Common Diseases in Nepal

Food and Water borne diseases

Diarrhea:
You are blessed if you do not come down with this ailment. It spares no one. Viral cases are commonest but self-limiting. Bacteria are the second most common, confirmed by a stool test. In most situations, it is treated with Quinolones for 3-4 days or Azithromycin. Giardia and Amoeba can be diagnosed by microscopic scrutiny under the microscope or treated empirically with Tinidazole 2-3 days if the history is suggestive. Loose motion with tiredness out of proportion to the amount of diarrhea maybe suggestive of “a blue green algae” called Cyclospora which causes loose motions especially during April to September. Bactrim DS for 10 days will provide the cure. Cholera causes loose watery diarrhea and rapid dehydration but it has rarely affected tourists.
Most important point regarding diarrhea is to keep oneself adequately hydrated. Oral rehydration salts (jeevan jal, nava jeevan) mixed with a liter of water is a good choice to replace lost water and electrolytes. Plain water or aerated drinks are not good alternatives.

Typhoid Fever:
Typhoid Fever is endemic in Nepal and can occur in any season with predominance in monsoon. It is rarely fatal after the invent of antibiotics but can make you very sick and take 1-2 weeks to recover fully. Salmonella serotypes, Typhi and Paratyphi, cause this bacterial illness, with high fever and headache with profound weakness. This disease needs to be treated with antibiotics. With growing number of bacteria becoming resistant to commonly used antibiotics, treatment can sometimes be tricky.

Hepatitis A:
This disease is a self-limiting viral disease affecting the liver but has an unpleasant course. Fever, poor appetite, nausea, vomiting, is followed by yellow discoloration of the eyes and skin.

Hepatitis E:
Similar to Hepatitis A, but can be hazardous in a pregnant lady. It has no long term sequelae. At present no vaccine is available for this disease.

Arthropod Borne Disease
(mostly in the Terai region of Nepal)

Malaria:
Is a serious illness with high grade fever with fever free intervals in-between and is caused by Plasmodium. It is transmitted by mosquitoes, and out of four types of plasmodia, vivax is the commonest here. Occasionally we do see the more serious form caused by Plasmodium falciparum. This disease is only endemic in the flat Terai region of the country and not in the Katmandu valley or the trekking routes. If you intend to go to the Chitwan National Park it would be a good idea to take drug prophylaxis. Mefloquin and Malarone can be used in areas where Chloroquin is resistant. Locally available drug Doxycycline may be used. Please enquire with your health providers for more detail.

Japanese Encephalitis:
Another disease transmitted by mosquito which is mostly found in the Terai region but recently, cases have been documented in Katmandu . It may present as a simple flu but other times may cause severe illness with high mortality, and those who survive may be left with some neuropsychiatric complications. There is no drug for this disease but it is a vaccine preventable disease.

Kala-Azar:
This disease is also very much common in the terai region of Nepal. Patient may complain of Fever of prolong duration,