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decrease discomfort. These should not be used for more than
a day or two; they are better considered as temporary relief
than a definitive solution. Antibiotics may also be prescribed
for traveler’s diarrhea and can speed resolution.
Wounds
High heat and humidity, endemic pathogens and varying levels
of sanitation mean some tropical environments present a higher
risk for infection of wounds. Immediate, thorough cleaning is
important once any bleeding is under control. Irrigate the wound
with water clean enough to drink to remove debris and help flush
out pathogens. Wash around the wound with soap; the same soap
you would use at home is fine. Consider application of a topical
antibiotic ointment and a sterile dressing. It is important to keep
the wound as clean and dry as possible. Repeat this process every
day until the wound is closed. Any redness, fever, increased
drainage or pain should prompt medical attention.
The best defense against disease is maintenance of good
health. Routine hygiene, a healthy diet and regular exercise are
essential. Knowing what diseases you are likely to encounter will
provide direction for preventative measures and help guide your
choices when it comes to eating and drinking, excursions and
activities. With proper planning and preventive strategies, your
travels can be rewarding and uncomplicated.
AD
“Some tropical
environments
present a higher
risk for infection
of wounds.”
A NN B E NN E T T
Traveling divers frequently ask which malaria medicines are safe for
diving. There is a particular piece of incorrect information that surfaces
from time to time. It has been stated erroneously that some malaria
medications increase the risk of decompression illness (DCI). There is
no evidence this is true. Mefloquine (Lariam
®
) may produce side effects
that could potentially mimic symptoms of DCI. Less-common side effects
that raise concern are vivid or bizarre dreams, restlessness or anxiety,
confusion, paranoia and depression. These side effects are rare but
clearly problematic should any of them occur during a dive.
The DAN Medical Information department has received reports of dive
operators in certain parts of the world who denied service to divers using
mefloquine because of some of the drug’s known side effects. Due to
this possible controversy, divers should consider requesting an alternative
medication that is equally suitable for the area of travel. Some branches
of the U.S. military prohibit flight crews and diving personnel from using
mefloquine. The most common alternative medications are chloroquine
(Aralen
®
), atovaquone/proguanil (Malarone
®
) and doxycycline, none of
which are known to be particularly problematic for divers.
Verify which medication or medications are effective for your planned
destination using the CDC’s or WHO’s websites, and then discuss the
advantages and disadvantages of each medication with your personal
health-care provider.
Malaria Medications and Diving
S T E P H E N F R I N K