Africa
Asia
Caribbean
Central America
Europe
Middle East
North America
Pacific
South America
Vaccination against this serious bacterial disease is very effective, so you don't need to worry if you've been properly immunised against it. It mainly affects children and causes a cold-like illness that is associated with a severe sore throat. A thick white membrane forms at the back of the throat which can suffocate you, but what makes this a really nasty disease is that the diphtheria bug produces a very powerful poison which can cause paralysis and affect the heart. Otherwise healthy people can carry the bug in their throats, and it's transmitted by sneezing and coughing. It can also cause a skin ulcer known as a veldt sore. Vaccination protects against this form too. Treatment is with penicillin and a diphtheria antitoxin, if necessary.
Also known as enteric fever, Typhoid is transmitted via food and water, and symptomless carriers, especially when they're working as food handlers, are an important source of infection. Typhoid is caused by a type of salmonella bacteria, Salmonella typhi. Paratyphoid is a similar but milder disease. The symptoms are variable, but you almost always get a fever and headache to start with, which initially feels very similar to flu, with aches and pains, loss of appetite and general malaise. Typhoid may be confused with malaria. The fever gradually rises during a week.
Characteristically your pulse is relatively slow for someone with a fever. Other symptoms you may have are constipation or diarrhoea and stomach pains.
You may feel worse in the second week, with a constant fever and sometimes a red skin rash. Other symptoms you may have are severe headache, sore throat and jaundice. Serious complications occur in about one in 10 cases, including, most commonly, damage to the gut wall with subsequent leakage of the gut contents into the abdominal cavity.
Seek medical help for any fever (38°C and higher) that does not improve after 48 hours. Typhoid is a serious disease and is not something you should consider self-treating. Re-hydration therapy is important if diarrhoea has been a feature of the illness, but antibiotics are the mainstay of treatment.
Several different viruses cause hepatitis; they differ in the way that they are transmitted. The symptoms in all forms of the illness include fever, chills, headache, fatigue, feelings of weakness and aches and pains, followed by loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-coloured faeces, jaundiced (yellow) skin and yellowing of the whites of the eyes. Hepatitis A is transmitted by contaminated food and drinking water. Seek medical advice, but there is not much you can do apart from resting, drinking lots of fluids, eating lightly and avoiding fatty foods. Hepatitis E is transmitted in the same way as hepatitis A; it can be particularly serious in pregnant women.
Hepatitis B is spread through contact with infected blood, blood products or body fluids, for example through sexual contact, unsterilised needles (and shaving equipment) and blood transfusions, or contact with blood via small breaks in the skin. The symptoms of hepatitis B may be more severe than type A and the disease can lead to long-term problems such as chronic liver damage, liver cancer or a long-term carrier state. Hepatitis C and D are spread in the same way as hepatitis B and can also lead to long-term complications.
There are vaccines against hepatitis A and B, but there are currently no vaccines against the other types. Following the basic rules about food and water (hepatitis A and E) and avoiding risk situations (hepatitis B, C and D) are important preventative measures.
A yellow fever vaccination certificate is required from travellers over 1 year of age coming from infected areas.
