DIARRHOEA

What is Traveller’s diarrhoea?
Traveller’s diarrhoea is one of the most common illnesses for tourists going to tropical climates. As many as 60% of all travellers suffer some form of diarrhoea, sometimes dubbed "Delhi Belly" or "Montezuma's revenge".
These can range from diarrhoea to nausea and vomiting and usually last about two or three days.
Patients usually self-treat, but experts say cases can be cleared up much quicker if sufferers take antibiotics.
About 10% of all cases are serious and people with long-term symptoms should seek specialist advice.
All patients with traveller's diarrhoea are advised to ensure they replace lost fluids with fluids and rehydration tablets.
My doctor said I have giardia, what is it?
Giardia and cryptosporidium are intestinal illnesses caused by the protozoan parasites affecting the gastrointestinal tract of humans and animals. They are shed in faeces and can remain dormant for long periods.
They are particularly difficult to remove from water systems.
Infections may be asymptomatic, or may cause diarrhoea, nausea, abdominal cramps, fever, vomiting and headaches. Most people will recover within several weeks, but individuals with weakened immune systems, such as HIV/AIDS or cancer patients, may be unable to remove the parasites from their systems and can suffer debilitating illness and even death.
How can I avoid giardia?
Carefully wash your hands after toilet visits; dispose of sewage wastes carefully to avoid contaminating surface water or groundwater and ensure you never drink untreated water from spring, streams or lakes.
My doctor says I have typhoid - what is it?
Typhoid and paratyphoid are also spread through contaminated water and food. They are recognised by the sudden onset of sustained fever, severe headache, nausea and severe loss of appetite.
There can be fatalities in 10% of cases, but this can be reduced to less than 1% with the right antibiotics.
There are about 17 million cases of typhoid each year globally and about 600,000 deaths.
How did I get typhoid?
Typhoid is transmitted by food and water contaminated by the faeces and urine of patients and carriers.
Polluted water is the most common source of typhoid. In addition shellfish taken from sewage contaminated beds and vegetables fertilized by faeces and then eaten raw are also sources of contamination.
There is a vaccine that can protect against typhoid, but it will not protect against paratyphoid.

A red nosed dwarf hamsterThe huge grey thunder storm clouds were about to burst on this Sunday April afternoon at 5 p.m. The sky flashed with brilliant streaks of lightning. A few rain drops had splashed onto the pavement of the surgery. April seemed to be a rainy month in Singapore. The phone rang. "I have got a red nose hamster," said Mr Tan. "It has not been eating today and is lethargic. Is it in serious trouble?"A veterinary diagnosis by telephone was difficult. How would I know why the 4-week old dwarf hamster develop a red nose? Was he suffering from the flu? Do hamster suffer from flu viral infection in Singapore? I have not heard of a case. "How much it would cost if I bring it in for treatment?" asked Mr Tan. The Syrian hamster cost $10.00 to buy. Its cage and other accessories would cost more. "Consultation fees would be three times its purchase price. Would it be worth treating it? Why not wait another day? Mrs Tan was more concerned and brought the hamster for consultation. The hamster really had a shiny red nose. Luminous pink skin extended from its nostrils backwards prominently from it. As it was one third the size of an adult palm, 3 mm area of its red nose was very outstanding. "It had wet tail," said Mrs Tan. The internet is really a very useful medium for pet lovers. Wet tail refers to diarrhoea in hamster and the cause in this case was an improper diet. A strong smell of hamster urine wafted from the little one. It had been trying to clean up its back end without success. More loose stools came as he tried to remove them. His nose became irritated and sore, hence the red nose. "The stools were a bit soft and brown," said Mr Tan. "Was it all right for the next 3 days after purchase," I asked. "Yes," said Mrs Tan. "It had passed normal black stool lumps and was very inquisitive, exploring ways to escape." "Did you change its diet?" I asked. This is a common practice amongst new hamster owners. "It liked pears and vegetables," said Mrs Tan. "According to the hamster website in the internet, hamsters appreciate fruits once a week." "Did the hamster dealer advise you to adhere to its original diet?" "Yes, but the internet said it would benefit the hamster to have some fruits rather than the melon seeds and pellets every day."The baby hamster had a swollen tummy. It was active at the clinic, sniffling the smells on the examination table in contrast to its lethargy at home. "Some hamsters with wet tails die fast from dehydration and bacterial infection of the gut," I said. "Wash its backside in lukewarm water. Make sure it drinks. Hand feeding very small amount of the original diet and observe. The next 12 hours will be crucial." The hamster was still active but looks could deceive.Mr Tan showed me a small white plastic bottle with red words saying that the drops would be used for the treatment of hamster diarrhoa. No mention of the ingredients. The hamster disliked this medicine.Rehydration would be important in diarrhoea cases as the baby hamster gets dehydrated quickly and dies."He's not moving," Mr Tan phoned me when he reached home. "Is it going to die?" The backside had been cleaned with lukewarm water. Medication was given by mouth.The hamster was not dead. It needed a lot of rest. Should Mrs Tan take leave on Monday and take care of the hamster? If she brought the hamster to the office, would her boss object? In any case, the office air conditioning would be too cold. The next 12 hours would be very important to the life and death of this hamster. Nursing would be most important now. It would be a sleepless night for the couple. Would it survive? Vets seldom get to see the wet tail hamster again, most likely owing to the reluctance of the hamster owner to spend more money on treatment. Self treatment with drugs from the pet shop are commonly practised and veterinary attention would be the last resort after several days of diarrhoea. By then, it was usually too late.
The Golden Hamster leapt over the table A woman in uniform always command attention. A tall, fair and handsome woman with her long hair in a bun and dressed in the floral batik dominant blue uniform you may see in the international magazine never fail to make an impact on most people.And a lady with such a handsome well-looked after Golden hamster in a sleek coated golden brown coat, trim as his owner made this case unforgettable. "The hamster has diarrhoea," Ms Lee said as she put her cage down on the examination table. Her taxi was waiting outside the surgery ready to take her to the Airport. "My mum had given him a treat of potatoes.""Sometimes, the potatoes may contain a large amount of pesticide which would not affect people unlike the much smaller hamster," I said. "Some farmers harvest their crop without waiting for the recommended withholding period if the demand is great at the moment." The withholding period is the number of days the farmer has to wait after stopping the use of pesticide before selling the crop to permit the pesticide to dissipate before sale. In some cases, the demand is great during the withholding period and the farmer just sell to the dealer to get the higher price.The diarrhoea was severe and had lasted a few days. Ms Lee powdered it as she had been doing it for the past two years as she left the hamster at the surgery for treatment. This was the hamster powder, not the ordinary baby powder. No wonder the hamster smelt good. The globular sand granules stuck the hamster's tail as the diarrhoea was too much for him to lick away. There was also the cotton wool for the hamster to sleep. The sand tray for toiletry. The wheel for exercise. A clear plastic cage to prevent escape. The top barred cover had a clip to prevent the hamster from opening the cover. This good looking hamster was a joy to appreciate. I would have thought this hamster's coat was made of synthetic nylon fibers as they glistened under the sunlight. Those type of fibers you would find on a branded teddy bear toys if you know what I mean. The diarrhoea stopped for the next three days after treatment and rehydration. The hamster went home. He had diarrhoea again and came back to the surgery. The taxi driver was waiting outside for Mr Lee. She powdered him with a wool of cotton, he scurried away, climbed over the slope of the stainless steel consultation table in a split second. He fell off the table before you could say "hammie come here." I picked him up quickly. He looked all right. The next day he was dead. Was the death due to wet tail or to the fall? Or both? The last two weeks of diarrhoea was a stress to this senior citizen. The fall could have injured him. I knew Ms Lee was extremely sad but she was stoic and did not say much. We buried him in a grass plot. This was one of the fastest hamsters I had encountered as many of them would be easily caught before they reached the edge of the table.