Flesh-eating bugs to heart-stopping parasites – tropical terrors to avoid on holiday

After almost two years of Covid restrictions, we’re all desperate to board a plane and fly away to more exotic climes.

But while sun, sand and sea are an exciting prospect, it’s not just Covid we need to look out for – worrying infections lurk in all corners of the world.

This month, the third annual World NTD (Neglected Tropical Diseases) Day will be raising awareness and encouraging action in the fight against NTDs.

There are 20 around the globe – three of which kill more than 200,000 people a year!

From flesh-eating bugs to heart-stopping parasites, it pays to be aware of these terrors in the tropics…

Chagas disease

Up to eight million people in Mexico, Central and South America have this parasite. Blood-sucking insects called triatomines bite people’s faces and infect them with their faeces.

Pregnant women can infect their babies and you’re also at risk from uncooked contaminated food. If untreated, the infection may be fatal.

Fever, fatigue, body aches and vomiting are among the early symptoms, lasting weeks to months. There may be swelling at the bite site or where the faeces has been rubbed into an eye – known as Romaña’s sign.

Later, up to 30% of sufferers develop heart problems, including cardiac arrest, and stomach complications, but most have no symptoms at all. Anti-parasitic medication is needed to rid your body of the infection.


Parasitic worms carry this waterborne illness, also known as bilharzia, infecting more than 200 million people worldwide.

Freshwater is contaminated by Schistosoma eggs when human carriers urinate or defecate in it. The eggs hatch and parasites develop and multiply in certain freshwater snails.

They then enter the water where they can penetrate skin and mature into worms, which lay eggs. Signs of infection include a rash or itchy skin, fever, chills, a cough and muscle aches.

The eggs can damage the liver, intestine, lungs and bladder and, rarely, cause seizures and paralysis. Drugs are effective but also drink safe water, boil bath water and avoid freshwater in at-risk areas.


This parasitic menace appears around 1.6 million times a year in South and Central America, Asia, Africa and also in Southern Europe.

Anyone can catch it, including TV’s Ben Fogle who caught the flesh-eating bug in Peru and needed “poison injections” to banish it.

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Sand flies carry the infection. Their bites cause symptoms such as a high fever, weight loss, skin sores on exposed parts of the body and swelling of the spleen and liver, as well as lowering the number of white blood cells – our body’s defence against illness.

Look out for bumps, lumps and ulcers – like a volcano with a raised edge and central crater – although you may have no signs at all. There’s no drug or vaccination to prevent it. Cover skin and carry insect repellent.

Dengue fever

Vomiting, rash, aches and pains (muscle, joint or behind the eyes) are common signs of dengue, which affects up to 400 million people a year in the Americas, Africa, the Middle East, Asia and the Pacific Islands.

Infected mosquitos spread the virus by biting humans. Symptoms usually clear up after seven days but severe infections (one in 20) can be fatal, with the warning signs appearing as the fever begins to ease.

Look out for belly pain, bleeding gums and blood in vomit or stools. Rest, fluids and paracetamol will ease mild symptoms.

Buruli ulcer

Limb ulcers are a sure sign of this bacterial disease, with cases mostly seen in West Africa and Australia. But it’s not known how people get the disease.

It can destroy skin and soft tissue, and infect bone. Left untreated, it may cause irreversible deformity or disability. About 6,000 cases are reported a year in 15 of at least 33 countries where it’s present. Antibiotics are essential and in rare cases, surgery is needed.

Tropical diseases – the numbers

More than one billion people – a sixth of the world’s population – are infected with one or more neglected tropical diseases. An additional two billion people are at risk.

Each year, about 185,000 people die from these infections. In 2019, India had the highest number of cases needing intervention, approaching 734 million

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