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Health Information for Travelers to
Guatemala
Contact your health department or physician at least 4-6 weeks before your trip to plan for immunizations and prescriptions. Take a list of your immunizations and medications with you. Check to see if your health insurance covers you while traveling out of the country. Temporary medical insurance available from a reputable company that specializes in international travel insurance is available for purchase. Injuries, especially those from motor vehicle crashes, pose the greatest risk of serious disability or loss of life to international travelers. Seat belts and defensive driving are important preventive measures. Fire injuries are also a significant cause of injuries and death. Don't smoke in bed and be aware of fire exits in hotels. Other major causes of injury trauma include drowning and injuries to swimmers, water skiers, and divers due to boat propellers. Wear a personal flotation device whenever you ride in a boat.. Travelers should also be aware of the potential for violence-related injuries. Risk for assault or terrorist attack varies from country to country; heed advice from residents and tour guides about areas to be avoided, going out at night, and going out alone. Do not fight attackers. If confronted, give up your valuables. Animals in general tend to avoid human beings, but they can attack, particularly if they are protecting their young. Many areas in Guatemala have reported cases of rabies; domestic dogs, cats, or other animals should not be petted. Wild animals should be avoided; most injuries from wild animals are the direct result of attempting to handle or feed the animals. Upon returning home, continue taking your malaria
medication weekly for 4 weeks. If you become ill after your trip—even as long
as a year after your return—tell your doctor where you have traveled. Drink only the following beverages while in Guatemala: bottled or boiled water, hot beverages (such as coffee or tea) made with boiled water, and canned or bottled carbonated beverages. Ice may be made from unsafe water and should be avoided. It is safer to drink from a can or bottle of beverage than to drink from a container that was not known to be clean and dry. However, water on the surface of a beverage can or bottle may also be contaminated. Therefore, the area of a can or bottle that will touch the mouth should be wiped clean and dry. Remember also to brush your teeth with bottled water. Wash hands often with soap and water, or bring along and use an anti-bacterial waterless skin cleanser. Food should be selected with care. Any raw food could be contaminated,
particularly in areas of poor sanitation. Foods of particular concern include
salads, uncooked vegetables and fruit, unpasteurized milk and milk products, raw
meat, and shellfish. Consumption of food and beverages obtained from street food
vendors has been associated with increased risk of illness. Food that has been
cooked and is still hot is generally safe. Eat only thoroughly cooked food or
fruits and vegetables you have peeled yourself. Remember: boil it, cook it,
peel it, or forget it. Malaria risk in Guatemala is in rural areas only, except that there is no risk in the central highlands. If your visit will include travel to areas at risk for malaria, you should take preventative medication and adopt measures to avoid mosquito bites. Chloroquine (Aralen®) is the recommended drug for travelers to risk areas in Guatemala. This is a prescription medication. Directions for use: · The adult dosage is 500 mg (salt) chloroquine phosphate. · Take the first dose of chloroquine 1 week before arrival in the malaria-risk area. · Take chloroquine once a week while in the malaria-risk area. · Take chloroquine once a week for 4 weeks after leaving the malaria-risk area. · Chloroquine should be taken on a full stomach to lessen nausea. Chloroquine side effectsAlthough side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching can occur. Chloroquine may worsen the symptoms of psoriasis. Protect yourself from mosquito bites See
your doctor at least 4–6 weeks before your trip to allow time for
immunizations to take effect. Tetanus/Diphtheria Hepatitis A Hepatitis B Typhoid Yellow Fever Cholera Travelers’ diarrhea is not uncommon in visitors to Guatemala. Episodes usually begin abruptly, occur during travel or soon after returning home, and are generally self-limited. Mild cases may be treated with anti-motility agents such as loperamide (Imodium AD) and increased fluid intake. Imodium should not be used in persons with high fever or with blood in the stool, and should be discontinued if symptoms persist for more than 48 hours. The antibiotics Bactrim DS or Cipro 500mg may be taken twice a day for three days for treatment of more severe cases. Travelers should consult a physician rather than attempt self-medication if the diarrhea is severe or does not resolve within several days, if there is blood and/or mucus in the stool, if fever occurs with shaking chills, or if there is dehydration with persistent diarrhea. Taking antibiotics on a regular basis while in Guatemala in an attempt to prevent traveler’s diarrhea may be effective, but is not generally recommended. The routine use of antibiotics will not prevent parasitic and viral infections, and may cause side effects and promote the development of resistant infections. Bismuth subsalicylate, taken as the active ingredient of Pepto-Bismol® (2 oz. 4 times a day or two tablets 4 times a day), has decreased the incidence of traveler's diarrhea by about 60% in several studies. Side effects include temporary blackening of tongue and stools, occasional nausea and constipation, and rarely, tinnitus (ringing of the ears). If you are taking other medications, check with your doctor before doing this, as there may be drug interactions with Pepto. Most cases of
diarrhea are self-limited and require only simple replacement of fluids and
salts lost in diarrheal stools. This is best achieved by use of an oral
rehydration solution such as World Health Organization (WHO) Oral Rehydration
Salts (ORS) solution. This solution is appropriate for treating as well as
preventing dehydration. ORS packets are available at stores or pharmacies in
almost all developing countries. ORS is prepared by adding one packet to boiled
or treated water. Packet instructions should be checked carefully to ensure that
the salts are added to the correct volume of water. ORS solution should be
consumed or discarded within 12 hours if held at room temperature or 24 hours if
kept refrigerated. For more information on travel in Guatemala, visit the following web sites: · Centers for Disease Control and Prevention: Traveler’s Health Information · World Health Organization: International Travel and Health · State Department: Travel Warnings & Consular Information Sheets
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