lonely-planet-myanmar-burma-11-edition

384HEALTH IN MYANMARInfectiousDiseasesThe following are the mostcommon for travellers:Dengue Fever Increasinglyproblematic throughoutMyanmar. The mosquito thatcarries dengue bites day andnight, so use insect avoidancemeasures at all times.Symptoms can include highfever, severe headache, bodyache, a rash and diarrhoea.There is no specific treatment,just rest and paracetamol– do not take aspirin asit increases the likelihood ofhaemorrhaging.Hepatitis A This food- andwater-borne virus infects theliver, causing jaundice (yellowskin and eyes), nauseaand lethargy. All travellers toMyanmar should be vaccinatedagainst it.Hepatitis B The onlysexually transmitted disease(STD) that can be preventedby vaccination, hepatitis Bis spread by body fluids,including sexual contact.Hepatitis E Transmittedthrough contaminated foodand water and has similarsymptoms to hepatitis A,but is far less common. It isa severe problem in pregnantwomen and can resultin the death of both motherand baby. There is currentlyno vaccine, and prevention isby following safe eating anddrinking guidelines.HIV Unprotected heterosexualsex is the main methodof transmission.Influenza Can be verysevere in people over theage of 65 or in those withunderlying medical conditionssuch as heart diseaseor diabetes; vaccination isrecommended for theseindividuals. There is nospecific treatment, just restand paracetamol.Malaria While not notedin Yangon or Mandalay,malaria (which can be fatalif untreated) is very muchpresent throughout the restof rural Myanmar in altitudesbelow 1000m. Before youtravel, seek medical adviceon the right medication anddosage for you; note thatsome areas of the countryhave strains of the diseaseresistant to Mefloquinebaseddrugs. Wherever youare, wear long pants andsleeves and spray insect repellentto prevent bites. Alsosleep in air-con or screenedrooms with bednets.Rabies A potential risk, andinvariably fatal if untreated,rabies is spread by the biteor lick of an infected animal(most commonly a dog ormonkey). Pretravel vaccinationmeans the postbitetreatment is greatly simplified.If an animal bites you,gently wash the wound withsoap and water, and applyiodine-based antiseptic. Ifyou are not prevaccinatedyou will need to receiverabies immunoglobulin assoon as possible.Typhoid This serious bacterialinfection is spread viafood and water. Symptomsinclude high and slowlyprogressive fever, headache,a dry cough and stomachpain. Vaccination, recommendedfor all travellersspending more than a weekin Myanmar and other partsof Southeast Asia, is not100% effective so you muststill be careful with what youeat and drink.Traveller’sDiarrhoeaBy far the most commonproblem affecting travellers isusually caused by a bacteria.Treatment consists of stayingwell hydrated; use a solutionsuch as Gastrolyte. Antibioticssuch as Norfloxacin,Ciprofloxacin or Azithromycinwill kill the bacteria quickly.Loperamide is just a ‘stopper’,but it can be helpful incertain situtations, eg if youhave to go on a long busride. Seek medical attentionquickly if you do not respondto an appropriate antibiotic.Amoebic dysentery isvery rare in travellers; onesign is if you have blood inyour diarrhoea. Treatmentinvolves two drugs: Tinidazoleor Metronidazole to kill theparasite in your gut, and thena second drug to kill the cysts.Giardiasis is relativelycommon. Symptoms includenausea, bloating, excessgas, fatigue and intermittentdiarrhoea. The treatmentof choice is Tinidazole, withMetronidazole being a secondoption.HEALTH ADVISORIESConsult your government’s website on health and travelbefore departure:» Australia www.smartraveller.gov.au» Canada www.phac-aspc.gc.ca/tmp-pmv/index-eng.php» New Zealand www.safetravel.govt.nz» UK www.dh.gov.uk» USA wwwnc.cdc.gov/travel/EnvironmentalHazardsAir PollutionAir pollution, particularly vehiclepollution, is an increasingproblem, particularly inYangon. If you have severerespiratory problems speakwith your doctor before travellingto any heavily pollutedurban centres. This pollutionalso causes minor respiratory