Dengue Fever: Fastest Growing Vector Borne Disease?

The map shows worldwide distribution of Dengue Fever. Blue: Areas infested with Aedes aegypti. Red: Areas with Aedes aegypti and recent epidemic dengue fever.

WorldNomads.com‘s roving medical expert Dr. Erik McLaughlin MD discusses Dengue Fever, its symptoms and the preventative measures travelers can take when visiting at risk areas.

What is Dengue Fever?

A recent article on Medical News Today discussed Dengue Fever as the fastest growing vector borne disease in the world. Dengue is a viral illness that is spread by the bite of infected Aedes mosquitoes. This illness, once confined to SE Asia has now become more common in Latin America, Asia, Africa, North America and even Australia. Dengue, nicknamed “breakbone fever” due to the wracking muscle cramping it causes, has no specific treatment and carries a case fatality rate of 40-50% if left untreated and progresses to the dreaded Dengue Hemorrhagic Fever (DHF).

Dengue fever is a flavavirus that is classified into 4 different strains, named Dengue 1, 2, 3 and 4. All four different strains can be present in the same geographic area, at the same time. Once a person is infected with a specific strain of Dengue, they are believed to be immune to that strain for life. The problem occurs when a person who has been previously infected with one strain acquires a second and different strain. This infection by a second strain increases the likelihood that a person will acquire Dengue Hemorrhagic Fever (DHF) characterized by uncontrolled bleeding from the gums, intestinal tract, skin rash and fevers. The increased risk of progression to DHF with each subsequent infection is exactly one of the reasons why producing a successful vaccine has been so difficult.

What are the symptoms?

Symptoms of Dengue fever can be as mild as a slight fever, head and muscle aches, rash and nausea/vomiting. Often times, the first case of Dengue gets undiagnosed by a person who believes they simply have a “bad cold” and then go on to make a full recovery.

This has now made their body a candidate for DHF should they become infected a second or even third time.

Who is at risk?

The World Health Organization estimates that there are roughly 50 million Dengue infections per year and 2.5 billion people live in areas at risk for Dengue infection. This is 2/5 of the world’s population. In 1970 there were only 9 countries with Dengue fever and at present there are 100 countries that contain Dengue. With the Aedes Mosquito acting as the vector or carrying agent for Dengue, one can clearly see the explosive growth the mosquito species has had, as well.

Researchers are attempting to link increased global temperatures and rainfall with the increased Dengue activity. The idea that warmer weather leads to increased mosquitoes and mosquito breeding grounds is nothing new, especially combined with standing water which allows the mosquitoes to have an ideal breeding ground.

How can I prevent Dengue Fever?

Prevention of Dengue fever by travelers centers around several key points. First, knowledge that one is traveling in a potential Dengue area should raise alert and prompt the traveler to be cautious. Second, prevention of mosquito bites should become a way of life. Using DEET sprays, permethrin treated clothing, bed nets and long sleeves and pants are vital steps to help keep mosquitoes away from your skin. Lastly, be cautious of areas with standing water such as upturned canisters, flower pots, tires that may contain water and lakes or large puddles. Public Health campaigns center on the destruction of these standing water breeding grounds, trying to eliminate of at least decrease the Aedes mosquito population.

Travelers headed to areas with Dengue activity should travel prepared to do what they can to prevent mosquito bites. Caution should also be used when looking at the time of year traveling occurs, especially during rainy seasons. Dengue should not be going away any time soon and savvy travelers need to be aware of it and start getting used to taking proper precautions.

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com – an essential part of every adventurous traveller’s journey.

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Travel Scams 2.0: The Evolution of Deceit

You’ve most likely been warned about pickpockets, drink spiking, and conniving tuk-tuk drivers. However, new and increasingly more creative scams seem to keep popping up on the backpacker trails everywhere. We’ve highlighted some of the latest scammer tricks and trends, and how to handle them safely while they are happening.

The Bogus Doctor Scam

Relatives of overseas travellers are being contacted by bogus doctors and hospital staff claiming their family member has been injured and asking for money to be sent for medical treatment. In this new scam, relatives are contacted by phone, email or SMS text messages and given contact details of where to send the money that will pay for the treatment of their supposedly injured loved one. In reality, no one is in hospital, the details are their personal accounts – and if you panic and act on their request, you will be out a large sum of money.

How to avoid this scam – You should share your insurance policy details with friends or family before leaving. If they can’t get through to you, then at least they can get through to the emergency assistance number and they can contact the person who is claiming someone is injured.

How to stay safe when it’s happening – If you are the friend or relative of a traveler and receive such a call, it’s advised to hang up and call the hospital or doctor back – but only through a publicly advertised number such as the yellow pages or other reputable directories. Do not use the contact details the potential scammer has sent you or the organization’s contact details given by the person requesting the information. Again, contact your travel insurance emergency assistance team to help, that’s why they’re there !

The Gems Scam

Gem scams are the most prolific and website forums are littered with stories of travellers who thought they were buying rare, ‘illegally smuggled’ Burmese gems at a fraction of the cost. Soon they find out that their polished gems are polished glass and worthless and the shop they bought from, was not an official government gem store and is no longer there. Worst still are those travellers that choose to pay up front on the belief that the ‘precious gems’ will be sent home, but alas nothing arrives in the mail. This is particularly prevalent in Thailand.

How to avoid this scam – As a rule of thumb, if the price appears to be too good to be true, it probably is! Thai people may sometimes be poor by Western standards but they are not stupid (that goes for market traders everywhere). You’ll be interested to know that there are no jewelery or gem shops that are owned, operated, or sponsored by the government in Thailand.

How to stay safe when it’s happening – As with the tailor scam, you’re unlikely to be at risk from a personal safety viewpoint. Golden rule, do not, under any circumstance agree to follow a street vendor to a gem store that’s ‘just around the corner’, you may well end up being mugged in a back alley!

The Gambling Scam

A traveller is approached on the street by a friendly local who invites you for a drink at their house. After a nice meal a friend or relative arrives and lets them know of a card game happening later that day with some inside tips on how they can cheat and make some easy cash. The ‘mark’ turns up for the game, is allowed to win a few hands but then starts losing and is bankrolled by that friendly person they met on the street, who cooked them such a lovely meal. You see where this is going?

Suddenly the new-found friend is not so friendly and wants that money back and now. Generally under the threat of violence, the ‘mark’ ends up cashing their travellers cheques or clearing out their ATM.

How to avoid this scam – Just be cautious when accepting the warm hospitality that locals may display that you’re not being coerced into something other than a terrific meal. Trust your instincts if you’re not comfortable. Better to risk offending than your personal safety.

How to stay safe when it’s happening – of all of the scams this is the one that has the most amounts of reported threats of violence. If you do find yourself stuck in this situation, and I hope not after reading this, comply with your attacker. If you’re essentially being robbed at knifepoint, the safest course of action is to hand over the money. Personal safety has to come first.

The Tailor Scam

A classic scam involving promises of the finest Kashmir suits, made to perfectly fit, paid in advance. Two days later your clothes arrive at your hotel and low and behold the material does not seem to be the finest Kashmir and the fit is suitable for an 8-year old. Not to worry, the tailor comes to your hotel to measure for adjustments and tells you the dodgy material is just being used to get the fit right. Promises of delivery are made, ensuring that you’ll have them before your flight leaves. Sure enough 30 minutes before you have to get on a plane, they arrive. The same ill-fitting, poor material rags you saw the day before. Too late to chase them down, home you go with what’s now a pretty worthless outfit.

How to avoid this scam – This is a tough scam to avoid, given the relatively hit & miss results travellers have experienced when getting tailored suits, particularly throughout Asia. One suggestion is to bring your own material and research online for those tailors who are well regarded by other travellers.

How to stay safe when it’s happening – You’re generally not going to be at risk from a personal safety viewpoint when it comes to this scam, aside from the rogue tailors pin when measuring up. Our advice to best avoid this particular problem is to only use a tailor who has a shop or factory and to arrange fittings there.

For more information and tips on popular scams check out:

Travel Scams 101

Scams – the advanced course

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com provides travel insurance and travel safety service s to residents over 150 countries. Find out why WorldNomads.com is an essential part of every adventurous traveler’s journey.

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If Travelers Are Where Disaster Strikes: Survival Tips from WorldNomads.com

Immediately following the tragedy in Haiti, WorldNomads.com, the travel services company that’s helping travelers stay safe and stress-free on the road, posted information on their Travel Safety Hub on how travelers can safeguard their own health and safety in an earthquake / disaster affected area.

If you have access to a working phone or the internet:

- Make contact with family, friends & your local embassy and let them know that you’re safe.

If you are injured or become ill

- Contact your travel insurance 24-hour medical assistance service as soon as possible, they’ll guide you through what to do next. Follow their advice to the letter.

- If you’re not covered under a travel insurance policy, seek attention at the nearest medical clinic or ask for directions to your nearest embassy.

Beware of the environment:

- Avoid downed power lines and disaster-caused hazards. Use battery-powered flashlights and lanterns, rather than candles, gas lanterns or torches. Following a disaster there may be rapidly moving water that can also carry infections. Disasters resulting in massive structural damage can also result in exposure to chemical or biologic contaminants (i.e asbestos).

- Do not return to your hotel / accommodations, or any building, if they are in any way damaged as aftershocks could cause a collapse.

- Move to the nearest open area (oval, park) away from damaged buildings, trees or roads where powerlines may have fallen.

Keeping Safe:

- Disease can spread very quickly post disaster, so ensure you protect against injuries and infections by wearing sturdy footwear. Tetanus is a potential health threat for cuts and grazes.

- Frequent hand washing helps keep germs at bay. (If a traveler becomes unwell within six weeks of returning home and has fever, rash, respiratory illness or any other unusual symptoms, advise a physician of having just returned from a disaster-affected region.)

- Drink only bottled, boiled or disinfected water. For more information refer to the CDC website (http://www.cdc.gov/).

- In the event of diarrhea, replace lost fluids with clean drinking water or oral rehydration solutions.

- Keep close tabs on personal belongings, passport and money.

Getting out:

- Follow all advice from either your medical assistance service and/or local emergency service team and authorities to move to safe zones or transport to take you to the airport for evacuation.

Chris Noble, General Manager of WorldNomads.com says “Being caught in the middle of a natural disaster is both terrifying and confronting, but it’s also the one situation where you need to remain as calm as possible. Help those around you if able, take every pre-caution to avoid placing yourself at further risk and follow all directions from emergency services”.

WorldNomads.com products and services include global travel insurance protecting residents from over 150 countries with high value medical and evacuation coverage, 24-hour emergency assistance and coverage for a large range of adventure activities; language guides and travel blogs plus a stream of travel safety information to ensure all World Nomads stay informed, educated and safe when traveling.

WorldNomads.com clients may also donate to a range of community development projects when purchasing travel insurance through the company’s Footprints Charity program http://footprints.worldnomads.com/.

Collectively, The Footprints Network has raised over $800,000, from over 310,000 donations, which has funded 53 projects across the globe through partner organizations such as Oxfam, Save the Children and Water Aid.

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5 Things I Wish I Knew Before Going to Mexico

Ay, Caramba! You’ve gone on that long awaited vacation to Mexico and all of sudden you 1. Are sick 2. Had your money stolen or 3. Are stuck alone on a roadside! At World Nomads we’re lucky to have lots of friends in the travel industry, we polled them to give you the very best tips staying safe in Mexico.

1. Learn the Lingo.
A little bit of Spanish goes a long way! Try your hardest with the locals and it will get you a lot further than simply trying to get them to understand English.

Daniel Radcliffe, Volunteer HQ

2. Drink responsibly.
The variety of tequila is simply overwhelming, so was the hangover! Drink responsibly and test new alcohols cautiously and with friends that can watch out for you. No matter what your friends say don’t eat the worm in the Tequila bottle!!

Mat Lewis, i-to-i
3. Stay alert!
If you get far off the beaten path (for example, deep in the Copper Canyon) and see fancy late-model pickups and gated driveways, know that you’re in a drug growing and trafficking area and get the hell out of there.

Josh Steinitz, Nile Guide
4. Check the water.
Don’t drink the water also means don’t drink the ice! Check with your hotel or restaurant if the ice is made with purified water, same goes for anything that would be washed in water during preparation like salads.

Christina Tunnah, World Nomads
5. Get directions.
Rural roads can be bad. Very, very bad. Make sure your vehicle can handle them. The last thing you want is your rental to break down, your cell phone doesn’t work and no one speaks English. Check with the locals on which routes are the safest to take.

Kathy Dragon, Travel Dragon

It always helps to know a little bit of the local language, so have a quick study of the below:

¡Hola! = Hello
Buenos Dias = Good Day
Buenas Noches = Good Night
Gracias = Thank You
De Nada = You’re Welcome
¿Cuanto Cuesta? = How Much?
¿A Que Hora? = At What Time?
¿Donde esta el baño? = Where is the bathroom?
¡Emergencia! = Emergency!
¡Ayudame por favor! = Help me please!

Keen to learn more?

If you want to learn more Spanish in prep for your trip, check out our FREE Spanish Language Guides. If you’re determined to nail more than just the basics, check out our latest Spanish Language Guide PLUS iPhone app with over 500 phrases!

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When bears attack! Practical tips for staying safe in the wilderness

One of my favorite quotes from Hunter S. Thompson is “Civilization ends at the waterline. Beyond that, we all enter the food chain, and not always right at the top.” I feel the same can be said for those who venture into the wilderness.

WorldNomads.com‘s roving medical and adventure expert Dr. Erik McLaughlin MD shares these practical tips to help you enjoy the North American wilderness from the top of the food chain.

Adventurers who enjoy hiking, tramping, cycling, climbing and outdoor pursuits should always be prepared for conditions they cannot control. You can run into stronger, nastier and faster animals than yourselves… and it’s vital to know what to do.

Perhaps the most frightening animal to outdoor adventurers is the bear. I have a very healthy respect for bears of all types. Common sense should be used by those traveling through bear country and all bears should be considered dangerous.

Bear safety when you are camping:

Avoid camping in known bear feeding areas or movement routes
Keep garbage away from your campsite and do not camp in areas with garbage
Sleep in a tent and keep a flashlight inside
Keep sleeping bags partially unzipped for a quick get-away
Strongly consider carrying pepper spray or if properly trained, carry a firearm
Store food properly and keep it in bear-proof containers or hung in a tree, away from you
Cook and store food at a site away from your sleeping area
Try to change clothes after cooking and leave them with your food, away from your sleep area
Do not keep food, trail mix or energy bars in your tent or pockets when you sleep

When you are hiking or traveling:

Make lots of noise while moving so a bear is aware you are approaching
Do not rely on bear bells alone to produce adequate noise
Be aware of wind direction; an “upwind” bear cannot smell you
Heavy forested areas, rushing water, rain or fog can all act to decrease sound transmission. In these places be extra loud
Do not approach bears or any wild animal too close, especially not for a photograph or “better view”
If you observe signs of bears in the area (tracks, droppings or fresh prey carcasses) consider them to be close by
Avoid berry patches, elk grounds or streams with spawning fish because bears like to eat there

If you see a bear:

Allow the bear to see you are there. As a human, you are not one of their favorite meals
Avoid sudden movements or yelling
Do not climb a tree or attempt to run
Do not stare at the bear or make eye contact; look to one side or the other
Do not attempt to hide
Avoid standing next to objects such as tree stumps, bushes or things which will cause the bear to think you are anything but “human shaped”
Speak to the bear in a clear, calm voice to allow the bear to identify you as human

If attacked:

Do not run, climb trees, fight back or scream
Do not hold out an arm to ward of an attack
Drop to the ground and cover your head, in a fetal position
Curl into the smallest ball you can make yourself
Interlock your hands behind your head, covering your ears and use your elbows to protect your face
After you think the bear has left, try to move as little as possible while looking around
Try to see which way the bear went and travel in the opposite direction

If you are attempting to carry either a firearm or pepper spray, ensure you are properly trained to use these items. Fatal accidents can result from improper use or inadequate training.

Tips for avoiding other animal attacks

Avoid sudden movements around animals
Never pet an unknown dog
Never pet or kiss an animal, avoid petting them on the head
Do not reach into animal cages
After preparing food, wash your hands before touching an animal
Never leave children alone with animals
Do not try to take food or toys from an animal
Do not try to separate fighting animals

Perhaps the greatest danger from an animal attack or bite comes from the initial trauma of the bites or scratches. After the initial blood loss has been controlled and first aid has been rendered, there should be concern for infection. Often times, antibiotics are indicated following an animal bite, especially wild animals.

Rabies is always a concern and victims of animal attacks should speak with their health professional immediately about treatment or prevention following a bite. Frequently, stitching or tightly closing an animal bite will only serve to trap dangerous bacteria in the wound.

Finally, after being bitten, do not forget to check the status of your last tetanus shot.

Bear scare gadgets

Before hitting the trails in North America, you might like to whack these into your hiking pack…

Bear pepper spray

Bear bells
Further reading about

Travel Safety

Bear attacks

Surviving a mountain lion attack

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