Assignment 1

1) Please provide a list of health concerns that we may need to consider before traveling to Roatan.

Here are your answers: This is an impressive list and indicates that many of you have been seriously thinking about health issues. A good sign.

Health Concerns Summary:
1.) Malaria
2.) Yellow fever
3.) rabies
4.) typhoid fever
5.) Hepatitis A & B
6.) Tetanus
7.) Dengue Fever
8.) Filariasis/Ochocerciasis
9.) Chagas Disease (American Trypanosomiasis)
10.) Food and water born pathogens (contaminated food and Water)
11.) STDs
12.) Blood born pathogens (hepatitis etc.)
13.) Crime/political unrest
14.) Rabies
15.) Cholera
16.) Brucellosis
17.) Heat/sun related problems (Sun burn, sunstroke, etc)
18.) Dehydration

The following information is based upon the CDC Homepage, CDC Travex - Mary Fosse of the Student Health Center, the State Department of Health, the Education Coordinator of the Roatan Institute for Marine Sciences, and from your answers to the questions.

It is going to be very important that everyone is current on shots. And everyone should be in good health. The main health concerns to consider are diseases transmitted by insects, contaminated food and water (although not as much of a risk at Roatan because they do purify all of their own water), and contact with infected people (also probably not a huge risk at Roatan).

Insects: Best prevention is wear insect repellent and protect yourself from insect bites with appropriate clothing.

Malaria: Preventive drugs are available to take while on the trip.

The main risk in Honduras is mainly in rural areas.

Yellow Fever: no outbreaks in Honduras. Some countries require a vaccine, but it is not required in Honduras.

Dengue Fever: Not extremely common but a number of cases have been reported in Honduras. No vaccine available.

Preventing insect bites: To reduce mosquito bites travelers should remain in wellscreened areas, use mosquito nets, and wear clothes that cover most of the body. Travelers should also take insect repellent with them to use on any exposed areas of the skin. The most effective compound is DEET (N,N-diethyl meta-toluamide), an ingredient in most insect repellents. However, DEET insect repellents containing DEET should always be used according to label directions and sparingly on children. Avoid applying high-concentration (greater than 35%) products to the skin, particularly on children, and refrain from applying repellent to portions of the hands that are likely to come in contact with the eyes and mouth. Pediatric insect repellents with 6-10% DEET are available. Toxic reactions or other problems have rarely developed after contact with DEET. Travelers should also purchase a flying insect-killing spray to use in living and sleeping areas during the evening and night. For greater protection clothing and bednets can be soaked in or sprayed with PERMETHRIN, which is an insect repellent licensed for use on clothing. If applied according to the directions, permethrin will repel insects from clothing for several weeks. Portable mosquito bednets, repellents containing DEET, and permethrin can be purchased in hardware, back-packing, and military surplus stores.

Note: In general, students on past years field trips to Roatan did not encounter problems with insects - I think we have been lucky.

FOOD/WATER DISEASES:

Traveler's Diarrhea: caused by viruses, parasites, and bacteria.

Hepatitis A: Vaccine or gamma globulin shots recommended.

Typhoid Fever: Caused by Bacteria.

Cholera: caused by bacteria. Not considered as a major concern on Roatan.

Also, not a bad idea to have "off the shelf' nausea and diarrhea medicine.

Roatan however is a resort area, and as we will be eating tourist food and traveling during the dry non-mosquito season, these things probably would not be as much of a concern. Furthermore, it is recommended that you refrain from eating food from street vendors, as the preparation and storage of the foods may be questionable. As for pure water, it's not a bad idea to drink bottled water in any foreign country.

Health precautions (provided by Jennifer Keck, Education Coordinator of the Roatan Institute for Marine Sciences): There are cases of Malaria on Roatan. The risk for tourists staying for short periods is quite low. Especially if bug spray is worn during times of increased mosquito activity. There are preventative medicines that can be prescribed. They are also the same medicines used to treat the infection as well. The most common drug is chloroquine. It is taken one week prior to departure, once a week while in areas of malaria and for at least 2-4 more weeks upon return. I hope I am not alarming you. The major form of malaria on the island is P.vivax The symptoms are similar to the 24 hour flu. It is easily detected and quickly treated. If students are concerned they should consult a doctor.

An updated tetanus/diphtheria is also recommended

The information that was presented by Mary Fosse (from the Student Health Center) was intended for our informational use. Although vaccination etc. for the diseases mentioned by Mary Fosse (as per the Travex Immunization Summary) are not mandatory, we ask that you make a personal decision as to what your personal health needs may be.

Travel health: You should consult with the Student Health Service about immunizations recommended for Roatan, Honduras or with your family doctor. Nothing heavy duty is required, but you should be current on tetanus and diphtheria and should consider about hepatitis, typhoid and malaria. You may also want to ask about an antibiotic to take in case of traveler's gastrointestinal distress. Decisions on what you get are personal ones. These are routine considerations and should not be interpreted that the Roatan standard for health is low.

An additional informational source is the State Department of Health (Phone: 800-831-6293).

For additional information on health considerations while traveling visit these websites:

CDC Travel Information: Mexico and Central America: http://www.cdc.gov/travel/camerica.htm