Exotic travel is no longer a form of leisure activity for the very select few. Cheap flights and tours from travel agencies are increasingly attractively priced, making it more accessible to visit even the most remote corners of the world. Many people opt for last-minute offers to the tropics, which usually guarantee dreamlike weather, warm water in a body of water and carefree relaxation without any rush. Sounds fabulous, doesn't it? The memories remain beautiful, but a few days or weeks after your return you may find that, in terms of your health, you're in for a difficult time....

What can you "bring back" from the tropics?

Fever after returning from holidays in faraway places is not always associated with a tropical illness. Nevertheless, any person with a history of travel to the tropics in the last few weeks should be diagnosed for tropical diseases. These include dengue, typhoid, malaria, Zika virus infection, West Nile fever, yellow fever, travellers' diarrhoea and haemorrhagic fevers. Fevers should not be underestimated and should be explained by changes in climate zones, long travel and fatigue or cold.

Of course, an elevated temperature is not always indicative of infection by a dangerous virus or bacteria. It can be the result of common diseases (regardless of climate zone). These diseases include: influenza, measles, infectious mononucleosis, respiratory infections, urinary tract infections, nervous system infections, tuberculosis, gonorrhoea, HIV infection, dermatological diseases.

What symptoms besides fever should be alarming?

In addition to the fever, which may appear a few days or even weeks after returning from holiday, there may be other symptoms that should not be ignored. The most common include a skin rash of spots, papules or petechiae, vomiting, abdominal pain, headache, sore throat. Inflammation may involve lymph nodes with their enlargement and joints with increased soreness, warmth and tenderness. Symptoms that should immediately refer to the emergency department include dizziness, fainting, disturbance of consciousness, dyspnoea, visual, balance and gait disturbances. Jaundice can be a symptom of viral infection and liver damage.

Most common tropical diseases and geographical region of the world

Malaria - one of the most common infectious diseases of the tropical group. Caused by a protozoan of the Plasmodium group. Infection occurs during a mosquito bite, which introduces malaria spores into the human bloodstream along with saliva. Geographical region of malaria: Sub-Saharan Africa, Southeast Asia, Central and South Asia, the Caribbean, Central and South America. Prophylaxis with antimalarial drugs is necessary before travelling to countries with a high risk of infection.

Dengue - a tropical infectious disease caused by the Dengue virus, transmitted by various mosquito species. Symptoms can range from those similar to influenza to severe haemorrhagic fever, with hypovolaemia leading to shock in extreme cases. The geographical area covers Asia, Central and South America, Africa and Australia. There is no effective vaccine against Dengue, so protection against mosquitoes through the use of repellents and mosquito nets is important.

photo: panthermedia

Typhoid fever - a bacterial disease caused by Salmonella. The source of infection can be dirty water or contaminated raw food. It is characterised by high fever (up to 40 C), severe abdominal pain and a rash. During the trip, proper hand hygiene, thorough washing of vegetables and fruit, and caution when buying and preparing food is essential. A vaccine that gives immunity for 3 years is also possible. Geographical regions at risk of infection include Central and South Asia and Africa.

Rickettsioses - diseases of bacterialaetiology running mainly with fever. These include spotted fever, spotted fevers and scrub typhus. This is the main cause of fever after being in South Africa.

Zika virus infection - a mosquito-borne virus. It originated in Africa, but has spread to other continents and infection is likely in most regions of the world. Characterised by flu-like symptoms, with a rash, symptoms are usually mild. It can be dangerous for pregnant women, and cases of microcephaly have been reported in children of women infected with this virus.

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What can be done to reduce the risk of tropical disease?

Before going to the tropics, it is very important to prepare rationally and gain knowledge about the risk of infection in the region you are travelling to. I will outline some principles to be aware of when planning an exotic holiday.

• acquaint yourself with current epidemiological reports on the risk of exposure to tropical diseases in the places to which you are planning to travel (e.g. on the website of the World Health Organisation, WHO, at the following link: http://www.who.int/topics/tropical_diseases/en/),
• visit a centre (Travel Medicine Clinic) for prophylaxis and vaccination against infections in intertropical countries. During the visit, the doctor will take a medical history, recommend necessary and possible vaccinations and prophylaxis. (This is also handled by public health facilities),
• the provision of suitable repellents(agents containing DEET - one of the best known insect repellents) and mosquito nets to protect against mosquitoes, ticks and other insects. You can find out about suitable preparations during a visit to the Travel Medicine Clinic,
• during the trip consume drinking water only (preferably bottled), do not consume raw and semi raw products, unpasteurised dairy products,
• avoid contact with people who are ill; if you have had such contact, see a doctor on your return,
• appropriate clothing to protect against insect bites (long trousers, long-sleeved shirts, hats), especially after dusk,
• air-conditioned rooms with sealed windows and doors are the best accommodation.