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To prevent diarrhoea, avoid tap water unless it has been boiled, filtered, or chemically disinfected (e.g. with iodine tablets); only eat fresh fruits and vegetables if cooked or peeled; be wary of dairy products that might contain unpasteurised milk, and be highly selective when eating food from street vendors. If you develop diarrhoea, be sure to drink plenty of fluids, preferably an oral re-hydration solution containing lots of salt and sugar. A few loose stools don't require treatment but, if you start experiencing more than four or five stools a day, you should start taking an antibiotic (usually a quinolone drug) and an antidiarrhoeal agent (such as loperamide). If diarrhoea is bloody, or persists for more than 72 hours, or is accompanied by fever, shaking chills or severe abdominal pain you should seek medical attention.
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 (38C 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.
Vaccination is recommended for travellers spending longer than a week in Korea adn travelling outside of Seoul.
This parasitic disease is transmitted by mosquitoes. There's no vaccine available against lymphatic filariasis. Filariasis is caused by blockage of the lymph channels by long thread-like worms (filaria) which are transmitted by the bite of several varieties of mosquito. There may be no symptoms at all with light infections, or you may get fever, painful swellings of the lymph glands (eg in your armpits, groin or elbows) and, for male travellers, swelling of the testes with scrotal pain and tenderness. Note that symptoms usually develop about six months after infection. If the infection is not treated, you can get permanent damage to the lymph system, leading to swelling of the arms, legs, breasts or scrotum, with associated thickening and wrinkling of the skin that's supposed to resemble elephant skin, hence the name 'elephantiasis'. If you think you may have filariasis, seek medical advice as soon as possible for appropriate treatment. Infection can be diagnosed with a blood test.
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.
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, and impregnating clothes with permethrin effectively deters mosquitoes and other insects.
