|1999 NE VOSH Travel Advisory|
During the best of times, travel to any third-world country entails risk due to poor sanitary conditions and health infrastructure. Natural disasters such as flooding enhance those risks and introduce new ones. Enhanced precautions this year can keep those risks to a minimum.
We will be working in Masatepe and staying in Granada. Both of those towns were spared the flooding, mudslides, and other disastrous sequelae of Hurricane Mitch. The greater devastation was towards the northern region of Nicaragua. The worst disease outbreaks will be confined to those areas but there will be pockets and smaller outbreaks throughout Central America as displaced, homeless refugees export certain illnesses with them. Specific illnesses such as leptospirosis should be confined only to the devastated
Joe D'Amico's VOSH group will see more direct damage in San Juan del Sur.
What to expect:
You can expect to see some added pathos. You might see patches of devastation: roads and bridges washed out; communities destroyed. I would imagine that there will be many more displaced homeless refugees in Granada with a significant rise in begging. My contacts have not reported any increase in crime. There will be a significantly increased risk of mosquito-borne illnesses: malaria and dengue fever. Last year I took a straw vote
regarding malaria: 50% of participants were not taking medicine. This year the choice is not really optional... You will hear of outbreaks of leptospirosis, typhoid fever, and cholera elsewhere in the country.
Granada has, or at least had, a relatively safe municipal water supply.
At the clinic, your patients will have increased incidence of conjunctivitis, skin rashes, and diarrhea. And they will still need eyeglasses and bless you when you are done...
Summary of recommendations (detailed explanations in next section):
Diptheria/tetanus booster: every 10 years
Malaria prophylaxis with CHLOROQUINE
Hepatitis A prophylaxis: either Hep A Vaccine or gamma globulin
Hepatitis B vaccine
Oral typhoid fever vaccine
Container of hand-wipes
Food/drink precautions (reviewed below)
Needed vaccinations should be obtained as soon as possible.
Diphtheria/tetanus booster: needed every 10 years
Spread by the bite of specific species of mosquito infected with malaria, a protozoan.
Prophylaxis: use CHLOROQUINE; first tab one week before travel, then one tab a week for 4 weeks following return
Caused by a subspecies of Salmonella, a bacterium
Like cholera, obtained by ingestion of
food/drink contaminated by sewage, ie: oral/fecal
|Be careful out there.
Common sense food/drink advice (courtesy of the CDC):
"Boil it, cook it, peel it, or forget it"
If you drink water, buy it bottled or bring it to a rolling boil for 1 minute
before you drink it. Bottled carbonated water is safer than uncarbonated
Ask for drinks without ice unless the ice is made from bottled or boiled
water. Avoid popsicles and flavored ices that may have been made with
Eat foods that have been thoroughly cooked and that are still hot and
Avoid raw vegetables and fruits that cannot be peeled. Vegetables like
lettuce are easily contaminated and are very hard to wash well.
When you eat raw fruit or vegetables that can be peeled, peel them yourself.
(Wash your hands with soap first.) Do not eat the peelings.
Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street, and many travelers get sick from food bought from
Further internet information:
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