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Basic Rules

Food & Water

Stomach upsets are the most likely health problems, and the majority of these will be relatively minor and probably due to overindulgence in the local food. Some people take a while to adjust to the regular use of olive oil in the food.

Tap water is drinkable throughout Italy although Italians themselves have taken to drinking the bottled stuff. The sign acqua non potabile tells you that water is not drinkable (you may see the sign in trains and at some camp sites). Water from drinking fountains is safe unless there is a sign telling you otherwise.

Everyday Health

Normal body temperature is 37C or 98.6F; more than 2C (4F) higher indicates a "high fever". Normal adult pulse rate is 60 to 100 beats per  minute (children 80 to 100; babies 100 to 140). As a general rule, the pulse increases by about 20 beats per minute for each C (2F) rise in fever.

Environmental Hazards

Heatstroke

This serious (and occasionally fatal) condition can occur if the body's heat - regulating mechanism breaks down and body temperature rises to dangerous levels. Long, continuous periods  of exposure to high temperatures and insufficient fluids can leave you vulnerable to heatstroke.

The symptoms are feeling unwell, not sweating very much (or at all) and a high body temperature (39 to 41C or 102 to 106F). Where sweating has ceased, the skin becomes flushed and red. Severe, throbbing headaches and lack of coordination will also occur, and the sufferer may be confused or aggressive. If untreated, severe cases will eventually become delirious or convulse. Hospitalisation is essential but in the interim get victims out of the sun, remove their clothing, cover them with a wet sheet or towel and then fan them continually. Give them fluids if they are conscious.

Hypothermia

Too much cold can be just as dangerous as too much heat. If you are walking at high altitudes, particularly at night, be prepared.

Hypothermia occurs when the body loses heat faster than it can produce it and the core temperature of the body falls. It is surprisingly easy to progress from very cold to dangerously cold due to a combination of wind, wet clothing, fatigue and hunger, even if air temperature is above freezing. It is best to dress in layers: silk, wool and some of the new artificial fibres are all good insulating materials. A hat is important as a lot of heat is lost through the head. A strong, waterproof outer layer (and a "space" blanket for emergencies) is essential. Carry basic supplies, including food containing simple sugars to generate heat quickly and fluid to drink.

Symptoms of hypothermia are exhaustion, numb skin (particularly toes and fingers), shivering, slurred speech, irrational or violent behaviour, lethargy, stumbling, dizzy spells, muscle cramps and violent bursts of energy. Irrationality may take the form of sufferers claiming they are warm and trying to take off their clothes.

To treat mild hypothermia, first get the person out of the wind and/or rain, remove their clothing if it's wet and replace it with dry, warm clothing. Give them hot liquids (not alcohol) and some high-kilojoule, easily digestible food, Do not rub victims - allow them to slowly warm themselves. This should be enough to treat the early stages of hypothermia. The early recognition and treatment of mild hypothermia is the only way to prevent sever hypothermia, which is a critical condition.

Heat Exhaustion & Prickly Heat

Dehydration and salt deficiency can cause heat exhaustion. Take time to acclimatise to high temperatures, drink sufficient liquids such as tea and drinks rich in mineral salts (such as clear soups and fruit and vegetable juices), and do not do anything too physically demanding. Salt deficiency is characterised by fatigue, lethargy, headaches, giddiness and muscle cramps: salt tablets may help, but adding extra salt to your food is better.

Prickly heat is an itchy rash caused by excessive perspiration trapped under the skin. It usually strikes people who have just arrived in a hot climate. Keeping cool by bathing often, using a mild talcum powder or even resorting to spending time in an air-conditioned environment may help.

Fungal Infections

These occur more commonly in hot weather and are usually found on the scalp, between the toes (athlete's foot) or fingers, in the groin and on the body (ringworm). You get ringworm (which is a fungal infection, not a worm) form infected animals or other people. Moisture encourages these infections.

To prevent fungal infections wear loose, comfortable clothes, avoid artificial fibres, wash frequently and dry yourself carefully. If you do get an infection, wash the infected area at least daily with a disinfectant or medicated soap and water, rinse and dry well. Apply an antifungal powder or cream like tolnaftate. Try to expose the infected area to air or sunlight as much as possible. Wash all towels and underwear in hot water, change them often and let them dry in the sun.

Infectious Diseases

Diarrhoea

Simple things such a change of water, food or climate can all cause a mild bout of diarrhoea, but a few rushed toilet trips with no other symptoms is not indicative of a major problem.

Dehydration is the main danger with any diarrhoea, particularly in children or the elderly where dehydration can occur quite quickly. Under all circumstances fluid replacement (at least equal to the volume being lost) is the most important thing to remember. Weak black tea with a little sugar, soda water, or soft drinks allowed to go flat and diluted 50% with clean water are all good. With sever diarrhoea a rehydrating solution is preferable to replace minerals and salts lost. Commercially available oral rehydration salts (ORS) are very useful; add them to boiled or bottled water. In an emergency you can make up a solution of six teaspoons of sugar and half teaspoon of salt to litre of boiled water. Keep drinking small amounts often. Stick to a bland diet as you recover.

Gut-paralysing drugs such as loperamide or diphenoxylate can be used to bring relief from the symptoms, although they do not actually cure the problem. Only use these drugs if you do not have access to toilets, for example if you must travel. Note that these drugs are not recommended for children under 12 years.

In certain situations antibiotics may be required: diarrhoea with blood or mucus (dysentery), any diarrhoea with fever, profuse watery diarrhoea, persistent diarrhoea not improving after 48 hours and severe diarrhoea. These suggest a more serious cause of diarrhoea and in these situations gut-paralysing drugs should be avoided.

Hepatitis

Hepatitis is a general term for inflammation of the liver. The symptoms are similar in all forms of the illness, and include fever, chills, headache, fatigue, feelings of weakness and aches and pains, followed by loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-coloured  faeces, jaundiced (yellow) skin, and the whites of the eyes may turn yellow. People who have had hepatitis should avoid alcohol for some time after the illness, as the liver needs time to recover.

Hepatitis A is transmitted by contaminated food and drinking water. You should seek medical advice but there is not much you can do apart from resting, drinking lots of fluids, eating lightly and avoiding fatty foods. Hepatitis E is transmitted in the same way as hepatitis A; it can be particularly serious in pregnant women.

Hepatitis B is spread through contact with infected blood, blood products or body fluids - for example, through sexual contact, unsterilized needles and blood transfusions or contact with blood via small breaks in the skin. Other risk situations include having a shave, a tattoo or body piercing with contaminated equipment. The symptoms of hepatitis B may be more severe than type A and the disease can lead to long-term problems such as chronic liver damage, liver cancer or a long term carrier state. Hepatitis C and D are spread in the same way as hepatitis B and can also lead to long-term complications.

There are vaccines against hepatitis A and B but there are currently no vaccines against the other types of hepatitis. Following the basic rules about food and water (hepatitis A and E) and avoiding risk situations (hepatitis B, C and D) are important preventative measures.

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