Malawi Heath Advisory
Not to be a fear monger, but a informed traveler is a happy traveler....
Rene
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TRYPANOSOMIASIS - SOUTH AFRICA EX MALAWI
Date: Mon 12 Feb 2007, Source: Lucille Blumberg, National Institute for
Communicable Diseases
Trypanosomiasis was confirmed in 4 travelers to Malawi in the last month.
The travelers were from Canada, Great Britain and Australia, respectively;
all had a history of travel in the preceding 1-3 weeks to the Kasunga
National Park, and 2 had also traveled to the Vwasa Marshes National Park in
northern Malawi. All the patients presented
with acute onset of fever; one patient had a trypanosomal chancre, and
trypanosomiasis was confirmed in all patients on peripheral blood smear.
Thrombocytopenia was noted in 2 patients; one patient experienced
hallucinations, and one patient developed a hepatitis either as an adverse
reaction to suramin or as a complication of disease. Examination of
cerebrospinal fluid was normal in all patients. To date, all patients have
responded well to suramin treatment, administered in South Africa. East
African trypanosomiasis is an uncommon but acute often fulminant and
potentially fatal disease in travelers that is frequently missed or
misdiagnosed as malaria.
In November 2005, 2 travelers were also treated in South Africa for
trypanosomiasis acquired in the Kasunga National Park, Malawi. Since 2001 a
total of 18 cases of East African trypanosomiasis have been treated in South
Africa in travelers to Malawi, Tanzania, Zambia, Zimbabwe and Kenya.
Tourists visiting game reserves in central and east African countries should
be alerted to the danger of this disease for which there are no effective
preventive measures, but which if acquired, requires expert diagnosis and
treatment.
[Trypanosomiasis has been emerging for almost a decade in Africa. In 2001,
tourists visiting Tanzania acquired trypanosomiasis, and recent outbreaks in
Angola, Congo, Zimbabwe and probably Sudan have underlined that the
infection is not under control. The recent report illustrates that Malawi
also is an endemic country, with cases
in the indigenous population not being reported, but travelers infected show
that the infection is endemic in the area. More information on African
trypanosomiasis can be found at the Programme Against African
Trypanosomiasis (PAAT)
website:<http://www.fao.org/ag/againfo/programmes/en/paat/home.html>.
- Mod.EP]
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Go slow, be well.
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