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Panama: Marine Ecology and Blue Carbon Conservation in the Pacific and Caribbean

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Panama: Marine Ecology and Blue Carbon Conservation in the Pacific and Caribbean Panama: Marine Ecology and Blue Carbon Conservation in the Pacific and Caribbean TABLE OF CONTENTS GENERAL INFORMATION ................................. 2 PREVENTION OF INSECT-BORNE ILLNESSES ........................................................................... 2 PREVENTION OF FOOD- AND WATER-BORNE ILLNESSES ........................................................ 3 OTHER DISEASES ............................................ 5 IMMUNIZATIONS ............................................... 6 IMMUNIZATION SCHEDULE ............................. 7 GENERAL INFORMATION SIT Study Abroad programs may venture off the To protect your health in Panama, you need certain usual tourist track. Pay careful attention to health pre-departure immunizations followed by reasonable and safety guidelines. health precautions while in the country. The following health guidelines and requirements are PREVENTION OF INSECT- based on years of experience and the current recommendations from the US Centers for Disease BORNE ILLNESSES Control and Prevention. They are designed to inform Insect precautions are recommended for this you of health concerns that may be present in program. There is no risk of malaria in Panama City Panama especially as you venture to smaller cities and the scheduled destinations of the program. off the usual tourist track, or spend time in small While there is a low risk of malaria in portions of villages and rural areas for extended periods. Comarca Guna Yala- it is mostly on the eastern Although no information sheet can address every side, a significant distance from your program conceivable contingency, the following health excursion to the farthest western tip of Guna Yala. guidelines and requirements are an attempt to Insect precautions only against mosquito bites are provide you with a standard, which if followed, usually sufficient for this program. should optimize good health during your stay abroad. Personal Protective Measures You may find that local customs and practice, as The following insect precautions should be followed, well as varying US physicians’ approaches, at times to prevent mosquito bites: conflict with these guidelines. It is essential that you • Wear long-sleeved shirts and long pants. review these health guidelines and requirements • Use insect repellents on skin and clothing. with your physician, to discuss individual issues DEET-containing products (e.g. Off, Off Deep such as pre-existing medical problems and allergies Woods, Jungle Juice, and Muskol) may be used to particular drugs. Any further questions or on skin in concentrations up to 30–40% and on concerns should be directed to the US Centers for clothing in higher concentrations. Permethrin Disease Control and Prevention (CDC) in Atlanta (Permanone) may also be used on clothing. (www.cdc.gov/travel) or to your own physician. SIT Study Abroad suggests that if you have further questions, you should not hesitate to contact the Malarial Division of the CDC at 888-232-3228 for recorded information or to visit the CDC website http://www.cdc.gov/malaria/travelers/index.html 2 Panama 2020 Dengue protective measures) and by getting the vaccination This is a viral disease and is transmitted by shots that are available at any yellow fever mosquitoes which bite primarily in the daytime. It vaccination center (consult your physician for the occurs in urban as well as rural areas. There is no nearest center). licensed vaccine against it, but personal protective Please note: yellow fever is not a concern for the measures against mosquito bites are effective in scheduled program destinations. However, if you prevention (see under Personal Protective plan to travel to a yellow fever risk area after the measures). The disease causes considerable program, we recommend the yellow fever discomfort (fever, body aching, but is self-limited in vaccination. adults. Zika Zika is a viral infection that is also transmitted by the bite of the Aedes mosquitoes. Symptoms include mild fever, rash, conjunctivitis (red eyes), joint or muscle pain and headache. The disease causes considerable discomfort, but is mild and self-limited, lasting for several days to a week. There are no vaccines or medications available to prevent or treat Zika infections therefore students should be vigilant in using insect precautions and personal protection measures against day-biting mosquitoes (see insect precautions section above). PREVENTION OF FOOD- AND CDC recommends that pregnant women consider WATER-BORNE ILLNESSES postponing travel to countries where the Zika virus Tap water is generally safe to drink and cook with in is prevalent. Panama City and other major cities and it is usually safe as well to eat fresh fruits, vegetables, and Chikungunya salads and to put ice in your drinks. Food and water Chikungunya is an arboviral infection that is safety however, cannot be guaranteed from street transmitted by day-biting Aedes mosquitoes. It is food purchases and the water quality is variable in prevalent in tropical Africa and Asia, parts of Central rural areas. and South America, and the Caribbean. Low risk If you are unsure of the food and water quality in the exists throughout the country including Panama area you are visiting, check with a reliable source City. Symptoms are typically fever and joint pain. before using. If in any doubt, take all the There is no licensed vaccine against it, but insect recommended precautions and respect certain do’s precautions and personal protective measures and don’ts: (especially during peak times (early morning and late afternoon) are the main prevention strategy. DO WASH your hands scrupulously with non- contaminated water and soap before eating and Yellow fever snacking. This is a viral disease transmitted by mosquitoes that occurs only in parts of Africa and South DO DRINK America. It is a concern for all mainland areas east • Bottled or canned beverages (water, soda, soft of the Canal Zone (including Comarca Guna Yala – drinks) from a trusted source (ensure caps are an excursion destination). Yellow fever is sealed). • characterized by severe hepatitis with fever. It may Hot beverages (coffee, tea). be prevented by avoiding mosquito bites (personal 3 Panama 2020 • Water that reached a rolling boil for at least one minute at sea level (longer at higher altitudes). • Carbonated mineral water. DON’T DRINK • Tap water, even in ice; don’t risk using it for brushing your teeth either. • Tap water in larger cities is often safe, but the water in rural areas is probably not, so be sure to check with a reliable source before using, and if in any doubt, take all the recommended precautions. Diarrhea-Producing Infections In Panama, there is a mild to moderate incidence of DO USE diarrhea among travelers. Most common is • Commercial iodide or tinctured liquid iodine to “traveler’s diarrhea”, a self-limited diarrhea lasting treat water, ONLY if bottled water (from a trusted from a few to several days, characterized by watery, source) is not available and boiling water is not non-bloody bowel movements. Traveler’s diarrhea possible. Chlorine in various forms is less usually requires no treatment other than fluid reliable than iodine. These provide substantial replacement including ORS (World Health protection when added to tap water. Organization’s oral rehydration solution, which comes in package form). Antidiarrheals such as DO EAT Imodium or Lomotil may be used short-term in some • Cooked vegetables, fruits with thick covering circumstances. Pepto Bismol in large amounts and (citrus, bananas, and melons); and well-washed certain antibiotics (doxycycline, sulfa-TMP, raw fruits and vegetables. ciprofloxacin) can prevent or attenuate the infection. • Meat or fish that is thoroughly cooked (pork and Antibiotics are indicated for more severe cases of lamb should be very well done). traveler’s diarrhea. • Pasteurized dairy products from large commercial dairies. Hepatitis A DON’T EAT Hepatitis A is a highly contagious virus that causes • Unwashed or unpeeled raw fruits and liver inflammation. It is most commonly spread vegetables. through contaminated food and water. Most • Fruits that do not have a thick, disposable Americans have not previously been exposed to the outside covering. hepatitis A virus and are at risk of contracting the • Rare or raw meat or fish or shellfish. disease during travel to areas where the disease is • Dairy products from small, independent vendors more prevalent. A very effective vaccine is available without pasteurizing facilities, including food of and should be administered 2–3 weeks prior to any kind that has been left out in the sun, travel. especially custards, creams, and mayonnaise. • Raw (unpasteurized) milk or milk products. Typhoid Fever Tuberculosis and brucellosis, both serious Typhoid is an infection caused by a particular diseases are transmitted in this way, so the species of the salmonella bacterium. It is spread by consumption of unpasteurized milk and milk contaminated food and water. Symptoms include products should be strictly avoided. fever, severe toxicity, rash, and in about half the cases, bloody diarrhea. Untreated, there is a 30% There may be times when refusing an offer of food mortality rate. Vaccines are 60–70% effective in or beverage, even a drink with ice or avoiding a prevention. One vaccine involves a single injection, salad will be considered rude. You must decide for with immunity lasting 2 years. A second one is yourself, but polite refusals, thought out in advance, administered orally every
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