Cuba - Lonely Planet [397]
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, 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
Animal 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 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 (Click here). 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.
Spiny sea urchins and coelenterates (coral and jellyfish) are a hazard in some areas. Some stings (eg from a Portuguese man-of-war) can produce a bad reaction, and if you start to feel nauseous or faint you should seek medical treatment.
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. Sunscreen should be generously applied to all exposed parts of the body approximately 30 minutes before sun exposure and should be reapplied after swimming or vigorous activity. Travelers should also drink plenty of fluids and avoid strenuous exercise when the temperature is high.
Insect Bites & Stings
Because of an aggressive program of mosquito control, mosquito-borne illnesses are usually not a concern in Cuba. However, outbreaks of dengue fever (Click here) have occurred in the recent past, so you should be aware of the means of preventing mosquito bites, if necessary. If dengue or other mosquito-borne illnesses are being reported, you should keep yourself covered (wear long sleeves, long pants, a hat, and shoes rather than sandals) and apply a good insect repellent, preferably one containing DEET, to exposed skin and clothing. Do not apply DEET to eyes, mouth, cuts, wounds or irritated skin. Products containing lower concentrations of DEET are as effective, but for shorter periods of time. In general, adults and children over 12 should use preparations containing 25% to 35% DEET, which usually lasts for about six hours. Children between two and 12 years of age should use preparations containing no more than 10% DEET, applied sparingly, which will usually last about three hours. Neurologic toxicity has been reported from DEET, especially in children, but appears to be extremely uncommon and generally related to overuse. DEET-containing compounds should not be used on children under the age of two.
Insect repellents containing certain botanical products, including eucalyptus and soybean oil, are effective but last only for 1½ to two hours. Products based on citronella are not effective.
For additional protection, you can apply permethrin to clothing, shoes, tents and bed nets. Permethrin treatments are safe and remain effective for at least two weeks, even when items are laundered. Permethrin should not be applied