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Less Common Diseases
The following diseases pose a small risk to travellers, and so are only mentioned in passing. Seek advice if you think you may have any of these diseases.
Cholera
This is the worst watery diarrhoea and medical help should be sought. Cholera outbreaks are generally widely reported, so you can avoid problem areas. Fluid replacement is the most vital treatment - the risk of dehydration is severe as you may lose up to 20L a day. If there is a delay in getting to hospital then begin taking tetracycline. The adult dose is 250mg four times daily. It is mot recommended for children under nine years nor for pregnant women. Tetracycline may help shorten the illness, but adequate fluid intake is required to save lives.
Filariasis
This is a mosquito-transmitted parasitic infection found in India and other parts of Asia. Possible symptoms include fever, pain and swelling of the lymph glands; inflammation of lymph drainage areas; swelling of a limb or the scrotum skin rashes and blindness. Treatment is available to eliminate the parasites from the body, but some of the damage already caused may not be reversible. Medical advice should be obtained promptly if the infection is suspected.
Leishmaniasis
This is a group of parasitic diseases transmitted by the bite of sandflies which are found in India and other parts of the world. Cutaneous leishmaniasis affects the skin tissue causing ulceration and disfigurement and visceral leishmaniasis affects the internal organs. Seek medical advice as laboratory testing is required for diagnosis and correct treatment. Avoiding sandfly bites is the best precaution. Bites are usually painless, itchy and are yet another reason to cover up and apply repellent.
Lyme Disease
This is a tick-transmitted infection which may be acquired in India. The illness usually begins with a spreading rash at the site of the tick bite and is accompanied by fever, headache, extreme fatigue, aching joints and muscle and mild neck stiffness. If untreated, these symptoms usually resolve over several weeks but over subsequent weeks or months disorders of the nervous system, heart and joints may develop. Treatment works best early in the illness. Medical help should be sought.
Rabies
This fatal viral infection is found in many countries, including India. Many animals can be infected (e.g. dogs, cats, bats and monkeys) 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.
Tetanus
This disease is caused by a germ which lives in soil and the faeces of horses and other animals. It enters the body via breaks in skin. The first symptom may be discomfort in swallowing, or stiffening of the jaw and neck; this is followed by painful convulsions of the jaw and whole body. The disease can be fatal. It can be prevented by vaccination.
Tuberculosis (TB)
TB is a bacterial infection transmitted from person to person by coughing but which may be transmitted through consumption of unpasteurised milk. Milk that has been boiled is safe to drink, and the souring of milk to make yoghurt or cheese also kills the bacilli. Travellers are usually not at great risk as close household contact with the infected person is usually required before the disease is passed on.
You may need to have TB test before you travel as this can help diagnose the disease later if you become ill.
Typhus
This disease is spread by ticks, mites or lice. It begin with fever, chills, headache and muscle pains followed a few days later by body rash. There is often a large painful sore at the site of the bite and nearby lymph nodes are swollen and painful. Typhus can be treated under medical supervision. Seek local advice on areas where ticks pose a danger and always check your skin carefully for them after walking in a danger area such as a tropical forest. An insect repellent can help, and walkers in tick infested areas should consider having their boots and trousers with benzyl benzoate and dibutylphtalate.
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