Prevent Illness on Your Cruise Vacation with Proper Hand-washing

December 5, 2013 By Leave a Comment

proper handwashing for health

Staying Healthy on your Cruise Vacation

Many people enjoy going on cruises during the winter in order to get away from cold, dreary weather. A cruise can be a great way to relax and visit new destinations without having to arrange for hotels, flights and other expenses. However, cruises can also be potential health hazards. Because travelers are staying in a contained space with many other people, infections and viruses can quickly spread through the ship and turn a lovely vacation into a possible health emergency. Excursions to cities and towns can also bring illnesses aboard. Highly infectious “bugs” such as norovirus or gastroenteritis can cause stomach upsets like diarrhea and vomiting.

Fortunately, there are some simple ways to safeguard your health during your cruise. If you have any existing medical issues, make sure that you bring enough medication to last throughout your trip. For example, diabetics will want to make sure that they bring enough insulin or metformin to cover their usual intake as well as any changes in blood sugar due to increased food intake. Everyone who goes on a cruise should also avoid undercooked food and especially raw shellfish. Try to keep your hands away from your face, and be wary of touching railings and fixtures in public places. If you see someone become ill near you, you should leave the area immediately and report it to the nearest staff member. If you do get sick during the cruise, there are medical facilities available that can help you, but you may end up confined to your cabin for the duration of the trip.

However, one of the most important steps you can take to keep yourself healthy on a cruise is developing a good hand-washing regimen. While you are on the cruise, wash your hands before and after eating, smoking, touching your face, and using the toilet. You should also wash your hands after touching garbage or waste such as diapers.

Proper Hand-Washing

This advice is particularly timely given that it is National Handwashing Awareness Week, which lasts from the December 1 through the 7. Indeed, whether you are on a cruise or at home, proper hand-washing is a crucial means to prevent disease. You can properly wash your hands by wetting them under clean running water and applying soap. Rub your hands together to form a lather, making sure that you scrub between the fingers, under the nails, on the backs of your hands and past the wrists. You should scrub for at least 20 seconds, or however long it takes you to sing “Happy Birthday” twice. Rinse your hands and dry them with a paper towel, or let them air dry.

Cruises are a wonderful way to relax and reconnect with friends and family. By washing your hands properly throughout your journey, you can make sure that you enjoy your trip as much as possible.

Sources
http://www.cdc.gov/handwashing/
http://www.cdc.gov/nceh/vsp/pub/Handwashing/HandwashingTips.htm
http://www.henrythehand.com/news-events/national-handwashing-awareness-week/
http://www.cdc.gov/Features/CruiseShipTravel/

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Hepatitis C Titer Testing: Save Money and Your Life

December 2, 2013 By Leave a Comment
Key Takeaways:
  • Baby boomers who might have experimented with drug use in their younger days and people who received blood transfusions before 1992 are thought to be at a particularly high risk of hepatitis C infection.

  • Screening for hepatitis C is important for the Baby Boomer generation and for younger Americans who fall into a risk category.

  • Passport Health clinics offer this test to anyone who wants to know their results and have the peace of mind that comes with that knowledge.

What is Hepatitis C?

Hepatitis C is a viral infection that is transmitted from person to person through contact with blood. Injection, drug use, sharing of tattoo needles, and, more rarely, blood transfusion or sexual activity can result in the transmission of hepatitis C. Once infected, a small percentage of people will develop an acute illness with symptoms that include fever, body aches, jaundice and elevated liver enzymes. More often, the infection becomes chronic. Over time, the virus causes damage to the liver. Hepatitis C can result in cirrhosis of the liver and liver cancer. Co-infection with another form of viral hepatitis or use of alcohol or certain medications can worsen the effects of the disease, and it can become very serious. An estimated 16,000 Americans died of hepatitis C infection in 2010, according to the Centers for Disease Control (CDC).

Who Is Most at Risk?

With an estimated 3.2 million infected Americans, hepatitis C is the most common blood-borne pathogen in the United States. Intravenous drug users are the most likely population to be infected with hepatitis C. Baby boomers who might have experimented with drug use in their younger days during the 1960s and 1970s are thought to be at a particularly high risk of having the disease. People who received blood transfusions before 1992 are also at an increased risk of hepatitis C infection. Therefore, if you fall into one of these groups, getting a Hepatitis C Titer test is highly advisable.

How can you get tested?

Many people do not know that they are infected with hepatitis C, which is why screening for the disease is of utmost importance for the Baby Boomer generation as well as younger Americans who fall into a risk category. People who are in need of a hepatitis C test can get one from a Passport Health clinic or from their primary care physician. Some local health departments also offer hepatitis C testing. The hepatitis C titer test, or HCV RNA test helps those who are infected understand how well their bodies are managing the infection. This test measures the viral load of hepatitis C in a person’s bloodstream. Passport Health clinics offer this test to anyone who wants to know their results and have the peace of mind that comes with that knowledge.

What are the other types of Hepatitis?

Hepatitis C is not the only type of viral hepatitis. Hepatitis B is also a blood-borne pathogen. It can be spread through sexual activity, intravenous drug use, during childbirth, and, in the past, via blood transfusion. It also affects the liver and is the leading cause of liver cancer worldwide. Hepatitis A is a food-borne disease spread by eating fecally contaminated food, and it causes an acute illness that can be severe. Less commonly, people can also be infected with hepatitis D or E. Hepatitis D infection requires an existing infection with hepatitis B, as the D virus is an incomplete virus that requires parts of hepatitis B to cause illness. People co-infected with hepatitis B and D may have a more severe course of the disease. Hepatitis E is another food-borne disease and is most common in people who have contact with pigs, such as farmers. Passport Health also offers titer testing for hepatitis A and B infection, as well as vaccinations against these diseases. Hepatitis A is a two-shot series while hepatitis B vaccination requires three shots for complete immunity.

Sources:
http://online.wsj.com/news/articles/SB10001424052702304200804579163523170170660
http://www.cdc.gov/hepatitis/PublicInfo.htm#whatIsHep
http://www.cdc.gov/hepatitis/HCV/LabTesting.htm

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How Has Typhoon Haiyan Increased the Risk of a Typhoid Outbreak in the Philippines?

November 28, 2013 By Leave a Comment
Key Takeaways:
  • Typhoid is transmitted by ingesting contaminated water or food that has come into contact with the bodily waste of an infected person.

  • In the wake of Typhoon Haiyan, the Philippines will have to face public health issues that could negatively affect the country for years to come.

  • Taking part in the effort to provide sanitation and relief is something to be admired, but aid workers and residents alike should make sure that every precaution possible is taken to protect their health – consult with a travel health specialist prior to departure.

The typhoon that struck the Philippines on November 7th and 8th, 2013, has claimed the lives of over 4,000 people and has left hundreds of thousands more without homes or access to safety, food or medical care. Tacloban, a city of 220,000 people, was completely destroyed by the typhoon. The area has become the subject of intense media focus due to the ongoing devastation. Many residents of the area have to make long journeys for clean water provided by aid workers, or they resort to drinking water in the area that is of dubious quality and safety. It is a grim scene that is playing out across the Philippines, and these contaminated water sources pose a threat to public health.

One of the biggest disease risks after the typhoon is that of a typhoid fever outbreak. Because of the lack of clean, safe drinking water, officials are concerned that residents of the Philippines will turn to poorly treated water sources that may have come in contact with human feces or with dead animals. The bacteria contained in this standing water can not only trigger typhoid fever, but it can attract bugs that spread other diseases. The combination of standing water, human waste, and dead bodies also increases the risk of residents and relief workers developing diseases such as cholera, dengue fever, malaria, bacterial dysentery and hepatitis.

What Is Typhoid?

Typhoid fever, or “typhoid” for short, is a bacterial disease caused by Salmonella Typhi. It is transmitted by ingesting contaminated water or food that has come into contact with the bodily waste of an infected person. While cases still occur in the United States, most instances of typhoid fever occur abroad. Symptoms include a prolonged high fever, with some sufferers reaching temperatures of 104° Fahrenheit, or 40° Celsius, as well as headache, stomach pains, loss of appetite and rashes. Left untreated, typhoid fever can quickly lead to intestinal hemorrhaging and perforation, which can be fatal. Encephalitis and abscesses are also common among typhoid sufferers. Antibiotics such as ampicillin are used to treat typhoid fever. Before the development of these drugs, the diarrhea that typhoid causes was often fatal. Survivors tend to recover after three to four weeks though they will need to rest for a significant amount of time afterwards.

How Can I Protect Myself if I am Traveling to the Philippines?

You may have plans to travel to the Philippines as part of wider relief efforts or by yourself in an attempt to make contact with loved ones. Before you go, you should consult with a travel health specialist. He or she will be able to provide you with medical advice that is tailored for your individual situation as well as a thorough exam and discussion of your own medical history. If they feel that you are at risk for certain diseases, such as typhoid fever, they may strongly urge you to consider vaccination. There are two typhoid vaccines available in the United States, and both can provide protection within two weeks. There are also vaccines available for hepatitis as well as antibiotics one can take to treat cholera in areas with no access to medical resources.

While the vaccine against typhoid fever is effective, it does not provide complete protection against the disease. It is, therefore, important that travelers to the Philippines are very careful about the foods they eat, the water they drink and the populations with which they come into contact. A travel health specialist will advise you to drink only sealed bottled water and to carry a water purification kit with you in case of emergencies. You should use only bottled water to wash fruit and vegetables, and do not consume soft fruits or anything that cannot be peeled, washed or sterilized. It may also be recommended that you take antibiotics with you in case you do become ill.

As the Filipino population begins to rebuild after Typhoon Haiyan, they will have to face public health issues that could negatively affect the country for years to come. Diseases such as typhoid fever, cholera, malaria, and dysentery could become far more common and could cause significant damage to the nation’s recovery efforts. Taking part in the effort to provide sanitation and relief is something to be admired, but aid workers and residents alike should make sure that they take every precaution possible to protect their health.

Sources
http://www.npr.org/templates/story/story.php?storyId=245551287
http://www.nytimes.com/2013/11/15/world/asia/tacloban-philippines-typhoon-haiyan.html?_r=2&
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/

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Meningitis Scare at Princeton University – Learn More About How to Protect your Health

November 25, 2013 By Leave a Comment
Key Takeaways:
  • Bacterial meningitis is a serious threat to a person’s health, and the outbreak at Princeton demonstrates that it can happen anywhere and at any time.

  • Where meningitis and many other diseases are concerned, a vaccination can save your life.

  • Passport Health does not offer Bexsero, as it has not been approved in the U.S. However, Passport Health does offer the two meningitis vaccinations that are FDA-approved.

  • If you are traveling to an area where meningitis is prevalent, visit a travel medicine specialist and get vaccinated before you go.

A bacterial meningitis outbreak at Princeton University has caused significant alarm among students, parents and the administration. At the time of writing, seven people have already been hospitalized this year since the outbreak began when a student returning from spring break began to show symptoms. While meningitis is a risk for many university campuses, there are vaccinations available that can minimize the chances of the disease spreading. However, the outbreak at Princeton is a kind of bacterial meningitis that is very uncommon in the United States. On Nov. 18, the university’s trustees decided to approve the use and distribution of a meningitis vaccine that has been in use in both Europe and Australia, but is not approved by the Food and Drug Administration in the US (CDC). The vaccine, Bexsero, is designed to treat serogroup B meningitis, which is the kind currently placing Princeton’s residents at risk. The vaccination will be entirely optional, but officials hope that it will lessen the chances of a full-blown outbreak.

What is Meningitis, and How Can I Protect Myself?

Meningitis comes in many different forms, from bacterial to fungal. It is an inflammation of the membranes that surround the spinal cord and the brain. Bacterial meningitis is one of the types that is communicable. However, unlike viral meningitis, the bacterial form of the disease presents a true life-threatening emergency to those who catch it. The disease can be transmitted through coughing or exchanging saliva. Symptoms begin to appear three to seven days after exposure and include nausea, vomiting, sensitivity to light, a stiff neck and headache. Left untreated, bacterial meningitis can kill a person in hours, or leave them permanently incapacitated. Sufferers can lose limbs or extremities, go deaf or even suffer brain damage.

If you are living in or traveling to an area where a meningitis outbreak is occurring, then there are some steps that you can take to protect your health. Do not share plates, cups or other eating and drinking utensils with other people. Avoid kissing, sharing cigarettes and engaging in close contact with other people. A travel health specialist can advise you on how to take care of yourself and protect your health during travel. At a travel clinic, you can receive exams, health screenings, and any vaccinations or prophylactic health materials you may need. Where meningitis and many other diseases are concerned, a vaccination can save your life.

Can I Receive a Bexsero Injection Here in the United States?

Passport Health does not offer Bexsero, as it has not been approved here in the United States. While research on use of the vaccine in Europe has been promising, it is still not approved by the FDA. However, Passport Health does offer the two meningitis vaccinations that are FDA-approved and can administer them to you if you are in a high-risk group or are traveling to an area where there has been a meningitis outbreak. These vaccinations offer protection against bacterial and viral meningitis. Our travel health specialists can provide you with meningococcal polysaccharide vaccine (MPSV4) and Meningococcal conjugate vaccine (MCV4) depending on the type of meningitis that is prevalent in the area to which you are traveling. Visitors to the sub-Sarahan “meningococcal belt” as well as pilgrims visiting Saudi Arabia for hajj or umrah should be especially cautious.

Who Should Get a Meningitis Vaccination?

Current CDC guidelines recommend that young people receive the two FDA-approved vaccines, as they are at a higher risk of developing meningitis than most other demographics. All pre-teens should be be vaccinated at the age of 11 or 12, and a booster vaccination should be administered at the age of 16. A booster vaccination should always be administered between the ages of 16 and 18, before the child starts university or begins living in a group setting such as a dormitory or shared accommodation. People in high-risk groups, such as the elderly or those with autoimmune disorders, should consult with their travel health specialist before getting vaccinated.

Bacterial meningitis is a serious threat to a person’s health, and the outbreak at Princeton demonstrates that it can happen anywhere and at any time. Before you travel, make sure that you have taken as many steps as you possibly can in order to protect yourself against meningitis.

Sources
http://www.nytimes.com/2013/11/18/nyregion/princeton-university-considers-use-of-foreign-meningitis-vaccine.html?_r=2&
http://www.cdc.gov/meningitis/index.html
http://www.chicagotribune.com/health/sns-rt-us-meningitits-vaccine-princeton-20131118,0,5656875.story
http://www.cdc.gov/vaccines/vpd-vac/mening/who-vaccinate.htm

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Top 5 Travel Tips for Humanitarian Aid Workers

November 21, 2013 By Leave a Comment
5 Tips for Healthy and Productive Humanitarian Aid Travel:
  1. Visit a Travel Health Specialist before you go.
  2. Pack your travel kit with essential supplies to protect your own health abroad.
  3. Manage your stress levels.
  4. Minimize your risk of injury.
  5. When you return home, be aware of your own health condition.

As a humanitarian aid worker, you will be travelling to some of the most impoverished and dangerous areas of the world as you provide essential assistance to those in areas subjected to natural disaster or war. This aid can also come in the form of missionary work to people in third-world countries. In all of these situations, as a humanitarian aid worker, you will encounter a higher health risk than someone traveling through an area as a tourist. Therefore, proper pre-travel precautions are even more essential, and here are five tips to maintain your own health during the time you spend rendering assistance to those in need:

Preparing to Go

Once you learn that you are traveling overseas, you should schedule a visit with a travel health specialist. They can provide you with valuable information about the area to which you are traveling and the health risks you are likely to encounter. The specialist can then help you protect your health by supplying you with appropriate vaccinations, medications and essential components for your travel kit, such as water purification tablets, mosquito repellent and sunscreen.

Packing your Travel Kit

As a humanitarian aid worker, you will need to make sure that you have all the essential supplies with you to protect your own health abroad, as these items are not likely to be widely available in your destination. Some of the items you may want to pack include:

  • water purification tablets and/or filtration system, if water sources may be compromised
  • mosquito repellent and mosquito netting, in areas subject to malaria especially
  • sunscreen and hat
  • protective gloves and goggles
  • protective face mask, in areas subject to contagious illness
  • first aid kit
  • medication for prevention of travelers’ diarrhea

Manage Your Stress Levels

When entering a disaster area, it is easy to become emotionally stressed by the people and situations that you encounter. Be sure to bring family photos with you, so you can maintain a connection with the world you left behind. Many humanitarian aid workers find that keeping a journal of their experiences is a great way to alleviate stress during the situation, and the journal can be an invaluable source of information as you plan for future missions. Contact with those at home can also be another way to manage stress and maintain essential communication with your loved ones.

Minimize Risk of Injury

If you are in an area that just suffered a natural disaster, you face the additional physical risk of injury from unstable building collapses or injuries caused by falling debris. Stay alert to your surroundings and the possible dangers you may encounter as you go into the community to render assistance. If you are injured while on-site, even if it is something as simple as a small cut, seek attention from medical personnel traveling with you in order to minimize the chance of infection.

Upon Your Return

When you return home, be aware of your own health condition. If you experience any medical symptoms indicating that you may have been exposed to illness or disease during your trip, arrange to visit a medical professional as soon as possible.

Familiarize yourself with the symptoms of depression. Over 30 percent of humanitarian aid workers experience depression after they return home. If you believe you are suffering from depression upon your return, seek counseling so that you can cope better with the issue.

Your service as a humanitarian aid worker is of great value to those you are helping. Maintaining your own physical and emotional health is of utmost importance, so you can continue to provide support services to those in need during a crisis situation.

Remember: Maintaining your own good health is the best way to ensure that you can be of help to others.

SOURCES:
http://headington-institute.net
http://wwwnc.cdc.gov/travel/page/humanitarian-aid-workers

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Passport Health Attends World Extreme Medical Conference

November 18, 2013 By Leave a Comment

From October 28 to October 31, 2013, Passport Health attended the World Extreme Medical Conference held at Harvard Medical School in Boston, MA. Passport Health joined other conference attendees such as Andes CME Expeditions, Special Operations Medicine, and Concentra in learning about and sharing best practices for disaster management and proper medical care for extreme travel. This was a very international crowd, including many hospital physicians from overseas and even the head of Disaster Medicine for Tel Aviv University.
 

 
Passport Health had the privilege of attending many interesting lectures such as “Xtreme Everest” that detailed the trials and tribulations of summiting the world’s tallest mountain. What a reminder that a pre-travel health consultation is crucial before undertaking such an adventure! Additionally, “Disaster Management” was a riveting speech that detailed the proper medical procedures to implement in the case of a natural disaster. We were pleased to note that many of the processes outlined were best practices that are addressed in a pre-travel health consultation for travelers heading to risky destinations.

 
Although primarily targeting those who engage in extreme adventures, this conference served as a good reminder that pre-travel health planning is a key part of any trip, but it is absolutely indispensable for travelers headed to remote and dangerous corners of the globe.

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World Pneumonia Day: November 12, 2014

November 12, 2013 By Leave a Comment
Key Takeaways:
  • Approximately 4 million deaths are attributed to pneumonia each year
  • The mortality rate for children under five is especially grim, with 18 percent of global child deaths being attributed to some form of pneumonia.
  • Several drug-resistant strains of pneumonia are appearing in communities across the globe.
  • The focus of World Pneumonia Day is on treating both pneumonia and the underlying health conditions that can trigger it.
  • Leading a healthy lifestyle and getting vaccinated are a couple key ways you can protect yourself.

What is World Pneumonia Day?

Today, November 12th of this year, people across the world will recognize World Pneumonia Day in an effort to raise awareness about pneumonia in all of its forms. This condition is one of the biggest killers of young children, elderly people and those who suffer from chronic illnesses. Approximately 4 million deaths are attributed to pneumonia each year, and hundreds of millions of people will develop the condition and suffer greatly. Education and outreach efforts for World Pneumonia Day are organized by the Global Coalition Against Child Pneumonia. There are over 140 different organizations that are participating, including NGOs, academic institutions and public health groups.

Because of vaccinations and the development of antibiotics, viral and bacterial pneumonia can be treated with great success when there is access to these medications. Great strides have been made in prevention, treatment and support for people suffering from pneumonia in developed countries. However, pneumonia is still a deadly disease, and more efforts need to made in order to lessen the number of pneumonia cases each year in the developing world.

What is Pneumonia, and How is it Caused?

Pneumonia is a condition characterized by inflammation of the lungs. It is often caused by either viruses or bacteria, though in some instances it can be triggered by fungi, parasites or certain medications. Pneumonia can also occur when substances are aspirated into the lungs. Symptoms include coughing, wheezing, difficulty breathing, chest pain and fever. Bacterial pneumonia is the most common form of the condition, but some 30 percent of pneumonia cases are viral in nature.

As antibiotic misuse becomes more widespread, our ability to fight back against pneumonia becomes compromised. Several resistant strains of the condition are appearing in communities across the globe. While healthy adults can usually recover, the young, infirm and the elderly are at a high risk of dying from the disease. The mortality rate for children under five is especially grim, with 18 percent of global child deaths being attributed to some form of pneumonia.

How Can We Fight Back Against Pneumonia or Minimize Our Risk of Developing It?

When it comes to fighting diseases, education is always the key. Teaching people in high-risk areas about vaccination, proper antibiotic usage, recognition of symptoms and proper quarantine measures can help reduce pneumonia cases in various communities. However, because of the relatively high rate of successful treatments of Western adults who develop pneumonia, there is little focus on expanding treatment regimes to other countries. This attitude must change, and the focus of World Pneumonia Day is on treating both pneumonia and the underlying health conditions that can trigger it.

One of the ways you can minimize your risk of developing pneumonia in a developed country is by leading a healthy lifestyle. Avoid smoking, eat a healthy diet and exercise regularly. If you are traveling to a country or region where bacterial and viral pneumonia is common, then there are additional steps you may need to take in order to protect yourself. Before you depart, you should consult with a travel health specialist. He or she will be able to advise you on how to minimize your risk of developing pneumonia.

There are vaccines available for viral strains of pneumonia. You should inquire about receiving these if you are concerned, and you may want to consider bringing an antibiotic regimen along with you in case you do develop pneumonia. Environmental factors can also play a role in prevention, both for yourself and for the general population. The reduction of indoor air pollution can help people maintain good lung health, making them less susceptible to catching pneumonia.

Pneumonia is life-threatening, and it can occur anywhere, to anyone and at any time. By encouraging people to engage in activism and education on World Pneumonia Day, we can all make an effort toward eradicating this deadly condition.

Sources
http://wwwnc.cdc.gov/eid/pages/world-pneumonia-day.htm
http://worldpneumoniaday.org/
http://worldpneumoniaday.org/learn/
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961459-6/fulltext

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Transition in the Causes of Fever in Tropical Areas

November 11, 2013 By Leave a Comment
Key Takeaways:
  • Previously malaria was the major cause of fever in tropical regions of the world, however dengue is increasingly the cause of human illness in these regions currently.
  • According to the CDC, occurrences of malaria in Ecuador have decreased by more than 75% in the past 20 years while dengue has increased.
  • If you plan to travel to urban areas within the world’s tropical regions, dengue fever is a real health threat.
  • Prior to travel to these areas, visit a travel health specialist to lower your disease risk for many illnesses, including dengue fever and malaria.

Decisions regarding how to treat patients and enact public health measures depends on the ability of physicians and researchers to identify the cause of an illness. In tropical regions of the world, the historical cause of fevers was malaria. However, recent studies have found that dengue is increasingly the cause of human illness in these regions, especially in urban communities of tropical areas. Changes in the causes of human disease require that health care practitioners, public health agencies, and scientific researchers act quickly to prevent and treat disease.

Changing Times in Ecuador

The change in the cause of fever in tropical areas of the world is striking in many areas, perhaps most notably so in Ecuador. According to the Centers for Disease Control and Prevention, occurrences of malaria in Ecuador have decreased by more than 75 percent in the past 20 years. Dengue, however, re-emerged in Ecuador in 1988 and took its time spreading throughout the various provinces of the nation. All four of the viruses that cause dengue fever have been circulating throughout Ecuador, and researchers believe that increases in infrastructure projects are the leading cause.

A Scientific Study

To determine the cause of the fever, scientists and doctors at a key hospital, Hospital Civil de Borbón, conducted a study. Samples of blood or serum were collected from patients with febrile fevers. The samples were processed and stored according to standard protocols, and all patients gave their consent to participate in the study. During the time period July 2010 through February 2011, doctors collected a total of 77 blood or serum samples from residents of Borbón and the surrounding area. The patients ranged in age from 2 to 74 years and had a fever duration of 3 to 20 days. Tests run on the samples found that 17 percent of serum and 17 percent of blood samples were positive for dengue fever. Due to the type of test that was used, scientists estimate that the 17 percent positive rate was actually a lower bound, and up to 42 percent of the patients actually suffered from acute dengue infections within the past 90 days.

Changing Medical Care and Public Health Strategies

In Borbón, most people who show up at the hospital with symptoms such as a fever and headache are triaged as if they are sick with malaria. However, in this study, none of the patients actually had malaria, but at least 17 percent of them had dengue. This shows the need to accurately identify the cause of illness so that patients can be treated with the appropriate medications and public health actions such as mosquito control in urban areas can begin.

Staying Healthy When Traveling Abroad

If your travels will take you to urban areas in tropical nations, dengue fever is a real threat to your health. Before departing on your trip, be sure to visit a Passport Health travel health specialist for a pre-travel health consultation. The travel health specialists will provide you with vaccinations and medications as well as preventive strategies, guidance, and supplies to lower your disease risk for illnesses for which there is not a vaccination or prophylactic medication. From advice on packing mosquito repellant and netting to providing you with guidance on safety and international health, a Travel health Specialist will help you to have a healthy and safe trip and work with you to lower risk of dengue, malaria, and other common travel health concerns.

Sources:
http://wwwnc.cdc.gov/eid/article/19/10/13-0137_article.htm?s_cid=eid-gDev-email
http://www.mayoclinic.com/health/dengue-fever/DS01028

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Flu Vaccination Coverage among Pregnant Women During the 2012-13 Flu Season

November 7, 2013 By Leave a Comment
Key Takeaways:
  • Flu vaccination in pregnant women has been found to lower infection and hospitalization rates for the women and their babies.
  • A CDC survey determined vaccine coverage was higher among pregnant women whose doctor both recommended and offered the vaccine.
  • The top three reasons why pregnant women said they got vaccinated against flu was to protect their babies, protect themselves, and because their doctors told them to.
  • The top three reasons why pregnant women didn’t get vaccinated were concern about the safety of the vaccine, belief that the vaccine causes the flu, and that the vaccine was ineffective against the flu.
  • Education is a key factor in improving flu vaccination rates among pregnant women.

Pregnant women and babies less than six months of age are at high risk of getting infected with the flu and developing flu complications that require hospitalization. However, research studies have found that flu vaccination in pregnant women lowers infection and hospitalization rates in the women as well as their babies. To protect the health of pregnant women and newborns, the Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists issued recommendations that all women who are pregnant or are planning to be pregnant during flu season get vaccinated, no matter how far along they are in their pregnancy.

Surveying Pregnant Women about Flu Vaccination

To determine the extent of flu vaccination coverage among pregnant women during the 2012-13 flu season, the CDC conducted an Internet panel survey from April 1 – 12, 2013. The survey respondents were self-selected and were pregnant at some point during the time period of October 2012 through January 2013. Participants ranged from 18–49 years of age and were recruited to participate in the survey from a SurveySpot Internet panel.

Of 6,633 women who started the survey, 2,198 were found to be eligible for the study. Of those, 2,047 (93.1 percent) completed the online survey, a remarkably high rate of completion for an Internet survey. Data was weighted by statisticians to reflect the age groups, race, ethnicity, and geographic distribution. A woman was considered vaccinated for the purposes of the study if she was pregnant and got her vaccination during the 2012-2013 flu season.

Vaccination Rates among Different Groups of Pregnant Women

The CDC survey determined that 50.5 percent of women reported vaccination before or during pregnancy. Vaccine coverage was higher among women whose doctor both recommended and offered the vaccine (70.5 percent) versus women whose doctors recommended it, but didn’t offer it (46.3 percent), or women who didn’t receive a recommendation from the doctor at all (16.1 percent).

Attitudes and Knowledge About Flu Vaccination Among Pregnant Women

Pregnant women who were least likely to be vaccinated against the flu fell into the following demographic categories: ages 18 to 24, having less than a college education, not married, uninsured, not working, living below the poverty level, having fewer than six prenatal or other doctor visits within the previous six months, and not having any risk factors for serious influenza disease. Women with a negative attitude about influenza vaccination were less likely to have been vaccinated (9.8 percent) compared to women with a positive attitude about flu vaccines (64.2 percent). Women who thought the flu vaccine was unsafe were also less likely to be vaccinated (19.4 percent) compared to women who felt the vaccine was safe (68.8 percent). The top three reasons why pregnant women said they got vaccinated against flu was to protect their babies, protect themselves, and because their doctors told them to. The leading three reasons why pregnant women didn’t get vaccinated were concern about the safety of the vaccine, belief that the vaccine causes the flu, and that the vaccine was ineffective against the flu.

Study Limitations

The CDC reports five limitations to these study results:

  • Selection bias for survey participation. The survey itself may have caused women who were more or less likely to be vaccinated to enter the study in the first place.
  • The survey was self-administered without a way to verify that the information provided by the women was correct.
  • The weighting of the survey results didn’t take into account women without Internet access.
  • The cross-sectional nature of the survey only measured a specific rate of vaccination coverage at a specific point in time.
  • The study results couldn’t be compared to the previous two years of results due to changes in the definition of the vaccination period.

The Importance of Flu Vaccination for Pregnant Women

The study of pregnant women suggests that vaccination rates could be improved by enhancing access to low-cost vaccination sites, having doctors recommend and offer the vaccine in office during prenatal exams, and educating pregnant women about the safety, importance, and efficacy of the vaccine for themselves and their babies.

If you are pregnant and considering the flu vaccine, please visit this link for additional flu vaccine information.

Sources:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a3.htm
http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Influenza_Vaccination_During_Pregnancy

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Polio Outbreak in Syria

November 4, 2013 By Leave a Comment
Key Takeaways:
  • The United Nations has confirmed an outbreak of polio among Syrian refugees.
  • Polio is a highly infectious disease that can cause disability and potentially death in those who are infected.
  • Due to the civil war in Syria, mass vaccination campaigns for children have been halted for years.
  • Polio was a common infection throughout the world until 1955 when a vaccine was released. Since then, many nations in the world have been able to eradicate the disease.
  • Anyone considering a trip to an area of the world where polio cases occur should visit a travel health specialist and get vaccinated.

During 2012, the world saw just 223 confirmed cases of polio. The much-feared disease has been eradicated throughout most of the world due to widely successful mass vaccination campaigns and improvement in sanitation and hygiene. In a disturbing news release on October 30, 2013, however, the United Nations confirmed an outbreak of polio among Syrian refugees living in small towns situated along the Euphrates River near the border with Iraq. The disease threatens the health of more than 500,000 children due to the ongoing civil war that, among many other tragic effects, has halted childhood vaccination programs.

What Is Polio?

Polio is a highly infectious disease that can cause disability and potentially death in people who are infected. According to the Centers for Disease Control, it is caused by a virus that invades the brain and spinal cord. About 4 to 8 percent of people who are infected develop mild symptoms including a fever, fatigue, nausea, headaches, stiffness in the neck, and back and limb pain. In about 1 percent of cases, permanent limb paralysis develops, typically in the legs. Of those who become paralyzed, 5 to 10 percent die as the paralysis affects lung function. The disease is spread from person to person and only infects humans.

The Syrian Polio Outbreak

In October, 2013, 22 children in Deir al-Zour Province in northeastern Syria were tested for polio after becoming ill. Ten of those children tested positive for the virus, and physicians are awaiting results on the remaining children. Due to the civil war and ongoing breakdown of human services in Syria, mass vaccination campaigns for children have been halted for years. Previous to the national conflict, more than 95 percent of Syrians were vaccinated against polio. Most of the Syrian children with polio are under the age of 2, highlighting the toll the 31 months of civil war has taken on the nation. In a statement by the United Nations, the organization reported that it intends to initiate a mass vaccination campaign of 2.4 million Syrian children to halt the spread of the disease. Unicef has already vaccinated 800,000 Syrian children against polio this year.

Cause of the Outbreak

Polio was not endemic to Syria before the current outbreak. Physicians and scientists are trying to find the source of the virus. They speculate that Jihadi fighters traveling to Syria from Pakistan are a possible source of polio, as Pakistan is one of three nations in the world where polio continues to spread. Aid organizations are urging the Syrian president and rebels to cease fire so the outbreak doesn’t become epidemic.

Polio Vaccination

Polio was a common infection throughout the world until 1955 when a vaccine was released for mass vaccination campaigns. Since then, many nations in the world have been able to eradicate the disease. Today, most people get the polio vaccine during childhood. Full immunization against polio requires four doses, which are typically given at ages 2 months, 4 months, 6 to 18 months and a booster at age 4 to 6. The vaccine can be given orally or as a shot. Adults who were never vaccinated as children can receive the vaccination series to gain immunity as well. Anyone considering a trip to an area of the world where polio cases occur should visit a travel health specialist well before departure to determine whether the polio vaccine is needed for good travel health.

Sources:
http://www.nytimes.com/2013/10/30/world/middleeast/un-confirms-polio-outbreak-in-syria.html?_r=0
http://www.npr.org/templates/story/story.php?storyId=241578700
http://www.cdc.gov/polio/about/

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