Waterfalls in Iguacu Parana, Brazil
“Yellow fever continues to take its toll on those who are not vaccinated.
It causes more than 200,000 illnesses and 30,000 deaths worldwide among unvaccinated populations.”
Terry Parsons R.N.-C
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International travelers tend
to plan their trips based on
activities: Napa and Sonoma
for wine country touring, Costa
Rica for ecotourism, and Lyon
to experience dégustation
gastronomique. What if you could
do them all in one country?...
A doctor friend, Harold, called me one afternoon at the office. “My daughter, Anna, is
about to leave for Colombia with her fiancèe and they are flying to rural Columbia
where the embassy says it is dangerous to travel. What should I tell my daughter?”...
 Q- After receiving immunizations
for international travel, will I be
able to donate blood?
Q- I am traveling to a country
where the Yellow Fever
vaccine is required.
Are you authorized to give the vaccine? Do you have it available in all your offices?
Q- I had the flu shot in October
and I am traveling this summer
to Brazil. Why is the influenza
vaccination recommended?
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| Walter Reed was referring to
the Aegypti mosquito as “this
most dreadful pest of humanity”
in a letter to his wife in 1900. He
had recently discovered that the
Aegypti mosquito was the vector
of transmission for yellow fever.
Soon after his breakthrough
discovery, mosquito eradication
and sanitation efforts began with
remarkable results. Yellow Fever,
a disease that once took so
many lives has been controlled in
the U.S. Yellow fever, although
not the threat that it once was,
continues to take its toll in illness
and death in many parts of the
world. A traveler’s risk of acquiring
yellow fever is determined by
immunization status, geographic
location, season, exposure, activity,
and the local rate of virus
transmission. Fatality rates are
greater than 50% in non-immune
travelers. |
Female Aedes aegypti mosquito
Photo by: James Gathany,Center for Disease Control and Prevention
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In 2008 Paraguay has
had 22 cases and 7 deaths and
Brazil has had 48 cases and 25
deaths. The government of Brazil
is recommending that all travelers
to all areas of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Minas Gerais, Pará, Rondônia, Roraima, Tocantins, and the following states: northwest and west Bahia, central and west Paraná, southwest Piauí, northwest and west central Rio Grande do Sul, far west Santa Catarina, and north and west São Paulo obtain the yellow
fever vaccine prior to travel.
Visitors to the interior of South
America are at an increased risk
to become victims of yellow fever
where costal regions are currently
outside of the endemic zone.
|
In
Brazil, transmission risk increases
from January to March which is
their rainy season. Yellow Fever is a life threatening
viral infection. The incubation
period ranges from three to
six days.
Andes Mountains, Venezuela
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Initial symptoms, fever,
chills, headache, muscle aches,
backache, loss of appetite, nausea
and vomiting usually subside
in three or four days. One in six
persons will enter a second toxic
period characterized by recurrent
fever, vomiting listlessness, jaundice,
organ system failure and
hemorrhage. About 50% of patients
who enter the toxic phase
die within 10 to 14 days. Since
there is no specific treatment for
yellow fever, care is based on
relief of symptoms.
Steps to prevent yellow
fever include appropriate use of
insect repellents, protective clothing
and vaccination. To avoid
mosquito bites when outside wear long sleeved clothing and long pants. For
extra protection treat clothing with the insecticide
permethrin. |
Chile--Photo Courtesy of Destination 360
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Obtain the yellow fever vaccine
at least ten days prior to entering a yellow fever
zone. The yellow fever vaccine is an injectable,
attenuated, live virus, thimerosal free vaccine.
Mild reactions to the vaccine are generally headache,
myalgia and a low grade fever. If you are
receiving the yellow fever vaccine for the first
time, are younger than 9 months or older than
65 years you may be at greater risk for complications. Yellow fever is the only internationally regulated
immunization.
Proof of yellow fever immunization
may be officially required as a condition for entry to
some countries, including many that have no yellow
fever transmission themselves. They may require a
certificate of vaccination from travelers arriving from
areas or countries with risk of yellow fever transmission.
Proof of vaccination, a completed International
Certificate of Vaccination, signed and validated with
the center’s stamp is valid 10 days after vaccination
and for a subsequent period of 10 years.
Terry Parsons R.N.-C
Executive Director, Passport Health |
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International travelers tend to plan their trips based
on activities:
Napa and Sonoma
for wine country touring,
Costa Rica for ecotourism,
and Lyon to experience
dégustation gastronomique.
What if you could do them all
in one country?
In our first E-zine edition of Hot Travel Destinations, we will discover
some of the hidden jewels Peru has to offer. If you have traveled
to Peru only to go to Machu Picchu, good for you; but you might be
missing a lot. If you are a wine lover, you owe it to yourself to visit the
place where the oldest vines were planted in the new world: Ica.
Grape Vineyard- Ica, Peru
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Paracas National Park
Ica is
better known for Pisco, which is both a brandy and the port from which
this libation was exported to Spain in the 1500s. A brandy is simply
a distilled wine, so it makes sense that Pisco is made from distilling
fermented white grape wine. While you are tasting Pisco and wine you will be, literally, in an
oasis surrounded by what has been called the world’s driest desert:
a narrow desert fringe that stretches for more than 1,400 miles along
Peru’s central pacific coast. The fertile valleys would not exist were it not for roaring rivers descending
from the slopes of the Andes. In Ica, Peru’s wine country, these valleys create the perfect microclimate for
grape growing.
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Every year in March, the grape harvest is celebrated in Ica during the National Vintage Festival.
Festivities include wine and grape tasting, a floats parade, marching bands, and commercial and hand
craft exhibitions. Several winery tours are available, but don’t forget to check out Vista Alegre Winery
which is the one of the oldest in Peru, and is presently the largest producer of Pisco.
To whet your appetite for adventure, you may wish to visit Paracas, which in Quechua
literally means “raining sands.”
Paracas is just a hop from Pisco and it’s home to the Paracas National
Reserve, a World Heritage National Site. The stark contrast between the dessert topology and the sea
provides breathtaking vistas which come to life with thousands of wild resident and migratory birds including
flamencos, red-legged cormorants, Humboldt penguins, and Inca terns. On your way back, check out
the Regional Museum of Ica, one of the best regional museums in the country.
Within its realm you will find a variety of archeological pieces
such as pottery and textiles from the Nazca and Paracas
cultures that developed in the area. If you want to get some
exercise you can trek Cerro Blanco (the highest sand dune in
the world) or explore the surrounding dessert dunes.
Ica is also home to the world renowned Nazca Lines.
You can now fly directly out of Pisco and over the Nazca Lines in
charter flights.
These lines can only be seen from the air but the
amazing designs are still as intriguing today as they were
when they were first discovered. The area encompassing
the Nazca Lines is about 800 square miles and some of the
largest designs are over 900 feet long.
Nazca Lines |
On your return
trip to Lima, make sure
you plan at least one
great dinner before flying
back home. Lima
has some of the best
restaurants you will
find in South America
–and Pisco is not too
far behind-- revitalized
by a recent gastronomic
renaissance, traditional
ingredients are carefully
mélanged using classic
culinary techniques
that elevate the dishes
to levels comparable to Michelin 3-star restaurants. You will
be amazed as you taste the most flavorful seafood dishes
like Ceviche: white Corvina fish or a mixture of fish and other
seafood, marinated with lemon, coriander, Peruvian yellow
chili and garlic. |
PLEASE NOTE: Ceviche is served raw. Consuming raw or undercooked meats, poultry, seafood, shellfish or eggs may increase your risk of food borne illness. Only consider dining at reputable establishments that have been inspected by the Peruvian Department of Health. The best way to prevent food borne illnesses is to avoid raw meats altogether. Unless you know exactly where the fish came from and how it was handled, you are at risk.
This refreshing and ever-evolving dish
that inspires chefs to try different approaches and variations
on a simple, yet tantalizing dish is available throughout the
Peruvian coast.
If you are looking for a truly memorable experience,
you should try La Rosa Nautica (The Nautical Rose) right
on the ocean of Lima. When I say “on” the ocean, that is
precisely what I mean. Perhaps the best restaurant in Peru,
La Rosa Nautica floats on the ocean and it is accessible
only after you reach the end a long pier. Inside you will have
a spectacular 360 view of the ocean and the coast. Try a
Peruvian classic, Aji de Gallina: a delectably creamy, chicken-
based dish cooked with walnuts and parmesan that is
similar to a good korma and is an absolute classic, a must have
dish.
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Pisco Sour
The safest way to enjoy a Pisco Sour is at home, where you know where your water, ice and other ingredients are coming from. Below is a classic recipe. I prefer to use a blender and make a larger batch. This allows for the egg white to really fluff up and it makes your presentation better. Remember to always use fresh lime juice.
• 2 fl oz (8 parts) Pisco
• 1 fl oz (4 parts) Lime juice
• 3/4 fl oz (3 parts) Simple syrup
• 1 Egg white
• 1 dash Bitters
Preparation: Shake hard or blend with ice
and strain into glass. The bitters are an aromatic
garnish topping the finished drink, put
on top of pisco sour foam.
PLEASE NOTE: Contaminated water or ice may carry pathogens that cause illness. Only consider beverages from reputable dining establishments that have been inspected by the Peruvian Department of Health. Only consume bottled water and make sure that ice used for drinks is made from bottled water as well. If you can not confirm the source of the water, you are at risk.
Jorge Eduardo Castillo
Passport Health |
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Red Cross Helicopter
Q: After receiving immunizations
for international travel will I be able
to donate blood?
A: The American Red Cross’s guidelines for blood
donation eligibility are as follows:
After immunization for Influenza, Hepatitis A, Typhoid
(injectable), Tetanus, Meningitis, HPV (Gardasil)
or Polio (injectable), blood donation is acceptable
immediately.
MMR (Rubeola, Mumps, Rubella), Chicken Pox or
Shingles, wait four weeks after immunization.
Red Measles (Rubeola), Mumps, Polio (oral), Typhoid
(oral), and Yellow Fever, wait two weeks
after immunization.
Hepatitis B, wait seven days after immunization.
Smallpox vaccination without complications, wait
eight weeks and two weeks after resolution of
complications.
If you have traveled outside of the US to an area
where malaria is found, wait twelve months after
returning.
If you have been treated for malaria you must wait
three years. |
Q: I am traveling to a country where
the Yellow Fever vaccine is required. Are you authorized to give the vaccine? Do you have it available in all your offices?
A: Yes there are adequate supplies of the Yellow Fever vaccine at our locations. All 170 Passport Health locations are state certified to administer the Yellow Fever vaccine.
Q: I had the flu shot in October and
I am traveling this summer to Brazil.
Why is the influenza vaccination
recommended?
A: The flu shot is only effective for the season in
which it was given. Your October immunization will
have lost it’s effectiveness in three to six months.
In the southern hemisphere the influenza disease
circulates from April to September.
In the central latitudes,
where Brazil is located, the influenza disease
circulates throughout the year. Passport Health carries
at least four injectable vaccines for influenza and
one nasally administered preparation for protection.
Have a travel question?
Call Toll Free: 1-888-499-Pass (7277)
Passport Health |
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| A doctor friend, Harold, called me one afternoon
at the office.
“My daughter, Anna, and her fiancée are about to leave for rural
Colombia where the embassy says it is dangerous
to travel. What should I tell my daughter?”
I needed more details:
"When is she planning to leave?
Where is she planning to travel? What did the Embassy personnel
say? Tell me a little about your daughter and her fiancée."
Harold said, "They are leaving from Argentina and will fly to Bogota, Colombia and then
to a little town near the Ecuadorian border. She and her fiancée
plan to drive to Pitalito
, a mountainous road trip, in a rental
car to visit friends. Anna has lived in
Latin America, speaks fluent Argentine Spanish and her fiancée
grew up around the town to be visited."
Bogota, Colombia
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Bogota, Colombia
I wrote Harold the following letter:
Harold,
I spoke to Monica Ortiz at OSAC/State. While she sounds a note of caution, she
says that it is very unlikely that flying into Bogota and driving in daytime to Pitalito is a
real risk. She suggests that Anna register at the US Embassy (can be done on line at
www.travel.state.gov) and contact local authorities about any immediate developments,
risks or advisories.
She points out that there have been a number of FARC, Revolutionary Armed Forces (Fuerzas Armadas Revolucionarias de Colombia) related incidents reported
in this area. Anna and her fiance’e speak Spanish and know the area so they are
less likely to be targeted for kidnapping. Daytime travel is not likely to be interrupted
by FARC roadblocks.
You may wish to inquire further at Private Intel. I would certainly advise that Anna have
travel and evacuation insurance. We have partnered with some of the best organizations like International SOS.There is also a company that will get you home to the USA from any point
on the globe under circumstances like that of your daughter: Global Rescue.
Let me know how Anna fairs.
Peter V Savage
Passport Health |
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