Belize's Battle: Navigating The Complexities Of Infectious Diseases

Belize is a popular destination for tourists seeking sunshine and snorkelling, but there are some health risks to be aware of before visiting this tropical Central American country. Infectious diseases, including bacterial diarrhoea, hepatitis A, and typhoid fever, pose a high risk to travellers, according to a 2016 report. Vector-borne diseases such as dengue fever and malaria are also prevalent, with the Zika virus being transmitted by Aedes mosquitoes. Chagas disease, or kissing bug disease, is another potentially fatal illness caused by parasites transmitted through contact with kissing bug excretions.

The good news is that Belize has made significant progress in reducing the number of malaria cases, with a 95% decrease between 2007 and 2012. The country is currently in the pre-elimination phase to control the disease further. Additionally, pharmacies in Belize are well-stocked, and medicine prices are comparable to those in the US. Healthcare is also affordable, with doctor visits costing only a few dollars.

Insect-borne diseases like dengue fever and malaria

To prevent mosquito bites, it is recommended to use insect repellent, wear long-sleeved shirts and pants, and stay in accommodations with window screens or air conditioning. Additionally, using bed nets, burning mosquito coils, and emptying containers of stagnant water can help reduce the risk of being bitten.

It is important to note that there is no specific treatment for dengue fever, but early detection and proper medical care can lower fatality rates. For malaria, anti-malarial medications such as chloroquine pills are available, and prevention measures include the use of insecticide-treated mosquito nets and indoor residual spraying.

In addition to dengue fever and malaria, other insect-borne diseases in Belize include Chagas disease, leishmaniasis, and Zika virus. Chagas disease, also known as the kissing bug disease, is transmitted by triatomine bugs or "kissing bugs", while leishmaniasis is caused by the bite of parasite-infected female phlebotomine sand flies. The Zika virus is spread through mosquito bites and usually causes mild symptoms, but it can lead to birth defects if contracted during pregnancy.

Food and waterborne diseases

Hepatitis E is another waterborne disease, also caused by a virus, which interferes with the liver. It is usually spread through faecal contamination of drinking water, and causes jaundice, fatigue, abdominal pain, and dark-coloured urine.

Typhoid fever is a bacterial disease spread by consuming food or water contaminated with faecal matter or sewage. It causes sustained high fevers, and if left untreated, can be fatal in up to 20% of cases.

The CDC recommends that all international travellers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine. They also recommend that travellers to Belize should be vaccinated against hepatitis A and consider vaccination against hepatitis B, chikungunya, and rabies.

Zika virus

The Zika virus is transmitted primarily by the bite of an infected Aedes mosquito, which is most active during the day. The virus was first identified in Uganda in 1947 and has since been associated with serious birth defects, including microcephaly. While most people with Zika do not develop symptoms, those who do typically experience a rash, fever, conjunctivitis, muscle and joint pain, malaise, and headaches that last for 2-7 days. There is currently no vaccine or specific treatment for Zika.

In Belize, there is a risk of Zika virus transmission. The mosquito responsible for transmitting Zika is common in towns and cities and bites mostly during the day. As such, it is recommended that travellers to Belize practice strict mosquito bite avoidance at all times. This includes covering exposed skin, using insect repellent, and sleeping under mosquito nets.

Pregnant travellers or those planning a pregnancy should consider avoiding travel to Belize. If travel is necessary, it is recommended to use barrier methods of contraception during and after travel and to avoid becoming pregnant while travelling. If symptoms of Zika infection develop, it is advised to avoid pregnancy for a further two months after recovery.

Chagas disease

The triatomine bug typically bites an exposed area of skin and then defecates close to the bite wound. The parasites enter the body when the person instinctively smears the bug's faeces into the bite, the eyes, the mouth, or any other break in the skin. Chagas disease can also be transmitted orally through food or beverages contaminated with T. cruzi, during pregnancy or childbirth, through blood or blood product transfusion, through transplants of some organs, and through laboratory accidents.

The disease has two phases: acute and chronic. The acute phase lasts for about two months after infection and is often symptom-free or mild, with possible signs and symptoms including fever, headache, enlarged lymph glands, muscle pain, difficulty breathing, swelling, and abdominal or chest pain. In some cases, if the infection is not treated, Chagas disease will advance to the chronic phase. Signs and symptoms of the chronic phase may occur 10 to 20 years after initial infection, or they may never occur. In severe cases, Chagas disease signs and symptoms in the chronic phase may include sudden cardiac arrest, difficulty swallowing due to an enlarged oesophagus, and stomach pain or constipation due to an enlarged colon.

To prevent Chagas disease, it is important to avoid contact with the triatomine bug and take measures such as using insecticide-soaked bed nets, improving house cleanliness, practising good hygiene, and using insect repellent on exposed skin.

Tuberculosis

The World Health Organization (WHO) defines the incidence of tuberculosis as the estimated number of new and relapse cases arising in a given year, expressed as the rate per 100,000 population. In 2020, the incidence of TB in Belize was 23 per 100,000 people. Over the past 20 years, this figure has fluctuated between 61 in 2001 and 23 in 2014.

TB is preventable and curable, but the emergence of drug-resistant strains poses a significant threat to global health. World TB Day is observed annually on March 24 to raise awareness and understanding of the disease and its impact.

To prevent infection, travellers to Belize should ensure they are up to date with all routine vaccinations and take steps to avoid exposure to TB bacteria, such as avoiding close contact with people who are sick and practising good hand hygiene.

Frequently asked questions