Colombia (Lonely Planet, 5th Edition) - Jens Porup [275]
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TRAVELER’S DIARRHEA
To prevent diarrhea, avoid tap water unless it has been boiled, filtered or chemically disinfected (iodine tablets); only eat fresh fruits or vegetables if cooked or peeled; be wary of dairy products that might contain unpasteurized milk; and be highly selective when eating food from street vendors.
If you develop diarrhea, be sure to drink plenty of fluids, preferably an oral rehydration solution containing lots of salt and sugar. A few loose stools don’t require treatment but if you start having more than four or five stools a day you should start taking an antibiotic (usually a quinolone drug) and an antidiarrheal agent (such as loperamide). If diarrhea is bloody or persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain you should seek medical attention.
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ENVIRONMENTAL HAZARDS
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Altitude Sickness
Altitude sickness may develop in travelers who ascend rapidly to altitudes greater than 2500m, including those flying directly to Bogotá. Being physically fit does not in any way lessen your risk of altitude sickness. Symptoms may include headaches, nausea, vomiting, dizziness, malaise, insomnia and loss of appetite. Severe cases may be complicated by fluid in the lungs (high-altitude pulmonary edema) or swelling of the brain (high-altitude cerebral edema). Most deaths are caused by high-altitude pulmonary edema.
The standard medication to prevent altitude sickness is a mild diuretic called acetazolamide (Diamox), which should be started 24 hours before ascent and continued for 48 hours after arrival at altitude. Possible side effects include numbness, increased urination, tingling, nausea, drowsiness, nearsightedness and temporary impotence. For those who cannot tolerate acetazolamide, most physicians prescribe dexamethasone, which is a type of steroid. A natural alternative is gingko, which some people find quite helpful. The usual dosage is 100mg twice daily.
To lessen the chance of altitude sickness, you should be sure to ascend gradually or by increments to higher altitudes, avoid overexertion, eat light meals and avoid drinking alcohol.
If you or any of your companions show any symptoms of altitude sickness, you should not ascend to a higher altitude until the symptoms have cleared. If the symptoms become worse, immediately descend to a lower altitude. Acetazolamide and dexamethasone may be used to treat altitude sickness as well as prevent it.
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Animal & Snake Bites
Do not attempt to pet, handle or feed any animal, with the exception of domestic animals known to be free of any infectious disease. Most animal injuries are directly related to a person’s attempt to touch or feed the animal.
Any bite or scratch by a mammal, including bats, should be promptly and thoroughly cleansed with large amounts of soap and water, followed by application of an antiseptic such as iodine or alcohol. The local health authorities should be contacted immediately for possible postexposure rabies treatment, whether or not you’ve been immunized against rabies. It may also be advisable to start an antibiotic, since wounds caused by animal bites and scratches frequently become infected. One of the newer quinolones, such as levofloxacin (Levaquin), which many travelers carry in case of diarrhea, would be an appropriate choice.
In the event of a venomous snake bite, place the victim at rest, keep the bitten area immobilized, and move the victim immediately to the nearest medical facility. Avoid tourniquets, which are no longer recommended.
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Heatstroke
To protect yourself from excessive sun exposure, you should stay out of the midday sun, wear sunglasses and a wide-brimmed sun hat, and apply sunscreen with SPF 15 or higher, with both UVA and UVB protection. Travelers should