When struggling with gout, it is very important to choose foods that won’t trigger or worsen joint pain. These include foods that are low in purine and foods that won’t increase blood acid levels. If you’re traveling to South America soon, here are some of the best dishes and snacks that won’t activate or exacerbate symptoms if you suffer from gout.

Arepas (Venezuela and Colombia)

Made from ground corn or cooked flour, arepas are a South American favorite. This round flatbread can be filled with pretty much whatever you want. Common fillings are cheese, eggs and meats. You’ll want to make sure the arepa isn’t filled with any animal organ meat such as liver, since organ meats are very high in purine and will increase uric acid production, causing an onset of joint pain. Cheese and eggs are quite low in purine content, so stay on the safe side and get an arepa filled with either of these delicious options. Arepas are typically lightly pan fried, so they have a relatively low oil content and won’t increase the acidity of your blood.

Metemgee (Guyana)

This guyanese dish is a savory combination of cassava, sweet potatoes, yams, plantains, onions and garlic. Boiled in a pot of deliciously seasoned coconut milk, Metemgee is a safe choice for those looking for gout-friendly foods in South America. It’s sometimes served with salt or fried fish on the side, so make sure to kindly decline or substitute this. Fish is quite high in purine and can make your gout worse.

Dulce De Leche (Colombia, Argentina, Uruguay, Brazil)

Dulce De Leche isn’t a particularly healthy option, but it is okay when enjoyed in moderation. With its main ingredient being milk, its low purine content won’t trigger your gout. Made primarily from milk, sugar and sometimes vanilla, this is a mouthwatering sweet treat that pairs well with other low purine treats such as donuts or white-bread toast.

Travel Gout-Friendly in South America

There are so many other gout-friendly dishes on the beautiful continent of South America. Once you step foot on the streets of one of these bustling South American countries, you’ll see for yourself. As you explore the various cuisines of the region, make sure to stick to foods low in purine content and foods that won’t elevate blood acid levels. Stick to foods that aren’t spicy, deep-fried or excessively greasy. Avoid foods with a high caffeine content as well. Keeping these tips in mind, you’ll be able to find delicious food options as you travel the captivating continent of South America.

Street foods can be delicious, but make sure you are prepared before traveling. Passport Health offers a variety of travelers’ diarrhea options and advice for any destination. Call or book online to schedule your appointment today.

Ese Agboh is a student nurse who wants to specialize in pediatric nursing and wound care. In her free time, she enjoys reading and writing articles related to medicine and the pathophysiology of communicable diseases. Ese currently lives and studies on the east coast of the United States.

Traveling across the globe on an airplane to your vacation destination is exciting. But, flights can last eight hours or even more. It is wise to catch some sleep on the plane before you arrive, if you can. Here are five tips for better sleep on a plane.

Fly Direct If Possible

If it is possible to get a direct flight to your destination, it is better overall for your sleep. When you have connecting flights and layovers, it can disrupt any sleep you might want to catch on the plane. You will feel much more refreshed and ready to have fun if you plan for a direct flight.

Shut Off The Blue Lights

Chances are that you have your phone, tablet, computer or other electronics with you. But, if you want to grab a few winks before you land in another country, it is integral to put your devices that emit blue light away. This is so that your body can wind down and get some rest.

But, it also throws off the secretion of melatonin, which is the hormone that is responsible for your sleep cycle and has a significant influence over your circadian rhythm. That can turn your whole sleep cycle for the trip upside down. It is essential to put away any items that give off blue light, at least during the plane ride while you are trying to rest.

Grab Some Sleep Essentials

If you know that you are going to be on a plane for a while, you will want to gather up some items essential for sleep. Bring them with you on your carry-on, so you have easy access to them. Some ideas for things that can help one rest are:

• Travel pillow
• A warm blanket
• Sleep mask
• Earplugs
• Headphones

You should also make sure that you are wearing comfortable clothes if you are planning to get some sleep on the plane. That way, you are not restricted by anything tight or constricting and can relax.

Avoid Caffeine Before The Flight

Drinking caffeinated beverages before your flight can mess with your sleep schedule, especially if you plan to grab a nap. It is best to skip the caffeine and get some extra rest instead. You should also not drink alcohol when you are sleeping on a plane. While in the beginning, alcohol may lull you to sleep, it can lead to more awakenings during your sleep cycle, and it can interrupt how you feel when you land. While on the plane, try to drink plenty of water, though, so you do not get dehydrated.

Stick To Your Normal Sleep Routine

When you are ready to get some rest, try sticking to what you usually do at bedtime. Whether it be meditation or listening to music, try using some of the essential sleep gear listed above to help you in this process. You could even try some light stretching just before you board the plane.

By utilizing these tips for your next long-distance flight, you’ll be lulled to sleep while being swiftly carried to your long-awaited destination vacation. Make sure that you are up-to-date on all of your travel vaccinations by making an appointment here at Passport Health.

Planning an international trip? Make sure you’re protected with immunizations from Passport Health. Call or book online to schedule your appointment today.

Jennifer Passmore is a stay-at-home mom, writer and beader. She loves creating art with her words and through her jewelry. She is also a passionate mental health advocate. You can find more writing at her website Positivity In Pain.

The Nipah virus (NiV) is zoonotic, meaning it can be transmitted from animals to humans. It can also spread through contaminated food or directly between people. Recently, a 12-year-old boy in India died from the virus. This was shocking news as the southern Indian state of Kerala beat the Nipah virus in 2018. Now, doctors and researchers have to make more effort to prevent the spread of Nipah and try to understand it more.

Transmission

While Nipah is a significant concern in India, it could affect the rest of the world. The virus is not as transmissible as others. But each time a person becomes infected, the virus finds a new environment that suits them for human adaptation and transmissibility. The risk of an outbreak grows since new strains can emerge and transmit from person-to-person.

In the first known outbreak in Malaysia and Singapore, direct contact with sick pigs or their contaminated tissues led to people developing Nipah. In later instances in Bangladesh and India, consumption of contaminated fruits or fruit products (such as raw date palm juice) was the cause. These products were tainted by urine or saliva from infected fruit bats. Due to the various forms of transmission and difficulty establishing how some people contract the virus, Nipah is still a mysterious virus.

Symptoms

Infection of the Nipah virus can cause mild to severe symptoms. Swelling of the brain (encephalitis) and even death are risks associated with the disease. Symptoms usually appear in 4 to 14 days following exposure to the virus.

General symptoms include:

• Fever
• Headache
• Cough
• Sore Throat
• Difficulty breathing
• Vomiting

Severe symptoms include:

• Disorientation, drowsiness, or confusion
• Seizures
• Coma
• Brain swelling (encephalitis)

It is possible to recover, but the fatality rates for the virus are very high. Doctors have noted that with Nipah, once symptoms set in, you start spreading the virus. It differs from COVID, in which you are most infectious before the signs begin. Your ability to infect other people wanes as you develop the symptoms. Since the virus is spread human-to-human through bodily fluids, it is best to follow similar protocols as with COVID-19. Physically distance yourself and wear a mask in risk zones.

Treatment & Prevention

There are no specific drugs or vaccines available for the Nipah virus. If you contract Nipah, the best route to take is undergoing intensive support care. This is especially recommended to treat severe respiratory and neurologic complications.

As for prevention, thoroughly cleaning and disinfecting pig farms and other livestock areas can prevent infection. If an outbreak is ever detected, you should immediately quarantine the sick animals and the premises. Wear gloves and masks to protect yourself when handling materials, animals, or being around other people. Also, ensure that you are washing your hands regularly to limit the chances of exposure.

Planning a trip? Make sure you’re ready for Nipah or any other infection with Passport Health. Call or book online to schedule your appointment today.

Written for Passport Health by Shelbi Jackson. Shelbi is a freelance writer from Illinois. She enjoys writing about various topics from health care to music and book reviews. In her free time, you can find her at a live event, taking a stroll outside, or playing with the family dogs.

Rabies is a fatal viral disease from the rhabdovirus family. When thinking about rabies, most people think of wild animals, intense drooling, and aggression. In North America rabies is typically found in wild animals such as bats, raccoons and foxes. But, in other areas of the world the most common carrier of rabies is dogs.

According to the World Health Organization (WHO), up to 99 percent of human confirmed rabies cases are caused by dogs. While rabies is preventable, it’s still a very serious disease that “causes tens of thousands of deaths every year, mainly in Asia and Africa.”

Spread through direct contact with saliva, such as a bite or scratch from an infected animal, the rabies virus attacks the central nervous system. When infected with rabies, the virus can affect the body in one of two ways. Either the virus enters the peripheral nervous system directly and then migrates to the brain or it replicates within the muscle tissue and eventually enters into the nervous system.

The initial symptoms of rabies are very similar to having the flu. The infected person can have a fever, headache and experience a general weakness that can last for a few days. Along with this the site of the bite or scratch will be uncomfortable and have a prickling or itching sensation.

If left untreated the disease progresses and the infected person can experience more severe symptoms including delirium, hallucinations, insomnia and hydrophobia. These are clinical signs of rabies and once they appear, the disease is nearly always fatal. In about 80 percent of rabies cases, the person infected develops furious, or encephalitic rabies, and is likely to experience hydrophobia.

Hydrophobia is the fear of water, but why is it a symptom of rabies? When rabies affects the nervous system, one potential side effect is intense spasms in the throat, or pharynx. While involuntary, these painful spasms can also be triggered when the person tries to swallow, leading to severe issues with swallowing. No matter how thirsty the infected person is, the spasms can occur and it can become difficult to swallow anything.

These uncontrollable contractions of the pharynx are responsible for the hydrophobia symptoms. The infected person then becomes terrified of water because just the thought of it can send their throat into violent and painful convulsions.

While rabies is preventable through simple measures such as leaving wildlife alone and vaccinating your pets, you could still contract rabies and it’s important to work fast. If you’ve been bitten or scratched by wildlife, or any unfamiliar animal, you should first wash any wounds immediately with soap and water, then immediately seek medical attention. Rabies can be a fatal disease and should be treated with a medical urgency.

Depending on your area’s state or local health department, post-exposure prophylaxis (PEP) treatment will be “based on your type of exposure, the animal you were exposed to, whether the animal is available for testing, and laboratory and surveillance information for the geographic area where the exposure occurred.” For example, in the United States, treatment can consist of a regimen of one dose of immune globulin and four doses of the rabies vaccine over a two-week period.

Rabies is present in 150 countries, so anyone who is traveling to areas where rabies is a risk, or are participating in activities where wild animals are present, such as caving or hiking, should consult their doctor about vaccinations prior to traveling. Call or book online to schedule your appointment today.

Written for Passport Health by Brianna Malotke. Brianna is a freelance writer and costume designer located in Illinois. She’s an avid coffee drinker and enjoys researching new topics for writing projects. Her site can be found here.

Although cholera has been around for centuries, scientists haven’t always known what causes the disease.

While we don’t know when the disease first surfaced, ancient texts describe what may have been cholera in the 4th century BC. The first fully documented cholera pandemic took place in 1817 in India and quickly spread throughout Asia and into Europe.

The pandemic ended around six years after beginning, only for a second cholera pandemic to occur in 1829. This time around, the disease spread much further, making its way to the Americas.

There were continuous outbreaks of cholera throughout the world until 1851.

It wasn’t until 1854 that one scientist made a link between the disease and what causes it.

“In the nineteenth century it was believed that the disease was transmitted and spread by a ‘bad air’ or ‘bad smells’ from rotting organic matter,” the Royal College of Surgeons of England wrote. “This thinking dominated official medical and government statements and the recently created General Board of Health was among those that believed in this theory. But it was not until 1854 that the physician John Snow made a major contribution to fight cholera when he was able to demonstrate a link between cholera and the contaminated drinking water through his pioneering studies.”

Snow was able to speak with officials about the public pump handle, which resulted in a drastic drop in cholera cases.

But Snow wasn’t the only one to make significant discoveries surrounding cholera. The bacterium that causes cholera was also discovered that year by an Italian microbiologist named Filippo Pacini. Later, in 1883, a German microbiologist named Robert Koch also discovered the presence of the cholera bacterium in the intestines, and named the bacteria V. cholerae.

Once the cause of cholera was discovered, many countries were able to make changes to public sanitation, which helped to lower cholera cases and prevent pandemics. Today, about 120 countries are still impacted by the disease. Some have had outbreaks in recent years including Zimbabwe, Haiti, Somalia and Yemen.

Planning a trip to a region with cholera? Make sure you are immunized with Passport Health. Call or book online to schedule your appointment today.

Written for Passport Health by Elle Johnson. Elle is a freelance journalist and social media content creator in Florida. Not only does she enjoy working as a freelancer, but in her free time she enjoys working on fictional stories.