Spots of Time

July 22, 2003

A Mosquito Has 47 Teeth

"Recovery is complete, if you survive."

Sitting in the doctor's office, that statement did little to reassure me. In fact, I could feel my heart beating faster as my stomach contracted. Granted, the disease was Ebola. And, it was only endemic to a few countries in Africa. And, I was here to get vaccinations for my upcoming trip to South-East Asia. Regardless, I was not reassured.

Thinking about a trip to a third world nation is easy - and exciting. The reality of pre-trip preparations is a little more complicated.

Australia, like most first-world nations, is fairly benign when it comes to pre-travel protection for diseases. Sure, there are dozens of poisonous spiders, snakes, jellyfish and the like that can kill you - but these are visible threats. The invisible ones are the ones that really get under your skin (sometimes literally). And, while almost nothing is 100% effective, a visit to a doctor for pre-trip vaccinations can be your only line of defense against contracting certain illnesses overseas.

I've heard it quoted that nearly 80% of international travelers get traveler's diarrhea at some point during their travels. Though most folks would gladly avoid it, besides some minor discomfort and frequent trips to the bathroom - it's really not that bad. Especially if you consider all the other possibilities.

Hepatitis A, Typhoid Fever, and Poliomyelitis (Polio) are all viral diseases transmitted through contaminated food and water. Hep A infected individuals can be incapacitated for up two months. Typhoid Fever can cause death if untreated. Polio, eradicated in most countries, is still found in areas of Africa and India. All three have pre-trip vaccinations that offer "excellent long-term protection." And don't think that your childhood inoculations are still good - many vaccines require boosters every ten years to remain effective.

Vaccines are not required for every possible disease. Some, like Cholera, which sounds quite serious (who's read Death in the Time of Cholera by Gabriel Garcia Marquez?) is actually fairly benign, at least to the international traveler. A bacteria-caused disease, think of it as an extreme form of traveler's diarrhea. Properly treated with replaced electrolytes and fluids, most adults can recover completely within two days. While a vaccine does exist, most doctors don't recommend it. And, in 1973, the World Health Organization (WHO) abolished the rights of countries to require a certificate of vaccination from international travelers.

Some ailments, like worms for example, have no vaccination. Heard of Roundworm (Ascaris)? Easily contracted from contaminated food, roundworms usually cause no symptoms. Great, right? Sure, until you find out that the only way to know you have them is when you see the adult worms - white, wiggling creatures - in your feces or toilet bowl. I really wish I made that up - but I didn't.

Then there are the insect-borne diseases. Malaria jumps to mind right away - but that is just the beginning. Ever heard of Dengue Fever, Japanese Encephalitis or Yellow Fever? All mosquito-transmitted diseases, they range from relatively harmless to life threatening.

While the name - Dengue Fever - sounds scary as hell - in terms of insect-borne diseases, it's really not so bad. Contracted by urban mosquitoes during daylight hours, Dengue Fever produces flu-like symptoms in those that are infected. Treatment includes bed rest, extra fluids and OTC pain medication - with most people recovering in one to two weeks.

Japanese Encephalitis, on the other hand, is a bit more serious. Typically found in areas of ground water, especially rice paddies, this disease can result in a serious brain infection in humans - in some cases progressing to a coma and resulting in permanent brain damage or even death. Did I mention that with the exception of the vaccination, there is no specific treatment available?

Yellow Fever is another mosquito transmitted disease - and one of the most serious. It is the only internationally required vaccination for travelers, and only if you are or have traveled to parts of South America or Sub-Saharan Africa. So called because of the severe jaundice caused by liver infection, the death rate in unprotected individuals is 50%.

A pre-trip vaccination doesn't seem like such a hassle anymore, does it?

But, by far the scariest of the diseases is one called Lassa Fever. Listed under the "Exotic Infections For Your Interest" section of the health guide I was reading in the doctor's office, its write up follows the paragraphs on Anthrax and Ebola.

"Lassa Fever is caused by a virus, which is transmitted to humans from the urine of infected rats. Lassa Fever has an incubation period of between 3 and 21 days and is manifested initially by fever followed by bleeding from all body openings."

I stopped reading, feeling sick to my stomach. I began recalling every horrible disease-related horror movie I'd ever seen. Looking back at the brochure, I scanned for infected countries and possible vaccinations. While I found none, the section ended like this:

"Although the risk to international travelers is extremely low, the existence of this disease nevertheless underscores the importance of seeking medical attention for any fever while traveling in high-risk areas."

"Melanie, the doctor will see you now."

A hypochondriac is born.

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For those interested in more information or to confirm that the above is all true, check out www.traveldoctor.com.au. By the way - the brochure really did say that a mosquito has 47 teeth - and, that after feeding on your blood is able to fly carrying a load twice its body weight. Wow.