...s, and often sufferers may feel like they have a bad cold or flu on the ay. The onset of typhoid fever is normally gradual, ith fever, malaise, chills, headache, generalized aches in the muscles and joints, tiredness, loss of appetite, and sore throat. Abdominal pain and distension may occur. Vomiting, hich may occur toard the end of the first eek, is not usually severe. Diarrhea is infrequent constipation occurs more often than diarrhea. A fever develops hich rises a little each day until it is around 104 degrees Fahrenheit or more. The persons pulse is often slo relative to the degree of fever present and gets sloer as the fever rises, unlike a normal fever here the pulse increases. In the second eek, the high fever and slo pulse continue and a fe pink spots may appear on the body. Trembling, delirium, eakness, eight loss and dehydration are other symptoms. Pea soup diarrhea may occur. Abdominal pain and distension may be increased. If there are no further complications, the fever and other symptoms ill sloly diminish during the third eek. Hoever, typhoid is a very dangerous infection and an infected individual must get medical help as soon as possible, because pneumonia or peritonitis perforated boel are common complications. Diagnosis comes from isolation of Salmonella typhi from the blood or stool of an infected person.The best protection is to avoid consuming food or ater that may be contaminated. For foreign travelers, drinking only boiled ater or carbonated beverages and eating only cooked food, loers the risk of infection.The fever should be treated by keeping the victim cool, and dehydration should also be atched for. Treatment is ith ampicillin, chloramphenicol, Bactrim, or Cipro, depend ing upon the clinical circumstances. Chloramphenicol is the most effective drug for treatment of the acute illness, if the organism is not resistant. If hospital facilities are not close by, consider starting treatment ith Cipro. Ampicillin and amoxicillin are effective alternatives. Fatalities are less than 1 percent ith antibiotic treatment. Even after effective treatment, you may continue to carry typhoid bacteria in your intestinal tract, hich can be passed to close contacts such as family members. Follo-up testing is very important. Relapses are common, and the frequency of relapse does not appear to have been changed dramatically by antibiotic therapy.Vaccines are available that afford significant protection. Currently available vaccines have been shon to protect 70 - 90 of the recipients. Therefore, even vaccinated travelers should be cautious in selecting their food and ater.The oral vaccine consists of 4 capsules containing live attenuated bacteria. They are taken every other day for seven days. The oral vaccine is effective for travelers to infected areas for five years. The entire 4 doses should be repeated every 5 years if the person is at continued risk. Reactions are rare and include nausea, vomiting, abdominal cramps, and skin rash.The injectable vaccine consists of a primary series of to shots, spaced at least 4 eeks apart. A booster dose given every 3 years provides continued protection for repeated exposure. If there is insufficient time for to doses a month apart, an accelerated schedule of three shots a eek apart may be administered. The accelerated schedule may be less effective.CDC recommends a typhoid vaccination for those travelers ho are going off the usual tourist itineraries, traveling to smaller cities and rural areas, or staying for six eeks or more. Typhoid vaccination is not required for international travel.HIV AIDSAcquired Immune Deficiency Syndrome AIDS is caused by infection ith the Human Immunodeficiency Virus HIV. HIV destroys the bodys immune system, hich means that the body can no longer successfully fight against certain infections and some forms of cancer.AIDS is a global problem. It is estimated that more than six to eight million people are no infected ith the HIV virus. Sex orkers are frequently infected the proportion infected exceeds 80 in many parts of the orld, and the current stated average population infection rate in Africa is one in 40.Human immunodeficiency virus HIV hich causes acquired immunodeficiency syndrome or AIDS is found primarily in blood, semen, and vaginal secretions of an infected person. HIV is spread by sexual contact ith an infected person, by needle-sharing among injecting drug users, and through transfusions of infected blood and blood clotting factors. Babies born to HIV-infected mothers may have the disease.In the United States blood is screened for HIV antibodies, but this screening may not take place in all countries. Scientific studies have revealed no evidence that HIV is transmitted by air, food, ater, insects, inanimate objects, or casual contact. Even though HIV antibodies are normally detected on a test ithin 6 months after infection, the period beteen infection and development of disease symptoms incubation period may be 10 years or longer. Treatment has prolonged the survival of some HIV infected persons, but there is no knon cure or vaccine available.AIDS is found throughout the orld. The risk to a traveler depends on hether the traveler ill be involved in sexual or needle-sharing contact ith a person ho is infected ith HIV. Receipt of unscreened blood for transfusion poses a risk for HIV infection.Most everyday activities pose no risk of HIV transmission. Normal social contact, simming in public pools, eating in restaurants and using public toilets are not dangerous. There is no scientific evidence to suggest that mosquitoes transmit HIV.Avoiding casual unprotected sexual contacts is the best solution. Other than this, condoms are a reasonable barrier. Hoever, if petroleum lubricants are used, condoms are liable to break as petroleum products attack latex. Also, locally produced condoms can often be poor quality and are not recommended.Never use needles or syringes that have been used by others. hen receiving medical attention, alays insist that unused, disposable equipment or fully sterilized material is used. If you do need an injection, ask to see the syringe unrapped in front of you, or better still take a needle and syringe pack ith you overseas - it is a cheap insurance package against infection ith HIV. Never use another persons razor or toothbrush. Dont have parts of your body pierced, or allo yourself to be tattooed.HIVAIDS can be spread through infected blood transfusions. Most developing countries cannot afford to screen blood for transfusions.No effective vaccine has been developed for HIV.CHOLERACholera is an acute intestinal diarrheal disease caused by a bacterium -- Vibrio cholerae, hich is found in ater contaminated by seage. Cholera occurs both sporadically and in large, abrupt epidemics.An epidemic of cholera started in South America in 1991, and has sept through Central and South America since then. Cholera cases ere first recognized in Peru in the last eek of January 19...
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