Travel in Good Health – Part 3 of 3

26 07 2014

Babies and small children are less able to fight off foodborne and waterborne infections. Little ones who are crawling or walking around and putting things in their mouths increase their exposure risk.

What comes from those infections? Yes, you knew we had to get there. We’re talking poo. The kind that makes you want to pay strangers good money to change an oozing diaper.

But, there are a few things we can do to help prevent the big D.

Breastfeeding helps eliminate foodborne and waterborne transmission to infants.

Use purified water for drinking, ice cubes, formula, brushing teeth, washing food if eating food raw, or just anytime you’d use water. Purify the water, unless you know the water source is safe.

Wash hands with soap and water frequently each day and certainly before eating anything and before preparing foods, after changing diapers, after going to the restroom, after coming in from outdoor activities (this includes shopping!), when you get up in the morning and before going to bed at night. Use soap and water if available and always when you can see any grime on the hands. Alcohol-based hand sanitizer can be used to help disinfect your hands.

Pacifiers and other items made to go into a baby’s mouth that you bring or buy on the trip need frequent cleaning.

Don’t eat food from street vendors. Make sure all your food is either cooked thoroughly or washed with purified water and, if applicable, peeled.

Dehydration due to diarrhea and vomiting

Infants and young children can easily become dehydrated due to diarrhea and vomiting. They need plenty of liquids each time they have a watery stool or vomit. If you’re unaware of the signs of dehydration, you should read up on it prior to departure. Prevention is the best thing, but just in case, there are commercial oral rehydration solutions, or you can make your own. Here are some suggestions from rehydration.org:

Make sure the rehydration drink has in it starches and/or sugars, a little sodium and some potassium. Breastmilk is great for those nursing, or watery cooked cereal, carrot soup, or rice water is fine as long as they’re made with purified water.

You can make a simple solution yourself by using salt and sugar (molasses, raw sugar or white sugar) and something like orange juice or mashed banana for potassium. Add one teaspoon of salt to eight teaspoons of sugar and stir into a liter of boiled and cooled water, stirring until everything is dissolved.

Fresh fruit juice, weak tea or even simply boiled and cooled water will help, if nothing else is available.

Parasites in the soil

There are parasites in sand and soil where children love to play. They should wear enclosed footwear and play on a tarp or covering. Don’t put clothing or towels on the ground to dry, and iron anything you hang out to dry before using. All of these precautions are dependent on your destination, of course.

Rabies

Children are more likely to be bitten by animals yet less likely to tell parents about the bite. Remind the children to stay away from animals and to report any wound immediately. If a child is bitten or wounded, wash the area with soap and water and take the child in for evaluation. If possible, bring the animal in as well.

Water and infectious agents

Children and adults can pick up illnesses or infections by swallowing or simply being in contact with contaminated water. If you don’t know the area, don’t swim in fresh, unchlorinated water and, depending on where you travel, be careful with washing in the bathtub.

Well, that’s about it. We’ve come to the end of our Travel in Good Health series. Hope you enjoyed it as much as we did and, hey, maybe we’ll meet you on the road somewhere and do some trading. Ten diapers for a barf bag?  Anybody?

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Gastro Bugs

17 09 2012

There is no such thing as “stomach flu,” despite the cavalier use of the phrase in some circles. What’s really going on is usually viral gastroenteritis.

Viral gastroenteritis isn’t caused by just one thing—it can be the result of any one of many different viruses, such as norovirus or rotavirus.

A gastro bug, as I like to call it, can be in the food or water we consume and will most commonly cause diarrhea, nausea and vomiting, and/or abdominal pain or discomfort.

Sometimes, it can also cause you to have a fever or chills, clammy skin, muscle or joint pain, and may put you off your feed. (That’s a “duh,” isn’t it!)

With liquids of various sorts pouring out of you, dehydration is a concern. Here are the signs, symptoms, and potential treatments to consider, as specified by NIH:

Signs and tests

The healthcare provider will look for signs of dehydration, including:

  • Dry or sticky mouth
  • Lethargy or coma (severe dehydration)
  • Low blood pressure
  • Low or no urine output; concentrated urine that looks dark yellow
  • Markedly sunken soft spots (fontanelles) on the top of an infant’s head
  • No tears
  • Sunken eyes

Tests that examine stool samples may be used to identify which virus is causing the sickness. This is usually not needed for viral gastroenteritis. A stool culture may be done to find out whether diarrhea are causing the problem.

Treatment

The goal of treatment is to prevent dehydration by making sure the body has enough water and fluids. Fluids and electrolytes (salt and minerals) that are lost through diarrhea or vomiting must be replaced by drinking extra fluids. Even if you are able to eat, you should still drink extra fluids between meals.

  • Older children and adults can drink sports beverages such as Gatorade, but these should not be used for younger children. Instead, use the electrolyte and fluid replacement solutions or freezer pops available in food and drug stores.
  • Do NOT use fruit juice (including apple juice), sodas or cola (flat or bubbly), Jell-O, or broth. All of these have a lot of sugar, which makes diarrhea worse, and they don’t replace lost minerals.
  • Drink small amounts of fluid (2-4 oz.) every 30-60 minutes. Do not try to force large amounts of fluid at one time, which can cause vomiting. Use a teaspoon or syringe for an infant or small child.
  • Breast milk or formula can be continued along with extra fluids. You do NOT need to switch to a soy formula.

Food may be offered often in small amounts. Suggested foods include:

  • Cereals, bread, potatoes, lean meats
  • Plain yogurt, bananas, fresh apples
  • Vegetables

People with diarrhea who are unable to drink fluids because of nausea may need intravenous (directly into a vein) fluids. This is especially true in small children.

Antibiotics do not work for viruses.

Drugs to slow down the amount of diarrhea (anti-diarrheal medications) should not be given without first talking with your healthcare provider. DO NOT give these anti-diarrheal medications to children unless directed to do so by a healthcare provider.

People taking water pills (diuretics) who develop diarrhea may be told by their healthcare provider to stop taking the diuretic during the acute episode. However, DO NOT stop taking any prescription medicine without first talking to your healthcare provider.

The risk of dehydration is greatest in infants and young children, so parents should closely monitor the number of wet diapers changed per day when their child is sick.

You can buy medicines at the drugstore that can help stop or slow diarrhea.

  • Do not use these medicines without talking to your healthcare provider if you have bloody diarrhea, a fever, or if the diarrhea is severe.
  • Do not give these medicines to children.

Viral gastroenteritis can become a serious illness, so watch for the symptoms and alert your healthcare provider if symptoms worsen.

Washing hands is the best prevention, along with vaccination when available (babies can be vaccinated against rotavirus).

Visit these websites for more information on gastro bugs

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001298/
http://www.cdc.gov/ncidod/dvrd/revb/gastro/faq.htm
By Trish Parnell (really by the NIH with a few asides from me)

Image courtesy of Examiner





It’s Global Handwashing Day!

15 10 2008

Here’s what Nancy L. Pontius reported on America.gov:

Littleton, Colorado — Every year, diarrhea and pneumonia kill more than 3.5 million children under age 5 worldwide. Many of them could have been saved by the simple act of washing hands.

Studies have shown that handwashing with soap can cut deaths from diarrhea by almost 50 percent and deaths from acute respiratory infections by 25 percent — saving more lives than any single vaccine or medical intervention. The challenge is to transform handwashing with soap from an abstract idea into an automatic behavior in homes, schools and communities worldwide.

To promote this life-saving habit, millions of children in 20 countries across five continents will participate in the first Global Handwashing Day on October 15. Supporters of the event will focus on mobilizing school children worldwide to wash their hands with soap to increase the practice of this important behavior.

Global Handwashing Day is supported by the Global Public-Private Partnership for Handwashing with Soap (PPPHW).  Established in 2001, partnership members include the U.S. Agency for International Development (USAID), World Bank, Water and Sanitation Program, UNICEF, Unilever, Water Supply and Sanitation Collaborative Council, U.S. Centers for Disease Control and Prevention, Procter & Gamble, Colgate-Palmolive and the Johns Hopkins University School of Public Health.

“Global Handwashing Day is designed to bring international and individual country attention to this critical public health intervention,” John Borrazzo, chief of the Maternal and Child Health Division, USAID Bureau for Global Health, told America.gov.

The event supports the 2008 World Water Week conference’s international focus for this year on sanitation. (See “2008 World Water Week Highlights Water-Related Challenges.”)

“Global Handwashing Day is important because diarrhea still unnecessarily kills 1.6 million children a year, and we know that effective handwashing with soap can prevent almost 50 percent of these diarrhea [illnesses],” Borrazzo said. “Recent research results also show that effective handwashing by birth attendants and mothers may reduce newborn deaths — which globally total 4 million a year — by as much as 40 percent.”

OBSERVANCES PLANNED AROUND THE WORLD

During the week of October 15th, from India to Egypt, Peru to China, Indonesia to Ethiopia, high-profile promotional and educational activities are planned for school children, teachers and parents — joined by government officials and celebrities — to raise awareness that handwashing with soap is a powerful public health intervention.

In Madagascar, President Marc Ravalomanana and the government of Madagascar worked with the USAID Hygiene Improvement Project (HIP), local soap companies, the media and others to plan an all-out national weeklong celebration of Global Handwashing Day. During the week of October 15, all of Madagascar’s 19,300 primary schools will participate in the activities, culminating with 3.5 million children all washing their hands at noon on Global Handwashing Day. A parade of schoolchildren through the capital also is planned for October 15.

In Pakistan, the country’s vision for Global Handwashing Day is to have 1 million school children across the country all wash their hands on October 15. This will be accomplished through many local groups and school programs working with members of the PPPHW, including USAID and multinational consumer products maker Procter & Gamble.

USAID’s Pakistan Safe Drinking Water and Hygiene Promotion Project (PSDW-HPP) plans to celebrate with 65 partner nongovernmental, community and government organizations. Planned activities include interactive theater performances, speeches from community leaders and creative classroom activities to complement the interactive hygiene curriculum currently used by PSDW-HPP in more than 20,000 schools. School activities will end with an oath to always wash hands with soap at critical times and to help others to do so.
Procter & Gamble intends to teach 75,000 Pakistani children via its Safeguard Schools Program on October 15.

INTERNATIONAL HYGIENE EDUCATION PROJECTS

For many years, U.S. public and private organizations have joined with other countries to help develop the vital habit of handwashing with soap.

“USAID has long recognized the importance of incorporating hygiene education and handwashing promotion as part of both maternal and child programs, and water supply and sanitation activities,” Borrazzo said. “We have worked for over a decade with many international partners to encourage handwashing, including promotion through the community, private sector, health facilities and schools.”

For example, USAID has been assisting with hygiene-behavior education through one component of USAID’s participation in the $59 million West Africa Water Initiative (WAWI) that began in 2002. WAWI’s 13 partner organizations — including the Conrad N. Hilton Foundation, World Vision, UNICEF, USAID, WaterAid, Winrock International and World Chlorine Council — work in Ghana, Mali, Niger and Burkina Faso.
Multiple USAID programs partner with international organizations in many countries to carry out relevant hygiene education and sanitation programs, including in Ethiopia, Nepal, Madagascar, Pakistan and Indonesia.

“School programs that teach the benefits of handwashing and effective handwashing techniques have been shown to increase handwashing behavior,” Jay Gooch, associate director of external relations for Procter & Gamble, told America.gov. “Young people are the most effective age group to reach to develop this habit,” he said.

In Pakistan, 7.5 million schoolchildren have participated in Procter & Gamble’s Safeguard Schools Program since 2003. In a country where more than 250,000 Pakistani children die from diarrhea annually, the practice of handwashing could save many lives.

In China, more than 24 million school children have participated in Procter & Gamble’s Safeguard Schools Program since 1999.

More information is available on the Web sites for Global Handwashing Day and the Global Public-Private Partnership for Handwashing with Soap.