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Lassa Fever, Ebola’s Lesser-Known Cousin

July 11, 2016 by Will Sowards Leave a Comment

Lassa fever is most commonly spread by this mouse and contact with infected specimens.

In this world full of wanderlust, with all the planes, trains, and automobiles, we can travel to remote islands and the deepest jungles or the most crowded and impressive cities. Covering these distances is something early explorers couldn’t even dream of. Still, like those early explorers, we need to prepared for possible diseases in unfamiliar territory. A rare and unfamiliar disease for many today is Lassa Fever.

Background of Lassa Fever

Lassa Fever is an acute viral hemorrhagic illness. This general term is used to describe a severe illness associated with bleeding. The virus causing Lassa Fever was affecting individuals as early as the 1950’s. But, the virus wasn’t documented until 1969. The first cases occurred when two missionary nurses died in a little town in Nigeria known as Lassa.

Where could I get Lassa Fever?

Since those first cases in Nigeria, Lassa has been found in other West African countries. Lassa Fever was most recently found in Benin, with the first case diagnosed there in 2014.

According to the World Health Organization, Lassa Fever is endemic in:

  • Nigeria
  • Benin
  • Ghana
  • Guinea
  • Liberia
  • Mali
  • Sierra Leone

It is likely to exist in other West African countries as well.

How could I contract Lassa Fever?

Lassa Fever is not common. It is transmitted through exposure to the urine or feces of the common African rat or through direct contact with bodily fluids of another infected human. Those at greatest risk are those in communities where multimammate rats are commonly found. Risk increases even more in areas where healthcare and sanitation are poor or living conditions are crowded. Healthcare workers also have a higher risk of catching Lassa Fever, as they may come in contact with bodily fluids. There is no evidence to support the possibility of airborne contamination.

What does Lassa Fever look like?

The virus for Lassa Fever has an incubation period of about 1-3 weeks. When symptoms do appear, they are mild and go undiagnosed for a majority – about 80% – of cases. According to the Centers for Disease Control–

Mild Lassa Fever Symptoms can include:

  • Fever
  • General malaise and weakness
  • Headache
  • Sore throat
  • Nausea
  • Cough

The other 20% of cases see a more severe set of symptoms that could be fatal.

Severe Lassa Fever Symptoms:

  • Facial swelling
  • Hemorrhaging (eyes, gums, nose, etc.)
  • Repeated vomiting
  • Fluid in the lungs
  • Neurological problems, like hearing loss

In fatal cases, death occurs within 14 days of onset due to multiple organ failure. Lassa Fever does not have a high mortality rate. Only 1% of all Lassa Fever infections result in death.

Deafness is the most common complication of Lassa Fever, and can occur in both mild and severe cases. In fact, varying degrees of hearing loss occur in as many as one-third of Lassa Fever cases.

Lassa Fever symptoms vary, making diagnosis tricky in the early stages. Lassa Fever is also hard to distinguish from related viral hemorrhagic fevers such as Ebola virus. Other diseases like malaria also have similar symptoms.

What is the treatment for Lassa Fever?

The antiviral drug Ribavirin has been used to treat Lassa Fever patients, though it is most effective in early stages. It should be given in conjunction with supportive care like fluid and electrolyte balance maintenance, oxygenation and blood pressure, and treatment of other infections.

How can I avoid getting Lassa Fever when traveling to West Africa?

Unfortunately, there is no vaccine currently available for Lassa Fever. But, understanding viral transmission will help you in taking extra precautions. For example, try to avoid places with poor sanitation and crowded living conditions. And of course, be careful to make sure food has not been exposed to rodents.

If you are traveling to West Africa as a healthcare professional to donate your time and service, make sure to take extra precautions. Protect yourself against illnesses like Lassa Fever so that you can stay healthy while being such a great help!

Going to West Africa anytime soon? Learn more about the vaccinations needed for your own upcoming trip by scheduling an appointment with your local Passport Health Travel Medicine Specialist. Book now by calling or schedule online today.

Are you familiar with Lassa Fever or another lesser known disease? Do you have any advice for traveling to West Africa? Feel free to leave a comment below or contact us on Facebook or via Twitter.

Written for Passport Health by Adrienne St. Clair

Filed Under: General Posts

How Cows Helped Jump Start Vaccines

July 8, 2016 by Will Sowards 2 Comments

Edward Jenner's research saved millions of lives and paved the way for future vaccines.

Today, few question the legitimacy of a vaccination. Even fewer people consider a time when vaccinations were completely nonexistent. It is bizarre to think we owe our thanks to a cow, a dairymaid, an eight-year old boy, and the doctor who made a connection between them all.

People refer to Dr. Edward Jenner as “the father of immunology”. Immunization was not new, but Jenner was the first to study and document vaccination use. His curious experiment has saved an innumerable amount of human lives.

Smallpox was the greatest killer of Jenner’s time. In its most common form, the virus killed about 30% of those who caught it. It was the most feared disease that reached every part of society – even royalty suffered from it.

Smallpox is a virus that causes flu-like symptoms later accompanied by raised pink spots that grow over time. The spots cover the entire body. If the victim recovers, the blisters will shrivel up and fall off. They often leave behind sunken scars.

A similar but far less deadly disease than smallpox, is cowpox. This virus, which originates from cows, can transfer from animals to humans. It wasn’t uncommon for dairymaids to experience the mild infection. They would feel run down for a couple of days and develop some pocks, usually on their hands. Other than this, the sickness was harmless and did not cause any concern.

At the young age of thirteen, Jenner was an apprentice to a country surgeon. During his apprenticeship he overheard a dairymaid working nearby say, “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.”

Jenner took note of dairymaids’ natural immunity to smallpox. Many believed that those who had contracted cowpox were immune to smallpox.

Years later in 1796, a dairymaid consulted Jenner about a rash on her hand. Seeing the mildness of the infection, he diagnosed her with cowpox. She later verified to him that one of the cows she was working with recently had cowpox. Jenner saw this as his golden opportunity to prove the disease’s protection from smallpox.

To test his hypothesis, Jenner needed someone who never contracted cowpox or smallpox before. His gardener’s eight-year old son served as a perfect candidate. Jenner collected drops of fluid from the sores on the dairymaid’s hands and injected a small amount into the healthy boy’s arm. The boy became mildly ill with the cowpox infection, but recovered about a week later.

Two months later, Jenner injected some fluid from a smallpox sore into the young boy. As Jenner expected, the boy never became sick. To confirm his findings, Jenner continued to test the boy’s immunity. Hi various experiments all proved his hypothesis correct.

Jenner soon coined the word “vaccination”, of which the root word is derived from the Latin word “vacca”, meaning cow. Jenner published his research and discoveries, excited to share his success with the world.

Despite the success of Jenner’s techniques and findings, he faced opposition from others in the medical field. One criticizism was that cowpox wasn’t common. It was usually found in rural areas with farms having cows and dairymaids. This meant many doctors would have to get the vaccine from Jenner.

Edward Jenner continued to attempt to win approval as well as spread his new vaccine to the world. He came up with new, easy ways to have the cowpox matter widely transported. He was successful in his commitment to his scientific discovery.

Jenner’s work helped eradicate smallpox. Samples of the virus only exists in two labs permitted and trusted to secure it.

Jenner himself laid the foundation of vaccination as we know it today.

To learn more about the various vaccines that have been made since Jenner’s development, see our main vaccinations page.

Passport Health specializes in travel medicine, to schedule an appointment for your upcoming trip call or book online now.

How do you feel about Dr. Edward Jenner’s experiments? If you were living during his time, would you agree with his testing on an eight-year old boy? Leave your comments below, on Facebook, or via Twitter.

Filed Under: General Posts

You May Not Be Immune Forever- Why Boosters Are Important!

June 30, 2016 by Will Sowards 7 Comments

Vaccine boosters are super important for travelers and everyone.

Have you thought about becoming infected with an illness that you were vaccinated against? Few people do. Many vaccines only need a single shot, but not all of them. Booster shots are key in preventing the return or contraction of certain diseases. But, some individuals overlook their importance in sustaining disease immunity.

Why Do I Need A Booster Vaccine?

In the 1950’s, a diphtheria epidemic in Russia caused more than 750,000 cases. The majority of cases were in children. But, it wasn’t until 1958 that universal childhood immunization began. As a result, diphtheria cases decreased dramatically by 1963.

In the later years, a childhood vaccination schedule had to be completed for school entry. Case reports fell, and there was hope for elimination. But, diphtheria made an explosive comeback in Russia thirty years later.

In 1993, a major outbreak occurred. Except this time, the majority of cases were in adults.

“Most experts attribute the increase in diphtheria to failings in the Russian immunization program,” said Celestine Bohlen, in a New York Times article published during this second epidemic outbreak. “[This] allow[ed] a high number of infants to be turned down for the normal schedule of inoculations for medical reasons, while not keeping many adults, particularly those from age 20 to 50, up to date on their immunizations.”

This second diphtheria outbreak was different. Most cases were in adults. Thirty years earlier, the majority of cases were pediatric. A connection between the lack of booster vaccines and this outbreak was clear.

A booster vaccine could have prevented the second diphtheria outbreak. It is important to stay up to date on booster vaccines to avoid incidences such as this.

Why Do Some Infections Require Booster Vaccines?

One can never be sure that a sickness won’t re-emerge and put them at risk. It is necessary to know whether a vaccine from a certain disease requires a booster later on.

Booster need depends on a variety of factors including disease progression and immunological memory.

Immunological memory refers to the ability of the immune system to respond to a detected pathogen. The faster the immune system can recognize a pathogen and prevent a sickness, the better. Whether it is necessary to boost immune memory with a follow-up shot depends on the disease’s speed of progression.

If enough time has passed since the vaccination, and the disease can progress rapidly. It may even spread faster than the body can respond. In cases involving slow-moving infections, the immune memory is activated with plenty of time to respond. In these instances, a booster vaccine is not necessary to maintain immunity.

“Pediatricians and family doctors must begin to anticipate the need to provide booster vaccinations for several of the newer vaccines introduced in the recent years,” said Michael Pichichero, with the Rochester General Research Institute, who has studied booster vaccines in various states.

No one wants to get infected with an illness they thought they were immune to. Sometimes, it can be hard to remember. Long period of time can pass without needing a booster – the tetanus booster is only needed every ten years.

What Vaccines Require Boosters?

Other vaccines may need a booster more often, such as the annual dose for the flu.

Travel Vaccinations that Require Boosters:

  • Anthrax
  • Hepatitis A
  • Hepatitis B
  • Hepatitis A & B
  • Japanese Encephalitis
  • Meningitis
  • Polio (for some individuals)
  • Rabies (pre- and post-exposure)
  • Typhoid
  • Yellow Fever

Routine Vaccinations that Require Boosters:

  • Measles, Mumps, Rubella
  • Chickenpox
  • HPV
  • Tetanus, Diphtheria and Pertussis
  • Influenza

It is not only important to check if you will need a booster vaccine, but also to remember when it will be needed. You can check the adult vaccination schedule recommended by the CDC.

To learn more about these immunization or titer testing, see our vaccinations and titer testing portals.

If you are unsure of your vaccination history, consider titer testing to learn if you are immune. Your local Passport Health clinic can help, book your appointment today by calling or schedule online now.

Have you ever been infected with an illness you thought you were immune to? Share your thoughts on booster vaccines and their importance to your health in our comments section below, on Twitter or via Facebook.

Filed Under: General Posts

Which Vaccines Do You Need for Namibia?

June 22, 2016 by Will Sowards Leave a Comment

Namibia is a wonderful destination, but some prep work needs to be done before leaving.

Namibia is a popular safari destination on the southwest coast of Africa. Not only is it a great place for a safari, but also the country also offers countless other adventures. If you are planning an outdoor adventure to Namibia, don’t forget to plan ahead. Check out our health tips for travel to Namibia and a brief guide of what you can do.

Which Vaccines Do I Need For Namibia?

Before heading out for a Namibia, it’s important to receive a few key vaccinations. The World Health Organization and Centers for Disease Control recommend the following vaccines:

  • Hepatitis A
  • Typhoid
  • Hepatitis B
  • Rabies
  • Yellow Fever
  • Routine Vaccinations

To learn more about these infections and their vaccines, see their individual pages. Prepare before you go by visiting your local Passport Health clinic. Schedule today by calling or booking online now.

Mosquito-borne Diseases In Namibia

Avoid mosquitoes and other bugs

Mosquito-borne infections are a threat globally.Insect-borne disease are a
threat throughout the world.

Keep the bugs away with
Passport Health’s repellent options!

Mosquito bites can lead to malaria, a deadly disease. There is no vaccination against malaria. But, there are antimalarial medications that will protect you from infection. The CDC recommends mosquito nets, insect repellent and other related products.

Dengue is another mosquito-borne disease common in Namibia. Be sure to take proper precautions against mosquitoes.

Where Should I Visit In Namibia?

The Fish River Canyon is the second largest canyon in the world, and a popular destination. The 85 kilometer trail through the canyon is perfect for those up for a challenge. But, the trail is only open from May to the mid-September due to extreme temperatures the rest of the year. Travel plans to the canyon should be evaluated by a travel health professional. Schedule a travel health consultation with Passport Health four to six weeks before leaving.

If you prefer a less intense adventure, the Waterberg Plateau may be for you. The plateau is a pristine viewpoint to scope out many of the rare and endangered species in Africa. The park contains many self- and professionally- guided trails hikes are available.

The largest population of black rhinos in the world lives in Namibia’s Etosha National Park. It also has many waterholes that attract all types of African wildlife. This destination should be a part of any nature afficionado’s itinerary.

Namibia also has other great spots to stop at such as Swakopmund. It’s a great location for skydiving, kitesurfing and incredible views of sand dunes. No matter the type of person, Namibia has something to offer for everyone.

What are some Namibian travel destinations that you would add to your safari roadmap? Leave an answer in the comments below or on Passport Health’s Facebook and Twitter pages!

Filed Under: General Posts

Tuberculosis in China Remains an Ongoing Concern

June 20, 2016 by Will Sowards Leave a Comment

TB is a serious issue in China and other key regions.

China has a tuberculosis (TB) problem, one that generates a million new cases each year. Despite fewer cases, the disease remains a significant problem for much of the country.

Tuberculosis infections have declined each year since the 1990s. The prevalence per 100,000 population decreased from 215 in 1990 to 68 in 2014. This is due to government outreach and the help of global health organizations. But, many suffer from TB and an alarming number of these cases are drug-resistant.

China has the most cases of multi-drug-resistant tuberculosis in the world. Many of these patients go undiagnosed. This creates an increased risk of infection to others living in or traveling to the country.

Many people in China infected by TB come from poor socioeconomic groups in rural areas. Public healthcare is less than ideal in these regions. Often patients do not know they are carriers or cannot afford the treatments they need.

Tuberculosis is a bacterial infection that attacks the lungs. According to the Centers for Disease Control, the most common symptoms are:

  • A bad cough lasting three weeks or longer
  • Chest pain
  • Coughing up blood or sputum (mucus from deep in the lungs)
  • Weakness or fatigue
  • Other symptoms include weight loss, loss of appetite, chills, fever and night sweats

TB only spreads through the air, via infected air droplets, and not by shaking hands or sharing food. Whenever an infected person coughs, sneezes, or speaks, anyone standing nearby may become infected.

Not everyone infected by tuberculosis becomes sick right away. There are two forms of the disease: latent TB disease and TB disease. Those with latent TB are not infectious and may have no symptoms. Their body was able to isolate the bacteria and prevent it from growing. But, the bacteria lies dormant in the body and can become active at any time.

Latent tuberculosis infection is a problem in China and many other countries. Travelers are at increased risk of coming in contact with infected persons than they are at home.

This is why testing for TB is so crucial. You may have latent TB and not know it, especially if you have traveled to areas where the disease is endemic.

There are two diagnostic tests used to identify TB bacteria:

  • Skin test (also known as the PPD test)
  • Blood test

TB testing will not identify the type of infection, only whether you are infected. X-rays or other testing may be necessary if tests come back positive. Treatment usually starts immediately with oral medications. It can take up to a year to overcome TB.

Tuberculosis vaccination is common in some countries but is not available in the U.S.. The vaccine is not always effective in adults and can interfere TB testing. The CDC does not recommend its use.

There are ways you can protect yourself from this disease. Prevention is key to minimizing the risks of contracting TB. The CDC recommends travelers do the following to avoid TB:

  • Avoid exposing yourself to people with active TB, especially in warm, small rooms.
  • If you work in healthcare settings, wear a face mask to avoid breathing in the bacteria.
  • If you expect long-term exposure to victims of TB, receive a TB test upon your return.

To learn more about TB, see our tuberculosis testing page.

Are you planning on traveling to China or another country with endemic tuberculosis? Or, have you recently returned a from a TB-endemic area?

Protect your health by making an appointment with a travel health specialist today. Visit a Passport Health clinic to receive more information about TB or for testing. Book your appointment today by calling or schedule online now.

Let us know what you think about the continuing problem of TB disease in China. Comment below, on Facebook or via Twitter.

Filed Under: General Posts

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