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Vacation advice from UK newspaper includes cautions about ticks and Lyme disease.


http://www.dailymail.co.uk/health/article-2196798/Holiday-illness-The-hidden-risks-travelling-abroad.html

Malaria, DVT, liver disease... What you don't want to bring home from your holiday

By Dr Ben Macfarlan

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Feeling flat and tired now summer’s over and the schools are about to go back? It’s likely to be simply the usual post-holiday blues, but there’s a small chance it signifies something a lot more serious.
If you get an upset stomach or an injury on holiday, you usually realise immediately. But some less well-known conditions take a while to present any symptoms, so you need to know what to watch for. Travel health expert DR BEN MACFARLANE details the key post-holiday nasties to be on alert for . . .
Hospital stay: Cheryl Cole caught malaria while in Tanzania and was hospitalised on her return to the UK
Hospital stay: Cheryl Cole caught malaria while in Tanzania and was hospitalised on her return to the UK
SYMPTOMS: Lethargy, nausea and  yellow-looking skin two to six weeks after coming home.
IT COULD BE: Hepatitis A – a viral liver infection endemic in parts of Africa, Asia and Central and South America. It’s usually transmitted via dirty food, so be extra vigilant if you get food poisoning.

The yellowing of the skin – jaundice – can be masked by a holiday tan, so check the whites of eyes, which will also be yellow.

WHAT TO DO: It is possible to fight it off with bed rest but hepatitis A can be fatal. ‘If you develop bruising, bleeding, confusion or sleepiness, you should seek medical attention immediately,’ says Dr Ashley Brown, consultant hepatologist at St Mary’s Hospital in London.
 
SYMPTOMS:  Severe headaches behind the eyes – which start up to a fortnight after a holiday – plus fever and extreme joint pains. Up to five days after the onset of the fever, you might also start to show a bright red rash.
IT COULD BE: Dengue fever, another mosquito-borne illness common in tropical and sub-tropical holiday destinations such as Costa Rica, Singapore and the Seychelles.
WHAT TO DO: Speak to your GP. In most cases you’ll be able to recover with bed rest at home, but hospitalisation may be required in severe cases or if you have underlying health problems.
 

Malaria is transmitted by mosquitoes
Malaria is transmitted by mosquitoes
SYMPTOMS: Fever, shivering,  joint pains and vomiting, between  one week and several  months after returning.
IT COULD BE: Malaria – and you can’t assume you’re safe because you took anti-malarial drugs before visiting a risk area and didn’t seem to get bitten by any mosquitoes.
Travellers who took anti-malarial medication can take some time to show symptoms.
Cheryl Cole had been back from her holiday in Tanzania for two weeks when she was hospitalised with malaria in 2010.
WHAT TO DO: Seek help. Severe cases can lead to fits, anaemia, kidney failure, fluid on the lungs, loss of consciousness and even death. Treatment depends on the region you visited and which anti-malarial medication you took.
‘If you experience symptoms after your holiday, tell your GP that you have visited a malarial zone so they can do the relevant blood tests,’ says Dr Janice Main, consultant in infectious diseases at St Mary’s Hospital in London.
‘The more dangerous strains of malaria can take hold very quickly, so if you can’t get a GP appointment or you feel ill over a weekend, go to A&E.
‘Early symptoms are non-specific and often flu-like, so make sure the doctors know you have visited a “danger zone” and don’t be fobbed off.’
Some anti-malarial medications have to be taken for up to a month after you return from a malarial area. As malaria bugs can lurk in your system, it’s important to complete the course.
 
SYMPTOMS: A ‘bull’s-eye rash’ – a bright red patch of skin which then fades in the centre, perhaps coupled with muscle and joint pain, fever, headaches and fatigue.
IT COULD BE: Lyme disease. This was first described in Lyme, Connecticut, but it is widespread in central Europe.
High-risk areas in the UK are popular holiday spots such as the Scottish Highlands and the New Forest. It’s transmitted by bites from tiny insects called ticks, and diagnosis can be confused as the rash can take up to a month to appear and won’t necessarily be at the bite site.
WHAT TO DO: See your doctor. ‘If untreated, late complications include nerve damage, arthritis and damage to the rhythm control of the heart,’ says Dr Janice Main.

‘Blood tests can confirm the diagnosis and antibiotics given early can prevent more serious complications. Prevention is important, so if you are hiking through an area known to have infected ticks, wear long trousers instead of shorts.’
 
DVTs are more likely when travelling from a hot climate
DVTs are more likely when travelling from a hot climate
SYMPTOMS: Swollen, red or painful calf muscles on one leg within a week or so of your flight home.
IT COULD BE: Deep-vein thrombosis (DVT). These are blood clots that form in leg veins that can dislodge and travel to the heart or lungs, causing a fatal blockage.

DVTs are more likely when travelling from a hot climate, as dehydration leads to the blood clotting more readily.
Pregnant women, overweight people, the elderly, smokers, and women taking the Pill or on HRT are most at risk.
WHAT TO DO: See your GP. If DVT looks likely, a quick scan at hospital can confirm it. Heparin injections can stop a clot growing, while compression stockings can lower the risk of recurrence.
 
SYMPTOMS: Severe breathlessness, chest pain and coughing up blood up to a week after flying home.
IT COULD BE: A pulmonary (lung) embolus (blockage) caused by DVT.
WHAT TO DO: This is an emergency, so dial 999. Scans will show whether the artery to the lung is blocked. Surgery may be required.
 
SYMPTOMS: Recurrent bouts of severe diarrhoea, exhaustion  and smelly burps.
IT COULD BE: Giardiasis. This stomach bug, widespread in Africa, Turkey and former Eastern bloc countries, is usually transmitted through infected water in drinks, ice cubes, food or even from swimming in lakes or rivers. Once you’ve been infected, the parasites will be busy multiplying in your intestines for some time before the worst symptoms strike.
WHAT TO DO: Medication called antiprotozoals can kill the bugs. If you don’t get proper treatment, the disease can recur so you should obtain medical help early and tell your GP or practice nurse where you’ve been on holiday.