Q: I am going to the Maldives, but every time I dive or swim in plankton-rich water I end up with an ear infection, despite using fresh water to rinse my ears on surfacing, trying Swim Ear and using other treatments. The infection in the outer ear is always painful and keeps me out of the water for a few days. It has been suggested that I use a mixture of 5% acetic acid in propylene Glycol to 'oil' the ears and prevent infection. Do you think it would work?
Paul Brazier
Dr Jules Eden replies: The key to outer ear infection is in the prevention, and your friend's cocktail of vinegar and propylene glycol acts in very much the same way as Swim Ear, in that it breaks down the surface tension of the water that is left in your ear canal after a dive so it can run out more easily when you shake your head. As well as this, the alcohol component helps in evaporating any water left there, which means that any bacteria are expelled so the infection can't take a hold.
I always take antibiotic ear drops with me to use after I've showered. My preferred drops are Gentisone, as there is a small amount of steroid in them which can reduce the inflammation which is the main cause of the pain.
Q: I recently read about the West Nile Virus in the US. Would inoculations be wise or necessary as my fiancée is prone to insect bites?
A: West Nile Virus appeared last year on the upper eastern seaboard of the US and caused many cases of infection but thankfully only a handful of fatalities. It is a virus originating in birds but then transferred to humans via mosquito bites.
There are no inoculations at present, and in reality you and your fiancée don't really need them because the virus normally only causes a mild flu-like illness, which passes in a few days.
I suggest your fiancée buys a local insect repellent, and takes a daily Vitamin B12 tablet, or a clove of garlic a day, which seems to make you less of a tasty meal for mosquitoes.
Ask the flying doctor If you have any questions you want to ask Dr Jules Eden, email travel.doctor@theguardian.com, or write to The Flying Doctor, The Guardian, 119 Farringdon Road, London EC1R 3ER.
Dr Jules Eden created E-med as an online support service for anyone who finds themselves a long way from a doctor's surgery. You can get free pre-travel information on any destination in the world. Log on and click on the Travel Clinic icon.
