A little something I picked up in Fak Fak

Diseases are part and package of any exotic foreign travel. And there are some worrying trends, as Jonathan Gregson discovers

EVERY summer thousands of adventure-seeking travellers set out for tropical climates. And every year a few of them return with serious illnesses or harbouring diseases with hidden symptoms. When these do appear, your local GP or hospital may not recognise them, particularly if you don't own up to all the places you have visited.

That's what happened to a back-packing acquaintance of mine who recently returned from India. He went to his GP with flu-like symptoms, but forgot to mention he had previously been in Sumatra. The GP told him to come back in three days if there was no improvement. He ended up checking into the Hospital for Tropical Diseases in London, where he was discovered to be suffering from a serious cocktail of giardia and pancreatitis.

Of all the potential problems facing travellers to the tropics malaria is the most serious. Each year, an average of 2,000 people return to the UK with malaria, of whom around 10 will die. "Deaths are almost exclusively from the plasmodium falciparum type of malaria,"says Dr Sharon Welby, clinical lecturer at Liverpool's School of Tropical Medicine, "which is contracted in Africa or south Asia."

"Malaria cases account for between a quarter and a third of all patients here," comments Dr Ron Behrens, who is a consultant at the Hospital for Tropical Diseases and director of its travel clinic. "If you've been to a malarious country and have the typical symptoms - fever, diarrhoea, back pain or joint pain - then you should immediately seek a blood test and, if it is positive, be admitted to hospital for further treatment."

Speed is essential when dealing with tropical diseases as they can develop with alarming rapidity. "Those deaths from malaria that have occurred are mostly people who delayed coming in for treatment," says Dr Behrens. However, he is as concerned about prevention as cure. "If you're going to a malarial country you need to ensure you have the right information about what prophylactics you should take. Your travel agent, your GP or a travel clinic should advise you, but it is the individual's responsibility to follow that up."

Those who ignore that advice do so at their peril. Perhaps half or more of the people who die of malaria during one year turn out not to have bothered to take any prophylaxis whatsoever. And while there is controversy about taking mefloquine and its possible side-effects, Dr Behrens points out: "You shouldn't forget that malaria is a fatal illness or that in many parts of the world there are now strains resistant to other drugs."

This is especially true of sub-Saharan Africa. Even travellers who conscientiously take their pills while in a malarial zone often stop when they return to more temperate climates. "A lot of people do not continue their course for the recommended four weeks afterwards," says Dr Welby.

Other common complaints are "traveller's diarrhoea" and fever, often caused by unknown things. As Dr Behrens explains: "Sometimes we have to deal with illnesses we can't put a name to." These can range from the life-threatening ones to those bordering on the absurd - for example,my wife returned from Irian Jaya with a tropical ulcer on one leg and a coral growth inside the other foot. The coral-in-the-foot was sufficiently unusual for the consultant to bring with him a group of trainee doctors who giggled uncontrollably when she explained the infection had started in a town called Fak Fak.

When she added that we had visited the MacCluer Gulf the consultant grew interested, for the area is notorious for unusual tropical diseases. Its mushroom-shaped islets may be absurdly picturesque, but the opaque waters around them are a breeding ground for all manner of organisms. The pearl- divers we had met there complained of eye infections and problems with even the smallest grazes.

Fresh water, particularly lakes and river shallows in sub-Saharan Africa, holds the menace of bilharzia, which is a condition that is difficult to diagnose, but is seen with increasing frequency in returning travellers. There have also been more cases of skin rashes and blistering caused by the larva of the dog hookworm among visitors to the Caribbean.

But the most worrying trend is the growing number of people returning from tropical destinations who are HIV positive. Although not specifically a tropical disease, statistics show that 79 per cent of heterosexually transmitted HIV cases seen in the UK are acquired abroad. In other words, whether you're out in the bush or cruising the clubs, it's best to play safe under tropical skies.


1 Accidents

The most common serious health problems encountered on holiday result from accidents, ranging from road traffic to sporting. This is usually due to people attempting activities on holiday that they would not dream of doing at home. Over indulgence in alcohol plays a big part.

2 Malaria

One of the most serious infections that travellers are likely to encounter when travelling to certain destinations. Watch out for any flu like illness up to a year after returning home.

3 Diarrhoea

Definitely the most common problem. Ordinary travellers' diarrhoea should resolve in a few days. Any diarrhoea lasting more than 10 days could be something more serious like dysentery. Best advice for travellers' diarrhoea is to keep well hydrated by drinking plenty of fluid, ideally in the form of oral rehydration salts.

4 Sexually transmitted diseases

Another example of how people ten to throw caution to the wind while on holiday. Safe sex is vitally important wherever you are in the world.

5 Dengue

Malaria apart, most tropical diseases are quite unusual in holidaymakers, but dengue is definitely on the increase in the tropics. This is not usually fatal in adults but results in an extremely nasty infection which is guaranteed to ruin your holiday.

Larry Goodyer

people'It can last and it's terrifying'
Danny Welbeck's Manchester United future is in doubt
footballGunners confirm signing from Manchester United
footballStriker has moved on loan for the remainder of the season
footballFeaturing Bart Simpson
Have you tried new the Independent Digital Edition apps?
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
New Articles
Olivia Colman topped the list of the 30 most influential females in broadcasting
Kelly Brook
peopleA spokesperson said the support group was 'extremely disappointed'
The five geckos were launched into space to find out about the effects of weightlessness on the creatures’ sex lives
Life and Style
techIf those brochure kitchens look a little too perfect to be true, well, that’s probably because they are
Andy Murray celebrates a shot while playing Jo-Wilfried Tsonga
TennisWin sets up blockbuster US Open quarter-final against Djokovic
Arts and Entertainment
Hare’s a riddle: Kit Williams with the treasure linked to Masquerade
booksRiddling trilogy could net you $3m
Arts and Entertainment
Alex Kapranos of Franz Ferdinand performs live
music Pro-independence show to take place four days before vote
news Video - hailed as 'most original' since Benedict Cumberbatch's
Life and Style
The longer David Sedaris had his Fitbit, the further afield his walks took him through the West Sussex countryside
lifeDavid Sedaris: What I learnt from my fitness tracker about the world
Arts and Entertainment
Word master: Self holds up a copy of his novel ‘Umbrella’
booksUnlike 'talented mediocrity' George Orwell, you must approach this writer dictionary in hand
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

By clicking 'Search' you
are agreeing to our
Terms of Use.

ES Rentals

    iJobs Job Widget
    iJobs General

    SQL Implementation Consultant (VB,C#, SQL, Java, Eclipse, integ

    £40000 - £50000 per annum + benefits+bonus+package: Harrington Starr: SQL Impl...

    SQL Technical Implementation Consultant (Java, BA, Oracle, VBA)

    £45000 - £55000 per annum + Benefits + Bonus: Harrington Starr: SQL Technical ...

    Head of IT (Windows, Server, VMware, SAN, Fidessa, Equities)

    £85000 per annum: Harrington Starr: Head of IT (Windows, Server, VMware, SAN, ...

    Lead C# Developer (.Net, nHibernate, MVC, SQL) Surrey

    £55000 - £60000 per annum + Benefits + Bonus: Harrington Starr: Lead C# Develo...

    Day In a Page

    'I’ll tell you what I would not serve - lamb and potatoes': US ambassador hits out at stodgy British food served at diplomatic dinners

    'I’ll tell you what I would not serve - lamb and potatoes'

    US ambassador hits out at stodgy British food
    Radio Times female powerlist: A 'revolution' in TV gender roles

    A 'revolution' in TV gender roles

    Inside the Radio Times female powerlist
    Endgame: James Frey's literary treasure hunt

    James Frey's literary treasure hunt

    Riddling trilogy could net you $3m
    Fitbit: Because the tingle feels so good

    Fitbit: Because the tingle feels so good

    What David Sedaris learnt about the world from his fitness tracker
    Saudis risk new Muslim division with proposal to move Mohamed’s tomb

    Saudis risk new Muslim division with proposal to move Mohamed’s tomb

    Second-holiest site in Islam attracts millions of pilgrims each year
    Alexander Fury: The designer names to look for at fashion week this season

    The big names to look for this fashion week

    This week, designers begin to show their spring 2015 collections in New York
    Will Self: 'I like Orwell's writing as much as the next talented mediocrity'

    'I like Orwell's writing as much as the next talented mediocrity'

    Will Self takes aim at Orwell's rules for writing plain English
    Meet Afghanistan's middle-class paint-ballers

    Meet Afghanistan's middle-class paint-ballers

    Toy guns proving a popular diversion in a country flooded with the real thing
    Al Pacino wows Venice

    Al Pacino wows Venice

    Ham among the brilliance as actor premieres two films at festival
    Neil Lawson Baker interview: ‘I’ve gained so much from art. It’s only right to give something back’.

    Neil Lawson Baker interview

    ‘I’ve gained so much from art. It’s only right to give something back’.
    The other Mugabe who is lining up for the Zimbabwean presidency

    The other Mugabe who is lining up for the Zimbabwean presidency

    Wife of President Robert Mugabe appears to have her sights set on succeeding her husband
    The model of a gadget launch: Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed

    The model for a gadget launch

    Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed
    Alice Roberts: She's done pretty well, for a boffin without a beard

    She's done pretty well, for a boffin without a beard

    Alice Roberts talks about her new book on evolution - and why her early TV work drew flak from (mostly male) colleagues
    Get well soon, Joan Rivers - an inspiration, whether she likes it or not

    Get well soon, Joan Rivers

    She is awful. But she's also wonderful, not in spite of but because of the fact she's forever saying appalling things, argues Ellen E Jones
    Doctor Who Into the Dalek review: A classic sci-fi adventure with all the spectacle of a blockbuster

    A fresh take on an old foe

    Doctor Who Into the Dalek more than compensated for last week's nonsensical offering