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November 24, 2009
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Travel Medicine (cont.)

Polio

Polio is a viral illness that can lead to severe neuromuscular problems. The polio virus is ingested through the mouth and then makes its way to the central nervous system. Many people have no symptoms, but some have neurological problems such as weakness and paralysis. Symptoms are especially severe if they involve the breathing muscles. Polio is spread from person to person. Infected secretions and feces can cause disease.

Thanks to a major public-health campaign, many countries no longer have polio. A few countries in Africa, South Asia, Southeast Asia, and the Middle East still have outbreaks. The list of infected countries is constantly changing as some countries successfully eliminate the infection and others become reinfected. Check with the CDC to see if your itinerary includes any of these countries.

The inactivated polio vaccine is recommended if the traveler is going to an area where polio is still occurring. A single booster dose is sufficient if the traveler has received the usual vaccine series in childhood. If the traveler has not been fully vaccinated in the past, more doses may be needed.

Cholera

Cholera is an infection caused by bacteria (Vibrio cholerae) that look like curved rods. The bacteria attach to the inside of the intestines and secrete a toxin. The cholera toxin can cause the cells in the intestines to pour out large amounts of water. In severe cases, the excess water loss leads to massive amounts of watery diarrhea that can contain cells from the body and bacteria. The term "rice water" is often used to describe this diarrhea because of the appearance of small white flecks of mucus in liquid.

Cholera can be spread when human waste contaminates water and food. Because it takes a high numbers of bacteria to cause infection, the contamination usually has to be quite significant. For example, in areas of poor sanitation, cholera can be spread when the water supply is contaminated by feces from people who are sick. Cholera is rare in travelers because most travelers avoid heavily contaminated food and water.

Cholera is most common in areas that have poor sanitation, with faulty sewage systems or contaminated drinking water. Cholera can be prevented by using proper sanitation and sewage treatment. Boiling, filtering, or chlorinating water can help to prevent the spread of cholera.



Next: What about diseases for which there is no vaccine or preventive medication? »

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