How to treat diarrhoea?

It is extremely important to consume sufficient liquid and salt in order to prevent dehydration. You can do this by taking salt solutions, but tea with lemon, broth, soft drinks and fruit juice, supplemented with salt crackers are tastier. Commercial salt products are available on the market (ORS-solution).

Taking an anti-diarrhoea preparation (loperamide, e.g. Imodium®) can greatly reduce the number of bowel movements, with a considerable reduction of the complaints as a result. Imodium® may only be used by adults and older children and only for treating ordinary watery diarrhoea: 1 capsule after every loose movement up to a maximum of 4 per day.

Antibiotics are indicated :

1. If blood, mucus or pus are present in the stools.
2. If after 24 to 48 hours, there is no sign of improvement and the diarrhoea is accompanied by fever (above 38.5 C) or severe abdominal cramps, or if there are more than six stools per 24 hours and especially when these also occur at night.
3. Or if because of travel circumstances a quicker solution is absolutely desirable . Appropriate antibiotics are only to be used on doctor’s prescription

· SEXUALLY TRANSMITTED DISEASES

Casual sexual contacts tend to be higher while on holiday abroad. Sexually transmitted diseases, particularly AIDS, form therefore an important risk for travellers. Quite often unintentional and unsafe sexual contact takes place under alcohol influence. Prevention while on holiday abroad is no different from the precautions you take at home. Adequate use of a condom, preferably bought at home, is absolutely essential. Only a water-soluble lubricant should be used, but it only offers a partial guarantee (e.g. KY gel). Vaccination against hepatitis B is advised. Always consult your doctor if you think you are at risk, even when there are no symptoms.

· MALARIA (swamp fever, malaria)

Malaria is an infectious disease caused by a parasite (called Plasmodium) transmitted by the bite of the Anopheles mosquito. There are four different types of which Malaria falciparum is the most dangerous and the most widespread. The incubation period – the time between an infecting bite and the appearance of the disease – varies from ten days to four weeks (rarely several months).

The symptoms include attacks of fever, but can initially be quite similar to influenza. If adequate treatment is not started in time, an attack may sometimes result in death within a few days.

. Where does malaria occur?

Malaria only occurs in those areas in which Anopheles mosquitoes are present : in the tropics and in a large number of subtropical areas. From a height of 1.500 to 2.500 m onwards, depending on temperature and climate, Anopheles mosquitoes are either rare or non-existent.

In most big cities there is little or no risk at all of infection, except in Africa where a real risk exists.

Risk also exists in the suburbs of the big cities in Asia (e.g. in India). In a number of areas the risk varies according to the season.

. How can malaria be prevented?

It is very important for travel health to avoid mosquito bites : the Anopheles mosquito only bites between dusk and dawn, is rather small and hardly makes any noise.

- In the evening wear light-coloured clothing which covers your arms and legs as much as possible. Apply repellent cream with a DEET basis (20 to 50%, for children and pregnant women preferably 20 to 30%) to the uncovered parts of your body. Repeat this every four to six hours (it will not protect you all night).

Non containing DEET repellents were less examined; Autan-Active. and Mosegor. are however excellent safe products.

- Sleep in rooms that leave no access to mosquitoes, (mosquito nets on the sills, electrically-warmed anti-mosquito plates, air-conditioning) or sleep under a mosquito net impregnated with permethrine or deltamethrine hung over the bed with the edges tucked under the mattress.

If these measures are carried out correctly, the risk of malaria will be reduced by 80 to 90% and travel health is maintained

. The intake of pills as prevention

There is no drug efficient enough to prevent malaria 100%, which means that quite often a combination of measures is preferable. Also the drugs used have changed over the years. Moreover, the advantages and disadvantages of drugs should be considered against the risk of malaria infection. These risks are dependent on the visited country, and on the region, the season, the duration of your stay and the kind of trip.

Some people might be troubled by the side effects while taking antimalarial drugs. These are usually mild and are not always a reason to stop taking the pills. Sometimes it may be necessary to change to another type of medication due to intestinal problems, allergic reactions or other intolerance symptoms.

Therefore it is the doctor who can best decide for each individual which drug to use. This explains why individuals from the same group may end up taking different drugs.

Finally, as no drug is 100% effective in preventing malaria, it is important that if an attack of fever occurs in the first three months after your return from the tropics, a malaria infection should be considered as a possibility despite the correct use of the drug prescribed.

However, it is reassuring to know that malaria, provided it is recognised in time, is easy to treat without any danger of recurrent attacks. The belief that "once malaria always malaria" is totally untrue.

You can find even more travel health tips in the next pages:

DISEASES FOR WHICH VACCINATIONS ARE AVAILABLE: http://www.spain-holidays-advisor.com/vaccination.html

MORE TRAVEL HEALTH TIPS : http://www.spain-holidays-advisor.com/more-travel-tips.html

CAUTION: The information provided here should not be used during any medical emergency or for the diagnosis or for the treatment of any medical condition. A licensed physician should be consulted for any and all medical conditions. Call 911 for all medical emergencies.