I don’t know about you but I have had a belly full
of SARS! Judging however by the amount of telephone calls
and e-mails that I am getting, there are still plenty of questions
that need to be answered. SARS, or Corona Virus Pneumonia
as its currently preferred name, has had more than it’s
fair share of media hype (momentary relief from the Iraq crisis
mega media I suppose!). While awareness is necessary in epidemics
like this, the general public in many cases seems to perceive
a gross inbalance of risk. For example yesterday I saw a family
of 3 in Denpasar, riding along on a Motorbike wearing surgical
masks! Only one of the family members (the father I presume)
was wearing any protective headgear. The 2 children were not
wearing helmets, protective eye goggles or footwear. To date
(at writing this article) there have been no positively identified
SARS cases in Bali let alone deaths, the annual death toll
due to motor bike accidents in Bali alone however is in the
thousands. Do you think if road safety was given as much media
attention as SARS that helmets & seat belts would become
as popular as “the mask”?
So what is it that strikes terror in the hearts of the masses
when a disease such as this hits the headlines? Is it the
mystery of medical riddles that stretches our professors and
pathologists to the limit (“if the Doctors can’t
fix it we are doomed”), or the fact that this microscopic
factor of fear is invisible to us, and we cannot see it’s
approach (I can see the truck coming at me so I have a few
seconds to swerve before I get squashed, the virus I cannot
avoid)? Let’s look at how we can sensibly avoid any
microscopic menace without becoming a prisoner to our own
fears.
If “IT” is out there how do we avoid it?
For a start “IT” (whether it be SARS, Tuberculosis
or any other potentially fatal microbe), is definatly out
there. The question is to what extent and what is the supposed
risk of contacting any of these microbes in your area. At
this point in time the risk of contracting SARS in Bali is
very low. Caution needs to be taken by those that have direct
contact with persons that have high risk of carrying the disease.
Those sections of the population would be:
HIGH RISK.
Health workers such as doctors, nurses, and other hospital
/ clinic workers particularly those in general hospitals and
clinics targeted at the tourist population.
Health workers that are working in SARS isolation wards.
Personnel involved in health screening at ports of entrance
to Bali (airports etc).
These personnel need to take full precautions against disease
transmission. This includes wearing of the recommended N95
masks, gloves, gowns and stringent dis-infection of the working
area.
MODERATE RISK.
Any person that has traveled to those parts of the globe
currently epidemic for SARS i.e. Hong Kong SAR, China, Taiwan,
Vietnam, Singapore and Canada (Toronto).
Travel workers who work with tour groups / travelers from
high-risk areas.
Members of the community at large need only to pay attention
to general personal hygiene (a healthy revision for most of
us!). These measures would include:
Using tissue or cover their mouth when coughing or sneezing
and then wash their hands. Discourage spitting, “open
nose blowing” (closing one nostril and firing as hard
as you can!)
Washing hands before eating and after using the bathroom.
Be sure your staff washes their hands. You may wish to provide
hand soap and a nailbrush for your staff.
Should you develop symptoms of any contagious disease, especially
if you have had contact with travelers from the high-risk
SARS areas, you should take the following measures:
Avoid close contact with other friends / family members.
Cover your mouth and nose should you cough or sneeze and wrap
all tissues, handkerchiefs etc in sealed plastic, which should
then be discarded and burned immediately.
Wash your hands with disinfectant soap and rinse with alcohol.
Do not share towels. (Use disposable paper towels or hand
wipes).
Avoid touching your face, mouth, nose area until you are given
the all clear. Wipe all close contact surfaces with a disinfectant
bleach solution 2:100 or alcohol 70%.
Present yourself to a reputable clinic or Sanglah hospital
for assessment. (International SOS Ph. 710505, BIMC Ph. 761263).
What are the symptoms of SARS?
If you or someone in your family; or a close contact of the
family have recently been in risk the areas, please be alert
for the following signs and symptoms:
Fever 38º C / 100.4º F or greater and…
One or more signs or symptoms of respiratory illness including
dry cough, shortness of breath, difficulty in breathing, or
respiratory distress.
In addition to fever and respiratory symptoms, SARS may be
associated with other symptoms, including headache, muscular
stiffness, loss of appetite, malaise, confusion, rash, and
diarrhea.
While SARS may present with any or all of these symptoms,
fever is always the first sign. Any person presenting with
any of the above symptoms without fever is not a suspect SARS
case.
Note that the incubation period for SARS is between 2 –
10 days and most commonly 3 – 5 days. If you do not
develop any of these symptoms within 10 days of your return
from travel to high-risk zones, then you have not contracted
the disease on your travels.
Preparing the troops.
This would also be an opportune time to take stock of lifestyle
measures to increase the immune system for yourself and you
family. The following regime was recommended to me and it
seems like good advise to any one wishing to adopt a healthy
lifestyle as well as boost infection resistance:
1) Antioxidants arechemicals found in foods which exert great
value in strengthening our immune system. Boost up your immune
function by taking a cocktail of antioxidant supplements.
Vitamin E 1000 IU per day. Alpha-tocopherol is the biological
active form of vitamin E. There are two forms of it: d-tocopherol
and dl-tocopherol. d-is the natural form and dl- is the synthetic
form. Try to get the d- form because it is absorbed faster
in the body.
Vitamin C (ascorbic acid) 1000 milligrams (mg)daily. Instead
of taking supplements, you can take 2 pieces of citrus fruits
(e.g. orange) a day to get the vitamin C.
Beta-carotene, not more than 10000 IU daily
Selenium, 200 microgram daily
Zinc, not more than 500 milligram (mg) daily
Lipoic acid, 50 mg daily
Glutathione, 50 mg daily
2) Drink green tea daily becauseit contains tremendous amount
of antioxidantflavenoid & catechins (good luck getting
the kids to do this one!). Eat more tomatoes, broccoli or
fruits andvegetables in red and dark green color. They carryahuge
amount of antioxidant carotenoids, lycopeneand carotene.
3) No intense physical activities (i.e marathon work-outs)!
It has been shown that intenseexercise will suppress your
immune function (related to the upper respiratory infection)
evenseveral days following your workout. Instead ofintense
exercise, light-to-moderate workout helpsif you have been
training regularly.
4) Make sure you get enough carbohydrate foods (e.g. rice,
food concentrated in starch... etc)because carbohydrate is
the primary food for immune cells.Do some Gatorade or Pocari
if needed since theyareboth good sources of carbohydrate.
5) Make sure you get enough sleep and avoid stress! Take time
out to relax (walk on the beach, time out with the kids etc).
Anxiety, depression, andbeing run down will influence your
body’s stress hormones(e.g. catecholamine and glucocorticoids)
and sosuppress your immune status.
Most of all be HAPPY. Studies have shown that people considered
to be generally happy have better immune systems than those
that are not….Til next edition stay HAPPY, stay healthy
…and don’t forget your helmet!!!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
