Surviving the Amazon

Health, Food and Safety

Malaria meds are recommended, mefloquine is the meds for South America, but you may consider this; http://www.organic-pharmacy.com/ARG.Artemesia.htm  you should also think about yellow fever vaccination, Hep-A, and Hep-B. The people we will be with feel that these are very rare diseases and we would be fine with out them. But I don’t want to be the final word on your health. Ask your doctor.

CDC recommends the following vaccines (as appropriate for age):

See your doctor at least 4–6 weeks before your trip to allow time for immunizations to take effect.

• Hepatitis A or immune globulin (IG).
• Hepatitis B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay >6 months in the region, or be exposed through medical treatment.
• Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
• Typhoid, particularly if you are visiting developing countries in this region.
• Occurrence

An estimated 16 million cases of typhoid fever and 600,000 related deaths occur worldwide each year. Approximately 2.6 cases of typhoid fever were reported to the Centers for Disease Control and Prevention per 1 million U.S. citizens and residents traveling abroad during the period 1992–1994.

Risk for Travelers

Typhoid vaccination is not required for international travel, but it is recommended for travelers to areas where there is a recognized risk of exposure to S. Typhi. Risk is greatest for travelers to the Indian subcontinent and other low-income countries (in Asia, Africa, and Central and South America) who will have prolonged exposure to potentially contaminated food and drink. Vaccination is particularly recommended for those who will be traveling in smaller cities, villages, and rural areas off the usual tourist itineraries. Travelers should be cautioned that typhoid vaccination is not 100% effective and is not a substitute for careful selection of food and drink.

• Yellow fever vaccination, if you will be traveling outside urban areas.
• The risks of illness and of death due to yellow fever in an unvaccinated traveler are estimated to be 1:1,000 and 1:5,000 per month, respectively. (For a 2-week journey, the risks of illness and death are 1:2,000 and 1:10,000, respectively.) These estimates, which are based on risk to indigenous populations, may overestimate the risk to travelers, who may have a different immunity profile, take precautions against getting bitten by mosquitoes, and have less outdoor exposure than do indigenous residents. Based on data for U.S. travelers, the risk for illness in a traveler due to yellow fever has been estimated to be 0.4–4.3 cases per million travelers to yellow fever-endemic areas.
• As needed, booster doses for tetanus-diphtheria and measles. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not complete the series as infants.

To stay healthy, do...

• Wash hands frequently with soap and water. Don’t bite your finger nails.
• Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an “absolute 1-micron or less” filter AND adding iodine tablets to the filtered water. “Absolute 1-micron filters” are found in camping/outdoor supply stores.
• Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
• If you will be visiting an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
• Protect yourself from mosquito bites:
• Pay special attention to mosquito protection between dusk and dawn. This is when the type of mosquito whose bite transmits malaria is active.
• Wear long-sleeved shirts, long pants, and hats.
• Use insect repellents that contain DEET (diethylmethyltoluamide).
• Read and follow the directions and precautions on the product label.
• Apply insect repellent to exposed skin.
• Do not put repellent on wounds or broken skin.
• Do not breathe in, swallow, or get into the eyes (DEET is toxic if swallowed). If using a spray product, apply DEET to your face by spraying your hands and rubbing the product carefully over the face, avoiding eyes and mouth.
• DEET may be used on adults, children, and infants older than 2 months of age. Protect infants by using a carrier draped with mosquito netting with an elastic edge for a tight fit.

• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot. .

To avoid getting sick...

• Don’t eat food purchased from street vendors.
• Don’t drink beverages with ice.
• Don’t eat dairy products unless you know they have been pasteurized.
• Don’t handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague .

Your major threat will be bug bites. The tics and chiggers are in the grasses and rocks everywhere. One team member had over 300 individual bug bites on just their legs. I've yet to find anything that is real effective to stop from getting bit.

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Don't jump into any water or swim unless the local people say that is a safe place to swim. Don’t urinate in the water. There are fish that will be attracted to your urinary track if you do. Don’t wander into the jungle alone. Don’t put your hands into anything that you can’t see into first. Open and inspect clothes and bedding before putting on or getting into. Look were you put your feet when in the jungle, be aware and you will be safe. Keep your food and bedding closed and zipped. Be careful around the water at night, some types of snakes come out then.

Watch the locals and do as they do and you'll be safe. This may seem like a lot of dos and don’ts but these are things that I have learned from my trips to the Amazon and with a little fore warning we will all be that much more safe and comfortable.

Sunscreen with the highest protection factor possible and deet type insect repellant must be applied daily and often. Bring your own. Insect bite cream or anti itch cream should also be brought with you.

I always keep a supply of protein / food bars with me. I take enough to have two-a-day. Buy some now and test out the kinds you like. It helps you keep control of your stomach and less reliant on people to prepare food for you. If you control your stomach everything else will work out.

If you feel you are beginning to get sick; this is what I would do. Take a Cipro antibiotic and a anti-diarrhea medication. This will kill the offending bugs in your stomach and help you bounce back fast. There are not many bathrooms available when traveling in canoes or along the rivers.  So getting a bad case of the runs is disaster. If the malarial meds that you are taking are antibiotics then you'll think that you have an iron stomach but in fact your just killing the bugs as they come into your system.