Travel health

What is Giardia ?

grey What is Giardia ?What is Giardia ? Due to its potential for severe, long lasting effects Giardiasis (diarrhoea caused by Giardia) is like a small atomic bomb detonating in your gut. When you say “Giardia” to long term travellers they tremble more than those hyenas in The Lion King after hearing “Mufasa”.

Giardia is a bacterium which can cause symptoms ranging from the relatively mild (similar to travellers diarrhoea) to severe and disabling. It is a sneaky little bugger with a hard shell that allows it to survive long periods outside a host. This shell makes it tolerant to chlorine disinfection. Giardia is found in soil, food or water that has been contaminated by infected people or animals. Risk of infection is managed in the same way as regular travellers diarrhoea

Because it can cause symptoms similar to travelers diarrhoea Giardia can often go undetected, however it is usually more severe. On top of diarrhoea, vomiting, dehydration and the like, distinguishing features include:

  • Foul smelling gas (really, really bad, you’ll know)
  • Greasy floating stools
  • Severe cramping.

 

If left untreated Giardiasis can lead to intestinal damage, recurring flareups and possible malabsorbtion disorders, so if you suspect you have Giardiasis it is important that proper treatment is started quickly.

The most commonly prescribed antibiotic for Giardia is Metronidazole 200mg to 400mg three times daily for a week. A single dose of 2 grams of Tinidazole (related to Metronidazole) is becoming more popular as it kills the bug in 80% of people and is far easier to remember when on the go. Both of these are drugs that you simply cannot take with alcohol. It is important to not have a drink for at least three days after finishing a course of either medicine to allow the drug to get out of your system. Whaat, “no grog” I hear you scream! Yes, these drugs can cause a severe reaction with alcohol that you really do not want that on top of  your illness.

For more information check out this link:

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Travel Immunizations

Travel Immunizations work in a process whereby a person’s immune system is trained to respond to a particular agent. There is currently some exciting research being done to immunize people against things like cancer, obesity and nicotine addiction but here I will only speak about immunization in the context of travel.

NERDY CONTENT ALERT! The most common way to immunize against disease causing agents (bacterial or viral) is by a process called active vaccination. In active vaccination the immune system is trained to respond to a pathogen by introducing a safe form of that very pathogen to the immune system. Say ‘XYZ’ is a disease that makes you sick and assume ‘Z’ is the part that makes you sick. Chopping off the dangerous ‘Z’ and introducing ‘XY’ (the vaccine) to your immune system forces your system to recognise the disease causing ‘XYZ’ and prepare for an attack…make sense, sort of? Anyway enough of this nerdy stuff – Do you need vaccinations?

Whether or not you need travel immunization depends on where you will be traveling and personal preference. Not every country is going to demand that you have shots before you travel there – your concern will be more whether you want immunization cover. I would always recommend having whatever vaccines are suggested by WHO (The World Health Organisation) but ultimately it is your call.

 Make an informed choice:

Great interactive world map for Vaccines                

List of all vaccines

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Traveler’s Diarrhea

The dreaded lurgy, gastro, bali belly, dehli belly…traveler’s diarrhea is one of the most common ailments to strike a traveler. It is so common that many travellers consider that one has not truly experienced travel until they have spent a day or two hunched over a squat toilet somewhere in remote South East Asia. It certainly can change the dynamics of a travel partnership.

What causes Traveler’s Diarrhea? – There are two main causes of travelers diarrhoea (TD), viruses and bacterium. Viruses need a host (you) to live and reproduce in whereas Bacterium are single celled organisms that can live and reproduce on their own.

Rotavirus is the most common cause of viral gastro in kids as their immune systems have not yet developed a response to it. However, when you go abroad you may come in to contact with an unfamiliar virus that can cause symptoms.

Now the bacterium’s story. Our intestinal systems have a huge amount of bacteria living in perfect harmony with our body. They are so important to various bodily functions that many health professions refer to them as the forgotten organ. Our gut bacteria do such helpful things as the fermentation of energy providing substrates, training the immune system and production of vitamins K and Biotin. Having a healthy family of bacteria in your gut also helps to prevent the growth of harmful bacteria. If you got it in your mind to dry out a poo around 60% of the weight would dead bacteria. Not that you really care about all this when hunched over holding your stomach with tears streaming down your cheek…

How is Traveler’s Diarrhea spread? Mainly by consuming contaminated food or drink, also by person-to-person contact or touching contaminated objects. It is not airborne so you cannot breathe in the bugs and get sick.

Can I avoid Traveler’s Diarrhea? – The only way to absolutely avoid travelers diarrhoea is to not travel. “Forget that!” I hear you scream. The second best bet is to develop what I call TIOCD or Travel Induced Obsessive Compulsive Disorder:

  1. Wash you hands a lot with soap and use alcohol gel religiously.
  2. NEVER get drinks with ice cubes. The bugs that can survive in ice are particularly nasty.
  3. Only drink bottled water and ensure that bottled water is not refilled by touts.
  4. If you can’t get bottled water bring water to a vigorous boil and let it boil for a few minutes.
  5. Peel your vegetables and only eat food that has been cooked at or above 70 degrees (and not left at room temperature afterwards)
  6. If you go to the salt hotel at the Salar De Uyuni don’t lick the salt brick walls (duh Ben!)
  7. Did I mention to wash your hands a lot?

There are some non-prescription products available which claim to reduce the incidence of Travellers diarrhoea, the most proven one is Travelan. Travelan is a natural product specifically designed to reduce the risk of infection by Enterotoxigenic Escherichia coli or ETEC which is the most common bacterial cause of Travellers Diarrhoea. The active ingredient in Travelan is Bovine Colostrum, a rich source of antibodies that bind ETEC in the gastrointestinal tract. Basically you take Travalan before each meal and it stops (to some degree) the ETEC from attaching to the intestinal wall, thereby neutralising the bugs’ ability to make you sick.

Travelan has undergone independent trials in both the USA and Europe. The trials reported protection rates of up to 90% against infection with ETEC and there were no reported side effects in the clinical trials. Click here if you want more detailed (much more detailed) information.

What symptoms will I get? Viral and Bacterial gastroenteritis produce symptoms so similar that they cannot be distinguished on presentation alone, common symptoms include vomiting and watery diarrhoea. Both of these lead to dehydration which can give headache, lethargy and muscle ache. Symptoms take between 1-3 days to show and can last for up to a week, “Boo.”

How do I treat Traveler’s Diarrh

 

ea? At the first sign of a brewing issue I take a Cipro bomb. This is 1500mgs of Ciprofloxacin as a single dose. This antibiotic only works against bacterium and cannot kill viruses but I think it is a good precautionary measure for the places I normally get sick (high on mountains away from medical care).

You may think I have lost the plot when I say this, but diarrhoea and vomiting are your friend. They both expel nasties from your system and will speed up recovery time.

If you can handle it, for the first two days let it run, take rehydration salts, drink heaps of safe water and eat ‘boring’ foods, no dairy, spicy or rich food eat only plain stuff like plain boiled potatos and rice.

If the diarrhoea lasts for a few days consider taking an antidiarroheal like Imodium. This class of drug only work to slow the gut’s action and do nothing for treating the cause. Again if you don’t have major stomach cramping or blood in your stools the mainstay of treatment is rehydration. If you do have disabling cramps, blood in your stool, fever or diarrhoea for longer than three or four days I would strongly advise medical attention. Further information can be found on these websites:

Safer foods whilst traveling

Treatment

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Australian government travel alerts

Sometimes Australian government travel alerts can be a bit too cautious but they do have some handy information that is updated daily. 

Before you get on that plane check these links out (by clicking on the photo)

Smart traveler alerts                      

Checklist for before you go

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