Dengue and Rabies and Ingrown Nails, oh my

 I didn't know that much about tropical medicine before I came. Boy am I learning a lot. For example, rabies is a slow acting viral infection. If you have possibly been exposed to rabies from an animal bite, the hospital will give you both the immunizations and rabies immunoglobulin. This has to happen before you start to show signs of an infection. Otherwise it is fatal. Animal bites are so common in the Philippines that they actually have Animal Bite Clinics all around that specialize in just giving rabies shots. From what I hear, you get between 3-5 shots the first time and a couple of follow up. 

Dengue Fever is another viral infection but transmitted by mosquitos. With this, you tend to spike a high fever, be achy with a severe headache, often behind the eyes, and can throw up. Some people get a rash. I lost a lot of sleep one night working with missionaries who might have had dengue fever. We wanted to keep them out of the hospital if possible without damaging their health. There are no vaccines or treatment, just comfort and support. It gets dangerous when it causes you to expell blood, often with severe stomach paine and extreme fatigue. The high fever doesn't help. Note, you only give acetaminophen for pain so as not to encourage bleeding.

Ingrown toenails. I am starting to see a lot of them. These missionaries do a lot of walking in dress shoes which are not great on the toes. I am so glad I brought my dremel. However, I usually see them after they are infected and it is harder to treat.