoticed
wounds. Travelers are often more vulnerable to injury and may
find local medical facilities inadequate.
Typhoid Fever (Oral): Typhoid is caused by a bacterium (Salmonella
typhi). The Illness is usually characterized by fever, loss
of appetite, lethargy and a change in bowel habits. Constipation
is common but diarrhea can also occur. Without treatment, typhoid
can be fatal, with perforation of the gut producing peritonitis
or severe bleeding. Paratyphoid fever is similar but tends
to be less severe. Transmission is by ingesting food and water
contaminated by the typhoid bacterium. Outbreaks have occurred
when water supplies have been contaminated by raw sewage. Raw
or undercooked shellfish pose a particular risk.
Yellow Fever: Yellow fever is a viral infection, transmitted
by the bite of an infected mosquito,
that may cause a flu-like illness with symptoms including fever,
chills, headaches and muscular pain. In the more severe form
of the disease, the virus can affect the liver causing jaundice
and bleeding. The death rate can be over 50% in Western travelers.
Yellow fever is principally a disease of jungle areas but there
are occasional outbreaks in towns and cities. It occurs in
Africa, the Americas and some Caribbean Islands. |
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