Water

Ensure your water is purified! Illnesses such as diarrhea, typhoid fever, hepatitis A, polio and cholera can be transmitted through contaminated water.

1. Consume only canned or commercially bottled soft drinks or water
2. Ensure ice cubes are made from purified water - better yet do not use ice cubes
3. Filtration systems alone have not been proven 100% effective by independent studies
4. Brush teeth with purified water or hot tap water if pure water is not available

Purifying water is done by bringing water to a full boil:
Boil water for three minutes at sea level and up to 20 minutes for high altitude.
Or:
By chemically treating your water by adding 2 percent tincture of iodine as follows:
Clear water source: 5 drops per litre, let stand for 30 minutes
Cloudy water source: 10 drops per litre, let stand for several hours
1 drop = 0.05 ml

A final option is a portable filter obviously the smaller the pores in the filter the less that will slip through. Use as last resort.

Food

"Boil it, cook it, peel it, or forget it"

Poor sanitation, unhygienic food handling and the heat and humidity of tropical climates all contribute to the growth of bacteria that contaminate food.

1. Ensure all food is well cooked - especially meat and seafood
2. Serve food hot. Bacteria grow quickly as food cools.
3. Don't eat leftovers, food from street vendors or unpasteurized dairy products.
4. Never eat raw shell fish.
5. Avoid cold cuts, salads, watermelon and puddings.
6. Don't eat canned food if the tin appears "blown" or "swollen"
7. Fresh fruits and vegetables may be contaminated from the soil in which they grow or from being washed in contaminated water or handled improperly. AVOID RAW FOODS
   If you must eat fruits and vegetables wash and peel them yourself
8. Cook or bake fruit and vegetables that can't be peeled or washed
9. Remember to wash your hands carefully before eating or preparing food.
10. Avoid food and beverages from street vendors. It is difficult for food to be kept clean on the street. Many travelers get sick from food bought from street vendors.

Mosquito

Above 2500 metres mosquitoes are not a factor since they are not present above these altitudes. Getting to these altitudes is where prevention should be greatest. Here are some rules to follow:

1. If possible, avoid going out between dusk and dawn when malaria carrying mosquitoes commonly bite. Wear long-sleeved clothing and long trousers when going out at night, and avoid dark colours, which attract mosquitoes.
2. Apply insect repellants to exposed skin, choosing one containing either N,N-diethyl-m-toluamide (DEET) or dimethyl phthalate. Two common products found in sport and outdoors stores are Deep Woods Off and Muskoil. The concentration of DEET varies from product to product, and the higher concentrations protect for longer periods of time. In rare instances, application of insect repellants with high concentrations (>35%) of DEET has been associated with seizures in young children; therefore, DEET should be applied sparingly to exposed surfaces and washed off after coming indoors. Follow the manufacturers recommendations.
   35% protects for 4-6 hours
   95% protects for 10-12 hours
3. Stay in a well constructed and well maintained building in the most developed part of the city
4. Use screens over doors and windows; if no screens are available, windows and doors should be closed at night
5. If accommodations allow entry of mosquitoes, use a mosquito net over the bed, with edges tucked in under the mattress. Increased protection may be obtained by impregnating the net with permethrin or deltamethrin. In Canada impregnated nets can be obtained by calling 1-800-880-TRIP
   

Mosquito Related Disease

Since there is no vaccine for Dengue Fever prevention is the only way to avoid it even though it is rare. For a trip to Africa Yellow Fever and Malaria vaccines are highly recommended.

1. Dengue Fever

2. Yellow Fever

3. Malaria

Note for Malaria Drugs

The drug most often prescribed for Malaria is Mefloquine it should not be used in travelers with a history of epilepsy or psychiatric disorders, with certain heart disorders, or those requiring fine coordination, such as airline pilots. Mountain climbing would fall under the same category. Another reason my doctor did not recommend it is that side effects closely resemble those of high altitude sickness. Vertigo, lightheadedness, nausea, nightmares,visual disturbances headache and occasionally confusion. The benefit to this drug is that it needs to be taken only weekly.

An alternative is a daily drug called Doxycycline it's side effects are not similar to altitude sickness. Please go to the following page for complete outline of Malarial drugs. It must be taken two days before leaving daily while away and daily for four weeks after return.