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This diarrhoeal disease can cause rapid dehydration and death. It occurs in many parts of the Philippines, though outbreaks are generally widely reported, so you can avoid such problem areas. Cholera is caused by a bacteria, Vibrio cholerae . It's transmitted from person to person by direct contact (often via healthy carriers of the disease) or via contaminated food and water. It can be spread by seafood, including crustaceans and shellfish, which get infected via sewage.
Cholera exists where standards of environmental and personal hygiene are low. Every so often there are massive epidemics, usually due to contaminated water in conditions where there is a breakdown of the normal infrastructure.
The time between becoming infected and symptoms appearing is usually short, between one and five days. The diarrhoea starts suddenly, and pours out of you. It's characteristically described as 'ricewater' diarrhoea because it is watery and flecked with white mucus. Vomiting and muscle cramps are usual, but fever is rare. In its most serious form, it causes a massive outpouring of fluid (up to 20L a day). This is the worst case scenario - only about one in 10 sufferers get this severe form.
It's a self-limiting illness, meaning that if you don't succumb to dehydration, it will end in about a week without any treatment.
You should seek medical help urgently; in the meantime, start re-hydration therapy with oral re-hydration salts. You may need antibiotic treatment with tetracycline, but fluid replacement is the single most important treatment strategy in cholera.
Prevention is by taking basic food and water precautions, avoiding seafood and having scrupulous personal hygiene. The currently available vaccine is not thought worthwhile as it provides only limited protection for a short time.
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.
There are 6 known types of viral hepatitis:A, B, C, D, E and G. G is not dangerous. A and E are passed on by the fecal-oral route of transmission; there is a vaccine. Seek medical advice, but there is not much you can do apart from resting, drinking lots of fluids, eating lightly and avoiding fatty foods. A and E cause an acute illness, but you will recover fully from it.
B and D are passed on via blood, saliva, semen and vaginal fluids. They can be passed on by close contact, sexual contact, and blood-to-blood contact. 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. There is a vaccine.
Hepatitis C is only passed on from blood-to-blood contact. There is no vaccine.
This fatal viral infection is found throughout the Philippines. Many animals (such as dogs, cats, bats and monkeys) can be infected and it is their saliva which is infectious. Any bite, scratch or even lick from an animal should be cleaned immediately and thoroughly. Scrub with soap and running water, and then apply alcohol or iodine solution. Medical help should be sought promptly to receive a course of injections to prevent the onset of symptoms and death.
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.
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.
These parasites are most common in rural, tropical areas. The different worms have different ways of infecting people. Some may be ingested on food such as undercooked meat (eg, tapeworms) and some enter through your skin (eg, hookworms). Ascaris worm is common in East Africa.
Infestations may not show up for some time, and although they are generally not serious, if left untreated some can cause severe health problems later. Consider having a stool test when you return home to check for worm infestation and determine the appropriate treatment.
Unlike the malaria mosquito, the Aedes aegypti mosquito, which transmits the dengue virus, is most active during the day, and is found mainly in urban areas, in and around human dwellings.
Signs and symptoms of dengue fever include a sudden onset of high fever, headache, joint and muscle pains, nausea and vomiting. A rash of small red spots sometimes appears three to four days after the onset of fever. Severe complications do sometimes occur.
You should seek medical attention as soon as possible if you think you may be infected. A blood test can indicate the possibility of the fever. There is no specific treatment. Aspirin should be avoided, as it increases the risk of haemorrhaging. There is no vaccine against dengue fever.
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.
