Travel
Stories
These stories
were collected mostly from patients and friends. Some are for
humor and interest, others are to emphasize important health and safety issues.
Baboon
Barking Like A
Seal
Bottled Water
Broken
Ankle
Cats & Rats
Colostomy
Dental Work
Dining Friends
Exit Tax
Fish Water?
Food Poisoning
Food Poisoning 2
Hajj & Umrah Deaths
Hepatitis A
High Altitude
Implanted Defibrillator
Malaria
Manhole
Motion sickness
Nepal Accident
Rip
Tide
Rabies
1 - Dog Scratch in Africa
Rabies 2 - Bat Scratch in Kenya
Rabies 3 - Dog Bite in Nepal
Road Construction
Road Construction 2
Scorpion Tale
Sea
Urchins
Ticks in Africa
Ticks in Africa 2
Baboon
My daughter and I were enjoying ice cream cones in an Australian
park. A large male baboon began to follow us, pelting us with
rocks and making menacing noises. I hurried toward the car as he
came closer jumping and grabbing at me. In desperation, I threw
my ice cream cone at him. He quickly devoured it and jumped onto
the hood of the car. My daughter also threw hers at him while
scrambling into the car. Scooping up her cone, he
gulped it down and gleefully scampered away.
V.L.
Barking Like A Seal
My nurse came out of the exam room and said, "You better see this
one first, doctor, she's barking like a seal!" Entering the room it
was obvious the woman was miserable, coughing in fits, and hardly able
to talk. Her husband related that they had just returned home from
30 days in France. The week before, his wife developed cold-like
symptoms and started coughing uncontrollable on the flight home. I
examined her, ordered lab, a chest x-ray and sent her for
pertussis cultures which subsequently confirmed my diagnosis of
whooping cough.
S.S.
(Pertussis, also known as whooping cough is a world wide problem.
Since 1980, it has become increasingly common in adults and adolescents in the US.
Two new combination vaccines,
called Adacel and Boostrix, protect against tetanus, diphtheria, and
pertussis. Either vaccine is now recommended for all adolescents
age 11 to 18 and most adults, especially healthcare workers.)
Bottled Water
On an extended vacation in Nicaragua we ate meals at numerous local
restaurants. We always asked for
bottled water and found more often that
not, seals were broken and labels missing. On one occasion the cap was
taped on. Our suspicions were confirmed, when through the kitchen
door, we witnessed someone filling water bottles at the sink!
Unknown
Broken
Ankle
I was planning a trip to Mexico for a one month vacation in a small inland village. My travel medicine doctor insisted that I purchase travel
insurance. Several days after arriving at my destination, I stepped
on uneven pavement and severely broke my right ankle. I spent
the night in the local hospital while arrangements were made for an
ambulance trip back to Puerto Vallarta and a flight home for surgery.
The next day I rode for hours in the back of a make shift van "ambulance." Fortunately, my
travel insurance company covered
the hospital expense, the $1000 ambulance ride and flight home!
D.M.
Cats & Rats
In Northern India, I entered the
anteroom of our hotel suite, where the doors were usually left open to
allow ventilation from the hallway. Hearing a loud screeching, I
looked up to see a mangy cat hissing and snarling at me. Jumping to one side,
I allowed it to escape into the hallway and disappear. Asking the proprietor
about the intrusion, I was informed that cats were allowed to roam freely in
the hotel to keep the rats under control!
L.W.
Colostomy
On his first flight following a
colostomy for ulcerative colitis,
the
patient anxiously watched his ostomy bag distending while his plane
climbed to it's
cruising altitude of 35,000 feet. He barely made it to the rest room
before the bag burst!
D.T.
Dental Work
I was a missionary surgeon in Nepal for a number of years, during which
time, I developed a toothache and sought help from a dentist in Kathmandu.
After he pulled the
offending tooth, I begin to get up from the chair, when he said, "Wait
a minute, I'll put one suture in for you." Pulling a suture and
needle out of an alcohol jar he quickly finished the job, proudly adding, "That's
the 10th suturing I've gotten out of that needle and thread!" Sure
enough, I came down with hepatitis
six weeks later.
M.S.
(Hepatitis A & B, and influenza are the most common vaccine preventable diseases in the
world.)
Dining Friends
While
dining on an ocean side veranda in Mexico with my
friend, two sea gulls swooped down on us. One diverted my friend’s attention from
her meal by landing on her head, while the other made off with her filet
o’ sole dinner!
L.W.
Exit Tax
Scheduled for immediate departure from Ecuador's international airport, I
had not been aware of the required
exit tax in US currency.
Except for several US bills of larger denomination, I
had previously changed all of my money into local currency.
Frantically, I ran around the airport looking for someone to change a
$100 US bill, but to no avail.
I resorted to buying a $50 bottle of perfume I didn't want, to
get $30 in US currency and paid the tax, barely making the only flight
home for that day.
J.H.
Fish Water?
I come from a big city called Lagos (Nigeria) and water supply is a
problem in some areas. A lot of water is supplied by water tankers and
some of the sources of supply can be very suspect. I had a personal
experience with my water one day in the clinic. It was supplied by a
tanker and when I entered the clinic, there was a smell which I traced
to the water. (Could be fish water.)
Since then, I have been putting disinfectant in my bowl of water to wash
my hands with normal soap. I believe a lot of developing countries have
water problems.
A.A. (TRAVELMED)
Food Poisoning
My first trip to Haiti was the kind of
learning experience that becomes indelibly etched in your mind. We had several medical
lectures and were planning on working in clinics for the remainder of the week.
The first two days I naively ate the food and drank the
water at our "Five Star" hotel
without discretion. The second night I was awakened at 1 AM
with severe abdominal cramps and vomiting. By 3 AM, I was crawling
on all fours from the bed to the bathroom, thinking I would not survive
the night. Some how I did, but I was too weak to work in the clinic the next day.
My wife, being more astute than I, carefully watched what she ate and
drank and did not suffer any illness.
S.S.
Food Poisoning 2
What a difference a day and some Cipro can make! These last two
nights have been a lesson in gastrointestinal suffering. It all
began when we decided to go to the local "Drive thru"
(it's not really a drive thru, as much as a roadside stand on the outskirts of Kampala). Some of us had a craving for a late
night "Rolex." A Rolex is tortilla, fried with two eggs and
wrapped around onions and tomatoes. Shortly after enjoying my Rolex, I
began to get an uneasy feeling in my stomach. Food poisoning has
to be one of the most miserable experiences.
After vomiting for 6 hours that night, I was thrilled to
finally move on to chills and a fever. There is nothing quite like
puking one's guts out in a foreign country, to make one appreciate home
and mother's cooking.
(Uganda Communications with Franz 2007)
Hajj & Umrah
BBC News report summary in January 2006, 345 people died on
Mena (Jamarat Bridge) at Hajj. Last year (2005) their were 250 deaths. In 1990
after a disaster in a tunnel, 1426 pilgrims lost their lives.
Saudi authorities
have spent millions of dollars since 2004 to improve safety measures on
the Jamarat Bridge at Mina.
However, a British engineer who worked on the modifications said only a
major redesign would reduce the risks. Dr G Keith Still described
the Eastern Entrance as a "pinch point" to the whole system - one
million people trying to get through a 45-metre gap.
Dr Still said: "The Eastern entrance at noon on the 12th day is a
critical crush point. As soon as prayers are finished on the last day
all the pilgrims want to get home. Even with 60,000 security
forces in place, preventing more than one million Hajjis heading to that
point is the irresistible force meeting the immoveable object. It's an
impossible task."
Dr Still, who worked on the safety modifications, said the problems of
the Eastern entrance were highlighted to the Saudi authorities a number
of times. "The bridge is in the middle of a tight valley. Three
major roads converge at the Eastern entrance and there are 186 minor
access routes to the area." he said.
The crowd flow is also impeded to the north by huge numbers of
unregistered pilgrims squatting in the street with their baggage and
tents, Dr Still said.
TRAVELMED 1/15/2006
Hepatitis A
My
girlfriend and I spent three months traveling in Mexico and Guatemala.
Two weeks after returning to the States, I began experiencing severe fatigue and loss
of appetite. At first, I thought I was just worn out from
traveling. Constantly nauseous, I was unable to keep food down.
My urine turned a very dark orange. Squinting in
the mirror, I wondered about at my yellow eyes.
During this time, I had spent
Christmas Day with my girlfriend's family and unwittingly exposed 18 people to
hepatitis. Shortly after, I went to the emergency room and was told I
had hepatitis A. This caused a ruckus with the State Health
Department resulting in gamma globulin shots being recommended for almost everyone
that was at the party, in order to
protect them from hepatitis. Three weeks have passed and I am better, but
still recovering. As for my girlfriend, she was vaccinated for
hepatitis A before our trip!
S.B.
(Hepatitis A & B,
and influenza are the most common vaccine preventable diseases in the
world. Hepatitis A
infections occur even during standard
vacation itineraries in developing countries.)
High Altitude
It was my first mission trip to Bolivia and my first extended stay at
high altitude.
Arriving in La Paz, I felt well until that evening when sluggishness and
fatigued set in. That night I slept fitfully, awakening multiple times.
The next day my head
ached and I was nauseous. A friend gave me an oxygen bottle from our clinic
to use that night, which helped greatly.
The following morning when discussing this experience with the hotel owner,
he asked
me why I hadn't called him sooner, as he turned to open a large cabinet filled with
oxygen bottles!
A.W.
Implanted Defibrillator
We were on a cruise in the Caribbean when my
implanted defibrillator
went off, firing 50 times that day. The ship's doctor put me
off ship on the island of Grenada where doctors planned to cut the
defibrillator wires. I declined their offer, thinking I may actually be needing
those shocks! An air
ambulance jet arrived shortly and flew me back to Miami, where a faulty sensing wire was
discovered and replaced. My travel insurance paid for the $14,000
air ambulance bill!
Unknown
(Traveler's should never leave the US without
evacuation insurance.
This is especially important for those on Medicare or with chronic
medical conditions.)
Malaria
My parents had never been to Africa and we were excited to have them
visit us in Kenya. It was a great two weeks, but I never thought I
would be back in the US only a few days after they left. Upon
returning to the US, dad became severely ill with chills and a high fever. I took an
emergency leave to be with him as he lie on his sick bed with
malaria.
Experienced as I was in treating tropical diseases, I could do nothing but
pray, as he passed from this life to the next. I wonder, if he had
taken
malaria prophylaxis
would that vacation be one of fonder memories instead?
D.S. President of the
CMDA
Manhole
This was hot, crowded, Port Au Prince, the capital of Haiti. Our SUV
was inching along bumper to bumper, when the front end dropped down with
a clunk, jolting us to a stop. Getting out, I found the right wheel
deep in an open manhole. It took several hours to get the car jacked
up and out of the square manhole. Manholes may be square in Port
Au Prince which allows the cover to fall in or covers may be stolen when metal is needed for some
urgent repair work. Also, flooding storm drains during tropical
downpours blow covers off with geysers and wash them away.
B.C.
Motion
Sickness
My husband and I were on our honey moon in Mexico when we decided to take a
beautiful night time cruise with dinner. Five minutes after
departure from the dock, I remembered that I have always been very
susceptible to
motion sickness.
Beginning to feel a little woozy, I had my husband ask the captain to
take us back to shore, but he refused. Everyone on the cruise
enjoyed a fancy meal and champagne, while I spent the next three hours hanging my head
over the bow.
S.S.
Nepal Accident
It was only my first week of a three month planned stay in Nepal when
our SUV rolled over while swerving to avoid a motorbike. Not
having a seat belt on, I injured my neck, but otherwise only had a few
scratches. Kathmandu was miles away, so we found a small clinic
nearby, where the doctor told me I would be all right.
Since my neck was still
hurting, we drove to Kathmandu for another opinion. An orthopedic
surgeon x-rayed my neck and was concerned about a fracture. He put
me in a neck brace and highly recommended I be air evacuated to New Delhi,
India for a cat scan of my neck. I took his advice and flew to New
Delhi, where a fracture
in my upper neck was found.
Fortunately, I did not have any
neurological involvement.
My parents flew to New Delhi, but with difficulty due holidays, which
caused
visa problems. Not until contacting our
congressman were they able to obtain visas for India. I was
glad to have them escorting me back to the US, wearing my halo cast.
J.U.
(Motor vehicle accidents are the most common cause of death in
travelers.)
Rip
Tide
I was enjoying a restful day at our spot on the beach in Southern
Haiti, watching my son and husband swim. Thinking they were somewhat farther out
than usual, I jumped to my feet, yelling at them to come in closer. It soon became apparent something was drastically
wrong. Caught in a rip tide they were being sweep out to sea.
No boats were in sight to send help. Panic swept over me. Swimming
parallel to shore for what seemed like hours, they reached shallow water,
with their last ounce of strength. I sank into the sand sobbing.
S.W.
(Drowning and falls from heights are the second most common cause of death in travelers.)
Rabies 1 - Dog Scratch in Africa
A Belfast woman traveled to Africa a number of times over the
last couple of years. She began feeling unwell after her last trip
in March 2008.
It is believed she may have been infected with rabies as far back
as December 2006, while working in an animal sanctuary in South Africa.
At that time, she had sent home emails detailing how she had been
scratched while separating two quarreling dogs. One of the animals later
had to be put down after it started foaming at the mouth.
The length of the presumed
incubation period is not unheard of and probably contributed to a late
diagnosis of the unfortunate woman's condition. Since 1946,
there have been 24 rabies deaths among Britons, of which all were
acquired abroad.
Date: Wed, 7 Jan 2009 20:17:28 -0500 (EST)
From: ProMED-mail
promed@promed.isid.harvard.edu
Subject: PRO/AH/EDR> Rabies, human - UK (04): (N. Ireland) ex S. Africa
(The World Health Organization
has estimated the annual number of human rabies deaths to be between
40,000 and 70,000. Most of these deaths take place in developing
countries, particularly in South and Southeast Asia. Bangladesh, India, and Pakistan together report over 40,000 human deaths from
rabies every year.
China reports the second highest rate of rabies in the world. It is
predominantly distributed in the southern provinces of China, bordered
by the Yangtze River.)
Rabies
2 - Bat Scratch in Kenya
"On 24 October 2007, at the start of a two-week holiday trip through
Kenya, a small bat had flown against her face. While she was hitting
away the animal, it made two bleeding scratches on the right side of her
nose. The incident took place in a camping site between Nairobi and
Mombassa, at dusk, while she was brushing her teeth. The wound was washed
with soap and cleaned with an alcohol solution. The warden of the
campsite and medical personnel of the neighboring health centre were not
aware of the existence of rabies in bats in the area and no further
action was recommended. The woman and her husband then continued the
holiday trip."
"On 19 November 2007, the 34-year-old woman was
admitted to the Academic Medical Center of the University of Amsterdam
in the Netherlands with difficulty speaking, numbness of both cheeks and
unsteady gait, all of which started the day before."
The diagnosis of rabies was made on the second day
of hospitalization. Despite all efforts, the patient died on 8
December, 23 days after the onset of illness.
www.eurosurveillance.org/
edition/v13n02/080110_01.asp
(Bats should always be suspect for carrying
rabies. They are very agile flyers and
rarely, if ever "fly into people" unless sick.)
Rabies
3 - Dog Bite in Nepal
My father was a surgeon and my mother a nurse. We lived in a remote area of Nepal. One
morning a rabid dog came through the village and within minutes it had bitten
numerous dogs, cows and people. Villagers hunted down the rabid dog and
killed it. They also killed all the cows and dogs that had
been bitten. The children
and adults who suffered attacks were referred to Kathmandu for rabies vaccination. Unfortunately, not all of
them went to Kathmandu or finished the treatment. Some of these
later died of
rabies.
D.S.
Road Construction
I've spent a lot of time in India and have even learned a little Hindi
and how to read road signs. During one trip, I hired a
driver and car to take me to a meeting in a rural area. Traveling on a primitive road, we
reached an 800 foot deep ravine spanned by steel sheeting. I barely
notice the warning sign written in Hindi, as we followed traffic across.
We were in the middle, with one Jeep
in front and one behind. The make shift bridge was sagging
under the weight when the driver asked me, “What did that sign say?”
It dawned on me then, “One vehicle at a time!”
L.W.
Road Construction 2
Driving through winding dirt road
construction, we approached a group of workers who appeared to be idly standing
around. Suddenly, they scattered, waving their arms frantically and
yelling at us in Hindi, “Go back! Go back!” We stopped just
as a huge dynamite explosion rocked the area they were excavating,
pelting us with gravel and choking us with dirt.
L.W.
Scorpion Tale
Did I tell you my husband got stung by a scorpion on the airplane? It was
in my daughter's carry on bag. I put ice and a steroid ointment on the
sting site and then gave him Claritin and 10 mg of prednisone. He was fine!! I
smashed the scorpion to bits with my flip-flop. I travel with a little
pharmacy. Next time I will bring an EpiPen, but I forgot it this
time...My daughter later lamented to my husband that I'm such a tomboy.
Oh well...somebody had to dispatch the menace. Can you imagine what would
have happened if the scorpion got away on the airplane?
W.S.
Sea
Urchins
The crystal clear water was shallow where I was snorkeling in Haiti. Depth perception is difficult in these conditions, so that
when I stood up, I found I was only in knee high water.
Unfortunately, I stood up on a sea urchin which pierced my foot with
sharp spines, shooting excruciating pain up my leg. Instinctively,
I ran for the beach, crossing over a bed of sea urchins! I
couldn't stop running until I came to shore and collapsed in shock, with
multiple sea urchin spines in both feet.
T.H.
Ticks
in Africa
A local surgeon and his wife were hunting in South Africa. He
became ill with fever, intense headache and weakness after arriving back in South Dakota. An infectious disease specialist checked
blood samples and prescribed antibiotics for a presumed
bacterial infection. He had to cancel his office and surgical cases
for two weeks because of illness. Blood tests later confirmed African Tick
Bite Fever. He remembered having very small "pepper
ticks" on his body
while in Africa.
His wife came down with similar symptoms and was also treated successfully.
E.P.
Ticks In Africa 2
While on a 10 day mission trip to South Africa, an acquaintance of mine noticed a small sore on top of
her left foot the first week of her trip. Becoming more painful
daily, it developed a blacken
crater in the center. She returned to Phoenix as scheduled to meet
her family before coming back to Rapid City. By this time, there
was swelling of the
foot. She visited a clinic where she was told she might have a spider bite
and was given antibiotics. Over the next four days,
she visited two emergency rooms complaining of increasing headache with
fever, weakness, and pain in the left foot, leg and groin. During the last
ER visit, she was advised to see an infectious disease specialist.
The next day the patient's daughter suggested that she call me for
recommendations. Using her cell phone, she reached me at my
computer and
described the foot lesion and her symptoms in detail. Thinking out loud, I
said, "I wish I could see a picture of it."
To which she
replied, "I'm using my camera phone and can send you pictures."
The photos arrived minutes later by e-mail. Still not sure of the
diagnosis, I prescribed doxycycline on the chance that she could have
African Tick Bite Fever. Within 24 hours she was feeling better
and went on to recovered uneventfully.
African Tick Bite Fever is
common in Sub-Sahara Africa. The initial sore is called a "tache
noire" (black spot) and can be confused with spider bites, plague and
anthrax.
S.S.
