Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

Encounters with animals can cause problems for the traveller and any unnecessary contact with them should be avoided. Many large mammals are easily capable of killing humans.

Few animals will pick a fight with humans but most will defend themselves if cornered or surprised and females will defend their young aggressively. When venturing into wildlife country on foot be sure to take a guide who understands the local animals. Take great care when walking through long grass or dense scrub which could conceal a potentially dangerous animal.

Large carnivores cannot be outrun so are better faced. Try shouting, throwing rocks or waving sticks which may confuse the animal and make it back away. Running away is just what the prey would do and could precipitate an attack. Be very careful when camping in big cat country. Don't sleep in a tent with anything that may attract a large creature, bears will rip open tents to get at the contents.

There are many dangerous animals to be found roaming freely in parts of Africa and Asia. As well as the big cats, these include include rhinos, hippos, elephants and (African) buffaloes which can be particularly aggressive. Large primates like baboons and chimpanzees can be particularly dangerous. It pays to be well informed when travelling into areas where these animals are found. If you are going on a safari to a game reserve, stay inside your vehicle when appropriate and always follow the advice of your guide.

When travelling close to rivers in Africa, South America and parts of Australia beware of crocodiles which can be lurking in shallow water near to the river bank.

Because we have so much contact with domestic animals, we are much more likely to be injured by them than by wild animals. Travellers have been injured by cats, dogs, cattle, pigs, camels, water buffalo, elephants, etc. Be wary of any domestic animals you do not know.

By far the most common domestic animal responsible for attacks on humans are dogs. Worldwide they are responsible for hundreds of deaths annually. In many countries they often run wild and may respond aggressively when approached.

If you are threatened by a dog pick up a stick and wave it or some stones to throw at it or even pretend to if none are around. Most dogs will retreat if they think you are armed.

Dog bites not only inflict severe injury but can also spread dangerous infections like tetanus or even rabies.

Rabies is present worldwide - except in the United Kingdom, parts of Scandinavia, Japan, Oceania, Antarctica, Australia, New Zealand, Malta and some of the Caribbean islands. It can be transmitted to humans in several ways, but most commonly via the bite of an infected domestic dog. Rabies, if left untreated, will always cause death!

Precautions 

Do not stroke dogs and cats and avoid contact with bats, jackals, foxes and other wild animals. Animals that appear unusually tame may be dying of rabies.

In an area endemic for rabies all unprovoked bites or licks should be considered a possible exposure.

In the event of possible exposure to rabies immediate treatment should be instigated:-

• Thorough cleansing of the wound should be undertaken with soap or detergent and running water for 5 minutes.
• Apply an antiseptic such as iodine, chlorhexidine or alcohol.
• Seek medical assistance as soon as possible.

It may be necessary to commence rabies vaccination and anti-tetanus measures. If you have been immunised against rabies prior to being bitten you may still require further doses of vaccine. Travellers who have never been immunised against rabies and then receive a suspect bite, should be vaccinated within 24-48 hours.

Snakes

Most species of snakes are harmless and over half of the venomous species do not have the capability or temperament to be harmful. Even aggressive and venomous species will very often inflict a "dry bite" which is venom free. Snakes do not like to waste their venom on anything other than prey species. Remember, only one in a thousand people bitten by a snake actually dies as a result. Most deaths from snake bites occur on the Indian subcontinent where they are often forced into contact with humans.

However, if you are bitten by a snake you should always be assessed by an expert as it is often quite difficult for ordinary travellers to distinguish between dangerous and harmless species.

Dangerous species of snakes are found in many tropical and desert regions and local inhabitants are occasionally bitten and sometimes killed by them. Foreign travellers are rarely bitten.

Although snakes are found worldwide, the counties of the world where travellers are most likely to encounter venomous snakes are include; Australia, North, South and Central America, Africa, The Indian Subcontinent and South East Asia.

Snakes never attack without provocation, they are generally shy and where possible, shun human contact. Avoid disturbing, cornering or handling them.

Walking barefoot in vegetation, swimming in murky water and climbing rocks and trees covered with foliage are all risky. At night use a torch. Never tease a snake as teasing could cause the snake to increase the dose of venom.

If you are bitten, move away from the snake to prevent additional bites.

First aid for snakebite is controversial. The only universally approved first aid applicable globally, is immobilisation of the bitten area/limb and keeping the victim still. The victim should then be transferred to a hospital or clinic for medical treatment if available. This should involve the minimum of exertion by the victim as possible.

Snake venom travels primarily via the lymphatic system. Therefore, to prevent the spread of venom the movement of lymph needs to be restricted. This is achieved by immobilising the bitten area (usually a limb), keeping it level with or just below the heart and by the application of a pressure bandage.

You should NEVER apply a tourniquet to a snake bite. A tourniquet is a tight band placed around a limb designed to restrict the blood flow to and from the limb. Inappropriate use of tourniquets can lead to unnecessary loss of the limb. A splinted bandage to immobilise the limb can often be of more use. A suction device may be used to help draw the venom out of the wound without making cuts.

Whilst moving the victim to get medical help, monitor their vital signs i.e. pulse and rate of breathing. If there are signs of shock, lay them flat, raise their feet and try to keep them warm. Reassure them that bites can be effectively treated by trained medical staff.

In some areas where venomous snakes are endemic (such as Australia), venom detection kits are often used by medical personnel. These allow the site to be swabbed and a sample of venom collected which is used to accurately identify the snake or group of snakes to which the biter belongs to. This enables the use of more specific and more effective antivenom. Washing the bite may remove traces of venom that otherwise could be detected by the kit. However, these kits are not always available to medical staff in poorer developing countries so in this instance cleaning the wound thoroughly with an antiseptic soap or solution would a good idea.

Medical treatment will be greatly assisted if the snake can be accurately identified. If the snake can be captured and/or killed without risk of anyone else being bitten, take it to show the doctor at the treatment clinic. Anti-venom when available should only be administered by those experienced in its use.

Further information:

• University of Adelaide - Treatment of Snake Bites
• University of Sydney - Snake Bites
• First Aid for Snake Bites
• Treating and Preventing Venomous Snake Bites
• E-medicine Health - Snakebite
• How to Treat Snake Bites in the Wilderness
• Poisonous Snakes And Lizards from US army survival guide.
  
  

Spiders & Scorpions

Although most spiders are venomous, very few species are able to penetrate human skin and inject venom. Of those that can, only a few species in Australia and South America cause neurotoxicity requiring specific anti venom treatment.

Harmful species of spider include:-

• The Black Widow which is found in the Americas, Africa, southern Europe and warm parts of Asia and Australia. The bite gives rise to painful muscle spasms which can last up to two days.
• The Brown Recluse or Fiddle Spider which is found in the Americas, North Africa and the Mediterranean. Its bite can be fatal but deaths are rare. The bite which is initially painless causes localised tissue death leading to severe scarring. Deaths are rare.
• The Funnel Web mainly found in south and eastern coastal regions of Australia (the Sydney Funnel Web) and is a particularly nasty spider which is easily capable of causing human fatalities. Antivenin exists.
• Huntsman Spiders or Banana Spiders located in South America are quite aggressive and cause painful bites but are rarely fatal.
• Wolf Spiders are mainly found in South America but there is a European species. The bites cause tissue death leading to scarring up to 20cm long. It is rarely fatal.

The vast majority of spider bites are non-fatal but some can be very painful. Try to immobilise the affected limb and seek medical assistance. Ice can be applied to the bite site and antihistamines and pain killers may also be used to treat any symptoms.

Bites from the truly poisonous spiders such as Funnel Webs (left) should be treated like snake bites and medical assistance should be sought as soon as possible. The spider should be killed and taken along to the doctor for identification. The spider bite victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person.

Scorpions are usually found in arid regions. They like to hide in dark shady places and sometimes they will hide inside your boots. Therefore, you should always check your footwear before putting them on in areas where scorpions are found.

They sting in self defense using their tail sting which in most cases is very painful rather than life threatening. However, potentially lethal scorpions do exist in Mexico, South America, The Caribbean, North Africa, the Middle East and the Indian subcontinent which can cause neurotoxicity with blurred vision and breathing difficulty, myocardial damage and pancreatitis. Immediate medical help should always be sought if bitten.

First aid for scorpion bites is similar to that of spider bites. Wash the sting area and apply a cold compress. Immobilise the the victim and seek rapid medical help. Antihistamines and painkillers may be used to treat the pain and swelling. There are antivenins available for the more dangerous species but these must be given quickly.