posted
Just out of curiosity, how long and at what temperature would you say a fever needs to last/be before someone having recently returned from Africa -- specifically an area where yellow fever, typhoid, and malaria are all issues -- should become concerned? 'Cause, y'know, I'm just wondering.... (In this "hypothetical" situation, the person has taken/is taking immunizations/medicines designed to prevent all three. [TMIFSP] There could also be a theoretical loose stool/diarrhea issue having gone on since before said person left Africa, though such issues would have been listed as possible side effects from the malaria medicine, which is still being taken. [/TMIFSP])
[Lovitz] 'Cause, I'm writing a story about him. Yeah, that's it. A full-length novel. In fact, it's already a best-seller! It's going to be printed under my pen-name, Orson Sco-- uh, J. K. Rowling. Yeah, that's it. [/Lovitz]
posted
Probably not relevant, but since you're in the same general area . . . my youngest had a fever that kept rising to almost 104 for three days earlier this week. I hear something is going around among her age group.
Which you're not a member of, I know . . .
Posts: 32919 | Registered: Mar 2003
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posted
mmm, the actual amount of fever isn't the best way to tell how important the problem is. Although now I'm curious about how high this hypothetical fever is.
Does the fever wax and wane or is it everpresent? You're supposed to get a malaria blood smear if you come back from a malaria area with a fever. I suggest you see a family doctor. ERs and doc in the box places will be less helpful on average. The doctor will do the malaria test and may order other tests too, like these. This is a pretty good list, actually. http://www.utdol.com/application/image.asp?file=id_pix/labs_for.gif
Also, Travelers Diarrhea is quite common. It doesn't usually cause fever though. If your diarrhea is more than three times a day, or associated with blood or pus, then the fever could be from the diarrheal illness. That too needs evaluation, and antibiotics.
Posts: 1014 | Registered: Jul 2005
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posted
The hypothetical fever isn't very high -- peaked at just over 100. And it only started today (as far as is known -- today was then the hypothetical person started feeling warm/achy and took his temperature). It's gone down slightly since taking hypothetical ibuprofen a couple of times.
So the hypothetical person has been back for 11 days, and yeah, the diarrhea is more than three times a day. Of course, he also can't see his family doctor until Monday, since the office would be closed for the weekend. It so happens, though, that he has an appointment Tuesday for something unrelated -- would he hypothetically be reasonably safe to wait until then, assuming his symptoms weren't to change noticably?
posted
Hypothetically, an appt tuesday will mean more data about the fever so that should be ok. Unless symptoms are escalating. Keep tabs on the fever, and when you have it, when you don't. And on other symptoms besides fever and diarrhea, if you have them.
Looks like the incubation for malaria is like 12-35 days, and sometimes much longer than that. And it is the number one cause of fever in returned travelers from malaria countries. Very interesting. However, there are many many other reasons for low grade fever so don't jump to any conclusions. Just note all symptoms to the doctor.
posted
It's the brown plague -- lesser known cousin of the black plague. No-one ever died of the brown plague. You just sort of get a vague feeling of disatisfaction with your brand of paper products in the home and end up with a curable desire for day-old muffins.
There are ways to take care of this: - hog all the toys for a day - have a staring contest with a one-eyed dog - bury a Star Wars action figure head down, facing your house. - put the lime in the coconut.
If that doesn't work, you can still consult your doctor on Tuesday, but you'll just get the same advice and it'll cost you a co-pay. (and he or she will probably order some costly tests and prescribe something from the drug company they own stock in.)
posted
No fever upon waking, but several times in the past a fever would be gone in the morning only to reappear a couple hours later. Lots of pain this morning, though. Hypothetically. And I, uh... he was in the Luwero region in Uganda.
posted
Hypothetical pain, huh? Sounds much better than, say, REAL pain. Although I'm not sure what sort of pain might be there other than crampy abdominal pains?
I can't look up that location right now, but I'll be back later.
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posted
No, it's real pain for the hypothetical person, not hypothetical pain for a real person. Hypothetically. And it's sorta decentralized -- an extreme sensitivity to almost all physical contact, pretty much. (Crampy abdominal pains have occurred, but aren't an issue at this time.) And the hypothetical fever is indeed back up over 100.
posted
My humble opinion is that someone needs to lay hands on you. No, not that kind of thread! I mean, someone experienced should eyeball you and poke around. I think I'm going to be worried until you are seen, and I (personally) would prefer you not wait until Tuesday.
I think you should call your primary-care provider's answering service and leave a message for whomever is on call for him/her.
I love my Papa Moose.
Edited to Add: And though I generally end up advising people to avoid ERs unless absolutely necessary, I would consider a visit to the ER if you cannot go to an urgent care clinic today, on Sunday. I would also reflect on the knowledge that ERs are essentially "dead" during the day, but "lively" at night, and so waiting until things got worse at night would make the experience more harried and drawn-out.
Let me put it this way: in ERs, people on staff tend to gripe a lot about "why the heck did this person come to the ER?" When we had a young woman just back from a South American mission come in with abdominal cramps and recurrent fevers, we were all excited. Very interesting case and we were glad she came in to be taken care of.
Now, whether or not your insurance would cover an ER visit is never fully clear, except in the case where you are actively engaged in dying. (*wry look) And rightly so -- ERs should be for, well, emergencies. But I think any primary-care provider could write an exquisite letter to support a man being seen over the weekend in your particular situation.
Posts: 14017 | Registered: May 2000
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posted
I think I agree. I thought about saying it last night but decided to think about it longer. I hate telling people to go to the ER. I think I told three people to go to the ER on Saturday, though. So I actually do it pretty often.
I don't really have a lot of information on this thread about what your symptoms are. Low grade temp , extreme sensitivity/pain, and diarrhea is all you've mentioned and I'm not sure how they fit together. Anyway, I'd look at this site and print it and take in it with you. The bottom shows the list of diseases common from Uganda. They should do a good history and physical and do a malaria smear, blood tests, and stool tests at the very least.
Sunday morning is a great time to go to the ER, btw. Everyone seems to hold off till noon then they all rush in with full bellies.
http://www.cdc.gov/travel/eafrica.htm#returnhome and look at the very bottom, where it says things like diseases carried by insects, carried in by food and water, etc etc. Click on the words and the topics will expand. When you expand all of them, then print it and take it with you.
Posts: 1014 | Registered: Jul 2005
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posted
I suppose I should add that I thought of ER rather than doc in the box because the malaria blood smear has to be done correctly and in most cases the hospitals are the best places to do it. Maybe doc in the box/after hours places can do well; I'm just not as sure about them. And make sure your pcp's name gets put on all the labs so you can get your results quickly and with less hassle.
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posted
I spoke to a doctor on Sunday -- not my doctor, but the guy who led the team to Uganda. He said it didn't sound like malaria to him (and he's had decent experience with it, since this was I think his fifth time going to Uganda as a doctor, and I know he saw several cases just over the two weeks we were there) and it's probably nothing to worry about, but to be sure I should let my doctor know on Tuesday when I have the appointment. The fever is basically gone (highest over the last two days was 99.0), and all other symptoms gone as well.
Nonetheless, I bask in the love that is Hatrack, and assure you all that I am well.
posted
He's dead, haven't you noticed? A replacement quietly stepped in and became Papa Moose, but we can tell the difference. YOU CAN'T TRICK US! *shakes fist*
Posts: 21182 | Registered: Sep 2004
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posted
Haven't tried. But if both participants have diarrhea, then I suppose it would be about the same. It's having to be on both ends of it, so to speak, that was unpleasant.
Posts: 6213 | Registered: May 2001
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posted
Let me tell you, collecting stool samples from a just-toilet-trained child ain't no picnic either.
They didn't find anything either. Which I suppose is a good thing. And the problem did eventually rectify itself. (This was about 9 years ago, IIRC.)
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posted
I've had to do both. I was far more squicked out at collecting my own stools than another persons. YMMV.
When I was in the microbiology program at school, we had to microscopically examine our own stools for one of our labs. It was horrible. It was all I could do to keep my breakfast down. And I honestly believed it was made worse by the fact that it was my own. If it had been a random or anonymous sample, it would have been less traumatic.
Posts: 2069 | Registered: May 2001
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posted
Just curious, Pop. What kind of specimen container did they give you? We have what we call "stool hats" to collect clinical specimens when we suspect Norovirus or something like that. It sits on the rim of the toilet under the seat and then there's a plastic lid that covers the whole thing, which makes collection a whole lot easier.
Posts: 2069 | Registered: May 2001
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posted
You were were working in and coming coming out of the region infamous for the Ugandan genocide: death and mayhem designed to chase the native population out of their traditional homeland. Because the "ethnic cleansing" also destroyed nearly the entire sanitation infrastructure -- most of which has yet to be rebuilt -- there were lots of nasties out there that you could have caught. So I hesitated to give a more comforting probability that might have made you decide to put off seeing medical professionals.
Odds are, you got food poisoning / "stomach flu" / "Montezuma's revenge" from fresh fruits&vegetables or contaminated water. Here's the thing: even folks who are scrupulous about avoiding fresh local produce and local water often become ill because they don't think about where the ice is coming from. So they pour a nice safe bottle of pasteurized juice/etc over local ice, and voila... Happens quite often on the return flight home from the ThirdWorld. Back in the comfort of FirstWorld air carriers, they assume that they are back in the FirstWorld once again. And their nice safe FirstWorld soft-drink, etc becomes contaminated by the ThirdWorld ice bought from the local suppliers to the airport from which they just left.
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