Stealth Health: The Latest in Smart Microbe Management

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Outside Magazine March 2004

Stealth Health
The Latest in Smart Microbe Management

You're yearning to see foreign vistas and exotic wildlife. But some exotic (and invisible) wildlife is yearning to see you in the worst way. The best defense against the diseases of travel are, as always, knowledge and prevention. First, consult the up-to-date warnings posted on the Centers for Disease Control and Prevention (www.cdc.gov/travel) and World Health Organization (www.who.int) Web sites. And peruse our quick-and-dirty lowdown on the most prevalent bugs and how to safeguard against them.

Malaria
Each year, 300 to 500 million people contract this mosquito-borne protozoan disease, and about one million die. In recent years, strains of the disease have developed a resistance to the prescription drug chloroquine and, in some pockets, resistance to other prophylactics.
Hot spots: West Indies, Southeast Asia, South America, and Africa
Symptoms: Cold flashes, hot flashes, jaundice, and anemia
Prevention: If you're heading into chloroquine-resistant areas, ask for quinine, Malarone, or Mefloquine—but beware the psychological effects of the latter, which can include scary hallucinations.

West Nile Virus
This mosquito-borne virus, most prevalent in the summer and fall, hit the United States for the first time in 1999. In 2003 it infected at least 8,912 people, killing 211.
Hot spots: The U.S., Africa, and the Middle East
Symptoms: Flu-like symptoms that, in severe cases, lead to inflammation of the brain or viral meningitis.
Prevention: Like it or not, there is no vaccination—slather on the deet.

Hepatitis A
Hepatitis A is contracted through contact with the stool of an infected person, so when you're traveling in areas with questionable sanitation, religiously follow the "Boil it, cook it, peel it, or forget it" rule. Also, drink only bottled water, and wash your hands often.
Hot spots: Central and South America, Eastern Europe, and the United States
Symptoms: Malaise, weight loss, jaundice, dark urine
Prevention: There is a vaccination, but it's best to get a combined vaccination for hepatitis A and B as well as typhoid.

Dengue Fever
This mosquito-transmitted virus is like catching a nasty case of the flu.
Hot spots: 50 to 100 million cases of dengue occur each year in Central and South America, Central Africa, India, Southeast Asia, Oceania, and even parts of the U.S.
Symptoms: A fever that causes a severe frontal headache, joint and muscle pain, and a rash—and lasts seven to ten days.
Prevention: A vaccine is under development, but until then, stay mosquito-proof.

Yellow Fever
Another mosquito-borne virus, yellow fever has been a scourge on South America and sub-Saharan Africa for decades. It can range in severity from a flu-like syndrome to severe hepatitis.
Hot spots: The Panama-Colombia border region and Central and West Africa
Symptoms: Headache, fever, jaundice
Prevention: A live vaccine provides protection for up to ten years and is almost 100 percent effective.

SARS (Severe Acute Respiratory Syndrome)
In 2003, there were 8,098 confirmed cases of this virus worldwide, and China has already confirmed new cases this year.
Hot spots: China, Hong Kong, and Southeast Asia
Symptoms: Chills, headache, and fever, which can develop into a severe respiratory illness like pneumonia.
Prevention: The only way to avoid SARS is to avoid exposure—keep your eye on the news and the above-mentioned Web sites.

Ebola
Ebola is the T. rex of infectious diseases, an unstoppable hemorrhagic fever that kills 55 to 95 percent of those infected.
Hot spot: Central Africa
Symptoms: Bleeding, chest pain
Prevention: Stay out of Ebola's path. Check WHO's outbreak reports before setting out to to reenact Livingstone's African epic.

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