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This guide is intended to highlight the minor and major risks to the health of a visitor. It is deliberately short and should not be considered comprehensive. It was first written in 1992 and has since been updated.

Copyright Dr.Scott, Phnom Penh, 2005

  1. General Common Conditions
  2. Tropical Insect - Borne Infections
  3. Food & Water-Borne Infections
  4. Percutaneous Infections (Bites)
  5. Sexual Diseases
  6. Air-Borne Infections
  7. Health Care Problems – Advice from This Doctor

TROPICAL INSECT - BORNE INFECTIONS

Malaria

Malaria in Cambodia is endemic in all forested areas, and a few seaside regions, but is not present in Phnom Penh, nor in most towns, because of the absence of the vector mosquito Anopheles dirus which bites at night. Because the flight range of Anopheles is less than a mile, malarial areas are extremely focal, so local advice is often more helpful than that given back home. Non drug measures to prevent malaria are very important; use bed nets, preferably impregnated with synthetic pyrethroid insecticide, wear light coloured clothing which covers arms, legs, ankles and feet, using insect repellant on exposed skin, burn mosquito coils or use knock down insecticide spray, and sleep in an air conditioned room or directly under a fan. Avoid perfumes that not surprisingly attract the female mosquito. As most people can be expected to follow these measures rigidly for up to 2 weeks, prophylactic anti malarial drugs are not recommended for visitors staying less than 2 weeks in a malaria zone.

The most important advice after prevention is awareness. Any fever occurring more than 7 days after leaving a malaria area, regardless of whether an anti-malarial drug has been taken or not, could be malaria. A high fever of more than 48 hours should prompt a blood test for malaria; the risk of death rises considerably if treatment is delayed after the fourth day.

Dengue Fever

Dengue fever is common in urban areas of Cambodia and therefore foreign tourists are at risk. It is transmitted by Aedes aegypti, a mosquito which bites during the day and early evening. As the vector larvae live in the water containers (jars, flower pots) around houses, water in those should be emptied at least once a week. Peak incidence is in the rainy season. Symptoms include severe headache, muscle pains, and rashes. Dengue haemorrhagic fever rarely develops in the foreigner.

Japanese encephalitis

This is an infection of the central nervous system caused by a virus transmitted to man through the evening bite of a mosquito that lives in rice fields. Pigs are the normal host, but when the population of mosquitoes is high, as in the rainy season, epidemics in humans can occur. This disease is generally regarded as rural, and the risk factor is approximately 1 to 1.5 per 1000 to 5000 - with children most at risk. The majority of people bitten and infected never develop any illness; it is estimated that for every 100 persons infected, only one will develop overt disease; however this person has a high risk of dying or being left with permanent brain damage. 30,000 – 50,000 cases are reported in Asia every year of which 30% die.

Scrub typhus / Flea – borne typhus

Rickettsial infection spread by a mite of chigger, or flea; primarily a disease of wild rats, present in scrub or grasslands. Doxycycline, taken for malaria prophylaxis, also prevents typhus.

Plague

Very rare now; limited to small isolated areas. Disease transmitted by the rat flea.

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