DECEMBER 18, 2000 VOL. 156 NO. 24

For Every Paradise, There's A Parasite
By BERNADETTE CUASAY

Illustration for TIME by Harry Harrison

Heard any good parasite stories lately? Dr. Chung Wen-cheng, parasitology expert at Taipei Medical University Hospital has. Last July he helped expel an 8-meter-long tapeworm from the stomach of one of his patients. The 41-year-old Taiwanese patient traced his tapeworm to a trip to Malaysia six years earlier, possibly the result of eating undercooked meat.

"He complained of abdominal pain, nausea and anal itching," says Dr. Chung. "He was also constantly hungry, even though his abdomen felt quite full and seemed to be swelling." Two hours after the patient took a laxative concoction of atabrine and soda, the unwanted guest wriggled free from his intestines.

With exotic travel a commonplace, nasty diseases are only a plane ride away. Heading into the hinterlands of Borneo can be good fun, but bringing home a parasitic pal definitely is not. While there are no sure-fire methods to avoid every risk, knowing the enemy is a good start. Here's a rogue's gallery of parasites to watch out for. There are a lot of them out there.

Malaria: Cambodia, China, Indonesia, South Korea, Laos, Malaysia, Myanmar, Philippines, Thailand, Vietnam and the subcontinent. The scourge of jungle adventurers everywhere, malaria is the most virulent of parasitic diseases, and is responsible for more than 1 million deaths per year in more than 100 countries. And it's easy to catch: a single bite from an infected mosquito can pass the disease into your bloodstream. Within four weeks severe bouts of chills and fever—often exactly 48 hours apart—and muscle aches will surface. Cerebral malaria, a more virulent form of the disease, can be fatal if you are beyond reach of a hospital and blood transfusions. Malaria can stay with you for life, the symptoms recurring on a semi-annual basis. Prescription drugs can alleviate the symptoms, but the best course of action is prevention. Drugs such as Lariam or Aralen are effective against certain strains, though some patients have severe reactions. On the road, use industrial-strength bug repellent, wear long pants and long-sleeved shirts and sleep under mosquito nets.

TRAVEL WATCH For Every Paradise, There's A Parasite Heard any good parasite stories lately? Dr. Chung Wen-cheng, parasitology expert at Taipei Medical University Hospital has Web Crawling Before you jet off for your holiday on the tranquil shores of Kuta Bay or any global locale, first do your homework about staying healthy Hot Spot For those who dream of truly ripping through an airport: a $6.2 million motorsport facility has opened in, of all places, the former departure hall of Hong Kong's abandoned Kai Tak airport Travel Watch Archive Browse hundreds of Asian travel tips

Dengue fever: India, China and Southeast Asia. Often confused with malaria, this disease also flies on the wings of the mosquito population. Globally, there are an estimated 50 to 100 million cases each year. Also called the "bone-breaking disease," it is characterized by the sudden onset of a high fever that lasts two to seven days, severe joint and muscle pain, nausea and a distinctive skin rash. It can also have a potentially lethal complication called Dengue haemorrhagic fever, which causes severe internal bleeding. As no vaccine or treatment is available, all you can do is try to endure the symptoms with bed rest, fluid intake and pain medication. As against malaria, travelers should take precautions to avoid mosquito bites.

Leishmaniasis (kala-azar or black fever): India, Bangladesh and Nepal. You're sitting on the beach, enjoying the sunset when suddenly you feel the irritating nibble of a sand fly on your ankles. That's all it takes to bring on this disease, with devastating consequences. It comes in two variations: one that attacks your internal organs and another that attacks your skin. The internal form is more severe, causing fever, weight loss and an enlarged spleen or liver. Left untreated, leishmaniasis can be fatal. No vaccine is available; travelers can only take precautions against insect bites. Sand flies are silent, so it's wise to avoid sandy activities from dusk till dawn.

Schistosomiasis (bilharzia): Southern China, Philippines, Thailand, Laos, Cambodia, Japan, central Indonesia and the Mekong delta. It's a steamy day in Manila just after a rainstorm. You're wading in a fresh water pool when a wily flatworm slips into your body through a cut in the sole of your bare foot. Unfortunately, it wastes no time finding refuge in your intestines. Fever, itchy rash, muscle pain, diarrhea and nausea soon ensue. If untreated, this parasite can permanently damage the liver, kidneys, bladder and intestines. To avoid the risk, don't wade or bathe in suspect pools.

Lymphatic Filiarisis (elephantitis): Southern Asia. A thread-like filarial worm is passed from person to person through the bite of an infected mosquito. Once inside the warm body of an unsuspecting host, the worm thrives in the lymph vessels and tissues. As it grows, it causes marked swelling of the limbs and other extremities. People vacationing for short stints in tropical or sub-tropical areas where the disease is common are at little risk. While no vaccine is available, a year-long course of medicine can kill worms already in your system. For this and all the other nasty traveling bugs, the advice is simple—don't get bitten.

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