Prevention is better than Cure

I've gotten my jabs - and what a lot of jabs!My visit to Tan Tock Seng hospital's Travellers' Health @ Vaccination Clinic (Tel: 6357 2222) was a fruitful an informative one. The clinic interiors looks like a spa and the staff are knowledgeable and friendly. I highly recommend anyone heading to less developed places to pay them a visit.

I took a total of four jabs - Influenze Vaccine ($18.30), Tetanus-Diptheria (TD) ($10), Hepatitis A-Havrix (Adult) ($66.20), and Typherix Injection ($15.20). Consultation was $8.10. They'll also give you a World Health Organisation International Certificate of Vaccination card which records the details of the vaccination taken.

On my way out, I picked up several brochures which I found to contain useful information, especially for those of us who like travelling to uncharted territories *wink*

Here's a couple of more relevant information for people intending to climb to high altitudes and visiting places where hygiene is suspect. (Source: Brochures from Travellers' Health @ Vaccination Clinic, TTSH)

Acute Mountain Sickness - This occurs when one ascends to high altitudes especially if the ascent occurs over a short period of time. It can occur at any altitude but most frequently it occurs at 2,000m (6,500ft) or above. Commonly affects the younger male (me?), those with past history of altitude sickness and those who ascend quickly. Symptoms can start within hours to days after exposure to high altitudes.

Symptoms include:
MILD: headache, poor appetite, insomnia, nausea, tiredness
MODERATE: unrelieved headache, vomiting, decreased urine output
SEVERE: Unable to walk straight, decreased consciousness as a result of brain swelling, difficulty with breathing as a result of excessive water in the lungs, blueness in digits

What to do?
1. If mild symptoms occur, stop ascent and stay at the same altitude for a day or two, then ascend cautiously.
2. Severe symptoms require immediate descent to a lower altitude and drug treatment. Consult a doctor in the area. Normally, both descent and drug treatment are required for severe symptoms.
3. Oxygen therapy or use of a hyperbaric bag may be required.
4. In patients with brain swelling or water in the lungs, even if symptoms improve with treatment, they should not be allowed to reascend. Future trips should be in consultation with a doctor to discuss the use of drugs in prevention of symptoms.

Prevention:
1. A slow ascent is important. Monitor own rate by symptoms
2. Carry drugs for altitude sickness. This should be done in consultation with a doctor
3. Avoid sedatives, tranquilizers and narcotic analgesics (certain pain killers)
4. Drink plenty of fluids and take a low salt diet
5. Avoid strenuous over-exertion
6. Adequate clothing to prevent hypothermia which can aggraviate altitude illness
7. Avoid external transport to higher altitude (animal or mechanised) especially if person is having physical problems continuing on his own, because accelerated ascent can worsen the problems.

To a certain extent, altitude sickness can be prevented by taking 250mg acetazolamide (Diamox) three tiems per day from one day before ascent until two days after reaching the maximum height. Possible side effects include: nausea taste disturbance, tingling hands and feet, frequent and copious urination, visual disturbances and skin rash. Allergies to sulfur drugs are a contraindication to Diamox.

Hepatitis A - A viral infection that affects the liver caused by the Hep A Virus. It is usually transmitted by eating contaminated food and water, especially raw seafood (clams, cockles, mussels, oysters, shellfish) or even partially cooked or unhygienic food. Or even through poor personal hygiene - transmit from person to person!

Incubation takes 2 - 6 weeks. Syptoms include jaundice or yellowing or eyes and skin, fever, right sided upper abdominal discomfort, dark or tea-coloured urine, pale stools, poor appetite and nausea.

Prevention: Immunisation is best. But also to observe strict food and water hygiene (avoid ice from suspicious sources!).

Visit www.netdoctor.co.uk/travel for more information on travel health.