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Travel: Careful of your souvenirs; Some keepsakes from our travels abroad this summer will be very unwelcome. Illness is a common feature of many holidays, as Rachel Armstrong and Gabrielle Fagan discover.

Byline: Rachel Armstrong and Gabrielle Fagan

Coming home from an exotic holiday normally leaves you with incredible memories and a slight reluctance to return to work.

But what seems to be a bout of traditional British flu a few weeks later can actually be a rather more unpleasant souvenir.

Spending your holiday in the more remote parts of the world is becoming more and more popular. But, as with most good things, there's a downside.

Malaria, dysentery and typhoid to name but a few, can all travel with you on the flight home and you won't even realise you've got them until you're back.

The past three years have seen a 21per cent rise in the number of travellers contracting tropical diseases abroad, according to Prudential Insurance. And GPs are suddenly having to wise up on a range of illnesses they wouldn't normally expect to come across in the UK.

Dr Richard Dawood, a specialist in travel medicine at the Fleet Street Travel Clinic, says: 'There's a vast range of tropical diseases someone can bring back with them but by far the commonest problem is a persistent intestinal upset - diarrhoea that fails to get better on its own or with initial treatment.

'There are many possible causes of this, including giardia - a singlecelled parasite present in most places where hygiene is poor - and amoebic dysentery.

'By far the most serious tropical disease is malaria, which causes about 2,000 cases in travellers returning to the UK every year, of whom between ten and 20 will die.'

Tropical diseases and their symptoms include: MALARIA The biggest infectious killer in the tropics. Carried by mosquitoes, it's an infection of the red blood cells by a tiny organism called a protozoa. Nearly 90 per cent of travellers who contract it don't become ill until they return home - it can manifest itself months after you've been bitten bythe mosquito. Initial symptoms include fever, shivers, sweating, backache, joint pains, headache, vomiting, diarrhoea, and sometimes delirium.

If you exhibit any of these symptoms within a year of returning from holiday, even if you took antimalarial drugs, contact your doctor.TYPHOID A fever spread through food, water or contact with other sufferers. It's not actually a tropical disease but happens in areas with poor hygiene and sanitary conditions.

The disease's incubation period lasts between 10 and 20 days and the fever has several phases.

Initial symptoms are a fever and headache, followed by a loss of appetite, joint pain, sore throat, sweating and a general feeling of being unwell. The person will often experience soreness in the stomacharea, a bloated feeling and constipation. Occasionally symptoms also include coughing, nosebleeds and painful urination.

Children with typhoid fever often vomit and have diarrhoea. The illness rarely affects children under two years of age.

DENGUE FEVER A virus transmitted by mosquitoes which affects 20 million people a year and is endemic in 100 countries worldwide.

Unusually the mosquito which carries it bites during the day and there's no vaccine to guard against it, so be wary if you get bitten in daylight.

Early symptoms include headaches and fever. Some people get rashes, aches and pains. It's rarely fatal and in most cases will only last two to three days.

AMOEBIC DYSENTERY An intestinal infection usually spread through contaminated food where hygiene conditions are poor and symptoms can take several weeks to appear.

Symptoms are often mild and vague, but there is persistent lowgrade abdominal discomfort and nausea, mild diarrhoea with blood and mucus, and sometimes tenderness over the liver. Liver abscesses may cause fever and weakness, referred pain in the right shoulder (pain apparently in one place but actually caused somewhere else), nausea, jaundice, loss of appetite and loss of weight.

Dr Dawood says: 'If you return from holiday look out for any persistent symptoms - from diarrhoea to fever, skin lumps and bumps, or a rash.

'Any symptom that fails to improve immediately means you should go straight to your doctor. Make sure that your doctor knows where you've been - it's often difficult to make the right diagnosis without knowing that foreign travel may have been a factor.'

If you think you may have come in to contact with a tropical disease contact your GP or else arrange for a post-travel screening at a travel clinic.

CAPTION(S):

Malaria-infected blood cells. Falciparum malaria malignant tertian malaria is a potentialy fatal infection
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Title Annotation:Features
Publication:The Birmingham Post (England)
Date:Sep 4, 2004
Words:731
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