Travel Bugs – Don't Drink the Water! (Part II)

When considering traveling, working, or volunteering abroad, the responsible healthcare professional heads to the travel clinic to get updated on the typical vaccinations, such as tetanus, meningitis, and hepatitis. Depending where they'll wander, they may even get a yellow fever shot or a stock of malaria pills.

But what other bugs – whether rare or common – might one encounter, aside from the usual childhood diseases (e.g., mumps, measles, chicken pox) and other diseases familiar to North Americans (e.g., rabies, West Nile virus, Lyme disease, Norwalk virus, TB) …?

Today's "bugs" to beware of are worms and protozoans (Part II)!

* * * * *

Cyclosporiasis

• How do you get it? – By ingesting fecally contaminated food or water (person to person contact is unlikely, since the protozoan needs days to weeks to become infectious).

• What causes it? – A protozoan called Cyclospora cayetanensis.

• What is it? – A parasitic infection that can be asymptomatic, or can include symptoms like watery diarrhea, loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, fatigue, muscle aches, and low-grade fever. Untreated, cyclosporiasis can last for weeks to months, and the symptoms can come and go.

• Where is it found? – It is found predominantly in low-income countries, but it can be is found anywhere worldwide, and risk varies by season.

• Prevention? – No vaccine is available. Be careful about what you eat or drink, e.g., drink boiled or purified water, do not eat uncooked vegetables or fruit you have not unpeeled yourself, etc.

Dracunculiasis (Guinea worm disease)

• How do you get it? – Drinking standing pond water contaminated persons with dracunculiasis.

• What causes it? – The worm Dracunculus medinensis.

• What is it? – A parasitic infection. According to the CDC, "Adult female Dracunculus worms emerge from the skin of infected persons annually. Persons with worms protruding through the skin may enter sources of drinking water and unwittingly allow the worm to release larvae into the water. … Once inside the body … larvae find their way to the small intestine, where they penetrate the wall of the intestine and pass into the body cavity. During the next 10-14 months, the female Guinea worm grows to a full size adult 60-100 centimeters (2-3 feet) long and as wide as a cooked spaghetti noodle, and migrates to the site where she will emerge, usually the lower limbs. A blister develops on the skin at the site where the worm will emerge. This blister causes a very painful burning sensation and it will eventually (within 24-72 hours) rupture."

• Where is it found? – 12 countries in sub-Saharan Africa; 63% of cases are in Sudan.

• Prevention? – Don't drink the water.

Giardiasis

• How do you get it? – It is transmitted through fecal contamination – ingesting contaminated food or water, contacting contaminated surfaces, and person to person contact.

• What causes it? – A protozoan called Giardia intestinali.

• What is it? – An infection of the intestine, involving diarrhea, abdominal cramps, bloating, fatigue, weight loss, flatulence, anorexia, or nausea, in various combinations, which usually last over five days. The condition can become chronic, resulting in malabsorption.

• Where is it found? – It occurs worldwide.

• Prevention? – No vaccine is available. Be careful about where you swim, and what you eat or drink, e.g., drink boiled or purified water, do not eat uncooked vegetables or fruit you have not unpeeled yourself, etc.

* * * * *

Check back for other items in our Travel Bugs series:

• Travel Bugs – Beware the Bite!

• Travel Bugs – Gotta "Fly"?

• Travel Bugs – This Will Bug You!

• Travel Bugs – Don't Drink the Water! (Part I)

• Travel Bugs – Don't Drink the Water! (Part III)

• Travel Bugs – Fungus Among Us

• Travel Bugs – Miscellaneous Menaces

Want more information?

• World Health Organization's International Travel and Health page

• National Center for Infectious Diseases' Travelers' Health page