Even experienced travelers venturing into tropical realms often do so with some apprehension about their health--and understandably so. After all, lots of bacteria, parasites and other little unseen nasties are just waiting to strike.
But travel to the tropics isn't something to be feared "as long as good health habits are carefully practiced," says Martin S. Wolfe, a Washington specialist in tropical medicine. Wolfe is editor of the most recent edition of "Health Hints for the Tropics," a helpful, 51-page guide to staying well abroad, published periodically since 1948 by the American Society of Tropical Medicine and Hygiene.
"Although many exotic diseases and other health hazards in tropical locales are not found in the United States or Europe," says Wolfe, who has lived and worked in the tropics and is a tropical medicine consultant to the State Department, "most of these illnesses are preventable by maintaining sanitation and using common sense."
On the good news front, the guide reports that a new hepatitis A vaccine, which is now licensed in Europe, should be available in the United States sometime this year. It provides longer protection than the current recommended vaccine--immune globulin (IG)--against the hepatitis A virus, which means it does not have to be administered as frequently. The virus, considered a "significant risk" in developing countries, can be acquired by consuming contaminated food, water or shellfish taken from contaminated water--all of which are sometimes hard to avoid in the developing world.
And now the bad news: Malaria-causing mosquitoes are becoming increasingly resistant to antimalarial drugs in some parts of the world, the guide says, "and no present-day antimalarial drug regimen guarantees protection against malaria." To avoid malaria, travelers are advised to pay much greater attention now to avoiding mosquito bites. This means using an insect repellent containing DEET (35% concentration) on exposed skin, wearing clothes that cover most of the body and spraying an insecticide on clothing, using a mosquito net at night and spraying a flying-insect insecticide in your room.
Among other recommendations in "Health Hints":
* Cholera: For most travelers, cholera immunizations are no longer recommended. The only vaccine currently available is not considered very effective, says the guide, and the injection can cause a fever and headache. Instead, if you are going to an area of active cholera outbreaks, such as South America, your best protection is to be cautious in what you eat and drink. Improved oral vaccines may be available soon.
* Diarrhea: An estimated 20%-30% of travelers to the developing world suffer a bout of diarrhea. The most common sources are contaminated food, water and beverages. Many people get tripped up on what the guide calls "oversights": brushing your teeth with contaminated water, ordering a drink with contaminated ice, sipping a diluted fruit juice, or eating cold foods that are much more likely than hot substances to be contaminated by the hands of infected food handlers.
To spare your stomach, make it a practice to consume only hot cooked food, fruits that can be peeled, carbonated beverages (they inhibit the growth of bacteria), and coffee, tea, beer and wine. Boiling water for five minutes kills all dangerous organisms, including hepatitis viruses. You can carry iodine water purification tablets or small, portable water filters with an iodine component.
But be aware, says the guide, that many available water filters "cannot be considered reliable for removing all infectious agents." Also, make a point of washing your hands frequently--especially before eating.
Pepto-Bismol tablets, taken as a preventative, have been found safe and effective in warding off diarrhea for many people. Generally, tropical medical authorities don't recommend taking antibiotics as a preventative, unless you have other medical problems that could be worsened by diarrhea.
* Typhoid Fever: Since 1989, an oral typhoid vaccine has been available in the United States for travelers age 6 and older. A version of it is in development for younger children. Previously, prevention of typhoid, a bacterial infection caused by contaminated water and food, required a series of injections.
* Sleeping Sickness: In tropical Africa, sleeping sickness is "a potential hazard," warns the guide, particularly in the game parks of East Africa. But infection has been rare in American travelers. The disease is spread by the large tsetse fly, and the best protection is to wear long-sleeved shirts and pants to avoid bites.
For a copy of "Health Hints for the Tropics," send a check for $5 to the American Society of Tropical Medicine and Hygiene, 60 Revere Drive, Suite 500, Northbrook, Ill. 60062. For a directory of U.S. and Canadian physicians who specialize in traveler and tropical medicine, send a stamped ($1), self-addressed envelope (9 by 11 inches) to Dr. Leonard C. Marcus, 148 Highland Ave., Newton, Mass. 02165.
\o7 Christopher Reynolds is on assignment.\f7