Infections and preventive methods

All fruits and vegetables should be washed and scrubbed. In suspect areas, travelers should eat only cooked foods and use only milk known to be pasteurized. You may be asking, "Why all this fuss about a disease I have hardly heard about?" Consider this one fact about amebiasis: in some forms, it has a fatality rate of 40 percent. 

Your life, if you become infected, is only as good as a 6 to 4 bet; not very good odds. In addition, if an acute attack is survived, there may be serious, chronic complications. Fortunately, treatment has been improving, and today, when the best available treatment is applied promptly and vigorously, the fatality rate can be reduced to less than 5 percent. How is the disease recognized? In the tropics, it will usually start as full- blown amebic dysentery, with up to 25 bowel movements a day, and with stools often containing blood and bits of mucus.

The patient may feel slightly feverish and will soon be weakened by the abdominal distress and dehydration. In this country and other temperate zone countries, there is rarely such extreme diarrhea; and the combination of abdominal distress, diarrhea alternating with constipation, fatigue, slight fever, and vague aches and pains throughout the body may be passed off as "colitis," "irritable colon," or "upset stomach." In some persons, symptoms are so mild that they do not see a doctor for treatment and unknowingly become carriers of the amebic organisms.

Another problem in diagnosing the disease arises from the increasing numbers of Americans who take short winter vacations in semitropical and tropical countries. If a vacationer develops diarrhea and other intestinal symptoms, he is not eager to consult a doctor in a strange country. He also does not want to interrupt his brief holiday. So he doses himself with Lomotil, paregoric, or anything else he has brought along for "tourists' diarrhea." When he returns home, he plunges into work. Thus, the diagnosis of amebiasis may be missed, and the best time to treat it lost; later, there may be dangerous spread of infection in the body, making for treatment problems.

To be sure, most cases of diarrhea during vacations are the relatively harmless tourists' diarrhea. But we strongly advise anyone who develops diarrhea in a semitropical or tropical country to tell his physician about it promptly upon return home or, if the stay is to be more than the usual brief vacation, to consult a local doctor (you can usually find a competent physician by calling the nearest American consul and asking for the name of his doctor). 

When there are symptoms suggestive of amebiasis, your physician will rarely start treatment until a precise diagnosis is made. That means finding the amebic organisms in the stool. Unfortunately, locating the organisms is not always simple; and some physicians who have devoted themselves to the study of this disease will not exclude the diagnosis of amebiasis until six stools, including one passed after a saline purge, have been judged negative by a competent diagnostic laboratory.