Top Travel Health Tips for Peru

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Courtesy of Rocco Lucia on Flickr

 
Peru offers many different sites to visit and activities to partake in. However, the very first thing you must do when traveling to the South American nation is visit the ancient Incan ruins of Machu Picchu. If touring one of the Seven Wonders of the World is on your bucket list, then you can cross that off after visiting this ancient city built in the high mountains of the Andes. If you are going to make the trek to Machu Picchu, it is recommended to get there early and bring plenty of bottled water with you (or bring a water purification kit to ensure safe water).  Being physically fit is a must for this portion of a Peruvian trip.

If you are looking to be philanthropic for a day or even the entire trip, there are plenty of opportunities.  Peru is a major destination for those looking to participate in mission and volunteer trips.  Project CURE provides much needed medical supplies to communities that need them in the developing world, and the organization offers plenty of opportunities to volunteer in Peru.  To date, the organization has sent 14 cargo containers to Peru, and it is a great resource for a philanthropic journey.

For the adventurous type, consider a trip to the Peruvian Amazon Basin. While there, you can stay at an eco-lodge located right on the Apurimac River, visit the Sandoval Lake, or visit the Tambopata National Reserve. The Tambopata National Reserve has some of the richest wildlife conservation areas in the world!  If traveling to this area, however, the Centers for Disease Control typically recommends that travelers receive a yellow fever vaccination to protect against the mosquito borne disease.

Sillustani near PunoImage courtesy of guido da rozze on Flickr.

Depending on where in the country your journey may take you, antimalarial medication may also be recommended.  This is especially true if you are traveling to Iquitos or Puerto Maldonado on the border with Brazil.  Both jungle locations provide amazing opportunities to see wildlife and native culture, but yellow fever vaccination and antimalarial medications are both highly recommended for travel here.

If humidity is not your cup of tea, you might consider going to the southeastern department of Puno to experience the native culture and wonderful sights in the region.  One must-visit location is Sillustani where the ancient Aymara people constructed chullpas (large towers) to house the most elite in their culture.  Other exploring options include visiting the Uros Islands, which are man-made floating villages that have existed on Lake Titicaca for hundreds of years.

Altitude sickness is a rare problem when traveling to places like Europe or Africa but in Peru and other South American nations it can be a serious concern, consider these elevations for popular destinations:Cusco, Peru- 3,399 m (11,152 ft)
La Paz, Bolivia- 3,650 m (11,975 ft)
Puno, Peru- 3,830 m (12,556 ft)
Denver, CO- 1,731 m (5,690 ft)
Prague, Czech Rep.- 399 m (1,309 ft)
Rome, Italy- 24 m (79 ft)

While this more arid region poses less threat for infectious disease, its extremely high altitude, with most locations sitting at over 12,000 ft. elevation, can be problematic.  Because of this high elevation, the CDC recommends that travelers take proper precautions including:  ascending gradually, if possible; taking medications that will help with acclimation; avoiding alcohol for the first 48 hours, participating in only mild exercise for the first 48 hours and, if possible, staying at a high-altitude location (>9,000 ft) for at least two nights within 30 days of leaving on your trip.

Of course, trying Peruvian food is a must!  Each region has its own particular delicacy ranging from cuy (guinea pig) in the high sierra, to rocoto relleno (stuffed pepper) in the southern region, and ceviche (fish soaked in lime juices and chilis) throughout the coastal parts of the country.  When partaking of these foods, it is important to take proper precautions including to be sure that the restaurant you are eating at is reputable, and avoid eating street food.  Hepatitis A and typhoid vaccinations are recommended for travel to Peru, especially if you plan on making food a key part of your trip.

Before traveling to Peru, schedule a visit with a Passport Health Travel Specialist to discuss any health concerns you may have or vaccinations you need to have updated.If you plan on doing a lot of exploring, especially of the Inca Trail or ancient ruins, creating a first aid kit before you leave can be invaluable.  The kit should include: bandages, ibuprofen, aspirin, antidiarrheal drugs, antibiotics, adhesive tape, sunscreen, insect repellent, and re-hydration materials.

While in the country, do not drink the tap water, and avoid ice that may have been made from unfiltered water.  Bottled water, soda and other drinks made from pre-treated water are your best options.

For more information on the vaccines and other medications you might need for your Peruvian excursion, contact a Passport Health Travel Specialist.

Are you planning a trip to Peru?  What activities are you most excited about, and what are you doing to prepare?  Let us know via Facebook, Twitter, or by commenting below; we love hearing from you!

Tuberculosis in China Remains an Ongoing Public Health Concern

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China has a tuberculosis (TB) problem, one that generates a million new cases each year. While prevalence rates have decreased from previous years, and WHO-recommended programs have treated many cases, TB in China remains an active public health threat.

Prevalence rates of TB have steadily declined each year since the 1990s. The overall prevalence per 100,000 population decreased from 215 in 1990 to 108 in 2010. Government efforts and partnerships with global health organizations have allowed China to reduce its TB prevalence by half in 20 years, a significant accomplishment. However, many people still suffer from TB infections, including drug-resistant forms that do not respond to regular treatment.

China has the largest number of patients with multiple drug resistant tuberculosis in the world. Only a portion of these patients have been diagnosed, which enables the spread of this serious form to others. Many people in China infected by TB come from poor socioeconomic groups in rural areas. The healthcare system is far from ideal in these low-income communities, and the cost of treatment may be too high for many families.
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Need a Travel Visa? Follow These 3 Steps!

Visa and Passport Services

 
Are you getting ready to embark on your next journey abroad? Remember, booking a plane ticket and taking care of any medical needs are not the only things you have to check off of your to-do list before traveling overseas. You may also need a visa to even be able to get in to your destination.

Many countries require you to obtain a visa for travel by dropping off and picking up your actual passport and supporting application documents at the consulate that has jurisdiction over your state of residence. Unfortunately, this consulate is likely to be out-of-state and open only during select hours.  That would mean you would have to take time off from work and spend extra money just to make a trip to the consulate!  You would also likely have to wait a few days for your application to be processed, or you would have to make another trip to pick up the documents when your visa was processed successfully.

However, there is good news. Today, travelers have an option for Passport Health to handle the visa process (that is all too often fraught with bureaucratic red tape!) on their behalf.  Passport Health will handle the entire process of application completion and submission for you, so there is no need to become overwhelmed by paperwork or make a trip out to an out of state consulate.  The visa process often seems daunting, but three simple steps can help you find out what you need to know so that have everything ready before you go.

These three easy steps to a stress-free visa are:

1. First, pay a visit to the U.S.State Department’s website to find out the general requirements for obtaining a visa for your destination country.  You might be pleased to learn that some countries do not require visas for short stay. Visiting the website also provides other useful information like the maximum amount of currency you are allowed to bring into each country, and it provides some generic guidance on the vaccinations you need to have received for your trip.

2. Next, do a little research on your destination and create a timeline marking important dates and the expected amount of the time it will take for your visa to be processed. Some countries allow you to start your visa application process several months in advance. You also need to be aware of how long it will take to get your passport back, as visa processing times vary by country.

3. Ultimately, however, it is best to turn to a company that is expert in processing travel documents, like Passport Health, for help. Slogging through government web pages trying to find the right documents can take a lot of time, and accidentally making a mistake on your application can take even more.  Some countries are so particular that if the address on your driver’s license and the address you enter into your application differ by even a punctuation mark, the application will be rejected!  Leave the minutiae to the experts: we can handle the visa process for you and obtain a visa on your behalf. After just filling out a simple form, Passport Health’s travel document experts can help you get a visa for any global destination, and we are here to answer any questions you may have throughout the application process.

Don’t wait until the last minute to get your visa. Following these easy steps early on can help obtain your travel visa with ease. Avoid the nightmares of visa delays or expensive last-minute expedited processing, and you’ll be one giant step closer to the vacation you’ve been waiting for.

For more information on Passport Health’s visa and passport processing program please visit our Visa and Passport Processing portal.

Niger is Hit with a Meningitis Outbreak

Meningitis in Niger

 
A meningitis outbreak that started in the African country of Niger has just been declared an epidemic by health officials.  From Jan. 1 to Mar. 29, 2015, more than 345 cases of meningitis were reported, including at least 45 fatalities from the potentially deadly disease.

A report released by the Ministry of Health shows that the capital city of Niamey has been the hardest hit with 119 cases, comprising more than a quarter of reported deaths.  However, all regions except the most southeastern areas of the country have been affected by the outbreak.

Nearly half of Niger falls in the ‘Meningitis Belt,’ a region designated by the Centers for Disease Control and other organizations as being an area at high risk for outbreaks of meningitis.  At least one outbreak every year has caused the deaths of multiple victims in this region.

Officials in Niger’s health ministry say there is no reason to be alarmed, and precautionary measures are underway to ensure that further spread of the disease does not occur including the distribution of meningitis vaccine throughout the country.  The CDC and World Health Organization are monitoring the situation, but no extra precautions have been put in place for travel to Niger.
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The Flu Report: 4/8/2015

Flu Near You Map - April 8th
Image courtesy of flunearyou.org. Click here to view the interactive map.

 

In the last weekly Flu Report for the 2014-2015 season, we look at continued influenza decline throughout the United States and finally see a drop in one important flu statistic.

Overview:

The 2014-2015 flu season is almost over! Only two states, Oklahoma and Minnesota, are reporting a high level of influenza-like illness, and the majority of the United States is now listed as having minimal activity, according to the Centers for Disease Control.

Another key statistic, pneumonia and influenza mortality, is finally below the epidemic threshold, and all indicators point to it staying here. Likewise, the number of influenza-associated pediatric deaths has fallen and is now stable at a relatively low number. As of now, the 2014-2015 season was the second worst season on record over the last five years for both types of mortality. A new formulation of the flu vaccine will be used for the 2015-2016 season in both the northern and southern hemispheres, and hopefully mortality statistics will be much lower as a result.

Indeed, all indications point to an end of this flu season within the coming weeks, FluNearYou.org showed less than two percent of its users being affected by influenza again this week, and an overall decline in cases was again reported. In all likelihood, we will see the 2014-2015 flu season declared officially over within the coming weeks.
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Uganda Announces Typhoid Fever Outbreak

Market in Uganda

 
The Ugandan government has reported over 4,000 typhoid cases to the World Health Organization since the beginning of 2015.  The outbreak began in Kampala City and has since spread to neighboring districts.

Typhoid fever is a bacterial disease transmitted through contaminated food or water and can cause mild to severe symptoms, sometimes even death. Luckily, there have only been a few confirmed deaths from the Ugandan outbreak.

According to the WHO, the main cause of contamination has been water sources in the downtown district of Kampala.  As of now, the majority of those infected have been men between the ages of 20 and 39, mostly in the working population.  The WHO made special note that some of these individuals may be working in the food services sector, leading to a potentially greater spread throughout the city and the region at large.
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How to make your trip to Bangkok a successful one

Bangkok Thailand Skyline

 

According to Skift, Bangkok is the second most popular global destination behind London. That means more travelers go to Bangkok than Paris, New York, Rome and Tokyo! Over 16 million people travel to Thailand each year, but this can be a difficult trip if you don’t plan in advance. Here are our 10 tips to make your Bangkok trip absolute success!

Don’t fear the food – Thailand is a hotbed for food tourism so don’t be afraid to get out there and try something new. Much Thai cuisine is available from food carts which can be fantastic but also poses a potential health hazard. The Centers for Disease control do not recommend eating street food, but, if you are going to be sure to take extra care; only eat from vendors that are busy with locals and serve food that you can tell is well cooked.

But, watch where you eat! – Not all locations in Thailand are food-friendly zones. The transportation system is a no-food and drink zone. This policy makes for a nice and clean trip but can impede snacking on the go. Be sure to finish whatever you are eating before using public transportation.

Water World – Water is something to be very concerned about in Thailand. You should not drink tap water and should avoid ice cubes as well. Your best bet is to only drink liquids that come from a bottle, like water and soda. Getting sick on your trip will ruin your fun fast, and going to the hospital could turn your trip into a nightmare.

Move like a local – The best ways to get around are the subway and skytrain. Clean, fast, and inexpensive, these modes of transport are by far the safest you’ll run across. That being said, taking a tuk-tuk is a once in a lifetime experience, but, be very careful, as scamming is common.

Beware the scams – You name it, and there is a scam for it. There are a lot of smooth talkers, fake police, fake curators; basically a scam for everything can be found in Thailand. The best way to avoid becoming a victim is to do some pre-trip research so you know what is normal and isn’t. For example, the Grand Palace is almost always open. Don’t let some guy in a suit a few blocks away fool you.

Take organized tours – Organized tours can help avoid these types of problems. If you have a reputable guide and are going in a large group, it is going to be harder for you to get scammed. While pickpocketing and other issues can still be problems, being part of a group is one of the safest ways to stay safe and keep you money in your own hands.

Dress to impress – Though Thailand is hot and humid, it still has a fairly conservative culture in terms of dress, especially if you are going to the Grand Palace and Vinamek. Shorts are not allowed. Taking a sarong can help if you feel the need to wear shorts. You will need shoes and shirts with at least short sleeves. Long sleeve shirts must be rolled down. In the rest of the country modest shorts and sandals are generally okay.

Map it out – Planning out your trip with maps and a little bit of Google Earth research can be extremely helpful. Not only will you, hopefully, avoid scams, but this research will give you a good idea of how to navigate through Bangkok’s often confusing streets. Another good tip is to have your hotel write down its name for you, so you can show it to a taxi driver if needed. It is almost guaranteed that you will not be able to pronounce the name, but your taxi driver will know exactly where to go if you show him/her.

Don’t forget your ID – The Thai people can get pretty finicky about IDs. You may be 40, but that doesn’t mean anything to them. Take a photocopy of your passport with you, not the real thing. If you need the copy to prove your age, you have it, but this practice will help you keep your actual passport from being taken.

Don’t be afraid to haggle – This may well be the most fun tip on this list. We are all used to prices being fixed, but for taxies or tuk-tuks you can barter on the price. Just be sure to not pay until you are safely at your destination, and be sure to be kind. Becoming angry isn’t going to help your case, even if someone is trying to fool you. In a game of angry tourist versus Thai citizen, angry tourist always loses.

For any health questions regarding trips to Thailand, or anywhere in the world, feel free to contact Passport Health travel health specialists, and, remember, always travel safe!

The Flu Report: 4/1/15

Flu Report Map- April 1
Image courtesy of flunearyou.org. Click here to view the interactive map.

 
Influenza A infections near a season low and influenza B finally starts to decline in this week’s flu report.

Overview:

Flu season is nearing its end as we are finally seeing a decline in all types of flu cases, according to data released by the Centers for Disease Control. The week of March 21 had fewer than 1,400 confirmed influenza cases and few influenza B cases than the previous week. Current data appears to indicate that both influenza A and B infection rates have peaked and will be continue to decline for the foreseeable future.

The majority of states are reporting minimal to low influenza-like illness activity. Only five states (Georgia, Kansas, Minnesota and Texas) are experiencing high flu activity. This corresponds with FluNearYou.org’s real-time metrics that show less than two-percent of users reporting influenza-like infection. According to FluNearYou’s data, the majority of these cases are in the Midwest and a few in the Northeast. While this is not yet reflected in CDC data, remember that the CDC’s is delayed by a week while FluNearYou’s information is constantly updated.

Despite this downturn, there are still an above average number of deaths of pneumonia and influenza related deaths, still above the epidemic threshold. A total of 116 influenza-associated pediatric deaths have also occurred, the highest since the 2012-2013 season. While it is unlike that we will hit the 171 deaths from that season, this is still a scary metric that emphasizes the importance of childhood flu shots and of taking other important preventative measures.

By the Numbers:

In the United States, the CDC has reported:

  • Flu Cases (Laboratory Confirmed) – 1,358 (10.6% of specimens tested)
    • Influenza A- 334 (24.6%)
    • Influenza B- 1,024 (75.4%)
  • Flu-related Deaths (Percentage) – 7.4% (0.2% above epidemic threshold)

NOTE: Flu cases, as referenced above, are confirmed cases in people who have gone to see medical professionals. Percentage estimates, referenced in the “Overview” section, include these documented cases from medical professionals but also a variety of other self-reported metrics.

Around the World:

Most of the northern hemisphere is rated as having minimal to low influenza infection rates, according to Google Flu Trends. Highlights include Spain, France and Norway which were rated as severe just a few weeks ago and Sweden, Russia and Austria which are the only countries rated at high. In the southern hemisphere; Australia, Chile and Paraguay are all nearing moderate infection levels while most of the rest of the region remains shows minimal infection rates.

Staying Healthy:

As we near the end of flu season, don’t forget about the importance of getting your flu shot for the 2015-2016 season. Production is already underway and vaccinations should become available around September. If you would like to schedule an appointment for yourself, your family or your business then contact a Passport Health Flu Specialist today and we will make sure that everything is set up and ready to go when the time comes. It’s never too early to prepare to fight the flu, start planning for your future today!

For additional information on influenza and what can be done to prevent it, visit FluFree.com which contains a variety of flu related resources. In order to schedule your flu shot, even for the upcoming 2015-2016 flu season, please contact a Passport Health flu professional at 1-888-499-PASS (7277) and we’ll help you get everything arranged.

The Flu Report is a weekly blog post designed to give updates on the spread of influenza throughout the year. It is posted every Wednesday and focuses on regional outbreaks, global spread and ways to avoid infection.

Typhoid Mary: 100 Years Later

Typhoid Mary Page
Courtesy of Wikimedia

 
The case of Typhoid Mary sparked a public health debate in early 1900s New York, and her legacy continues to be discussed to this day. March marks the 100th anniversary of Mary Mallon, an Irish cook who inadvertently infected multiple people with typhoid fever and was later placed in isolated quarantine for over 20 years of her life.

Typhoid fever is caused by a strain of Salmonella bacteria, resulting in high fever, abdominal pain and loss of appetite. Mary was a carrier of typhoid, meaning she appeared healthy but continued to carry the bacteria in her body. Her story is unique because it brought to light the conflicting priorities of public health policies and individual freedom. During that time, typhoid had no cure and was sometimes fatal. Mary is thought to have caused over seven outbreaks, 50 infections and three fatalities over a period of 15 years.  What can we learn from her case?  read on to find out!

Mary was an Irish immigrant to the U.S., later establishing herself as a cook for wealthy families in the New York City area. She was skilled at her job, but she was unfortunately also skilled at something else: passing on typhoid to the unsuspecting families she worked for. Typhoid is often spread by eating or drinking foods that have been handled by someone infected with the feces-shed bacteria. In Mary’s case, it was her poor hygiene that allowed her to spread the disease. However, Mary was unaware of her health status, as she had never contracted typhoid before. She would accept new employment with a family, and, when the majority of the household fell ill, she moved on to another family.
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Doing Good Globally: Médecins Sans Frontières, The Doctors Who Did Away With Borders

MSF Doctor's Day
Photo Courtesy of MSF

Today is National Doctor’s Day, and we would like to recognize those who have made a difference by bringing better health to communities all over the world. One particular group, Médecins Sans Frontières, has impacted the lives of millions throughout the globe and forever changed the face of international public health and humanitarian aid. A key tenet of the organization is that borders are political boundaries, and we must prioritize people’s health and rights above these boundaries.

MSF TimelineImage courtesy of MSF. Click here to view an interactive timeline of MSF’s work and history.

In 1968, a series of protests broke out all over the world in response to social conflicts, and many of these protests were rebellions against military and bureaucratic elites. The Parisian protests in May of that year were some of the most significant in history. Ten million workers and students took to the streets of Paris, France, in an effort to overthrow the government of General Charles de Gaulle. Amid these upheavals, a group of young doctors came together and decided to do something about the worldwide issues of war and famine. They sought out to recreate the concept of emergency aid.

They decided to travel around the world to find and help victims of war and disease. Not only would they reinvent the idea of emergency aid, but they also succeeded in creating a new brand of humanitarianism. This group would later become known as Médecins Sans Frontières, or Doctors Without Borders.
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