By K.C. Summers
Special to The Washington Post
Sunday, December 7, 2008; P03
Q. There appears to have been a recent outbreak of dengue fever in St. Maarten, although we haven't seen it reported in the U.S. media. We are planning a cruise that has St. Maarten as a destination port and are concerned that neither the World Health Organization nor the U.S. Centers for Disease Control and Prevention has issued any warnings for travelers. Can you confirm how serious this problem is and what precautions we should take?
Lang Soo-Hoo, Gaithersburg
A. Dengue fever, a flulike virus that's spread through mosquito bites, has become a major public health problem in the tropical world. That includes St. Maarten/St. Martin, which share the same island in the Netherlands Antilles. An October outbreak there sickened 72 people and resulted in two deaths, according to the St. Maarten Daily Herald. Not the sort of thing a potential visitor wants to hear, but by taking precautions, you can minimize the risk.
Whenever you travel to a foreign country, you should check beforehand to see if there are any concerns about endemic diseases, said Fermin Arguello, a physician and acting chief of epidemiology at the CDC's Dengue Branch in Puerto Rico. In the Caribbean, he said, "you need to be concerned about dengue in particular." The disease is the most common cause of fever in U.S. travelers returning from the Caribbean, Central America and south-central Asia, according to the CDC. The agency's Travelers' Health site (http://wwwn.cdc.gov/travel/yellowBookCh4-DengueFever.aspx) warns travelers about the problem and gives advice on precautions and treatment.
Dengue symptoms include fever, severe headache, eye pain, joint or muscle pain and rash. There is no vaccine. Many cases are mild, but the severe form of the disease, dengue hemorrhagic fever, can be fatal. Children, young adults and people who have had dengue fever before are more at risk of getting dengue hemorrhagic fever.
If you're traveling to the tropics, protect yourself from mosquito bites. A few tips:
· Stay in hotels that are well screened or air-conditioned. If screens are inadequate, ask for mosquito netting for your bed.
· Use insect repellent when you're outside or in poorly screened buildings. If you're using sunscreen, apply that before the repellent. Use repellent that contains DEET, picaridin or oil of lemon eucalyptus. Spray it on your clothing for greater protection.
· Wear long-sleeved shirts and long pants when outdoors.
In addition to the CDC, the World Health Organization (http://www.who.int) and the Pan American Health Organization (http://www.paho.org) have information on the disease, including news of outbreaks. For more info, Arguello advised consulting your primary care doctor, a travelers medical clinic or the CDC (800-232-4636, http://www.cdc.gov).
I am planning a trip to Egypt. What time of the year do you recommend? I thought about March, but then I heard about the sandstorms.
Karin Pollehn, Alexandria
Winter is considered high season in Egypt, but most experts say the best times to visit are fall and spring, since winter can be chilly in the north. But spring is the time of the khamsin, the hot, dry winds that blow from the Sahara across the country between March and May.
These sandstorms can continue for days, coating everything with dust and grit. So: Think fall (September to November).
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