Bhutan - Lindsay Brown [222]
Self-treatment may be appropriate if your problem is minor (eg traveller’s diarrhoea), you are carrying the appropriate medication and you cannot attend a recommended clinic. If you think you may have a serious disease, especially malaria, do not waste time – travel to the nearest quality facility to receive attention. It is always better to be assessed by a doctor than to rely on self-treatment.
In most large towns there are shops that sell medicines. Most of the medical supplies mentioned in this section are available without a prescription in these medicine shops.
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INFECTIOUS DISEASES
Coughs, Colds & Chest Infections
Respiratory infections usually start as a virus and are exacerbated by environmental conditions such as urban pollution, or cold and altitude in the mountains. Commonly a secondary bacterial infection will intervene – marked by fever, chest pain and coughing up discoloured or blood-tinged sputum. If you have the symptoms of an infection seek medical advice or commence a general antibiotic.
Dengue Fever
This mosquito-borne disease is becomingly increasingly problematic throughout the tropical world, especially in the cities. As there is no vaccine available it can only be prevented by avoiding mosquito bites. The mosquito that carries dengue bites day and night, so use insect avoidance measures at all times. Symptoms include high fever, severe headache and body ache (dengue was previously known as ‘breakbone fever’). Some people develop a rash and experience diarrhoea. There is no specific treatment, just rest and paracetamol – do not take aspirin as it increases the likelihood of haemorrhaging. See a doctor to be diagnosed and monitored.
Hepatitis A
A problem throughout the region, this food- and water-borne virus infects the liver, causing jaundice (yellow skin and eyes), nausea and lethargy. There is no specific treatment for hepatitis A, you just need to allow time for the liver to heal. All travellers to Bhutan should be vaccinated against hepatitis A.
Hepatitis B
The only sexually transmitted disease that can be prevented by vaccination, hepatitis B is spread by body fluids, including in sexual contact. The long-term consequences can include liver cancer and cirrhosis.
Hepatitis E
Hepatitis E is transmitted through contaminated food and water and has similar symptoms to hepatitis A, but is far less common. It is a severe problem in pregnant 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
HIV is spread via contaminated body fluids. Avoid unsafe sex, unsterile needles (including in medical facilities) and procedures such as tattoos.
Influenza
Present year-round in the tropics, influenza (flu) symptoms include high fever, muscle aches, runny nose, cough and sore throat. It can be very severe in people over the age of 65 or in those with underlying medical conditions such as heart disease or diabetes; vaccination is recommended for these individuals. There is no specific treatment, just rest and paracetamol.
Japanese B Encephalitis
This viral disease is transmitted by mosquitoes and is rare in travellers. Like most mosquito-borne diseases it is becoming a more common problem in affected countries. Most cases occur in rural areas and vaccination is recommended for travellers spending more than one month outside cities. There is no treatment, and a third of infected people will die, while another third will suffer permanent brain damage.
Malaria
For such a serious and potentially deadly disease, there is an enormous