Management of a wild animal bite in a rabies enzootic area.

The British Armed Forces of the 21st century are trained and operate worldwide, often in places where rabies control is poor and prevalence may be high. Currently rabies is not a routine vaccination for all service personnel. Awareness of the risk of rabies, action to take post potential exposure, prompt access to clear management advice and reliable supplies of Rabies Immunoglobulin and Rabies Vaccination are critical. We describe the management of a recent case of animal bite in Kenya and discuss current recommendations.

Contact irritant dermatitis in Kenya.

Kenya is one of the British Army's main training areas outside of the UK and the flora and fauna present the physicians with several challenges. A 22 year old infantry soldier presented with a vesicular, linear painful rash across his chest caused by the chemical excreted from the Staphylinid or rove beetle, known locally as the Nairobi fly. Treatment included topical antibiotic and steroid creams to good effect. This report highlights the recognition, treatment and complications of the Nairobi Fly.

High altitude cerebral oedema during adventure training on Mount Kenya.

The trekking ascent to Point Lenana (4,985m) on Mount Kenya is a popular objective for soldiers on adventurous training in Kenya. The standard route previously taken has been the Naro Moru route which involves an ascent rate far in excess of that recommended to avoid altitude illness. This article describes the case of a British soldier who developed high altitude cerebral oedema during an ascent of Point Lenana via the Naro Moro route. Recommendations to reduce the risk of altitude illness on Mount Kenya include alternative and more gradual routes of ascent. Early symptom recognition and descent are vital to prevent clinical deterioration.