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Dengue doubts and tummy bugs


The Phnom Penh Post has partnered with licensed doctors from the International SOS Clinic to answer medical questions our readers may have. Check it out every first Wednesday of the month, and send questions to the Lifestyle Editor at

How common is Dengue in Phnom Penh? What kinds of precautions can I take?

Dengue fever is mostly a seasonal disease. It does occur at low levels year round but the main risk is during the rainy season.  In Phnom Penh this means a peak occurrence from July through to October, although this depends on when the monsoon starts. Adult disease (rare in Cambodians brought up in this country) usually lasts about 2 weeks, with a risk of bleeding from a drop in blood platelets, so blood should be monitored by your doctor. The severe form of the disease, dengue shock syndrome, is thankfully rare. 

Dengue is a viral disease that is transmitted by the bite of a day flying Aedes mosquito. They are a larger mosquito with white bands on the legs if you look closely. Aedes breed in small pools of fresh water, so you can protect yourself and your family by making sure that there are no empty pots or places where fresh water can collect in your yard, or around your office.  

Houses and offices should have mosquito screening and you could consider regular use of a DEET or citriodiol containing repellent. Citronella smells lovely but is ineffective. Intermittent fogging or use of knock down sprays (with proper ventilation) can also help ensure Aedes don’t lurk under your desk.  

The symptoms of dengue are essentially like the worst flu you ever had. Aching bones and muscles, pain behind the eyes, severe fatigue and high fever are classic. If you feel this way, you should see your doctor.  

If I’ve got a stomach bug, how do I know when to treat it at home, and when to seek medical help?

“Stomach bugs”, or intestinal symptoms like vomiting and diarrhoea can be caused by a wide range of factors including toxins from contaminated food, parasites, viruses and bacteria. “Traveller’s diarrhoea” is familiar to most as 24-48 hours of mild abdominal cramping and watery diarrhoea.

This is most commonly either a mild bacterial infection or a food toxin and usually gets better on its own. The main thing to do is to ensure that you drink plenty of water or an oral rehydration solution with some salt, sugar and electrolytes (green coconut water is very good) and rest. If you have high fever, blood in the stool, or you are becoming very dehydrated (dark concentrated urine, dry lips and tongue, dizziness) you should seek medical advice.  

What’s the difference between an infection and a parasite that causes consistent tummy troubles?

Sometimes some infections can become chronic or recurrent. Giardia is a protozoal infection, a tiny organism with a whip like tail that can cause a very unpleasant acute infection with a lot of bloating, sulphurous gas, stinky pale floating stools, and extreme fatigue. If this goes untreated you may develop a lingering chronic infection with intermittent milder symptoms, fatigue, bloating and cramping after eating.  

These symptoms are worth discussing with your doctor and asking for a stool test. Giardia may be difficult to detect on a test however, and it is essential that the sample is very fresh (still warm!) when it is brought to the clinic/lab as giardia cysts will only remain visible for around an hour or so.

How effective are antibiotics in treating stomach bugs?

Antibiotics are used in the treatment of diarrheal illnesses but indiscriminate use has led to widespread drug resistance in many bacteria. These multi-drug resistant gut bacteria, such as E.coli, may then cause blood, urine or prostate infections that are extremely difficult to treat. Antibiotics themselves may also cause diarrhoea as they effectively kill off all the “good”, so-called commensal bacteria that are essential for your gut to be healthy. Random self-medication with antibiotics bought over the counter should be avoided.  

This month’s guest columnist, Dr Laura Watson is the deputy CMO at the International SOS clinic in Phnom Penh. She is a British GP who specializes in women’s and family health care.
This article contains general information about medical conditions and treatments. The information is not advice, and should not be treated as such. You must not rely on the information as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.



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