Key words: Tropical African diseases, tourism, security

As a traveler, I have traveled to more than 130 countries and, of course, I have read a lot about the dangers that lie in wait for people in the tropics. Venomous snakes, spiders, crocodiles and lions frighten many. But the most dangerous of all are microscopic, almost invisible creatures, united by a common name-parasites. They live and reproduce thanks to the humid warm climate typical of the tropics of Asia, Africa and South America.

I remember that in 1998, five of us tourists went on a trip through several Latin American countries, and throughout the trip we were literally tortured by mosquitoes. We traveled thousands of kilometers on foot, on boats, riverboats, and buses, but the ferocious insects did not leave us alone anywhere. From constant bites, all of us did not stop itching day or night. The scabies had caused sores, and we were only partially relieved when we had a chance to rest on a steamer sailing down the broad Rio Madeira, a tributary of the Amazon. The sores went away pretty quickly, and we didn't stop scratching until a week later.

However, it soon started all over again. I especially remember the night at the foot of Raraima, a plateau in the Guiana Highlands. The temperature during the day and at night was completely unchanged-plus 24 degrees. It didn't seem to be very hot, but with absolute humidity in the rainy season, my body was constantly sweating. It rained intermittently; the inside of the tents was always stuffy, and you couldn't open the curtains a crack - swarms of mosquitoes were waiting in the wings...

However, they were already getting in by unknown means, and we woke up from the stuffiness and scabies every two hours and scratched desperately until we fell back into oblivion. In the neighboring tents, just like us, everyone was suffering from mosquitoes. Despite the mosquito nets that the tents were equipped with, it was almost impossible to protect yourself from these insects.

What it is - tropical mosquitoes-there is no exact definition in the literature. Most likely, mosquitoes mean mosquitoes and midges. Besides, midges in the tropics, unlike our Siberian ones, come in very many types and sizes. I must say that we were "philosophical" about physical suffering on the journey, in principle, we did not really care about it. It wasn't the mosquitoes we remembered, but the mountains, the jungles, and the people we met.

Africa's national parks are incomparable in their beauty and wildlife to any other places on Earth. For humans, this continent is also the most invigorating place, especially its vast tropical expanses, which opened up to the" civilized world " relatively - by historical standards, of course-recently. But even in terms of the scale of the danger that lies in wait for a person literally at every step, Africa has no equal.

For example, malaria "spits" on an area with a side of five thousand kilometers from north to south and from west to east of the continent. Local amoebas - microscopic organisms-threaten the traveler with catastrophic stomach disorders. Moreover, they can enter the body, for example, along with beer in a fashionable restaurant. And finally, almost all major lakes in Africa are fraught with danger for humans to become infected with schistosoma.

Take, for example, Lake Tana in Ethiopia, where the Blue Nile originates. Tana is located high above sea level. But the water here is warm, and schistosomes are plentiful. Fishermen swim on the lake in reed boats and are often struck by an invisible creature. There were several of us travelers from Russia here; we swam, according to our ideas, cautiously, that is, not near stagnant and overgrown banks, but with access to sand or large stones. We also swam in the upper reaches of the fast-flowing Nile, not far from the famous waterfalls. Cautious people will say that even under such conditions there is some probability of catching parasites, but... Honestly, if you believe the statistics, it is much more dangerous to drive in a car in St. Petersburg...

Lake Tanganyika and Lake Nyasa... How not to swim and fish in a lake the size of the sea! Especially in Tanganyika, where the water is the purest, and it is deep-water-the second deepest in the world after Lake Baikal. In general, it seems to me that those who are going to Africa, you need to remember the Russian saying: to be afraid of wolves - do not go into the forest. I wasn't afraid, although I did get schistosoma. How did this happen?

In 2008, I traveled to Africa with my family - my wife and two children. During the year, we actually crossed the continent, visiting 16 countries. The children studied externally. I am proud to say that we were the first Russian family that managed to cross Africa, as they say, "from end to end"...

After our "African epic", the children went to a regular school and, even without losing a year, continued to study successfully further. Next summer, we were going to go to Africa again, this time on a new route-through the Asian continent. They began to register children for distance learning, for which it was necessary to pass a special medical commission, and that's when it turned out: both of them have schistosoma.

We-the parents-even felt proud of the Russian medicine: a rare exotic disease was discovered by the most ordinary St. Petersburg doctors or even laboratory assistants. Naturally, I sounded the alarm, started calling everywhere, went to various specialists, and they, as if by agreement, claimed that it was unlikely that this was a schistosoma. We again passed tests to the most reputable medical institutions in the city-the Institute named after V. I. Abramovich. Sechenov University, Military Medical Academy, Hospital named after V. I. Sechenov. Botkin - and indeed it turned out that two of our children had contracted schistosoma in some tropical waters. The professors were asked: maybe we accidentally went into the water once or twice in Africa?.. It was not easy to admit: where we just did not swim there!

The tests cost money, but due to the unconventional nature of the disease, they were relatively cheap for us. Once we were even asked to "suffer for science" and invited to a lecture at a medical institute - where and when else could students see patients with real schistosoma? Our family even became quite famous in medical circles. But that didn't bother us - we needed to get cured immediately and go on another trip.

Schistosoma is treated easily, but not in all cases it is completely cured. Depending on the weight, a person should take two to five parasiquantel tablets daily. After 2-3 weeks, you need to take tests for schistosoma again and, if it does not help, swallow the pills again. My tests were not entirely clear to the doctors, but I also took pills just in case. And not only to be cured, but also to be "solidary" with the children. These pills, I must say, are pretty disgusting.

I don't need to tell you the details of our treatment for tropical parasites, but now I probably know more about schistosoma than anyone else in Russia. In the course of research and treatment, I was also told a lot about other parasites, including our northern ones, and they are, frankly, no better than African ones.

I would recommend that tourists after returning from any long-distance travel, be sure to go to a parasitologist. This will not take long, but you will be sure that the disease has bypassed you. I, for example, did not know before that parasites are small only at the time when they enter the human body, and then grow up several times. It's scary even to look at pickled scum in bottles and flasks, and even the drawings in parasitology textbooks are unpleasant to look at.

But one of the reputable professors reassured us: firstly, schistosoma is being treated, and secondly, millions of people suffer from it in tropical countries, and they do not make it a tragedy. You can and should travel, but always be careful.

In 2009, schistosoma disrupted our plans - we stayed in St. Petersburg for almost a month. And we agreed that in the future we will go to places located away from African parasites. For example, on the Golden Ring of Russia, or go to Lake Baikal, which, they say, is no less beautiful than the African savanna, especially in the golden autumn.

WHAT ARE SCHISTOSOMES AND HOW ARE THEY DANGEROUS?

Schistosomes are a type of helminth. Their second name is "blood flukes", because unlike most parasitic worms, they do not live in the human gastrointestinal tract, but in its cardiovascular system, and together with the blood flow can spread throughout the host's body.

Most of the population of schistosomes lives in South America, the Caribbean, the Far and Middle East, Indochina and Africa. Helminthiasis experts estimate that in tropical countries, schistosomiasis affects almost the entire adult population. According to official WHO data, schistosomiasis affects 200 million people worldwide; in fact, there are several times as many of them. The disease is also regularly detected in tourists. It is easy to get infected - just once walk barefoot along the shore or swim in a pond where the larvae of these helminths live. But if local residents develop immunity to the toxins released by schistosomes from childhood, and they practically do not suffer from the severe consequences of this disease, visitors react sharply and painfully to infection.

This parasite is especially dangerous because the symptoms may not appear for a long time, and for some time it is simply impossible to understand that a schistosome is parasitizing in the human body. As a result, those infected gradually develop liver fibrosis, kidney failure, and other serious diseases.

Modern medicine has an arsenal of tools for the treatment of schistosomiasis. However, the treatment cycle is long and complex, and the cure is not always complete.

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