Dysentery

Dysentery is a health risk for foreigners traveling in Honduras and other underdeveloped countries. The disease, which results from fecal-oral contamination, comes in two strains: bacillary (bacterial) and amoebic (parasitic). Bacillary dysentery hits like a sledgehammer, with a sudden onset of vomiting, severe diarrhea, and fever. It is easily treated with antibiotics.

Amoebic dysentery, caused by an infestation of amoebas, takes longer to develop and is also more difficult to get rid of. The most effective cure is a weeklong course of Flagyl, a very strong drug that wipes out all intestinal fauna. During and after a course of Flagyl, it’s important to eat easily digestible food until the body has a chance to rebuild the necessary bacteria used for digestion. Yogurt is helpful. Weak cases of amoebas can sometimes be treated with a half-course of Flagyl or other less traumatic drugs.

Symptoms for either form of dysentery are not unlike those for malaria or dengue fever, so see a doctor and don’t try to diagnose yourself. One of the greatest dangers with dysentery is dehydration, so be sure to drink plenty of water if you even suspect dysentery.

Malaria

The vixa vivax strain of malaria is present in most lowland regions of Honduras, and it is common on the north and south coasts, the coastal regions of the Mosquitia, and on the Bay Islands. If you’re below 1,000 meters, malaria can be present. Thankfully, the Aralen-resistant P. falciparum strain has not yet made it north of Colombia.

Symptoms of malaria include high fever, headaches, fatigue, and chills. If these symptoms are present, see a doctor immediately, as medical treatment is effective.

Opinions on how to cope with malaria vary wildly. The most frequent recommendation from doctors is to take 500 milligrams of Aralen (chloroquine phosphate) weekly. Some people react negatively to Aralen, experiencing nausea, rashes, fever, or nightmares. Stop taking the drug if you have these side effects.

In high doses, well above 500 milligrams per week, Aralen has been linked to retina damage and hearing problems. It’s not recommended to take the drug longer than six months. If you’re on Aralen, continue the course for four weeks after leaving malaria-prone areas. Some travelers, leery of using strong drugs on a regular basis, prefer to carry one powerful dose of Aralen with them to use in case malaria strikes, rather than enough for weekly doses. The problem with this solution is that while chloroquine alone serves as a preventative, treatment for malaria should be a combination of chloroquine and primaquine; the latter ensures that malaria doesn’t remain dormant in the liver.

Antimalarial drugs are available in many Honduran pharmacies, no prescription required.

Other Diseases

Cholera is not uncommon in Honduras, particularly during the rainy season. The best way to avoid it is to be careful with your food and water, don’t eat raw fish, and always wash your hands before eating.

The viral disease dengue fever is also a frequent health problem for Hondurans. It is treatable, and rarely fatal. The fever is contracted from the bite of an infected mosquito. Symptoms include fever, headache (especially behind the eyes), muscle and joint aches, skin rash, and swollen lymph glands. Known affectionately as “bone-breaking disease,” it’ll lay you out flat. Usually, the fever lasts 5–8 days, followed by about a week of the disease. Tylenol can help cut the fever and relieve headaches. Do not take ibuprofen or aspirin, as these can increase the bleeding if it turns out to be hemorrhagic dengue.

Hemorrhagic dengue, which can be fatal, is far less common, but does occur. Symptoms appear similar to classic dengue at first, which makes it essential to seek medical attention immediately for any of the above symptoms. Additional symptoms that may appear include bleeding from the nose or mouth, skin bruising, black stools, excessive thirst, and pale, cool skin. Rush to an emergency room if you have these symptoms, as they require immediate care. Hemorrhagic dengue is fully treatable if medical help is found within the first few days of the illness.

AIDS

After sub-Saharan Africa, the Caribbean Basin has the highest incidence of AIDS infections in the world. More relaxed, easygoing sexual practices and the frequent use of prostitutes by men are two prime causes for the quick spread of the disease.

AIDS is thought to have first arrived in Honduras in 1985; 2008 estimates put the number of HIV-positive at 28,000, although many believe the actual number of cases to be much higher. San Pedro Sula, in particular, has been hit hard by the disease. The government has stepped up publicity campaigns in the past few years and sponsored AIDS campaigns in the prisons, leading to a stabilization (or in some estimates, even a decline) in the rates of HIV.

Many HIV-positive prostitutes continue working, either through ignorance or the need for money. Should you choose to sleep with a stranger or newfound friend anywhere in the country, use a condom!

Health Information Sources

For more information on the health situation in Honduras, check the Centers for Disease Control and Prevention (CDC) Health Information for International Travel (tel. 404/332-4565, www.cdc.gov) or the International Association for Medical Assistance to Travelers (736 Center St., Lewiston, NY 14092, tel. 716/754-4883, www.iamat.org).

© Chris Humphrey and Amy E. Robertson from Moon Honduras, 5th Edition