Dr Gerry's Guide to Identifying Third World Diseases

Went looking for Gerald's letter about their current heat wave and found this one instead, vastly more important, so I'll post it immediately and look for the other later.

Background: Remember how, in Laos, I came down with that savage and mysterious illness? I wrote to my big brother asking what it could be, and this is his reply.

"I think it is too early for most of the more serious diseases, although Dengue does look a distant possibility because of the severe backache, pains and rash. Bit early for malaria and scrub typhus (aka Tsu-tsu-gamushi; maybe Christine can translate).

There is a local medicine called "Artemisia", made from the wormwood tree. If your fever has not come down after 24 hrs on this it is not Malaria, and if your fever is not down after 24 hrs of Tetracycline it is not tsu-tsu-gamushi, but you would normally have a painful boil with that."


By the time I got this advice I was fine again, thanks to lovely Native Practitioner Mr Sahi. Don't know what was in it, but he gave me a tissane that made me sleep for 14 hours, and when I woke up I was totally over whateveritwas!


But here's the important part that you should maybe keep somewhere if you too are a traveller!


"This is my aide memoir. It is actually a useful little list to keep handy if you insist on travelling within the sounds of gunfire:

TRAVEL RELATED FEBRILE ILLNESSES

(Affect 2-12% travellers, so don't forget CMV EBV i.e. glandular fever, toxoplasmosis.)

SHORT INCUBATION

10 DAYS

DENGUE: 3-7 days incubation. Myalgia, rash, low plats and bleeding.
GASTRO: in order of frequency affects 20-50% travellers
FLU: if cough is not a major feature it is not flu.
ENTERIC FEVER (TYPHOID): Vac only provide 70% protection. Can start with constipation. RICKETTSIAL:

MEDIUM INCUBATION

10-21 DAYS

MALARIA
ENTERIC FEVER (TYPHOID) (1-3 weeks)
SCRUB TYPHUS
BRUCELLOSIS
LEPTO
Q FEVER (Hey, Keith has this one!)

LONG INCUBATION
21 DAYS +

MALARIA
VIRAL HEPATITIS (A,B,C,E)
HIV
TB
AMOEBIC LIVER ABSCESS


Thank you Gerald for sending me this. Most appreciated indeed. And you were probably right about it being Dengue because when we got back there was an article in South China Morning Post about a new strain of Dengue doing the rounds in Indo-China! It's different enough to earn a new name only I don't remember what that was (starts with C and sounds Chinese), but I do recall it had already killed three people so was being taken seriously. Haven't seen mention of it since, however.

Mmmm, I've had so many mosquito-borne illnesses that it's probably appropriate that I get one of the first bouts of a brand new mutation!