1. Guatemala
Preparing For Your Trip

2. Where is Las Conchas, Guatemala?
http://www.geographyiq.com/countries/gt/Guatemala_map_flag_geography.htm
Las Conchas
3. Packing Essentials
Adequate supply of prescription medications
Medication for diarrhea
Pepto Bismol, Loperamide, and antibiotics for travelers diarrhea
Medication for other common illnesses
Headache Acetaminophen,Aspirin
Upset stomach Pepto Bismol
Motion sickness- Meclizine,Dimenhydrinate, Promethazine
Sunglasses and hat
Loose fitting clothing for tropical weather
Antibacterial liquid/wipes
Sleeping net for bed
Protection from mosquitoes
Insect repellant
DEET for skin
Permethrin for clothes, sheets, sleeping nets
Sunblock
SPF of 15 or greater
4. Before Your Trip
Vaccinations
The following vaccinations are recommended:
Be up-to-date on all vaccines required in U.S.
Hepatitis A
Hepatitis B
Typhoid
Rabies
Malaria Prophylaxis is strongly recommended.
5. Before Your TripRoutine Vaccines
Influenza
You need one dose every fall (or winter)
Pneumococcal
You need 1 or 2 doses if you smoke cigarettes or have certain chronic medical conditions
Varicella (chickenpox)
Consider this vaccine if you have never had chicken poxOR if vaccinated and you only receivedone dose
Tetanus, Diphtheria, pertussis (whooping cough)
Be sure to get a 1-time dose of Tdap (adult whooping cough vaccine)
You need a Td booster shot every 10 years
Measles, Mumps, Rubella
You need at least 1 dose of MMR if you were born in 1957 or later
more information available at:http://www.immunize.org/catg.d/p4030.pdf
6. Before Your TripHepatitis A
One of the most common vaccine-preventable infections acquired during travel
Spread person-to-person, or contaminated water/food
HepA is asymptomatic, but flu-like symptoms are not uncommon;
lasts 3 to 6 months
Vaccinations available
HAVRIX2 doses, 2nd dose 6 to 12 months after initial dose
VAQTA2 doses, 2nd dose 6 to 18 months after initial dose
TWINRIXprotects against both HepA and HepB; 4 doses
Other preventable measures
Boil/cook all foods for at least 1 minute
Do not drink tap water or brush teeth with tap water
Do not consume raw vegetables, or fruits that cannot be peeled.
Avoid food and drinks from street vendors
Eat only foods that have been thoroughly cooked or still steaming hot
Boil it, cook it, peel it, or forget it
Treatment
None; only symptoms are treatable
7. Before Your TripHepatitis B
Transmission
Bodily fluids
Early signs and symptoms
Nausea, vomiting, abdominal pain, jaundice, skin rashes, joint pain, arthritis
Incubation period
90 days
Two categories
Acute:usually goes away after 2 or 3 weeks.Liver function returns to normal in 4 to 6 months
Chronic:may lead to cirrhosis and death
Vaccinations
Recombivax HB
Energix-B
Both vaccines are inactivated and dosing periods are at 0, 1, and 6 month intervals
Treatment
Acute:none
Chronic:antiviral medications
8. Before Your TripTyphoid
Transmission
Consumption of water or food contaminated with infected human feces
Signs and Symptoms
Fever that gradually increases daily from low-grade to high, macular rash on trunk, headache, malaise, anorexia, enlargement of liver and spleen
Preventative Measures
Boil it, cook it, peel it, or forget it
Vaccinations
Vivotif:oral, live attenuated vaccine, must be refrigerated, dosage is 1 capsule every other day - 4 dosages
Typhim Vi:Vi capsular polysaccharide vaccine, IM injection every 2 years
Both are given 2 weeks prior to exposure
Treatment
Empiric treatment:Ciprofloxacin for duration of 3 to 5 days
Alternative:3rd generation cephalosporin(Cefixime, Cefdinir)
9. Before Your TripRabies
Rabies can be found on all continents except Antarctica
In certain areas of the world, including Central and South America, rabies in dogs is still a major problem
Preventative measures
Best accomplished by avoiding bites from mammals
Wound cleansing and disinfection
Vaccination
Vaccinations
HDCV:human diploid cell vaccine; given IM at pre-exposure or post-exposure
PCEC:embryo cell vaccine; given IM at pre-exposure or post-exposure
Human Rabies Immune Globulin:local infusion at wound site + IM distal site; post-exposure
10. Before Your TripMalaria
Location
Rural areas only at altitudes below 4,921 feet
No malaria in Guatemala City, Antigua, or Lake Antitlan
Drug Resistance
None
Malaria Type
P. vivax; 97%
P. falciparum; 3%
Prophylaxis for areas with malaria
Atovaquone/proguanil (Malarone)
Doxycycline
Mefloquine
Primaquine
Must be tested and documented to have normal glucose-6-phosphate dehydrogenase activity
11. How Do I Stay Healthy?
Avoid mosquito bites
Avoid outbreaks
Be aware of peak exposure times and places
Wear appropriate clothing
Check for ticks
Use Bed nets
Spray Insecticides
Treat clothes with Permethrin
Apply DEET containing insecticide to skin
Avoid areas of standing water
Reside in well air-conditioned, enclosed areas
12. How Do I Stay Healthy?
Prevent animal bites and scratches
Travelers to rabies-endemic countries should be warned about the risk of acquiring rabies and educated on avoiding bites (see rabies for additional information)
Street dogs represent the most frequent risk for bite exposure to travelers, followed by monkeys
Children are considered high risk because their small stature makes extensive bites more likely, they are attracted to animals, and there is the remote possibility that they may not report a possible exposure
13. How Do I Stay Healthy?
Avoid contaminated food and water
Drink only bottled water or use water sanitizing techniques
Boil water
Do not use ice cubes
Avoid undercooked meat and fish
All fruits and vegetables should be cleaned and peeled; if not, avoid it
Do not consume food from street vendors
Do not consume unpasteurized dairy products
14. How Do I Stay Healthy?
Other Important Tips
Be aware of possible natural disasters
Avoid injuries
Wear helmets, no drinking and driving, avoid overcrowded transportation, avoid night driving, consider hiring a driver, follow all traffic laws, wear a seatbelt
Keep feet clean and dry, and never go barefoot
Reduces the risk of fungal and parasitic infections
15. How to Stay Safe
Always travel with your group
Stay on main roads
Be cautious of ANY stranger who approaches you
Avoid having devices such as cell phones, laptops, and iPods visible (never use them in public)
Never hail taxis only use reputable tour organizations
Taxi Seguro safe taxi
Travelling after dark is strongly discouraged
If by chance, you are victimized, do not resist
Avoid large gatherings of people protests are common & may become violent
Crime and Safety
16. Crime and Safety
Kidnapping
Keep a close eye on any children in the group
Dont make any unnecessary contact with children
people are often accused of stealing children if they are seen talking or taking pictures withchildren
17. U.S. Embassy
Guatemalan American Citizen Services
(502) 2326-4501 normal business hours
Normal business hours
Monday Thursday - 7:30 a.m. 12 p.m. and 1 p.m. 3 p.m.
Friday 7:30 11:30 a.m.
(502) 2331-2354 after normal business hours
Guatemalan Police number equivalent to 911
120
122
123
The Embassy is located atAvenidaReforma 7-01, Zona 10, Guatemala City, Guatemala. The American Citizen ServicesUnit in the Embassy is accessed through the door on 7thCalle.
ASISTUR Assistance to Tourists
1500 2421-2810
1500 5578-9836
Fax
1500 2421-2891
18. References
We hope you enjoy your stay in Guatemala!
If you need additional information, please do not hesitate to use these resources:
Centers for Disease Control and Prevention: http://wwwnc.cdc.gov/travel/
World Health Organization: http://www.who.int/en/
US Department of State: http://travel.state.gov/travel/travel_1744.html
The Shalom Foundation: http://theshalomfoundation.org
19. http://theshalomfoundation.org