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Amebiasis is a parasitic infection of the intestines caused by the protozoan Entamoeba histolytica, or E. histolytica. The symptoms of amebiasis include loose stool, abdominal cramping, and stomach pain. However, most people with amebiasis won’t experience significant symptoms.

Countries with less access to clean water and washing facilities typically have a higher number of typhoid cases.

Typhoid is spread by contact and ingestion of infected human feces. This can happen through an infected water source or when handling food.

Before traveling to a high-risk area, getting vaccinated against typhoid fever is recommended. This can be achieved by oral medication or a one-off injection:

· Oral - live, attenuated vaccine. Consists of 4 tablets - one taken every other day, the last of which is taken 1 week before travel.

· Shot - inactivated vaccine, administered 2 weeks before travel.

Note: vaccines are not 100 percent effective and caution should still be exercised when eating and drinking.

Vaccination should not be started if the individual is currently ill or if they are under 6-years of age. Anyone with HIV should not take the live, oral dose.

There may be side effects to the vaccine:

· Shot: fever (1 in 100 cases)

· Shot: headache (1 in 30 cases)

· Shot: redness or swelling at the site of injection (1 in 15 cases)

· Oral: fever or headache (1 in 20 cases)

· Oral: stomach pain, nausea, vomiting, rash (rare)

Even when the symptoms of typhoid have passed, it is still possible to be carrying the bacteria. As a result, it is difficult to entirely stamp out the disease because carriers whose symptoms have finished may stop showing caution when washing food or interacting with others.

The following are some general rules to follow when traveling to help minimize the chance of typhoid infection:

Fluids and electrolytes may be given by IV (into a vein). Or you may be asked to drink uncontaminated water with electrolyte packets, while Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so it is important to ask a doctor for recommendations before choosing an antibiotic.

Typhoid is diagnosed by detecting the presence of S. typhi via blood, stool, urine, or bone marrow sample

A blood culture during the first week of the fever can show S. typhi bacteria.

Other tests that can help diagnose this condition include:

· ELISA urine test to look for the bacteria that cause Typhoid fever

· Fluorescent antibody study to look for substances that are specific to Typhoid bacteria

· Platelet count (platelet count may be low)

· Stool culture

Symptoms normally begin 6-30 days after exposure to the bacteria. The two major symptoms of typhoid are fever and rash. Typhoid fever is particularly high, gradually increasing over several days up to 104 degrees Fahrenheit. The rash, which does not affect every patient, consists of rose-colored spots, particularly on the neck and abdomen.

Other symptoms can include weakness, abdominal pain, constipation, and headaches; rarely, symptoms might include confusion, diarrhea, and vomiting (but not normally severe).

In serious, untreated cases, the bowel can become perforated; this can lead to peritonitis (an infection of the tissue that lines the inside of the abdomen), which can be very serious indeed.5

Note: paratyphoid has similar symptoms to typhoid but is caused by Salmonella enterica. Both conditions are of similar severity.

Typhoid fever is an acute illness associated with fever caused by the Salmonella typhibacteria. It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area.

No animals carry this disease, so transmission is always human to human. If untreated, around 1 in 4 cases of typhoid end in death. If treatment is given, less than 4 in 100 cases are fatal. S. typhi enters through the mouth and spends 1-3 weeks in the intestine. After this time, it makes its way through the intestinal wall and into the bloodstream.

From the bloodstream, it spreads into other tissues and organs. The immune system of the host can do little to fight back because S. typhi can live within the host's cells, safe from the immune system.

1. Drink and use;

· Bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.

· Safe water to brush your teeth, wash and prepare food, and to make ice.

· Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

2. Wash your hands often with soap and safe water;

· Before you eat or prepare food

· Before feeding your children

· After using the latrine or toilet

· After cleaning your child’s bottom

· After taking care of someone ill with diarrhea

3. Use latrines or bury your feces;

· Do not defecate in any body of water

· Use latrines or other sanitation systems, like chemical toilets to dispose of feces

· Wash hands with soap and safe water after defecating

· Clean latrines and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts water.

4. Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables

· Boil it, Cook it, Peel it, or Leave it.

· Be sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through.

*Avoid raw foods other than fruits and vegetables you have peeled yourself.

5. Clean up safely

· Clean the kitchen in places where the family bathes and washes clothes

· Wash yourself, your children, diapers, and clothes, at least 30 meters away from drinking water sources.

6. Consider getting vaccinated before you travel

Cholera requires immediate treatment because the disease can cause death within hours.

· Rehydration. The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). The ORS solution is available as a powder that can be reconstituted in boiled or bottled water. Without rehydration, approximately half the people with cholera die. With treatment, the number of fatalities drops to less than 1 percent.

· Intravenous fluids. During a cholera epidemic, most people can be helped by oral rehydration alone, but severely dehydrated people may also need intravenous fluids.

· Antibiotics. While antibiotics are not a necessary part of cholera treatment, some of these drugs may reduce both the amount and duration of cholera-related diarrhea for people who are severely ill.

· Zinc supplements. Research has shown that zinc may decrease and shorten the duration of diarrhea in children with cholera.