Peru - Lonely Planet Publications [471]
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. For longer trips, it’s probably worth trying mefloquine; for shorter trips, Malarone will be the drug of choice for most people. None of the pills is 100% effective.
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. If taking Malarone, take 650mg of quinine three times daily and 100mg doxycycline twice daily for one week. If you start self-medication, see a doctor at the earliest possible opportunity. If you develop a fever after returning home, see a physician, as malaria symptoms may not occur for months.
Ensure that you take precautions to minimize your chances of being bitten by mosquitoes (Click here).
Rabies
A viral infection of the brain and spinal cord, rabies is almost always fatal unless treated promptly. The rabies virus is carried in the saliva of infected animals and is typically transmitted through an animal bite, though contamination of any break in the skin with infected saliva may result in rabies. Rabies occurs in all South American countries. In Peru, most cases are related to bites from dogs or vampire bats.
The rabies vaccine is safe, but a full series requires three injections and is quite expensive. Those at high risk for rabies, such as animal handlers and spelunkers (cave explorers), should certainly get the vaccine. In addition, those at lower risk for animal bites should also consider asking for the vaccine if they might be traveling to remote areas and might not have access to appropriate medical care if needed. The treatment for a possibly rabid bite consists of rabies vaccine with rabies immune globulin. It’s effective, but must be given promptly.
All animal bites and scratches must immediately be thoroughly cleansed with large amounts of soap and water, and local health authorities should be contacted to determine whether further treatment is necessary (Click here for more details).
Tetanus
This potentially fatal disease is found in undeveloped tropical areas. It is difficult to treat, but it is preventable with immunization. Tetanus occurs when a wound becomes infected by a germ that lives in the feces of animals or people, so clean all cuts, punctures or animal bites. Tetanus is also known as lockjaw, and the first symptom may be discomfort in swallowing, or stiffening of the jaw and neck; this is followed by painful convulsions of the jaw and whole body.
Typhoid Fever
This fever is caused by ingestion of food or water contaminated by a species of salmonella known as Salmonella typhi. Fever occurs in virtually all cases. Other symptoms may include headache, malaise, muscle aches, dizziness, loss of appetite, nausea and abdominal pain. Either diarrhea or constipation may occur. Possible complications include intestinal perforation or bleeding, confusion, delirium or, rarely, coma.
Unless you expect to take all your meals in major hotels and restaurants, getting typhoid vaccine is a good idea. It’s usually given orally, but is also available as an injection. Neither vaccine is approved for use in children under two.
The drug of choice for typhoid fever is usually