Colombia (Lonely Planet, 5th Edition) - Jens Porup [273]
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HIV & AIDS
Infection with the human immunodeficiency virus (HIV) may lead to acquired immune deficiency syndrome (AIDS), which is a fatal disease. Any exposure to blood, blood products or body fluids may put the individual at risk. The disease is often transmitted through sexual contact, and in Colombia it’s primarily through contact between heterosexuals.
HIV and AIDS can also be contracted through infected blood transfusions, and you should be aware that not all hospitals screen blood supplies. The virus may also be picked up through injection with an unsterilized needle. Acupuncture, tattooing and body piercing are other potential dangers.
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Intestinal Worms
These parasites are common in humid, tropical areas. They can be present on unwashed vegetables or in undercooked meat, or you can pick them up through your skin by walking barefoot. Infestations may not show up for some time and, although they are generally not serious, can cause further health problems if left untreated. A stool test on your return home is not a bad idea if you think you may have contracted them. Medication is usually available over the counter and treatment is easy and short.
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Malaria
Malaria is transmitted by mosquito bites, usually between dusk and dawn. The main symptom is high spiking fevers, which may be accompanied by chills, sweats, headache, body aches, weakness, vomiting or diarrhea. Severe cases of malaria may involve the central nervous system and lead to seizures, confusion, coma and death.
Taking malaria pills is strongly recommended for all rural areas below 800m. Risk is highest in the departments of Amazonas, Chocó, Córdoba, Guainía, Guaviare, Putumayo and Vichada. There is no malaria risk in the major cities.
There is a choice of three malaria pills, all of which work about equally well. Mefloquine (Lariam) is taken once weekly, starting one to two weeks before arrival and continuing through the trip and for four weeks after return. The problem is that a certain percentage of people develop neuropsychiatric side effects, which may range from mild to severe. Atovaquone/proguanil (Malarone) is a newly approved combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side effects are typically mild. Doxycycline is a third alternative, but may cause an exaggerated sunburn reaction.
In general, Malarone seems to cause fewer side effects than mefloquine and is becoming more popular. The chief disadvantage is that it has to be taken daily.
Protecting yourself against mosquito bites is just as important as taking malaria pills, since none of the pills are 100% effective. If you have the chance to buy an insecticide-impregnated mosquito net before your trip, do so, as they are not yet available in Colombia.
If you may not have access to medical care while traveling, you should bring along additional pills for emergency self-treatment, which you should take if you can’t reach a doctor and you develop symptoms that suggest malaria, such as high spiking fevers. One option is to take four tablets of Malarone once daily for three days. However, Malarone should not be used for treatment if you’re already taking it for prevention. Antimalaria drugs are available free of charge at any Colombian hospital as part of the country’s antimalaria policy. Ask for the gota gruesa (thick smear) test.
If you develop a fever after returning home, see a physician, as malaria symptoms may not occur for months.
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Rabies
Rabies is a viral infection of the brain and spinal cord that is almost always fatal. The rabies virus is carried in the saliva of infected animals and is typically transmitted through an animal bite, though