Diagnose and Treat Staph Infection on Your Surf Trip
The most common and the easiest injury to deal with on a surf trip trip is Staph Infection. If it’s your first time visiting a tropical climate for surfing, then you may not know about it, but for anyone who has - you have to treat Staph infections. You will get nick and cuts, most commonly on your feet. Don’t ignore these little scrapes. Heres what you need to know before you go on your Costa Rica surf trip:
Staph, or staphylococcus, is the name given to a clan of single-celled bacteria that can potentially cause disease in humans. Surfers are especially susceptible to Staph through fin chops or reef scrapes, causing infected cuts, which can often lead to septicemia (blood poisoning) and, which can cause death quite rapidly if your immune system is weakened.
Obvious visual signs that you have a Staph infection are: Local redness around the wound, local swelling and pain around the wound, pus formation in the cut or abrasion, red lines traveling up from the infected area.
These conditions can be accompanied by fever and feeling unwell as well as swollen or tender lymph glands upstream from the area, especially in the groin or under the arms.
Follow these steps to avoid an unpleasant and dangerous Staph Infection:
1. Clean and remove sand, coral, and other foreign material from fresh cuts and abrasions.
2. Dress wound with clean or preferably sterile packaged gauze with betadine. You can apply 100-percent tea tree (melaleuca) oil. It’s a good, skin-friendly, safe substitute. You can also use lime juice in a pinch if you’re a masochist.
3. Protect cuts and grazes with waterproof sterile dressings like Duoderm and Tegaderm.
4. Don’t keep surfing with open wounds, especially in the tropics - and yes, that includes Costa Rica.
One of the worst Staph infections I’ve seen belonged to this coked-out dealer guy in Mal Pais. He was camping on the beach next to where my tent was set up, and was pretty friendly so we ended up chatting quite a bit even though we were there for two completely different reasons. he had a 6″ gash on his forearm that was all pussy and red around the edges. He had fallen off a motorcycle a couple weeks earlier and since then, had continued to party and ignore his wound. I gave him a tube of polysporin and some gauze. He was thankful and after a couple days the gash looked slightly better. The day I left he went surfing with his wound still totally open and irritated. I just shook my head. I wonder if he made it.
Montezuma’s Revenge!
That’s a fancy way of saying: Explosive Diahrrea - It’s coming to get ya!
The most common travel related ailment you will face is travelers’ diarrhea. The key to prevention is food and water precautions. All surfers travelling to Costa Rica should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool.
Most cases of travelers’ diarrhea are relatively mild and will not require either antibiotics or antidiarrheal drugs. However, adequate fluid intake is essential to helping mild cases run their course. If your diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
A few simple practices will help you avoid all this unnecessary pooing. Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, sea bass, and a large number of tropical reef fish.
Ask your family doctor or Travel Clinic which Antibiotic or medication to bring with you. Prepare for the runs in advance and don’t get caught with your pants down… literally. There are different medications that can be prescribed for diarrhea, so if you are interested in knowing more before you talk to a doctor, read the paragraph below:
A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) (PDF) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.
There. You’ve got it. A few simple preparations and precautions that will make all the difference if you end up with travelers diarrhea as so many before you have. My last case was in Peru about 5 years ago. I ended up stuck in a hotel room for three days, halfway to where I was trying to go. It was an unpleasant little town with no reason to visit. Luckily for me, I spent the whole time on the toilet, which was probably the best place in town anyway.
Immunizations for travel to Costa Rica
Wondering what exotic viruses and infections to be wary of? Here’s some important info on which vaccinations are needed before visiting Costa Rica, as well as some basic travel health info. Read this section carefully and take these inportant precautions. Your trip is pointless if you end up sick, or come home with a nasty bug.
First of all, you should visit your personal physician or a travel health clinic 4-8 weeks before your departure. What you require in terms of immunization will depend on where you plan to go within the country.
Hepatitus A: All visitors to Costa Rica
Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.
Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin (0.02 mL/kg) at a separate anatomic injection site in addition to the initial dose of vaccine. Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin (see hepatitis A for dosage) in the place of vaccine.
Hepatitus B: All visitors to Costa Rica
Hepatitis B vaccine is recommended for travelers who will have intimate contact with local residents or potentially need blood transfusions or injections while abroad, especially if visiting for more than six months. It is also recommended for all health care personnel. Two vaccines are currently licensed in the United States: Recombivax HB (Merck and Co., Inc.) (PDF) and Engerix-B (GlaxoSmithKline) (PDF). A full series consists of three intramuscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months. Side-effects are generally mild and may include discomfort at the injection site and low-grade fever. Severe allergic reactions (anaphylaxis) occur rarely.
Typhoid: All visitors to Costa Rica
Typhoid vaccine is recommended for all travelers. It is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Side-effects are uncommon and may include abdominal discomfort, nausea, rash or hives. The alternative is an injectable polysaccharide vaccine (Typhim Vi; Aventis Pasteur Inc.) (PDF), given as a single dose. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those over age two. There are no data concerning the safety of typhoid vaccine during pregnancy. The injectable vaccine (Typhim Vi) is probably preferable to the oral vaccine in pregnant and immunocompromised travelers
Yellow Fever: Visitors planning to stay 6 months or longer, or will have intimate contact with locals
Yellow fever vaccine is required for travelers arriving from one of the following yellow-fever-infected countries: Africa: Angola, Benin, Burkina Faso, Cameroon, Democratic Republic of the Congo, Gabon, Gambia, Ghana, Guinea, Liberia, Nigeria, Sierra Leone, and Sudan. Americas: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Peru, and Venezuela.
Yellow fever vaccine (YF-VAX; Aventis Pasteur Inc.) (PDF) must be administered at an approved yellow fever vaccination center, which will give each vaccinee a fully validated International Certificate of Vaccination. The vaccine should not in general be given to those who are younger than nine months of age, pregnant, immunocompromised, or allergic to eggs (since the vaccine is produced in chick embryos). It should also not be given to those with a history of thymus disease or thymectomy. Reactions to the vaccine, which are generally mild, include headaches, muscle aches, and low-grade fevers. Serious allergic reactions, such as hives or asthma, are rare and generally occur in those with a history of egg allergy.
Tetanus-Diptheria: Recommended for visitors born after 1956, or if vaccination has expired (10 yrs)
Tetanus-diphtheria vaccine is strongly recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.
Malaria: Visitors to the provinces of Limon (except Limon city), Alajuela, Guanacaste, and Heredia:
Prophylaxis with Chloroquine is strongly recommended for travelers to high risk areas. The areas of greatest risk of contracting Malaria are in the cantons of Los Chiles (Alajuela Province) and Matina and Talamanca (Limon Province). The drug of choice is chloroquine, taken once weekly in a dosage of 500 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Chloroquine may cause mild adverse reactions, including gastrointestinal disturbance, headache, dizziness, blurred vision, and itching, but severe reactions are uncommon. Insect protection measures are advised.
Update: An outbreak of malaria was reported in November 2006 from the province of Limon, chiefly the town of Batan on the Caribbean slope. The cases were caused by Plasmodium falciparum, which causes more severe disease and is not generally seen in Costa Rica (see ProMED-mail; November 16, 2006). All travelers to Limon province, except Limon City, should take chloroquine once weekly and follow insect protection measures to prevent malaria.
For further information about malaria in Costa Rica, including maps showing the risk of malaria in different parts of the country, go to the World Health Organization and the Pan American Health Organization.
All travelers should be up-to-date on the following routine immunizations:
Measles vaccine: Recommended for any traveler born after 1956 who does not have either a history of two documented measles immunizations or a blood test showing immunity. Many adults who had only one vaccination show immunity when tested and do not need the second vaccination. Measles vaccine should not be given to pregnant or severely immunocompromised individuals.
Chickenpox Vaccine (Varicella): Recommended for any international traveler over one year of age who does not have either a history of documented chickenpox or a blood test showing immunity. Many people who believe they never had chickenpox show immunity when tested and do not need the vaccine. Varicella vaccine should not be given to pregnant or immunocompromised individuals.
The following vaccine are not needed for visiting Costa Rica:
Cholera vaccine is not recommended. No cases of cholera have been reported since 1997.
Polio vaccine is not recommended for any adult traveler who completed the recommended childhood immunizations. Polio has been eradicated from the Americas, except for a small outbreak of vaccine-related poliomyelitis in the Dominican Republic and Haiti in late 2000.
Rabies vaccine is not recommended. Only two cases of rabies have been recorded in the last 30 years. For further information, go to Emerging Infectious Diseases.
Check with your doctor - tell him/her that the surf guru sent you and have a great trip!
