2019 Aug 30
Living in a beautiful paradise island like ours is indeed one of the best luxuries to be born into. However, along with the perks of a tropical climate comes its fair share of pitfalls. While most of us are aware of dengue, yellow fever, malaria (although now effectively eradicated by the careful coordinated efforts of our health system) there are a few other infectious diseases that the traveller in you should be aware of.
Disaster is better averted with the right knowledge after all! So, we put together a list of infectious diseases that one could potentially be exposed to while hiking, rafting, and being engaged in outdoor activities. Read on to find out how you can prevent them or identify them and thereby seek medical help.
Leptospirosis / Rat Fever
More commonly known as mee una or rat fever, this bacterial disease is carried by cattle, pigs, dogs but is mostly carried by rats. The disease can be passed onto humans when they come into contact with the urine of infected animals.
Rat Fever outbreaks are commonly seen among farmers who spend a great deal of their time outdoors. However, recently an outbreak was observed among whitewater rafters in 2013
There isn’t much that can be done in terms of prevention. However, avoiding bathing in rivers around which rats have been sighted are advisable, so asking villagers before stepping into the waters is always wise. Open wounds must be covered when going hiking or rafting.
Rat Fever is almost always treatable and curable, given that it is diagnosed early on. Therefore, being aware of the onset of the disease could save lives. An onset of fever along with headaches, fatigue and muscle aches (usually in the back of the calf muscle) within 1-4 weeks of your adventure is worth a trip to your doctor. With the correct prescription antibiotics, the condition can be resolved.
While leishmaniasis is classified as a neglected tropical disease by the WHO, it has been gaining a lot of attention in Sri Lanka over the past few decades. It is protozoan disease caused by the parasite- Leishmania which then transmitted to humans through the bite of the female sandfly that is locally known as Welimassa. For this reason, the disease is commonly referred to as Sandfly bite.
Leishmaniasis affects the districts of Anuradhapura, Polonnaruwa, Matara and Hambantota vastly due to the geographical distribution of sandflies in these areas. However, other regions with thick forests could also be at risk since sandflies often lodge within shrubs and dead leaves.
The most common form of the disease is the cutaneous form in which lesions develop at the site of the bite weeks or months after exposure. The lesion initially appears to be a tiny, painless dot in the skin which is often ignored or overlooked as a normal mosquito bite. This develops into a big, firm, red and tender lesion progressing into an ulcer, taking on the appearance of a volcano with a central open wound surrounded by raised skin around it.
Although sandflies are known to be active from dusk to dawn according to the data gathered in Sri Lanka, they appear to be active throughout the day. Adventure travellers, bird watchers and anybody exposed to outdoor activities are among groups that could be at risk.
Although rarely fatal, the development of lesions can require frequent bothersome visits to your healthcare practitioner proving that prevention is better than cure.
Clothing worn for outdoor activities could be laced or soaked in insect repellents containing Permethrin. Using repellent treated mosquito nets is a better bet than just plain old nets as the sandflies are very small and can get through the net.
Hantavirus is an emerging infectious disease that was first identified in Sri Lanka in 1988. Not much has been significantly uncovered in Sri Lanka with respect to its distribution in the country. The virus is carried by rodents and is transmitted to humans through inhalation of air droplets containing the urine, saliva and faeces of infected rodents.
Steps can be taken to minimize risk of contracting disease. Avoiding all possible contact with rodents is the primary preventative strategy. Hikers and campers could avoid contact with wild rodents by camping out in open and dry areas.
Hantavirus has two main types of clinical presentations: Hantavirus Pulmonary Syndrome (HPS) which affects the lungs and Haemorrhagic fever with renal syndrome (HPRS) which causes renal damage.
Symptoms of HPS could appear between 3 -7 days post infection. HPS symptoms include fever, chills, and body aches which may be accompanied with dry cough, headaches, backaches, stomach aches, diarrhoea. Symptoms of HPRS usually take longer than HPS taking up to about 1-2 weeks to appear, in rare cases it may take as long as 8 weeks to appear. Initial symptoms include fever, chills, intense headaches, back and abdominal pain, blurred vision.
If such symptoms are observed it is best to seek medical attention immediately without delay.
This viral disease was first described in Tanzania in 1953. The term chikungunya derived from chikungunde literally means “that which folds up” in the Mokandeon language accurately describes the folding of joints which is brought about by the disease.
Transmission of the disease occurs through bites of Aedes aegypti mosquitoes, the same vector responsible for dengue fever. The mosquito is most active during daytime.
During epidemics humans serve as reservoirs of the disease whereas in non-epidemic periods monkeys, rodents and birds act as reservoirs. Outbreaks have been observed in Puttalam, Kalmunai, Colombo, Jaffna, Mannar, Batticaloa and Trincomalee in 2006-2007. Although sporadic outbreaks are almost never heard of, a study conducted in 2013 showed that chikungunya could be a prominent cause of fever in the Southern parts of Sri Lanka.
Being outdoors especially during daytime increases risk of infection thereby leaving hikers, campers and adventure travellers at risk. Prevention of the disease is possible using insect repellent and wearing long protective clothing.
Symptoms usually manifest after approximately 3-7 days of infection and are similar to that of dengue. The initial symptoms are sudden onsets of headaches, high fevers with intermittent chills which may or may not be accompanied with muscle aches, joint pains, nausea, vomiting and a rash. If such symptoms occur, it is best to see your doctor especially if it is during a seasonal outbreak. While the disease is not fatal, it can be debilitating. The usual recovery period is one week with joint pain lingering for months in some cases.