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Don't paddle in the Nile!
Also known as bilharzia, this disease is carried in freshwater by tiny worms that enter through the skin and attach themselves to the intestines or bladder. The first symptom may be tingling and sometimes a light rash around the area where the worm entered. Weeks later, a high fever may develop. A general unwell feeling may be the first symptom, or there may be no symptoms. Once the disease is established, abdominal pain and blood in the urine are other signs. The infection often causes no symptoms until the disease is well established (several months to years after exposure), and damage to internal organs is irreversible. Avoid swimming or bathing in freshwater where bilharzia is present. Even deep water can be infected. If you do get wet, dry off quickly and dry your clothes as well. A blood test is the most reliable test, but it will not show positive until a number of weeks after exposure.
This serious and potentially fatal disease is spread by mosquito bites. If you are travelling in endemic areas it is extremely important to avoid mosquito bites and to take tablets to prevent this disease. Symptoms range from fever, chills and sweating, headache, diarrhoea and abdominal pains to a vague feeling of ill-health. Seek medical help immediately if malaria is suspected. Without treatment malaria can rapidly become more serious and can be fatal.
If medical care is not available, malaria tablets can be used for treatment. You should seek medical advice, before you travel, on the right medication and dosage for you.
If you do contract malaria, be sure to be re-tested for malaria once you return home as you can harbour malaria parasites in your body even if you are symptom free.
Travellers are advised to prevent mosquito bites at all times. The main messages are: wear light-coloured clothing; wear long trousers and long-sleeved shirts; use mosquito repellents containing the compound DEET on exposed areas (prolonged overuse of DEET may be harmful, especially to children, but its use is considered preferable to being bitten by disease-transmitting mosquitoes); avoid perfumes and aftershave.Use a mosquito net impregnated with mosquito repellent (permethrin) - it may be worth taking your own.
A yellow fever vaccination certificate is required from travellers over 1 year of age coming from infected areas. The vaccine against yellow fever is effective. Yellow fever is transmitted through the bite of an infected mosquito. Symptoms of yellow fever range from a mild fever which resolves over a few days to more serious forms with fever, headache, muscle pains, abdominal pain and vomiting. This can progress to bleeding, shock and liver and kidney failure. The liver failure causes jaundice, or yellowing of your skin and the whites of your eyes - hence the name. There's no specific treatment but you should seek medical help urgently if you think you have yellow fever.
