Dengue Fever

This mosquito-borne disease is becomingly increasingly problematic throughout Laos, especially in the cities. As there is no vaccine it can only be prevented by avoiding mosquito bites. The mosquito that carries dengue bites day and night, so use insect avoidance measures at all times. Symptoms include high fever, severe headache and body ache (dengue was once known as 'break bone fever'). Some people develop a rash and diarrhea. There's no specific treatment, just rest and paraceta­mol - do not take aspirin as it increases the likelihood of hemorrhaging. See a doctor to be diagnosed and monitored.

Filariasis

This is a mosquito-borne disease that is very common in the local population, yet very rare in travellers. Mosquito-avoidance measures are the best way to prevent it.

Hepatitis A

A problem throughout the region, this food-and water-borne virus infects the liver, caus­ing jaundice (yellow skin and eyes), nausea and lethargy. There is no specific treat­ment for hepatitis A; you just need to allow time for the liver to heal. All travellers to Southeast Asia should be vaccinated against hepatitis A.

Hepatitis B

The only sexually transmitted disease that can be prevented by vaccination, hepatitis B is spread by body fluids, including sexual contact. In some parts of Southeast Asia, up to 20% of the population are carriers of hepatitis B, and usually are unaware of this. The long-term consequences can include liver cancer and cirrhosis.

Hepatitis E

Hepatitis E is transmitted through contami­nated food and water and has similar symp­toms to hepatitis A, but is far less common. It is a severe problem in pregnant women and can result in the death of both mother and baby. There is currently no vaccine; prevention is by following safe eating and drinking guidelines.

HIV

According to Unaids and WHO, Laos re­mains a 'low HIV prevalence country'; Un­aids reported a range of between 1000 and 1800 as of 2001. However, it's estimated that only about one fifth of all HIV cases in Laos are actually reported. Heterosexual sex is the main method of transmission in Laos.

The use of condoms greatly decreases but does not eliminate the risk of HIV infec­tion. The Lao phrase for 'condom' is thceng andamdi. Condoms can be purchased at most haan khdi yda (pharmacies), but it is worth bringing your own condoms from home.

Influenza

Present year-round in the tropics, influenza (flu) symptoms include high fever, muscle aches, runny nose, cough and sore throat. It can be very severe in people over the age of 65 or in those with underlying medical conditions such as heart disease or diabetes; vaccination is recommended for these indi­viduals. There is no specific treatment, just rest and paracetamol.

Japanese B Encephalitis

While a rare disease in travellers, at least 50,000 locals are infected with Japanese B Encephalitis each year in Southeast Asia. This viral disease is transmitted by mosquitoes. Most cases occur in rural areas and vaccina­tion is recommended for travellers spending more than one month outside of cities. There   j is no treatment, and a third of infected people will die while another third will suffer permanent brain damage.

Malaria

For such a serious and potentially deadly disease, there is an enormous amount of misinformation concerning malaria. You must get expert advice as to whether your trip actually puts you at risk. Many parts of Laos, particularly populated areas, have minimal to no risk of malaria, and the risk of side effects from the antimalaria medi­cation may outweigh the risk of getting the disease. For some rural areas, however, the risk of contracting the disease far outweighs the risk of any tablet side effects. Remember that malaria can be fatal. Before you travel, seek medical advice on the right medication and dosage for you.

Malaria is caused by a parasite transmit­ted by the bite of an infected mosquito. The most important symptom of malaria is fever, but general symptoms such as headache, diarrhoea, cough, or chills may also occur. Diagnosis can only be made by taking a blood sample.

Two strategies should be combined to prevent malaria - mosquito avoidance, and antimalarial medications. Most people who catch malaria are taking inadequate or no antimalarial medication.

Travellers are advised to prevent mosquitobites by taking these steps:

Choose accommodation with screens and fans (if not air-conditioned).

Impregnate clothing with Permethrin in high-risk areas.

Sleep under a mosquito net impregnated with Permethrin.

Spray your room with insect repellent before going out for your evening meal.

Use a DEET-containing insect repel­lent on exposed skin. Wash this off at night, as long as you are sleeping under a mosquito net. Natural repellents such as citronella can be effective, but must be applied more frequently than products containing DEBT.

Use mosquito coils.

Wear long sleeves and trousers in light colours.