Parents

The problem with traveling with parents (or maybe just with my parents), is that through their worries and precautions you discover so many more things to be afraid of. My dad won't touch an uncooked vegetable from the time he lands in a developing country until his plane touches down on first-world soil. They carry IV bags and an IV in case bad food poisoning or a stomach bug causes life threatening dehydration.

And then there are the tropical diseases they know everything about. Consider Chagas' disease. (1) Present throughout much of South and Central America, Chagas is caused by a parasite (typanosoma cruzi) transmitted by the nocturnal "kissing bug" (so called because it usually bites near the mouth). The "kissing bug" is found mostly in coastal areas, and often lives in the thatched roofs of rural huts. After dropping from the roof during the night, the bug bites a person´s face, drinks a bit of blood, and defecates in or near the open wound. (2) The parasite, present in the feces of an infected bug, then enters the bloodstream through the open bite wound or through mucous membranes such as the eyes or mouth. The likelyhood of infection is increased when the sleeping person scratches or rubs the infected feces into the eyes, mouth, or bite wound. (3)

During the acute phase of Chagas´disease, lasting for a few weeks or monthes after infection, one of two things may happen: you may be completely symptom free, or you may have a variety of symptoms, ranging from mild to severe, including - but not limited to - nausia, vomiting, diarrhea, fever, headaches, etc. The symptoms usually fade away on their own. Unpleasant, yes, but the chronic phase, during which you have about a 30 percent chance of developing the following complications, is what you should worry about. Cardiac complications of Chagas' disease may include an enlarged heart, changes to your heart rate or rhythm, heart failure, or cardiac arrest. Intestinal compications may include an enlarged esophagas or colon. (3)

Of course, also widespread in parts of Latin America - and present on other continents as well - is leishmaniasis. Also a parasite, Leioshmaniasis is transmitted by sand flies. There are two types. Cutaneous leishmaniasis, which affects the skin, and visceral leishmaniasis, which affets the internal organs.

Cutaneous leishmaniasis causes skin sores, appearing within a few weeks or months of infection. The sores may or may not be painful, and may change in size and appearance over time, often appearing with a raised edge surrounding a central pit or craer, and may be covered with a scab. If left untreated, the skin sores will eventually heal, although this may take months or years and leave considerable scarring. Rarely, untreated cutaneous leishmaniasis may spread to the nose or mouth, causing additional sores on the mucous membranes (mucosal leishmaniasis).

Visceral leishmaniasis usually appears withing months (and occasionally years) of infection, and may cause fever, weight loss, and an enlarged spleen and liver. Left untreated, visceral leishmaniasis can be fatal.

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My parents flew home two days before I came to Ecuador, but they left me with their legacy (and their prescriptions). The quantity and variety of "just in case" medication I'm carrying is enough to give me nightmares. I have three types of antibiotics: Cipro, one for skin infections or infected cuts, and one to take if I get, for instance, pneumonia. I have two types of anti-nausia pills, two types of anti-malarial pills, antibacterial gel AND wipes in case of minor injury, band-aids, vitamins, and probiotic pills to replenish my intestinal flora when the antibiotic wipes it out. (Okay, the probiotics and the vitamins were my idea, but still.)

Of course, my first day in Ecuador I woke up with a cold, and nothing to do about it except compain. But if it turns into pneumonia, I´m set.

Sources:

1. Dad, M.D.

2. Moon Handbooks Ecuador. Julian Smith, 2005. Page 410

3. Chagas´Disease. U.S. Department of Health and Human Services, Centers for Disease
Control and Information; Division of Parasitic Diseases.

4. Leishmania Infection. U.S. Department of Health and Human Services, Centers for Disease
Control and Information; Division of Parasitic Diseases.