384
HEALTH
IN MYANMAR^
Infectious
Diseases
The following are the most
common for travellers:
Dengue Fever Increasingly
problematic throughout
Myanmar. The mosquito that
carries dengue bites day and
night, so use insect avoid-
ance measures at all times.
Symptoms can include high
fever, severe headache, body
ache, a rash and diarrhoea.
There is no specific treat-
ment, just rest and paraceta-
mol – do not take aspirin as
it increases the likelihood of
haemorrhaging.
Hepatitis A This food- and
water-borne virus infects the
liver, causing jaundice (yel-
low skin and eyes), nausea
and lethargy. All travellers to
Myanmar should be vacci-
nated against it.
Hepatitis B The only
sexually transmitted disease
(STD) that can be prevented
by vaccination, hepatitis B
is spread by body fluids,
including sexual contact.
Hepatitis E Transmitted
through contaminated food
and water and has similar
symptoms to hepatitis A,
but is far less common. It is
a severe problem in preg-
nant women and can result
in the death of both mother
and baby. There is currently
no vaccine, and prevention is
by following safe eating and
drinking guidelines.
HIV Unprotected heterosex-
ual sex is the main method
of transmission.Influenza Can be very
severe in people over the
age of 65 or in those with
underlying medical condi-
tions such as heart disease
or diabetes; vaccination is
recommended for these
individuals. There is no
specific treatment, just rest
and paracetamol.
Malaria While not noted
in Yangon or Mandalay,
malaria (which can be fatal
if untreated) is very much
present throughout the rest
of rural Myanmar in altitudes
below 1000m. Before you
travel, seek medical advice
on the right medication and
dosage for you; note that
some areas of the country
have strains of the disease
resistant to Mefloquine-
based drugs. Wherever you
are, wear long pants and
sleeves and spray insect re-
pellent to prevent bites. Also
sleep in air-con or screened
rooms with bednets.
Rabies A potential risk, and
invariably fatal if untreated,
rabies is spread by the bite
or lick of an infected animal
(most commonly a dog or
monkey). Pretravel vaccina-
tion means the postbite
treatment is greatly simpli-
fied. If an animal bites you,
gently wash the wound with
soap and water, and apply
iodine-based antiseptic. If
you are not prevaccinated
you will need to receive
rabies immunoglobulin as
soon as possible.
Typhoid This serious bacte-
rial infection is spread via
food and water. Symptomsinclude high and slowly
progressive fever, headache,
a dry cough and stomach
pain. Vaccination, recom-
mended for all travellers
spending more than a week
in Myanmar and other parts
of Southeast Asia, is not
100% effective so you must
still be careful with what you
eat and drink.Traveller’s
Diarrhoea
By far the most common
problem aff ecting travellers is
usually caused by a bacteria.
Treatment consists of staying
well hydrated; use a solution
such as Gastrolyte. Antibi-
otics such as Norfl oxacin,
Ciprofl oxacin or Azithromycin
will kill the bacteria quickly.
Loperamide is just a ‘stop-
per’, but it can be helpful in
certain situtations, eg if you
have to go on a long bus
ride. Seek medical attention
quickly if you do not respond
to an appropriate antibiotic.
Amoebic dysentery is
very rare in travellers; one
sign is if you have blood in
your diarrhoea. Treatment
involves two drugs: Tinidazole
or Metronidazole to kill the
parasite in your gut, and then
a second drug to kill the cysts.
Giardiasis is relatively
common. Symptoms include
nausea, bloating, excess
gas, fatigue and intermittent
diarrhoea. The treatment
of choice is Tinidazole, with
Metronidazole being a sec-
ond option.Environmental
Hazards
Air Pollution
Air pollution, particularly ve-
hicle pollution, is an increas-
ing problem, particularly in
Yangon. If you have severe
respiratory problems speak
with your doctor before trav-
elling to any heavily polluted
urban centres. This pollution
also causes minor respiratoryHEALTH ADVISORIESConsult your government’s website on health and travel
before departure:
» Australia http://www.smartraveller.gov.au
» Canada http://www.phac-aspc.gc.ca/tmp-pmv/index-eng.
php
» New Zealand http://www.safetravel.govt.nz
» UK http://www.dh.gov.uk
» USA wwwnc.cdc.gov/travel/