Sunday, October 12, 2014

Travel medicine

Prof. Steve Berger's specialty is unusual. He is Associate Professor of  Medicine at Tel Aviv University and Director of Geographic Medicine at Ichilov Hospital in Tel Aviv.  He spoke at Netanya AACI about his sometimes hair-raising experiences in his chosen specialty.
He showed a one foot long parasite removed from an Israeli woman's nose after she spent some time in Romania visiting relatives on a farm.  She had six other parasites in her stomach.  She caught these from eating vegetables that had not been properly washed.  In most countries the water used for growing and often washing vegetables and fruit is contaminated with all sorts of diseases.  The most common form of traveler's sickness is of course diarrhoea, that can be very dangerous and even fatal for children.  One couple who were very careful about not drinking the water caught diarrhoea from the ice used in their drinks at a bar.
The commonest group of diseases however, are infectious diseases, such as malaria, caught from mosquito bites.  In fact, there are at least 5 kinds of malaria spread by different types of mosquitoes, which also transmit 50 other diseases.  Israel has mosquitoes, but has eradicated malaria completely.  However, another mosquito-borne disease is West Nile Fever, but it is also prevalent in the USA and elsewhere. The easiest protection is an anti-mosquito repellent that really reduces the incidence of insect  bites and should be used in all mosquito-infected countries.  Other forms of infection come from fly bites, such as African sleeping sickness from the tsetse fly and Lyme disease  from ticks, often transferred from animals.  It is best to wear long trousers and sleeves in tropical countries and not to pet any animal, domestic or wild.  But, often these so-called "tropical" diseases, are in fact common in sub-tropical countries; for example, mosquito bites and exotic viruses are common in Sweden, and Lyme disease that comes from a tick is common on the East coast of the USA (it's named for  Lyme, Conn).
There are very few diseases in Israel which could be acquired by tourists in Israel, and several more which are contracted by Israelis living abroad.  By contrast there are dozens of exotic diseases in the USA, which are not found in Israel and could be acquired by foreigners and tourists.  The most recent well-publicized example of a travel-related disease is Ebola.  Although the patient who was infected and brought this into the US has since died (in isolation) he may have contacted hundreds of others, and this virus is extremely transmissible.  The USA may be forced to start checking every visitor and isolating any who show symptoms (fever, vomiting).  The best defense against an illness like that is not to go anywhere near West Africa.  Other examples are dengue fever and yellow fever, so it is important to get the appropriate advice and shots when going to a tropical country.


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