Annapurna. Siân Pritchard-Jones

      Malaria prophylaxis

      Malaria is not found in most of Nepal; it is at present confined to parts of the southern lowlands. However, those spending a night after a trek in Chitwan, for example, or travelling overland to India, will be exposed to malarial risks.

      These risks should not be ignored. Using insect repellent at and after dusk, as well as wearing suitable clothing, will give some protection against bites. The three main drugs used in Nepal are Mefloquine (Lariam), Doxycycline and Malarone (Atovaquone/proguanil). Lariam can have very nasty side effects on some people, so it is wise to test it out before travel. In Britain, travellers may be recommended to take Proguanil daily and Chloroquine weekly, if going to a high-risk area. See also www.ciwec-clinic.com and www.masta-travel-health.com.

      Other nasty bugs

      Giardia is another bug to watch out for, but there is no preventative treatment apart from careful eating and drinking. It is contracted mostly through drinking infected water. It strikes the digestive tracts and lives happily in its host until arrested by a course of Flagyl (Metronidazole), Secnidazole or Tinidazole (Tiniba in Nepal). This unpleasant bug manifests itself in sulphurous foul-smelling gases, cramp and sometimes diarrhoea.

      Dengue fever is occasionally reported in Nepal, but the risk is very low in Kathmandu. There is no treatment other than rest and avoidance of mosquitoes.

      Common ailments

      The most common ailments are colds, blocked sinuses, headaches and stomach disorders. In the event of stomach upsets, the use of Imodium or Lomotil initially is recommended if symptoms are not serious, and also for convenience during long road journeys. The antibiotic drugs Norfloxacin and Ciprofloxacin may be used in more debilitating cases, and are available from pharmacies in Kathmandu. It is necessary to drink more liquids in dry regions. Dioralyte will help rehydration in cases of fluid loss due to stomach upsets.