Travelers a country needs to consider certain guidelines particularly to health. It is pertinent to consider advice from your personal general practitioner firstly, who would usually have records of your health. Furthermore would be of help, particularly to health concerns and deceases prevalent and precautionary measures (vaccines and prophylactic measures) which should be taken.
Bird and Wildlife Team, members has close contact with some of the top physicians /doctors (wildlife enthusiasts) in Sri Lanka and would be able to get in contact at any time as well as get vital advice in case of emergencies. One team member also had worked in the pharmaceutical industry for over 15 years, and has a considerable knowledge on medicines which would be necessary in an emergency. It is also noteworthy to mention that most basic drugs may possibly be bought over the counter at most pharmacies at a lower cost (your doctor’s prescription would always be useful). Our team members are exceedingly knowledgeable in treating minor insect bites and alike.
It’s worth mentioning that common sense and abiding to general hygiene would help enormously in avoiding complications on a tour.
Bird and Wildlife Team tour leaders/guides and drivers are advised to act in accordance with general norms of safety and to advice our clientele of preventative measure to be taken at locations where necessary depending on subject matter. The company, also provide 2 -3 Lt bottled water per day free of charge.
As always with any travel company we would strongly recommend a Travel Insurance. This helps avoid complications caused by unforeseen circumstances.
Medical service and structure in Sri Lanka
Basically, a doctor could be reached or contacted within a few minutes or an hour or so in any remote part of Sri Lanka. In case of an accident or a medical emergency while on holiday one could go directly to the emergency department of the closest private or government hospital and you will be seen by an emergency physician.
Government Hospitals are graded depending on the town/location/population density. Rural Hospitals, District Hospitals, Base Hospitals, Provincial General Hospitals, Teaching Hospitals and The National Hospital of Sri Lanka based in Colombo.
Most rural towns usually would have general practitioners, if getting to a government hospital is unnecessary. Consulting times could vary but usually is from 9.00AM to 12.ooPM and from 3.30PM up to 8.00PM. When consulting a specialist, making an appointment is necessary, this could be done over the phone at most often (consulting starts from 4.00PM up to 8.00PM).
Booking an appointment with a specialist consultant
Call your preferred consultant or clinic and establish a time to be seen. You can also make appointments for a specific consultant through the e-Channeling service by dialing 225 on the local Dialog mobile service.
Sunstroke, sunburn and dehydration
Bring with you sun screen and a hat (check Climate and clothing). Long sleeved, full-length clothes are widely available, but please consider bringing some clothing that will help protect you from the mid-day sun.
As mentioned in Climate and clothing page humidity levels are generally is on the high most if the year, as a result perspiration would be high as well. Drinking of adequate amounts of water is always an essential prerequisite and should always be aware of this imperative.
Swimming
There are some fantastic beaches and shoreline to enjoy, but depending on the area and monsoonal season strong currents could occur in some areas it is always advisable to take local advice. The seas along the west, east and South Coastline are suitable for swimming during those seasons (read Climate and Clothing page).
Disabled travelers
In general, health advice is similar to that of other travelers. If you are disabled please discuss any special requirements in advance with your doctor prior to the tour. Bird and Wildlife Team will make sure that your requirements will be fulfilled to the best of our ability.
Though mosquitoes are a menace world over one would be surprised to find so few mosquitoes outside cities in Sri Lanka. One of the most feared illnesses in the tropics are the mosquito transmitted Dengue fever, Malaria and Japanese encephalitis. All hotels/lodges would have mosquito nets, repellents, vaporizes or coils, if for some reason they are not available, the hotel staff would provide it on request. Adequate amounts of insect repellent (preferably containing 50% DEET) during the day time also would provide further protection. Interestingly only densely populated areas are where most infections are recorded from. Interestingly the maximum mobility of a mosquito is approximately 500m.
http://www.epid.gov.lk is a useful website for information pertaining to vaccinations. It must be noted that countries have their own vaccination regimens and compliance would be an imperative.
Japanese encephalitis
The success of immunization against JE is reflected in the fact that since 1988, incidence of JE has decreased drastically with the increased coverage of vaccination. Since 2003, only sporadic JE cases have been reported from different parts of the country.
After considering the WHO’s SAGE recommendations and findings of the clinical trial carried out in Sri Lanka in 2007, the Advisory Committee on Communicable Diseases recommended replacement of the inactivated JE vaccine with the live attenuated JE vaccine with effect from July, 2009. Currently the National Immunization Progremme in Sri Lanka uses the live attenuated JE vaccine SA 14-2 to vaccinate children against JE.
For travelers aged more than one year visiting JE endemic area for at least two weeks, current established practice is to administer 3 primary doses of inactivated JE vaccine at days 0,7 and 28 ; alternatively 2 primary doses preferably 4 week apart. If continued protection is required, boosters should be given after one year and then every three years. A single dose of LJEV can also be used to vaccinate travelers. This information may help those who wish to travel to Asian countries regularly.
Dengue hemorrhagic fever
With more than one-third of the world’s population living in areas at risk for transmission, dengue infection is a leading cause of illness and death in the tropics and subtropics. Dengue is caused by any one of four related viruses transmitted by mosquitoes. There are not yet any vaccines to prevent infection with dengue virus (DENV) and the most effective protective measures are those that avoid mosquito bites. When infected early recognition and prompt supportive treatment, can substantially lower the risk of developing severe illness.
Aedes aegypti, the principal mosquito vector of dengue viruses is an insect closely associated with humans and their dwellings. People not only provide the mosquitoes with blood meals but also water-holding containers in and around the home needed to complete their development.
Tetanus
The disease may affect any age group, and case-fatality rates are high even where modern intensive care is available. The overwhelming majority of tetanus cases are birth-associated. Tetanus in children and adults following injuries may also constitute a considerable public health problem. A sharp decline has been observed from the 1980s onwards, during the 2nd Quarter 2012, 02 suspected Tetanus cases were notified to the Epidemiology Unit.
Immunization of persons who have not been immunized with tetanus should be given a dose of tetanus toxoid (1st dose) if there is a risk of developing tetanus. Second dose of tetanus toxoid should be given 4 weeks after the 1st dose and the third dose 6 months after the second dose. A booster dose (4th dose) of tetanus could be given 5 years after the 3rd dose. Fifth dose given 10 years after the 4th dose will produce a long lasting, probably a lifelong immunity.
Hepatitis B
Hepatitis B virus is transmitted among people by contact with the blood or other body fluids (i.e. semen and vaginal fluid) of an infected person. Modes of transmission are the same for the human immunodeficiency virus (HIV), but Hepatitis B virus (HBV) is 50 to 100 times more infectious.
Those at high risk of contracting HBV infection, including persons with high risk sexual behavior, partners and household contacts of positive persons, injecting drug users, persons who frequently require blood or blood products, recipients of solid organ transplantations.
Hepatitis B VACCINE 74
Unlike HIV, HBV can survive outside the body for at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected. Common modes of transmission are; sexual contact, injecting drug use, perinatal (from mother to baby at birth), unsafe injection practices and blood transfusions. HBV is a major infectious occupational hazard for health workers. Multiple options are available for incorporating the hepatitis B vaccine into the national immunization programmes and the choice of schedule depends on the country’s epidemiological situation and programmatic feasibility. (It would be advisable to consult your GP for any advice if required).
Hepatitis A
Is caused by the hepatitis A virus (HAV), an RNA virus which usually spread by the fecal-oral route, transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person. The time between infection and the appearance of the symptoms is between two and six weeks and the average incubation period is 28 days.
Acute liver failure from Hepatitis A is rare. Antibody produced in response to HAV infection persists for life and confers protection against reinfection. The disease can be prevented by vaccination, good hygiene and sanitation.
There are two types of vaccines: one containing inactivated hepatitis A virus, and another containing a live but attenuated virus. Both provide active immunity against a future infection. The vaccine is given by injection. An initial dose provides protection starting two to four weeks after vaccination, the second booster dose, given six to twelve months later, provides protection for over twenty years.
There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated.
Leptospirosis
Leptospirosis is a zoonotic disease which is endemic in Sri Lanka. Experience and data suggest that the disease is mainly associated with paddy farming. Therefore the persons engaged in paddy cultivation are are the high risk group. The ‘rat’ is the known most common carrier of the infection in Sri Lanka.
Poliomyelitis
Notification of cases from Hospitals is almost negligible. The vulnerable age group is under 15 year population.
Cholera
No confirmed cases of cholera were reported to the Epidemiology Unit during the 2nd Quarter 2012. Last case of cholera was reported in the country in January 2003.
Animal Rabies
Considering the country’s dogs and other carriers the number of victims, are negligible. It is worth mentioning that Stray dogs in Sri Lanka are surprisingly docile and friendly, many a time they tend to follow tourists expecting tidbits.
During this quarter 143 dogs were reported positive for rabies, compared to 162 in the previous quarter and 106 positive in the same period in the last year. In addition, the following animals were also reported positive; Cats-21, Domestic Ruminants-04
Dysentery
In the 2ndQuarter 2012, a total of 731 cases of Dysentery were reported to the Epidemiology Unit, in comparison to 746 cases in the previous quarter and2224 cases in the corresponding quarter of 2011. Nuwaraeliya (60 cases), Batticaloa (51 Cases) and Ratnapura (51 cases) reported the highest number of cases.
Typhoid fever
Typhoid or Enteric Fever is a serious systemic infection caused by an enteric pathogen Salmonella Typhi that, in the pre‐antibiotic era, had a case fatality of 10% to 20%. Salmonella Paratyphi A and B also cause illness (paratyphoid fever) clinically indistinguishable from typhoid fever. However, where typhoid is endemic, approximately 90% of the clinical cases are due to Salmonella typhi, and the rest, Salmonella paratyphi. Enteric fever is endemic in populated areas with poor access to clean water and where sanitation and hygiene practices are less than ideal.
Most often, confirmed typhoid occurred in children aged 5‐15 years.
Therefore, typhoid vaccination is recommended as a risk‐based strategy and targeted only for high‐risk groups and population.
There are two internationally licensed vaccines against typhoid. Visit http://www.epid.gov.lk/web/attachments/article/141/Guideline_to_Introduce_Typhoid_Vaccination_11th_May_2010.pdf for more information.