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Travellers’ diarrhoea can ruin an overseas holiday and even an experienced doctor can be laid low.

Thursday, 7 June 2012

Killer kulfi: A cautionary tale


Travelvax Australia’s doctors and nurses love travelling just as much as their patients. But, even professionals don’t always manage to dodge the travel health mishaps. We begin a short series of articles with the story of a memorable night in Mumbai...

 

By Dr Arjun von Caemmerer 

After a month of traversing the colourful streets of Pune, mainly on foot, the taxi ride seemed a luxurious extravagance. But, the prickle of guilt I felt was swamped by a sense of relief at leaving India unscathed.
This was something of a first. It was my sixth visit to the sub-Continent and I’d spent a singularly uncomplicated month: no fever, no runs, no cough. Even my back, which on three previous visits had unpredictably (and inconveniently) torted into severe spasm, had remained settled and silent.
I had arrived at Mumbai’s Hotel Ambassador for the final night of my trip. It was comfortably appointed and only a little further from the domestic airport than the internet advertisement had suggested.
 
“Dessert, Sir?”
I looked forward to my evening meal. Being Mumbai, it would have been remiss of me to bypass the delicious pom fret and tandoori potatoes, accompanied by stuffed naan and a small serving of dahi (buffalo yoghurt – its coolness the perfect balance to the fiery chillies).
I ate my fill as the waiters hovered. “Dessert, Sir? You want gulab jamun, kulfi?” I was easily tempted. And, in a spirit of gratuitous self-reward, I treated myself lavishly to pista kulfi, a splintery pistachio milk ice. It was followed by milky masala chai tea, which is spiced with cloves, cardamom, and ginger – sweet and warming.
Later, I turned on the television in my room and watched the cricket lying on my bed beneath my artfully arranged mozzie net, which I had managed tosuspend using the tried-and-tested combination of coat hanger, book, and a conveniently placed wardrobe. Knowing I had early start and a long day of travel ahead the following day, I turned off the light around 10pm.
 
At 2am, an ominous rumbling
The trouble began around 2am. I woke from an uneasy sleep with an ominous rumbling and a nagging discomfort deep within my small intestinal area (too low to be stomach, too high to be colon).
I tried to distract myself with the television, but the light seemed wrong and the action unnaturally distant. I remembered being sick as a child, when the room would retract as though I was looking through the wrong end of a telescope. Well before I was racked with shivering, I knew I had a fever.
I managed to force down two paracetamol, but they only seemed to trigger an intermittent and roiling nausea. Wrecked and wretched, I endured two very long hours until a voice on the phone announced: “Good morning, Sir. Taxi is ready.”
 
Airport nightmare
I staggered downstairs, feeling as though I might faint at any moment, and collapsed into the back seat of the cab. I remember little of the journey to the airport; it was only through sheer force of will that I didn’t faint or vomit.
My Sikh taxi driver may have thought my delirium was hashish-induced. A kind and considerate man, he ensured I reached safely inside the appropriate terminal of Mumbai’s Chhatrapati Shivaji International Airport.
Once inside, I used up most of the several small rolls of toilet paper that I had appropriated from the Ambassador in several awkward rushes to the toilets, which lacked such luxuries.
Checking in was grim; another test of endurance. Not wanting to appear so ill that I would be forced off the flight, I feigned tiredness and lay in line on the ground.
 
Suspicion falls on the kulfi
In my fever I imagined I had salmonella, or possibly septicaemia, and fingered kulfi as the culprit. Perhaps the power cut I had experienced on arrival at the hotel had been one of a series, some of them prolonged, and the ice cream had defrosted and warmed.
Sweating, pale, faint, and with the phrase ‘killer kulfi’ resonating through my head on a loop, I boarded the plane, my guts now mercifully emptied of diarrhoea.
The meals were not easy. While it was simple to refuse them, my neighbour’s concern mounted with each refusal. A large man who ate appreciatively and noisily, he concluded that the airline must have wrongly designated me as vegetarian and I was finding my meat-free fare inedible.
 
Miso to the rescue
He repeatedly offered me his chicken masala or another greasy, pungent dish which, he assured me, were delicious. He’ll never know how close he was to getting a tray full of matured kulfi.
Thankfully, what had started abruptly passed relatively quickly.
By the time we reached Singapore I was cautiously peckish.
Miso soup was an excellent choice: helpfully salty, rehydrating, tasty, and unlikely to provoke further intestinal distress.
An instant version is available. Don’t leave home without it!
 
Next time you travel overseas, don’t forget to pack a travellers’ diarrhoea kit tailored to you and your journey. Ask about them during your pre-travel consultation at any of Travelvax Australia’s 32 vaccination clinics around Australia, or call our travel health advisory line on 1300 360 164 (toll-free from land lines) for more details.

 

 

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HAITI: Cholera rising in west and north
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INDIA: JE season begins; Unseasonal malaria in Jaisalmar; Doubt over dengue figures
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ISRAEL: Measles rates rising in north
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PHILIPPINES: HIV/AIDS rates soar; Dengue rampant in Zambo as national rate falls
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UNITED KINGDOM: Legionnaires’ strikes in Edinburgh
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UNITED STATES OF AMERICA: The cost of imported measles
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Travelvax Australia compiles this weekly bulletin of global travel health alerts, risk assessments and advice for the information of Austrlaian travellers and the travel industry. Please contact our travel health advisory service on 1300 360 164 for broad destination-specific advice and vaccination recommendations. Recommended vaccines, travel medicine, trip-specific advice and accessories are available during a medical consultation with a travel health professional at any of Travelvax Australian’s 32 clinics. Visit our website or call 1300 360 164.
 
Source = Travelvax
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