health

Health Tips for Cambodia

Nota Bene: the follow is included in this section is for information only and is not intended for diagnostic purposes, if you feel unwell you should consult a qualified medical practitioner immediately.

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Acclimatisation

Adapting to a much warmer climate can take a couple of months. It is recommended that during this initial period visitors should increase their fluid intake, avoid outdoor activities in the middle of the day, wear loose clothing made from natural fibres and take frequent showers. It is recommended that you drink between four and six litres of water a day.

Sunburn

You can avoid serious sunburn by:
* Covering up, wearing suitable clothing for a hot climate, hats and long sleeves
* Use of a strong sun cream, especially on face, ears, arms and shoulders
* Covering any moles with plasters if you are going to be exposed to the sun for any length of time
* Wearing good quality sunglasses that filter out ultraviolet rays

Tropical Infections

Mosquitoes
Mosquito bites can carry Malaria, Dengue Fever and Japanese B Encephalitis.
Certain precautions can be taken to reduce the risk of being bitten, such as:
* Wear long trousers and long sleeved tops where possible, especially during dusk when mosquitoes are most active
* Ensure that your house, office, guest house or hotel has mosquito screens, especially in the bedrooms
* Sleep under a mosquito net, preferably one which is impregnated with permethrin ? nets should be retreated every six months
* Use an insect repellent on exposed skin, especially in provincial or rural areas
* Ensure that there are no breeding areas around your house. Still water in empty containers or tanks, ground water, et cetera

Symptoms of malaria include; headaches, chills, diarrhoea, high fever and nausea. In more serious cases delirium and coma can occur.

Symptoms for dengue fever include; severe headaches, muscle pains and rashes

Japanese B Encephalitis is a viral disease spread by the Culex mosquito which usually lives near rice paddies. Pigs are the normal host of the virus; the Culex mosquito is a night biter.

Scrub Typhus, or flea born typhus, is spread by mite, chigger or flea. It is primarily found in wild rats in scrub or grasslands.

Food and Water Borne Infections

General Guidelines for eating out
* Eat only freshly prepared cooked or fried foods served hot
* Never eat uncooked or poorly cooked shellfish
* Avoid raw salads or unpeeled fruit
* Avoid the ‘square’ ice and drink only the round ice with a hole

Diarrhoea is caused by a wide variety of bacteria, viruses and parasites. The most common bacterium is an unfamiliar toxigenic strain of E. Coli. People living here for a long time tend to become acclimatised to these different E. Coli strains within three to six months. Simple diarrhoea, without mucus or blood, is usually self-limiting and no specific treatment is required.
Diarrhoea can cause dehydration, so drink plenty of fluids, stay out of the heat and avoid strenuous exercise.

If symptoms persist for more than three days consult a medical practitioner.

Hepatitis A (HAV) infection is common and is caused by contaminated food or water. It is characterised by jaundice like symptoms and can be very debilitating, requiring plenty of rest and the absence of alcohol and fatty foods for a long time.

Hepatitis E (HEV) is also common and is also spread by contaminated food or water.

Percutaneous Infections

Dog and Animal Bites
If you are bitten by a dog or other animal immediately rinse the wound with clean, flowing, water for a minimum of fifteen minutes and then clean with alcohol or iodine; then seek qualified medical advice.

Snake bites and Scorpion Stings
There is little data about snake bites and scorpion stings in Cambodia and there is unlikely to be any serum available. Prevention is best achieved by:

* Walking on clear paths, wearing boots and using a torch at night
* Not putting your hands and feet in places that you can not see. The same applies for sitting down, snake bites to the bottom are not uncommon
* Being wary when exploring dark, cool, places such as inner temples, ruined houses, outside toilets, or caves where snakes and scorpions can reside
* Check shoes and clothing left on the floor overnight before putting on

That said, many snakes are not poisonous and even bites from poisonous snakes can often contain no venom. Scorpion stings, while painful, are rarely poisonous. Again, if bitten clean the wound and immediately seek qualified medical advice.

Hepatitis B
For expatriates, or long term visitors, the main routes of infection are through blood contacts e.g. shared needles, tattoo needles, blood transfusions and sexual intercourse. Vaccines are generally available in the West and recommended before arrival.

Swimming
It is fine to swim in the sea, however if swimming in rivers or lakes there is a risk of schistosomiasis (bilharzias) which is caused by humans defecating into water and leptospirosis that is caused by rats urinating into water.

Airborne Infections

Tuberculosis (TB) is common in parts of Cambodia. Infection is possible if you are working closely with an infected person, or if your partner is infected.

Worms and Things

People living in tropical climates are at a higher risk of becoming infested with parasites. Most infestations are asymptomatic, however others can present with signs and symptoms that range from minimal to life threatening.

Common parasitic infestations include; tapeworm, liver flukes, round worm, thread worm, whip worm, hook worm and filariasis.

How to avoid worms
* Wash your hands thoroughly before eating.
* Be wary of biting your nails in developing Countries, this habit can transfer germs from your surroundings into your mouth and stomach
* Choose your foods and fluids carefully, eat only food that has been freshly prepared and drink only bottled water
* Avoid going barefoot, especially in cultivated fields, or where people may have been to the toilet, some species of worms can enter through the foot

Treatment
Some people routinely take a mebendozole tablet every six months as a general preventative against intestinal worms. A stool sample test should reveal the presence of intestinal worms. Treatment is usually then given under medical supervision using either mebendozole or albendazole tablets in a dosage dependant on the test results, your doctor will explain the regime. A differing treatment is needed for tape worm.

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