Tropical Diseases

Ailment	Prevention	Treatment
Malaria	Prevent mosquito bites (use deet-containing insect repellent, treat clothing with permethrin, sleep under a mosquito net.) Prophylactic medicines: mefloquine, chloroquine, proguanil, plus-minus Fansidar standby in Central and South Americas. (check locally for resistant strains of the plasmodium). Read addendum	mefloquine, chloroquine, proguanil, quinine, quinidine, artemisinin (qinghaosu) and derivatives. Read the Malaria Page Read the Malaria Story
Leishmaniasis	Prevent sand fly bites (same measures as in malaria prevention).	For visceral leishmaniasis (kala azar) and severe cutaneous and mucocutaneous leishmaniasis, intravenous sodium stibogluconate (Pentostam) 20 mg/kg daily for 30-40 days is usually curative. For mild cutaneous leishmaniasis, dapsone 100 mg twice daily for 6 weeks, or Ketoconazole 600 mg daily for 28 days has been shown good results.
Amebiasis	Good hand washing, boil/filter water, cook food well, avoid fly-contaminated foods.	metronidazole(flagyl) 750 mg three times a day for 10 days, followed by iodoquinol 650 mg three times a day for 20 days.
Giardiasis	Good hand washing, boil/filter water, cook food well, avoid anal-oral contact.	metronidazole (flagyl) 500 mg three time a days for 7 days; quinacrine (atabrine) 100 mg three times a days for 7 days (not available in the United States); tinidazole (Fasigyn) (not available in the U.S.) 2 gm daily for 1-3 days; furazolidone (furoxone) (not available in the U.S.) 100 mg four time daily for 7 to 10 days.
Schistosomiasis	Avoid contaminated water (fresh water), chlorinated water and sea water is safe. Heat bath water to above 50 degree C or 122 degree F for more than five minutes, or stand water more than 48 hours in a container.	For Schistosoma mansoni and S. hematobium, praziquantil (Biltricide) is curative in a single dose of 40 mg/kg. For S. japonicum and S. mekongi, praziquantel 60 mg/kg is given in three divided doses 6 hours apart. Dexamethasone is a useful adjunct in the treatment of acute neuroschitosomiasis.
Traveler’s Diarrhea	Disinfecting techniques for water and food, food hygiene, may consider prophylaxis with medications.	For watery (non-bloody) diarrhea, fluid hydration is usually sufficient; for bloody diarrhea, need to start antibiotic or antiparacitic medicine in addition to prevention of dehydration. Antibiotic choices include Cipro 500 mg twice daily for 1-3 days; floxin 400 mg twice daily for 1-3 days; furazolidone(furoxone) 100mg 4 times daily for 1-3 days for bacterial infection and for 7-10 days for giardiasis; trimethoprim/sulfamethoxazole DS 1 tab twice daily for 3 days, combing with loperamide increases effectiveness; metronidazole (Flagyl) 500 mg three times daily for 5-7 days for giardiasis.
Yellow Fever	Vaccine every 10 years, avoid mosquito bites.	Supportive therapy only, no cure.
Hepatitis A	Good hygiene, disinfections of food and water, vaccine, or immunoglobulin.	No cure against the virus of hepatitis, but symptoms often disappear after a few weeks to several months. Vaccination is available for hepatitis A and B (and thus can help prevent hepatitis D as well). Only supportive therapy for dehydration from diarrhea and vomiting, no cure. Avoid alcohol and food heavy on the liver.
Hepatitis B	Good hygiene, disinfections of food and water, vaccine, condoms during intercourse, avoid unscreened blood transfusion.	Only supportive therapy for dehydration from diarrhea and vomiting; interferon may be useful in chronic hepatitis B, but no cure for either acute or chronic hepatitis B.
Hepatitis C	Avoid intravenous drug use, nasal cocaine use, unprotected sex, unscreened blood products.	Supportive therapy for dehydration from diarrhea and vomiting; there is no cure but interferon may be useful in chronic hepatitis C.
Hepatitis D and E	D: Same transmission as B, but usually occurs after contracting B E: Similar to A. Epidemic often occurs during big floods.	Supportive therapy for dehydration from diarrhea and vomiting; there is no cure.
Fungal infections (skin rashes)	Keep skin and clothing dry and clean.	Antifungal medications.
Bacterial skin infections (open sores, cuts)	Keep wounds dry and clean, wash wounds with clean saline for disinfections.	Antibiotics—topically or orally.
Chagas Disease	Avoid assassin (a.k.a. kissing, ruduviid) bugs which hide in the adobe hut structure (thatched roof and mud walls); avoid blood transfusion in Latin America.	Acute illness can be shortened with nifurtimox, but the side effects can be severe. No treatment for chronic disease. Other cure in the acute stage can be done with Benznidazol or Ragonil
Cholera—caused by Vibrio cholerae	Disinfect food and water, avoid raw or undercooked food or seafood (especially ceviche); vaccines are not recommended by WHO.	Fluid re-hydration, antibiotics (Cipro 1 gm as single dose, Floxin 800 mg as single dose, doxycycline, tetracycline, or furazolidone)
Dengue fever	Avoid mosquito bites.	There is no cure for dengue fever, but usually all symptoms disappear after a week. Supportive treatment with rest, fluid re-hydration, and pain medication.
Filariasis (one type of roundworm) --lymphatic filariasis (bancroftian or malayan filariasis) and subcutaneous filariasis (onchocerciasis—a.k.a. river blindness) and loiasis	Avoid mosquitoes, flies (especially black flies in Latin America, and red flies in Africa), and biting midges; prophylaxis with diethylcarbamazine (DEC) either weekly or monthly to prevent loiasis or lymphatic filariasis. There is no prophylactic drug for onchocerciasis. Do not use DEC if have previously been exposed to filariasis until treated and cleared of parasites.	Diethylcarbamazine (hetrazan) or high-dose ivermectin (200 micrograms/kg) for lmphatic filariasis; ivermectin (150 micrograms/kg every 6 months for 1 year, then annually for 5 years) for onchoceriasis; diethylcarbamazine (75mg/kg total, but start with Ľ tablet per day and slowly work up to 3 tablets 3 times a day over a 3-week period to avoid anaphylactic reaction from destruction of the worms.) or ivermectin (400 microgram/kg) as a single dose for loiasis.
Typhoid Fever—caused by Salmonella typhi	Disinfect food and water, good hygiene, avoid contact with infected individuals, vaccines (oral or the new one-dose injectable)	Antibiotics (Cipro, Floxin, ampicillin, trimethoprin/sulfamethoxazole, ceftriaxone, and chloramhenicol)—start self-treatment with antibiotic and see medical consultation if infection suspected.
Tropical ulcer	Avoid having open wounds, cleanse wound with saline if present, keep wound dry and clean.	Antibiotic powder (not ointment) to keep wound clean and dry.
Rabies	Avoid rabid animals, vaccine.	Antibiotics—see medical consultation for specific type.
Worms	Depend on types of worms, some worms can enter the skin by penetration, by oral ingestion such as roundworms in raw seafood, or by oral-anal route.	Some worms require surgical removal, some can respond to Albendazole, mebendazole, etc., but there are many types of worms and need to seek medical consultation for the correct antiparasitic medication.
Leptospirosis—caused by bacteria in the urine of domestic livestock, dogs, and small rodents	Disinfect food and water, good hygiene.	Antibiotic (penicilline, doxycycline).
Hanta virus	Avoid drinking rodent infested water and being in a rodent infested area, breathing in aerosolized virus.	Supportive therapy only, no cure.
Cutaneous Larva Migrans (caused by various roundworms - nematodes	Transmitted through dog or cat feces. Skin exposure (most common through the feet).	Thiabendazole orally 25 to 50 mg/kg/day in two divided doses for 2 days. Second course given after 2 to 7 days if lesion continues to extend. (also high doze of 22mg/kg twice a day for 5 days is possible). Strong side effects (anorexia, nausea, dizziness) lead to research of topical thiabendazole.
Myasis (infestation by larvae of flies)	The botfly fixes its eggs on insects bites. All insect bites could potentially lead to larvae infection.	Fill up the lesion with petroleum or with adhesive to suffocate larvae, then remove when dead. Treat infection. Or enlarge orifice with small incision and extract larvae.
CutaneTungiasis		The sand flea enters the skin where it resides in the epidermis and grows to the size of a small pea. The posterior of the flea remains in contact with the air. Pus-filled, itchy papules form around the protruding posterior of the flea, often leading to secondary infections. Cut the lesion and remove the flea with tweezers.

Note: We are grateful to Dr. Hui-Ying Lesage for helping us compile the information listed above.

Tropical and Travel Diseases

Dehydration

Other Exposure Related Problems

Food Poisoning - Toxins & Chemicals

Poisonous plants

Poisonous (stinging/biting) animals

Medical Kit

Treating Water

Using Liquid Chlorine (laundry bleach)