Posts Tagged ‘Asia’

Travel Bulletin Asia: Parts of Asia and the Indian Ocean Region Report Cases of Chikungunya Fever

Monday, October 18th, 2010 by

According to a recent report from the Centers for Disease Control (CDC), chikungunya fever continues to be active in Asia and the Indian Ocean region:

In 2009, the Ministry of Health in Malaysia reported over 4,430 cases of chikungunya fever. No deaths were reported. The most affected areas were the northern provinces of Sarawak Kedah, followed by Kelantan, Selangor, and Perak. Chikungunya fever activity has decreased in 2010. As of August 28, there are an additional 751 reported cases, which have occurred predominately in Sarawak and Saba provinces.

During 2009, Thailand reported 49,069 cases of chikungunya fever. Limited chikungunya activity has continued in 2010. Most cases have been reported in the south of the country. As of August 31, 2010, India has reported 16,870 suspected cases from 14 states. The majority of cases were from Karnataka, Maharashtra, Tamil Nadu, Kerala, and Gujarat states. In 2009, over 43,000 cases were also reported in Indonesia.

Limited chikungunya activity continues in the French island of Reunion. As of September 1, 2010, 110 confirmed and 38 probable cases of chikungunya were reported. Most of the cases have been identified in the western commune of Saint-Paul. Health authorities have increased surveillance for chikungunya on the island.

Advice for Travelers

No medications or vaccines are available to prevent a person from getting sick with chikungunya fever. CDC recommends that people traveling to areas where chikungunya fever has been reported take the following steps to protect themselves from mosquito bites.

- When outdoors or in a building that is not well screened, use insect repellent on uncovered skin. If sunscreen is needed, apply before insect repellent.

- Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535. Always follow the instructions on the label when you use the repellent.

- In general, repellents protect longer against mosquito bites when they have a higher concentration (%) of any of these active ingredients. However, concentrations above 50% do not offer a distinct increase in protection time. Products with less than 10% of an active ingredient may offer only limited protection, often only 1–2 hours.

- The American Academy of Pediatrics approves the use of repellents with up to 30% DEET on children over 2 months of age.

- Protect babies less than 2 months old by using a carrier draped with mosquito netting with an elastic edge for a tight fit.

- Wear loose, long-sleeved shirts and long pants when outdoors.

- For greater protection, clothing may also be sprayed with repellent containing permethrin or another EPA-registered repellent. (Remember: don’t use permethrin on skin.)

If you get sick with a fever and think you may have chikungunya fever, you should seek medical care. Although there is no specific treatment for the disease, a doctor may be able to help treat your symptoms. Avoid getting any other mosquito bites, because if you are sick and a mosquito bites you, it can spread the disease to other people.

 Copyright © 2010, Centers for Disease Control and Prevention

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Rabies Alert: CDC Highlights Threat to Travelers

Friday, October 15th, 2010 by

Though it may be far from many travelers’ minds, rabies poses a lethal threat in most parts of the world.  Today’s travel bulletin addressed the 100th rabies related death in Indonesia.  Earlier this month the Centers for Disease Control (CDC) reported on a fatal case of rabies acquired by a Virginia man in India in 2009. Rabies is rare in the U.S.– since 2000, only 31 cases have been reported but seven were acquired abroad. Cases were contracted by Americans traveling in India, the Philippines, Mexico, Ghana, El Salvador and Haiti. Rabies is transmitted by animal bites—most commonly by dogs but also wild animals, including bats.

The biggest threat is posed by dogs in Asia and Africa, but very few countries are free of rabies (see chart below). And many rabies cases are likely treated abroad and not reported. According to the CDC, the actual rate of rabies exposure in tourists has not been calculated with accuracy; however, studies have found a range of roughly 16 to 200 infections per 100,000 travelers.

Rabies immunization is widely available and is a good idea if you are traveling to the developing world. Unless treated early, rabies is usually fatal. Travelers are advised to avoid contact with unattended dogs, and spelunkers should seek treatment if they come into physical contact with a cave-dwelling bat that produces a scratch or cut.

Countries reporting no indigenous cases of rabies during 20051

Source: Centers for Disease Control   

Region Countries
Africa  Cape Verde, Libya, Mauritius, Réunion, São Tome and Principe, and Seychelles
Americas North: Bermuda, St. Pierre and Miquelon Caribbean: Antigua and Barbuda, Aruba, Bahamas, Barbados, Cayman Islands, Dominica, Guadeloupe, Jamaica, Martinique, Montserrat, Netherlands Antilles, Saint Kitts (Saint Christopher) and Nevis, Saint Lucia, Saint Martin, Saint Vincent and Grenadines, Turks and Caicos, and Virgin Islands (UK and US)South: Uruguay
Asia Hong Kong, Japan, Kuwait, Lebanon, Malaysia (Sabah), Qatar, Singapore, United Arab Emirates
Europe Austria, Belgium, Cyprus, Czech Republic2, Denmark2, Finland, France2, Gibraltar, Greece, Iceland, Ireland, Isle of Man, Italy, Luxemburg, Netherlands2, Norway, Portugal, Spain2 (except Ceuta/ Melilla), Sweden, Switzerland, and United Kingdom2
Oceania3 Australia2, Northern Mariana Islands, Cook Islands, Fiji, French Polynesia, Guam, Hawaii, Kiribati, Micronesia, New Caledonia, New Zealand, Palau, Papua New Guinea, Samoa, and Vanuatu

1Bat rabies may exist in some areas that are reportedly free of rabies in other animals.

2Bat lyssa viruses are known to exist in these areas that are reportedly free of rabies in other animals.

3Most of Pacific Oceania is reportedly rabies-free.

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Eyes Wide Shut? Know Your Destination’s Human Rights Record

Tuesday, June 15th, 2010 by

We’ve linked tolerance with health in the past. Now the unexpected outburst of ethnic violence in the Kyrgyz Republic is a vivid reminder of how tenuous the grip we humans have on tolerance, dignity, survival and health. With the Kyrgyz atrocities as a backdrop, the U.S. State Department yesterday released its annual report on human trafficking around the world, highlighting especially those countries whose efforts fall far short of complying with the U.S. Trafficking Victims Protection Act of 2000. Of the 177 countries surveyed (including the U.S.), fifty six, or 32%, are on a watch list because recent progress toward compliance is deemed at risk. Another thirteen, or 7%, are making no compliance efforts whatsoever. The remaining 60% are either in compliance or moving steadily in that direction. See charts below for a listing of countries falling into these categories and see the State Department’s interactive map and the full report.

As our readers circle the globe, we hope they pause to understand their host countries’ human rights record. There are unpleasant realities in many destinations, and some surprises for me in the Caribbean, Central America and Asia. Even developed countries such as Russia, Singapore and Thailand are called out. We aren’t suggesting you should avoid travel to these countries. We are recommending that as your horizons expand they encompass a commitment to promoting tolerance and dignity. We will all be healthier for it.

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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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For Swine Flu Root Causes and Risks, Dig Into Environment

Friday, May 1st, 2009 by

watermexico2Amid all the news and speculation, it’s natural to wonder how Influenza A H1N1 got off to such a galloping start in Mexico. Reports are coming in about cultural resistance to seeking medical care,  which no doubt is a contributing factor.  But I was struck by a report filed by Jason Beaubien of NPR  potentially linking the flu outbreak to the scarcity of clean water in many parts of Mexico. If maintaining basic hygiene is compromised by chronic water shortages, it seems the environment becomes ripe for infectious diseases to blossom.

Taking a global view of this issue makes it very clear why pandemics are expected to emanate from Africa and Asia –countries like China and India are among the most “water-stresssed” in the world. And Mexico appears to be on a par with them. Until a workable plan for redistributing water to needy populations is adopted, water-stressed destinations will be increasingly problematic for economic development and tourism.  The Healthy Travel Blog will keep digging into underlying environmental issues that world travelers need to understand to keep their travels safe and healthy.

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Posted in Environment, H1N1 (Swine) Flu | 2 Comments »