Archive for May, 2010

Going to the beach? Pack some common sense.

Friday, May 28th, 2010 by

A disturbing story from England hit the news this week.   A mother took her five month old boy to the beach where the powerful rays of the sun left him severely burned on over 40% of his body.  The fact that several people intervened to get the infant out of the sun and into care shows that most people recognize that the beach is no place for a newborn.  But with summer coming, it’s important for everyone to remember just how powerful the sun can be.  In case you need a reminder, check out CNN’s collage of bad sunburns.  

In addition to the threats of sunburn and sun poison, dehydration is also a serious risk for anyone who spends too much time in the sun. How much sun a person can tolerate depends on their age, their skin and their overall health.   So in addition to the necessary supplies including water, suntan lotion, sunglasses and a hat, be sure to bring your common sense with you when you hit the beach with or without your family this summer.

Photo by Dave Gray.

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Vaccinations and Autism – Fact or Myth?

Friday, May 28th, 2010 by

A British doctor, whose research linked autism to common vaccines, was stripped of his license to practice medicine earlier this week.  Dr. Andrew Wakefield, whose reports in 1998 found an increased incidence of autism in children who received the measles, mumps and rubella vaccines, and whose study influenced millions of parents to forego vaccinations for their children, was found to have conducted “unethical research.” 

In banning him from practicing medicine in the United Kingdom, Britain’s General Medical Council cited a January ruling that “Wakefield and two other doctors acted unethically and showed a callous disregard for the children in their study.”  Among other indiscretions, Wakefield allegedly paid children for blood samples collected at his son’s birthday party and later joked about the incident.

Despite the fact that numerous other studies failed to corroborate Dr. Wakefield’s results, and that the British journal Lancet eventually retracted the original article detailing his findings, vaccination rates in Britain and other rich countries remain lower than before the study was published over a dozen years ago.  This has led to a number of measles outbreaks in Europe each year and even sporadic cases in the United States. 

Dr. Wakefield has appeared as an expert witness in a number of lawsuits against governments and vaccine manufacturers claiming that the measles, mumps and rubella vaccines led to autism.  Over 5,500 claims have been filed attempting to indict the MMR vaccine, but most have been dismissed for lack of evidence.  Two rulings in March of last year by a special branch of the U.S. Court of Federal Claims found no link between vaccines and autism.

In addition, at least a dozen British medical associations including the Royal College of Physicians, the Medical Research Council and the Wellcome Trust have issued statements verifying the safety of the measles, mumps and rubella vaccine. 

Parents of children who did not receive recommended vaccinations as infants should be aware of the dangers of travelling outside of the United States, and of having close contact with other unvaccinated children who have travelled internationally.  In 2008, a 7 year old unvaccinated boy became infected with measles while traveling in Switzerland.  He unknowingly exposed over 800 people and infected 11 unvaccinated children when he returned to California.  The public health cost for managing the outbreak was almost $200,000!

If you have read this far, I hope you have concluded that the answer to this post’s title is: MYTH.  Were you swayed in the past by these false claims?  How about friends or family members?  Let us know if your opinion on this subject has changed over time and why.  It is important to spread facts and not fiction, at least that’s what we here at the Healthy Travel Blog think.

Photo by firma.

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New Meningitis Vaccine Offers Greater Protection

Tuesday, May 25th, 2010 by

As reported last month, several cases of meningitis have been reported in the Sub-Sahara so far this year.  In this area where the high season for meningitis runs from December to June, there has been a big push to get those at risk for infection vaccinated.  The vaccines being offered effectively protect 90% of those who receive it from the A and B subtypes of meningitis that are responsible for the epidemics in Africa.

However, there are other forms of meningitis, and it is important that children, travelers and those in developing countries are protected from the many different strains caused by bacterial infections.  In developed nations the Meningitis C vaccine  is given in childhood, but this still leaves children and adults vulnerable to other strains known as  type A (common in Africa), type W and type Y. The ACWY vaccine, a conjugate vaccine, was developed to provide the necessary protection across all of these strains.  Results of these tests show a greater level of protection, a reduction in the length of time an individual can carry the infection and provides longer lasting immunity.

The current guidelines for the new conjugate vaccine recommend administering the vaccine to those age 11 and up, but it is so good that some authorities (the JCVI) in the UK are advising off-license use in those under 11 years as well.

In summary: if you are traveling and/or want to protect your children, ask for the new conjugate Meningitis ACWY vaccine over the traditional one.

Author: Charlie Easmon, MBBS
Charlie Easmon, MBBS is a General Practitioner whose practice has a strong focus on Travel Medicine.  He is a Regional Physician Advisor for HTH Worldwide and the Medical Director for The Number One Health Group on Harley Street in London and ALC Global Health Insurance.  He is a member of the Royal College of Physicians, UK and has a Diploma in Tropical Medicine and Hygiene from the University of Liverpool.   Dr. Easmon is an Honorary Lecturer at the London School of Hygiene and Tropical Medicine. 
Photo by: Teseum

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Titanic Awards: From blog to book

Friday, May 21st, 2010 by

Last summer we introduced you to TitanicAwards.com, a blog recognizing the best of the worst in travel disasters.  If you enjoy the comfort that comes from realizing that your own travel disasters may not be unique, you might want to check out their book. It just came out on May 4th and doesn’t have any customer reviews on Amazon, yet.  But if you read it, let us know what you think!

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New Japanese Encephalitis Vaccine Reduces Side Effects

Wednesday, May 19th, 2010 by

Good news for travelers throughout Asia.  There is a new vaccine against Japanese encephalitis that significantly reduces typical side effects.

We all know that mosquitoes transmit some very serious viruses to humans. In addition to malaria and dengue fever, another mosquito-driven disease is Japanese encephalitis virus (JEV).  As reported by the World Health Organization (WHO) JEV is endemic in parts of China, India, the Republic of Korea, Japan, the Russian Federation, islands in the Torres Strait of Australia, Nepal, Thailand, Viet Nam, Cambodia, the Lao People’s Democratic Republic, the Philippines, Taiwan, Indonesia, Malaysia, and Sri Lanka. Its breakouts are generally most prevalent during the summer and fall.

There is no treatment available for this disease which can lead to permanent damage to the nervous system or death. Though many vacationers or expats will not find themselves in high-risk areas during peak times, it is recommended by the Centers for Disease Control (CDC) that anyone travelling to an endemic area during a possible transmission season or those who are headed toward a potentially dangerous area should be vaccinated for JEV.

Historically, the vaccine was toxic to some people — especially those with a history of allergy to wasp/bee stings.  Many doctors were hesitant to give the traditional vaccine and if they did, they would advise recipients to stay in a country with decent medical facilities in case they were one of the rare cases to develop an allergic reaction within 10 days of receiving the vaccine.  Fortunately for those over 18 years of age, there is now a new vaccine that does not cause those side-effects and can be given as safely as any of our other vaccines.

In summary: If you are over 18 years old and travelling to one of the high risk areas mentioned above, ask your doctor for the new non-allergic Japanese encephalitis vaccine.

Author: Charlie Easmon, MBBS
Charlie Easmon, MBBS is a General Practitioner whose practice has a strong focus on Travel Medicine.  He is a Regional Physician Advisor for HTH Worldwide and the Medical Director for The Number One Health Group on Harley Street in London and ALC Global Health Insurance.  He is a member of the Royal College of Physicians, UK and has a Diploma in Tropical Medicine and Hygiene from the University of Liverpool.   Dr. Easmon is an Honorary Lecturer at the London School of Hygiene and Tropical Medicine. 

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Eyewitness report from UNICEF in Tajikstan: Massive flooding can’t halt polio immunization campaign

Tuesday, May 18th, 2010 by

The problems caused in Tajikistan by the polio virus have been aggravated by a natural disaster. There have been unusual levels of rain this spring. However, nobody could have predicted that rainfall on the night of May 6th would have brought so much grief to Khatlon Province in the south of the country and to Kulyab, the provincial centre.

The number of deaths from the flooding has already reached 24, with more than 50 people missing and more than 200 injured. In addition to this, more than 500 homes were partially or completely destroyed, more than a thousand animals killed, thousands of hectares of wheat, cotton and vegetable fields were washed away and there was extensive damage to roads, bridges, schools, hospitals and electricity cables.

More than 2000 people are currently living in tent camps. For this agricultural area, where most of the population survives through farming, this natural disaster is a real tragedy.

UNICEF staff members, who were on mission in Khatlon Province during those days to monitor the national immunization campaign against polio, have seen with their own eyes what happened in Kulyab.

“I have never seen rain like that before,” says Salokhiddin Shamsiddinov, Child Protection Programme Assistant for UNICEF Tajikistan a witness to the natural disaster.  “In order to get to the city from Davlatobod village to observe how the immunization was going on, we had to take a detour because of destroyed roads, but the roads in the place that we went to had also been washed out, and so we travelled along a river bed. We saw how rivers were roaring and taking down everything in their paths. It was particularly painful to see what had happened in Kulyab. Many houses were flooded and washed out.”

Given that UNICEF staff were already in the field, they were immediately mobilized to provide support for the emergency relief. First-aid items were sent by UNICEF to Kulyab, and staff supervised its distribution as a first step to the affected families.

Despite the emergency, the UNICEF team continued its work and supported local health care professionals in their campaign to complete the first round of the national immunization campaign.

“I was most struck by the high dedication and commitment of primary health care workers during the polio campaign in the most isolated areas, in very remote villages,”  says Nisso Kasymova, UNICEF’s HIV/AIDS Coordinator.  “During the monitoring we met nurses and their assistants who under heavy rain, in rubber galoshes over bare feet walked around all the houses in the areas isolated by mountains to ensure that the children received their vaccinations on time.  It’s good that Khatlon Province received enough vaccines at the beginning of May — enough for all three rounds — otherwise, after everything that happened, delivery of vaccines would have been difficult.”

Currently, the Government of Tajikistan, along with the international and business communities, is taking measures to help people and often loved ones as well, to regain a place to live and hope in the future after having lost all their property so suddenly. Plans have been laid out to re-house displaced persons in safe districts, to build new houses and to provide the victims with essential supplies.

There is also a UNICEF team in the disaster zone that is cooperating with representatives of other organizations to evaluate the damage caused, and to assess the initial needs of the population, especially the needs of the children.

Despite the disaster, the Ministry of Health of Tajikistan has not altered its plans to carry out second and third rounds of vaccination of children against polio in Khatlon Province. “The only change that will happen during second and third rounds, “ says Sabir Kurbanov, UNICEF Health Specialist, “is that more mobile health teams will carry out vaccinations in Khatlon area now.”

Author: Olga Grebennikova
Olga Grebennikova, a guest contributor to Healthy Travel Blog,  is currently working for UNICEF in Tajikistan to help the country offices with the polio immunization campaign.  After her work there is finished, she will return home to Kyrgyzstan where she is the Media Liaison Office for the UNICEF Country Office.

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Rift Valley Fever Outbreak in South Africa: An Unwelcome Visitor to the World Cup?

Tuesday, May 18th, 2010 by

Last month, the South African National Institute for Communicable Diseases (NICD) reported an outbreak of Rift Valley Fever (RVF), a viral illness that generally produces relatively mild symptoms of fever, headache, and muscle pains but on rare occasions can lead to internal bleeding, inflammation of the brain and eyes, and even death.  This news raises some eyebrows, coming on the eve of South Africa’s final preparations for a tidal wave of soccer enthusiasts for the FIFA World Cup, scheduled for a month-long run in numerous urban venues throughout South Africa beginning June 11th.

RVF is transmitted to humans primarily by contact with the blood of infected animals, especially cattle, sheep, donkeys and goats.  Because mosquitoes are the primary means of transmission, RVF outbreaks usually occur during heavy, prolonged rains. Fortunately, June and July are among the driest months in South Africa, and most RVF cases in this recent outbreak have been confined to rural areas.  South African health officials are quick to point out that victims to date have been in close proximity to domestic animals, and that mosquito-to-human transmission has not been documented so far.  In addition, the cooler winter weather is expected to encourage heavier clothing and reduce mosquito bites.

What’s the worst case? Kenya and Somalia experienced outbreaks in the summer of 2007, with dozens of reported deaths.  The worst outbreak on record was in Egypt (1977-78) when millions were infected and thousands died.  Fortunately, the vast majority of those who contract the illness recover within 2-7 days.  Less than 2% of cases progress to hemorrhagic fever which carries a 50% mortality rate.

Despite this grim history, the threat of RVF should not deter anyone from traveling to South Africa next month for the World Cup.  However, if a sojourn into rural areas of South Africa is on your itinerary, take precautions such as avoiding livestock and using insect repellent, protective clothing and mosquito netting.  Soccer fans need to rein in their passions long enough to focus on avoiding a rendezvous with the RVF virus, which is also in attendance.

Photo info: http://www.flickr.com/photos/25444043@N02/ / CC BY 2.0
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Tolerance and Health: Breakthrough in South Africa?

Monday, May 17th, 2010 by

In previous posts we’ve tracked the links between tolerance, happiness and health and asked whether a wide gender gap may be a barometer of a society’s reluctance to commit to tending to basic human needs. Now recent reports strike a hopeful chord, indicating that tolerance is a precondition for combating the HIV/AIDS epidemic.

First, based on twenty years of data from the U.S., researchers at Emory University are reporting findings of an inverse relationship between tolerance and HIV/AIDS infection rates. In other words, the more open and tolerant a community, the more successful education efforts are. It’s no surprise that HIV/AIDS thrives in the shadows of ignorance, prejudice and fear. If it is true in a society as open as America’s, it’s no doubt doubly true in many other countries of the world. Country-level data on the prevalence of HIV/AIDS and other sexually transmitted diseases is spotty, but experienced travelers know that the highest infection rates are reported in sub-Saharan Africa and Southeast Asia.

So it seemed like a breakthrough last week when the President of South Africa, Jacob Zuma, broke with years of silence and denial to openly discuss his personal history with multiple female partners and his commitment to testing and promoting circumcision to help slow the spread of HIV/AIDS. His openness is a dramatic effort to erase a stigma and set very high standard for tolerance for his people to follow. In office for a year, Mr. Zuma is putting his government’s resources behind what the United Nations has called the largest and fastest increase in AIDS testing and treatment ever.

Perhaps South Africa’s entrance onto the world stage—hosting soccer’s World Cup beginning next month—has helped to enlighten its leadership. If we want tolerance to lay the foundation for a healthier planet, let’s put all world leaders on notice: the whole world is watching.

Photo info: http://www.flickr.com/photos/worldbank/ / CC BY-NC-ND 2.0
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Well Prepared Travelers Manage Threats with Help From U.S. State Department

Tuesday, May 11th, 2010 by

Last month we discussed the risk of “virtual kidnapping”, the practice of extorting funds from the families of those travelling abroad without an actual kidnapping taking place.  We’d like to highlight an important preventive measure. The United States Department of State strongly encourages all those who are travelling abroad, particularly if the itinerary includes underdeveloped or politically unstable countries, to register on their website.  A detailed itinerary in the hands of the State Department will enable local authorities to confirm the location of the alleged “victim” and eliminate the need to pay ransom to the “kidnapper.”

Registration is free and allows the State Department to reach you in the event of an emergency, such as a natural disaster, terrorism, civil unrest, or trouble at home.  Each year U.S. embassies and consulates assist over 200,000 Americans who are victims of accidents, violent crime, sudden illness, or who must be contacted because of a family emergency. By registering on the website, you make it much easier for the U.S. government to locate you. 

The registration process is simple. Create an account by clicking on the ”Create Account” link and following the instructions.  You will be prompted to create a username and password that allows you to enter and access your travel data during your trip and for subsequent trips abroad. The personal information requested includes your name, address, phone number and the names and numbers of emergency contacts. Each time you wish to add a destination or foreign address, you may click the “Add Overseas Residence” button that alerts the appropriate US embassy or consulate of your pending arrival.  The State Department will send you an e mail confirming your registration and updates.

U.S. consular offices supply updates on security issues and assist Americans overseas who encounter financial, medical or legal difficulties.   Although the consular office cannot provide medical care or legal advice, they can recommend local English speaking medical professionals and lawyers.  They are also able to offer emergency loans, help with absentee voting, the filing of U.S. income tax forms, and coordinating federal benefits.  Other services include issuing American birth certificates for the children of U.S. citizens born abroad, notarizing documents, and replacing lost or stolen passports. 

When traveling to destinations where kidnapping or political instability are rife, registration with the U.S. State Department should be part of every U.S. citizens’ plan.

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Polio Breaks Out in Tajikistan

Wednesday, May 5th, 2010 by

The World Health Organization (WHO) is reporting that 171 cases of acute flaccid paralysis, the most common sign of acute polio, have been reported in Tajikistan since January.  It appears that all the current cases are coming from the south-west part of the country which borders Afghanistan and Uzbekistan.  Of the 171 cases, 32 have been confirmed wild poliovirus 1 cases; results are pending for the rest.

The government of Tajikistan is planning a three step program to immunize all the children in the area.  If you are traveling to Tajikistan or any other polio-affected area, be sure to follow the WHO’s recommendation for vaccination.  There are two types of vaccine available, inactivated (IPV) and oral (OPV), and travelers headed into or out of an infected-country should receive a full course of the vaccine as described in Chapter six, page 107 of the WHO’s International Travel and Health Guide.

(Thank you for the photo, Olga!)

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