Prevention of Tropical Diseases

56 Pages·1985·7.7 MB·English

by  L. S. Yarotsky

Prevention

of Tropical

Diseases

LS.Varotsky
Prevention of Tropical Diseases
Prevention
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Diseases
L,S,Yorotsky
MirPublishersMoscow
Translated from the Russian by R. Medvednik
Contents

First published 1985
Revised from the 1983 Russian edition
Second printing 1988
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FOREWORD 8
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MB N"7392 GENERAL INFORMATION ABOUT TROPICS 11
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FOR THE TROPICS 13
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Ibn. N°l1/5663. T'apaac 26120 3K3. 3aK.120. IJ;eHa 45 xon ,
PREVENTION OF CLIMATE-RELATED
DISEASES 14
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Disturbances in the Water-Salt Metabolism 15
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Heat Stroke 16
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Sunburns 17
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Prickly Heat 17
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PREVENTION OF NERVOUS AND
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PSYCHIC DISORDERS 19
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POISONOUS ANIMALS AND PLANTS 20
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056 (Ol) - 88 Amphibia 20
Snakes 21
Ha a112JlUUC1<.OM Jl3bl1<.e Jellyfish 25
Molluscs 25
Printed in the Union of Soviet Socialist Republics
ISBN 5-03-000566-8
© Ib,mlTeJIhCTBo «MenHQHHa», 1983
5
© English translation, Mir Publishers, 1985
Sea Urchins 25
Living Quarters 85

Leeches 26
Clothes
88

Fishes 27
Personal Hygiene
90

Insects and Spiders (Arthropoda) 28
Water Purification
91

Poisonous Plants 46
Water and the Drinking Cycle 93

Foodstuffs 94

PREVENTION OF INFECTIOUS AND

PARASITIC DISEASES 48
PROTECTION OF CHILDREN'S HEALTH
IN THE TROPICS 98
Amoebiasis (Amoebic Dysentery) 48

American Trypanosomiasis 49
PREVENTION OF DISEASES IN THE FIELD 99
Ankylostomiasis 50

African Trypanosomiasis (Sleeping Sickness) 52
A PIECE OF ADVICE TO PEOPLE RETURNING
Bartonellosis 54
FROM THE TROPICS 101
Tropical Treponematoses and Venereal Diseases 54

Fungous Infections 55
Appendix L Biological and Chemical Preparations
Dracunculosis 57
Used for Protection Against Poisonous Animals
and Carriers of Diseases 102

Yellow Fever 58
Appendix 2. List of Medicines for Individual

Tick-Borne Spirochaetosis
Medical Chest
103

(Tick-Borne Relapsing Fever) 59

Leishmaniasis 60

Dengue 61

Pappataci Fever 62

Tsutsugamushi Disease 62

Malaria 63

Marseilles Fever 66

Myiases 67

Paragonimiasis 70

Sarcopsyllosis 72

Filariasis 72

Cholera and Other Intestinal Infections 75

Schistosomiasis 77

Plague 80

WORKING AND LIVING CONDITIONS

IN THE TROPICS 81

Daily Routine 81

Work 82

Rest 83

6
The purpose of this publication is to info~ people
Foreword

travelling to the tropics of the latest methods in the pre­
vention of the most widespread tropical diseases. These
methods include protection from insects, poisonous ani­
mals, and plants, as well as measures to ensure pr?per
living and working conditions and pers~nal hygle?e.
In the tropics, particularly in the developing countries,
public health authorities are simply unable, as yet,. to
provide the population with all the necessary medical
care. Thus people travelling to the tropics shoul.d ~e
aware of the recommended medical practices for hfe m
the tropics and observe them strictly.
Tropical diseases are either nonin~ectious (caused by
specific climatic conditions or by poisonous plants and
animals) or infectious. The infectious diseases may be
common to other climates as well as to the trOPiCS or
Tropical diseases are those diseases primarily or exclu­ may be specific to the tropics. This publication dea~s
sivelyfound in countries with a warm climate. Climatic, mainly with the prevention of diseases that are unfami­
working, and livingconditions, flora and fauna, diet, and liar to newcomers to the tropics and that, therefore, pre­
habitat are all factors in the development of various dis­ sent the greatest danger to their health.
eases specificto the tropics. Because of these tropical dis­ Preventive measures include four stages:
eases, residence in the tropics was until recently consid­ 1. Preparation for life and work in the tropics must
ered risky for people. Now the situation has changed begin before the traveller leaves home (looking through
considerably. Thousands of Europeans live and work in the relevant medical literature, medical examination, in­
the tropics and return to their own countries in good oculations, preparation of suitable clothing, a first-aid
health. This has become possible because advancements kit, and so on).
in medicine have provided doctors with the means for 2. Shortly after arrival, it is necessary to visit the local
prevention and treatment of a-number of tropical dis­ doctor who can supply detailed information about the
eases. It would be a mistake, however, to underestimate local conditions and who will be responsible for the
the significance of seemingly minor aspects of personal health of the new arrivals during their stay.
hygiene (care of the skin, proper clothing, sufficient 3. Throughout the stay in the tropics, it is important
liquid intake, and so on) in the prevention of disease and to follow strictly the medical recommendations concern­
the protection of individual health.
9
8
ing personal .hygiene, working conditions, diet, sleeping
General Information

habits, cJothm~, habitat, and everyday life.
4. On retur~mg home it is necessary to undergo a About Tropics

c0I1~plete medl~al examination and obtain necessary
advice on easmg the process of reacclimatl'zat'
Lt. JOn.
. ong- erm expenence has proved that careful observa­
non of the r~l~s c:f hygiene helps ensure health, fitness,
and good spirits m the tropics, as well as a safe return
home.
Climatic and socio-economic conditions in the tropics
differ considerably from those in the temperate regions.
Characteristics of the tropical climate are: high air tem­
peratures with only slight fluctuations during the day,
high humidity, high-level solar radiation, two seasons of
the year rather than four (the dry, summer season and
the rainy, winter season), seasonal regularities in the air
currents (winds). These climatic peculiarities cause the
high occurrence of such illnesses as heat and sun stroke,
sun burn, prickly heat, and so on in the tropics.
Unique and diverse flora and fauna have developed in
the warm and humid tropical climate. Many of the in­
sects, poisonous animals, and plants found in the tropics
are the sources or carriers of infectious and noninfectious
diseases that are not encountered in more temperate
climates. A considerable variety of pathogenic organisms
(viruses, bacteria, fungi, parasitic worms (helminths),
and so on) exist in the tropics, and these pathogens mul­
tiply quickly and thrive in the warm, humid air and
favourable environment (the soil, reservoirs, and plants).
11
·Certain socio~ec0Il:0mic factors in the tropical coun­
tries are als? conducive to the spread of disease among Getting Ready to Leave

the population there. These include malnutrition, inade­
for the Tropics

quate public health education, poorly developed public
h~a1th se~i~, inadequate medical care for the poor, cer­
t~ln condItions of everyday life (migrations, customs,
rituals, and so on). The above-mentioned natural and
social factors determine the epidemiological situation in
the tropics and its potential danger.
Conditions in different regions vary widely throughout
t~e !'"OPI:S as a whole, however, and may even vary
within a.single cou~try. As a rule, the climate of hilly and
mountain regions IS more favourable to live in than that
of the low lands. Diseases transmitted by insects are Individuals leaving for the tropics should first undergo a
more common in the countryside than in the towns. medical examination to make certain they are not suffer­
Medi~l service is better organized in the cities (particu­ ing from diseases that will aggravate their stay in the tro­
larly,. In ~he capital cities) than in the villages. People pies. At the same time they should ask their doctor for
w~rkmg 1~ the Jungle a~e more frequently injured by general advice on life in the tropics. The doctor should be
poisonous ms~~ts an? animals than those working in the made aware of past or chronic illnesses (e. g., gastric and
offices. Conditions In countries with a relatively high duodenal ulcer, psychic and nervous disorders, inflam­
leve~ ofsocio-economic development and, therefore, vast
mation of the middle ear, fungus skin diseases, diseases
cultivated territories are more favourable for both the
ofthe joints, certain gynaecological diseases, allergy, and
local population and recent immigrants than conditions
others) that may recur in the tropics. This is especially
in countries just embarking on the path of development
important when a long-term stay is planned in a remote
and independence.
region without qualified medical service or adequate
Thus, the degree ofrisk to the health varies. Protective
means of transportation to the nearest hospital. In each
measures must be rationally planned and carried out in
case the doctor will consider the patient's physical condi­
accord.ance with existing conditions in a specific country
tion, the region of the tropics, and the nature of the work
or region.
to be performed before advising the patient on the most
suitable life-style.
All dental work should becompleted before departure.
People who wear eyeglasses should take an extra p~ir
with them. The list of medicines recommended for the In­
dividual first-aid kit is contained in Appendix 2.
13
Prevention
others because of certain individual traits or diseases,
measures must sometimes be taken to improve the health
of Climate-Related

of the newcomer and to build up the organism's resist­
Diseases
ance to the tropical climate (usually by rest, improved
working conditions; medical treatment). But an acclima­
tized organism is still susceptible to the influence of
separate climatic factors (the heat and sun, for example);
therefore, protection from the harmful effect of the
environment must be provided throughout the stay in the
tropics.
The more the new climatic conditions differ from those DISTURBANCFS

one is used to, the more difficult acclimatization proves IN THE WATER-SALT METABOLISM

to be. Acclimatization is defined as the process of reor­ On hot days loss of salt and water with perspiration
ganization of the physiological functions of the organism affects the delicate balance of salt and water in the
to adapt to new environmental factors. Adaptation to organism. Minor losses of salt and water cause fatigue,
the new climate is either imperceptible or is accompanied headaches, and dizziness. Considerable changes in the
by increased perspiration, undue fatiguability, disturbed water-salt balance are likely to cause, within a few hours
sleeping, appetite, drinking or similar symptoms. Accli­ or days, fainting, pallor, and vomiting, cold and clammy
matization depends on the individual features, age, and sweat. Persons suffering from this condition are advised
sex, as well as on the character of the work, the season of to drink salted water and fruit juices for several days. If
arrival, and the climatic conditions in the region. the case is serious, a doctor must be consulted. First aid
Healthy individuals used to a temperate climate have consists of giving a salt enema (two teaspoonfuls of salt
difficulty, at first, adjusting to the tropical heat. In a few per litre of water).
weeks, however, most of them become acclimatized. Per­ The proper balance of salt and water can be main­
sons travelling to the tropics by ship acclimatize, to a cer­ tained by drinking sufficient quantities of liquids (three
tain degree, during the voyage. Children acclimatize or more litres of water a day during the dry season) and
more easily than adults. Even people coming to the tro­ eating slightly oversalted food. Persons engaged in heavy
pics for a short stay (two to three weeks) must spend physical labour or sports activities need still more water
their first day in the tropics resting. and salt; their water must be salted (four teaspoonfuls of
Since some people take longer to acclimatize than salt per one litre of water). Drinks must be taken fre­
14 15
SUNBURNS
quently and regularly. It is not advisable to drink too
much salted water at one time or to let long intervals pass The skin of fair-haired individuals is more susceptible
between drinks. to the sun's ultraviolet rays than the skin of dark-haired,
To ensure proper water-salt metabolism, especially dark-complexioned people. A suntan from brief sun­
during the dry season, a doctor must be consulted. baths of several minutes' duration enhances the skin's
resistance to prickly heat (tropical miliaria), fungus in­
fections, and other skin diseases widespread in the tro­
HEAT STROKE pics. Excessive skin irradiation by the sun may cause
When the body becomes overheated, the thermoregu­ bums of various degrees, ranging from slight reddening
lation of the organism is disturbed, and a heat stroke to vast lesions in the form of blisters filled with watery
may occur. The first signs of a heat stroke are pain in the fluid. In the tropics excessive daily sun irradiation of the
extremities, thirst, drowsiness, dizziness, headache, de­ skin (especially the neck) causes chronic dermatitis
creased perspiration or the absence of perspiration, and, ("sailor's skin"). In addition, small warty growths may
occasionally, nausea and vomiting. More serious symp­ appear on the face and on the backs of the hands.
toms develop if medical aid is not administered imme­ The main prophylactic measures include the use of
diately: mental fog, coma (with or without convulsions), creams to soften the skin, the application of sunscreen
elevated body temperatures (between 40 and 42°C). A preparations, proper clothing, and a suitable schedule of
heat stroke is more severe if alcohol was taken not long work and rest.
before the stroke.
Sinceheat strokes can bevery serious, first aid must be
offered as quickly as possible. The victim should be un­
PRICKLY HEAT
dressed and placed in a cool, air-conditioned room. The
air stream from the fan or air conditioner should be di­ Changes in the body's perspiration may cause various
rected at the victim while he is sponged with a damp skin diseases. Prickly heat (tropical miliaria) is one of the
towel until the body temperature drops to 39°C. The vic­ most widespread diseases among newcomers to the tro­
tim is then put to bed and covered with a light blanket. pics, especially among small children and stout women.
The body temperature should be checked frequently; if Minute blisters appear on the portions of the skin where
(
the temperature rises, cold sponging must be resumed. aeration is inadequate (in the skin folds and where the
[
Heat strokes can be prevented by measures directed I clothes fit tightly). People predisposed to miliaria must
against overheating: protection from the heat and the " limit their consumption ofliquids and avoid heavy physi­
sun's insolation, proper liquid intake, and so on. cal work, which causes excessive perspiration.
The irritating symptoms (itching, interrupted sleep)
can be eased by airing and drying the skin. Loose cotton
17
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