We are NOT authorized by Govt of India for Yellow Fever Vaccination

Saturday, June 29, 2013

Yellow fever shot farce at airport makes Bangalorean see red - Quarantined for no certificate

His forced quarantine on returning from Colombia was a charade

It was an experience that left him both rattled and fuming. When film expert George Kutty returned last week from Colombia, he was stopped at immigration at the Bengaluru International Airport for not getting the yellow fever shot, a prerequisite for those returning from many African and South American countries.
What followed was nothing less than an ordeal for the 62-year-old Bangalorean, angered by what he calls the “farce” of the quarantine process that followed. In the middle of the night, immigration insisted he be sent to a private hospital in Ulsoor to be quarantined for six days (as he had already travelled for three days, he would have had to stay put in isolation for three more).
‘Archaic and racist’
Mr. Kutty says that the rule itself is “archaic” and one that smacks of “racism”. But, even if that is the rule, he asks, of what use is it if the only purpose is to make people pay an exorbitant amount as hospital fee for the quarantine period and then send them back home.
The hospital issued him a bill for Rs. 10,000 (with a waiver of Rs. 3,000), which included bed charges, nursing charges and resident duty doctor fee for facilities he never used. All the “treatment” he got was three sessions where his temperature and blood pressure were checked. He even got a discharge slip that states that he was quarantined, monitored and declared fit. In the meanwhile, not only did Mr. Kutty not quarantine himself, he also (with the doctor’s permission) visited Kolar to attend a film event.
“If they were serious about the rule, they would have implemented it sincerely at three levels: when I left the country, by the airline (which never asked me for any vaccination) and then when I come back, where I am subjected to a real quarantine process,” he contends.
Rules are rolls: official
An immigration official, who spoke to The Hindu on condition of anonymity, denied that the rule was being enforced arbitrarily. “Once in a while people get by but the rulebook mandates that all travellers entering the country from African and South American countries get the yellow fever vaccination. When asked why Mr. Kutty was not stopped when he was leaving for Colombia, he said that the government does not enforce the rule for those leaving India. “We cannot comment on whether there are any real cases of yellow fever as we immediately refer them to the empanelled hospital.”
The hospital doctor remained unavailable for comment.

Thursday, June 27, 2013

Pan American Health Organization: Dengue Alert

PAHO / Epidemiological alert: Dengue : June 21, 2013 

The Pan American Health Organization/World Health Organization (PAHO/WHO) recommends that Member States, especially those in Central America, Mexico and the Caribbean, which are entering the rainy season with a higher rate of dengue transmission, continue preparation and response efforts, based on lessons learned and using the Integrated Dengue Management Strategies (IDS-Dengue) approach for prevention and control, with an emphasis on reducing deaths.
Current situation
From the beginning of 2013 up to epidemiological week (EW) 21, there have been 868,653 cases of dengue, 8,406 cases of severe dengue and 346 deaths (case fatality rate of 0.04%)in the Region of the Americas. The circulation of the 4 serotypes in the Region increases the risk of severe forms of dengue.
In the first semester of 2013, outbreaks of dengue were registered in Brazil, Costa Rica, Colombia, Paraguay and the Dominican Republic. In places like Peru, cases were registered where there had previously not been locally acquired dengue cases.
Given the usual pattern of dengue in the Region, an increase in cases is expected in the coming months in Central America, Mexico and the Caribbean. This increase would coincide with the rainy season of those countries.

This alert is to advise Member States that are entering the period of increased dengue transmission, to continue coordination with other sectors, based on the activities in the IDS-Dengue and comprehensive outbreak response plans.
 
Member States are also encouraged to adapt health services to receive a greater volume of patients, as well as strengthening and providing updates for health personnel on detecting warning signs of dengue and on the clinical management of cases.
 

JAPAN/ Over 10,000 cases of Rubella recorded so far in Japan this year


JAPAN: The National Institute of Infectious Diseases : June 18, 2013
 
The National Institute of Infectious Diseases reported Tuesday that Rubella in Japan has reached 10,000 cases early this month. As of June 9, there were 10,102 cases in the country, four times higher than last year’s 2,392 cases. The Institute reported last month that 5,000 cases were recorded in the first four months of 2013.  That implies that the past two months have easily doubled the number of cases.
The latest week’s cases were highest in Osaka and Tokyo Prefectures with new 129 and 82 cases, respectively.
Mapping the spread of the virus may no longer be based on prefecture proximity, as both prefectures are separated by the Chubu Region, or central Japan. With about 800 cases every seven days during the earlier weeks, the National Institute of Infectious Diseases should’ve reckoned its effect with such escalating cases.
 
The epidemic has been more prevalent among men from 20 to 40 years old, amounting to 75 percent of the cases.
Also known as German Measles or Three-Day Measles, Rubella is considered a mild infection except for those who are pregnant.
 
The virus, when caught by someone pregnant, may cause severe congenital complications like growth and mental retardation, deafness, and heart defects among others. Rubella may also cause stillbirth.
 
The symptoms of Rubella are not easily noticed and may be mistaken as those of flu so pregnant women are always told to take precautions especially during the first trimester of pregnancy.
 

Wednesday, June 26, 2013

Yellow Fever in Ethiopia - new cases reported after 45 years

Released: June 14, 2013

What is the current situation?

The World Health Organization (WHO)External Web Site Icon has reported six confirmed cases of yellow fever in Ethiopia. These are the first confirmed cases of yellow fever in Ethiopia in more than 45 years.The first case in this outbreak occurred in January 2013. All cases have been reported in the South Omo Zone in the Southern Nations, Nationalities, and Peoples’ regions of Ethiopia. In response, the Ministry of Health of Ethiopia launched an emergency yellow fever mass-vaccination campaign in June.

How can travelers protect themselves?

  • CDC recommends the yellow fever vaccine for travelers to most parts of Ethiopia. Learn more about CDC’s yellow fever recommendations for Ethiopia on the Ethiopia destination page.
  • Travelers can protect themselves from yellow fever by getting yellow fever vaccine and preventing mosquito bites.

Get yellow fever vaccine:

  • Visit a yellow fever vaccination (travel) clinic and ask for a yellow fever vaccine.
    • You should receive this vaccine at least 10 days before your trip.
    • After receiving the vaccine, you will receive a signed and stamped International Certificate of Vaccination or Prophylaxis (ICVP, sometimes called the “yellow card”), which you must bring with you on your trip.
    • Protection from the vaccine lasts for 10 years.
    • In rare cases, the yellow fever vaccine can have serious and sometimes fatal side effects. People older than 60 years and people with weakened immune systems might be at higher risk of developing these side effects. Also, there are special concerns for pregnant and nursing women. Talk to your doctor about whether you should get the vaccine.

Prevent mosquito bites:

  • Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
  • Use an appropriate insect repellent as directed.
  • Higher percentages of active ingredient provide longer protection. Use products with the following active ingredients:
    • DEETExternal Web Site Icon (Products containing DEET include Off!, Cutter, Sawyer, and Ultrathon)
    • Picaridin (also known as KBR 3023, Bayrepel, and icaridin) (Products containing picaridin include Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan [outside the US])
    • Oil of lemon eucalyptus (OLE) or PMD (Products containing OLE include Repel and Off! Botanicals)
    • IR3535 (Products containing IR3535 include Skin So Soft Bug Guard Plus Expedition and SkinSmart)
  • Always follow product directions and reapply as directed:
    • If you are also using sunscreen, apply sunscreen first and insect repellent second.
    • Follow package directions when applying repellent on childrenExternal Web Site Icon. Avoid applying repellent to their hands, eyes, and mouths.
  • Use permethrin-treatedExternal Web Site Icon clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself:
    • Treated clothing remains protective after multiple washings. See the product information to find out how long the protection will last.
    • If treating items yourself, follow the product instructions carefully.
    • Do not use permethrin directly on skin.
  • Stay and sleep in screened or air-conditioned rooms.
  • Use a bed net if the area where you are sleeping is exposed to the outdoors.

Yellow fever vaccine shortage drives travelers to Mumbai centre

Snehlata Shrivastav & Chinmayi Shalya, TNN | Jun 26, 2013, 02.56 AM IST
MUMBAI\NAGPUR: An acute shortage of yellow fever vaccine in the last few months has sent people scurrying to Mumbai from across the country. The vaccine is out of stock at most government centres, including Delhi, Cochin, Nagpur, Bangalore, Chennai and Goa among other places. The shortage has also forced the government to allow a private sector firm to sell the vaccine in the market, a move few are aware of. While the vaccine is sold by the private firm at five times the original rate, it has to taken to a government centre to be administered. 

However, the shortage at government centres has brought those set to travel to South America and Africa, flocking to the Airport Health Organisation (AHO) at Mumbai airport, the only big centre with any stock of the vaccine. Travellers are queuing up 10-12 hours in advance to make it to the quota of 70 people vaccinated per day. 

WHO norms make it mandatory for every foreigner travelling to 33 African and 11 South American countries to be vaccinated 10 days before their date of arrival, as 'yellow fever' is endemic there. The vaccine, which should ideally be available at all international airports and 18 other centers across the country, has gone out of stock everywhere except at the international airport Mumbai. Vaccination centres at Nagpur, Delhi, Panaji and Cochin confirmed the shortage. There are also reports of a shortage at Hyderabad and Ahmedabad for two months now.

A private company has already brought the vaccine to the market. "It is available in shops where instead of the government rate of Rs 300, it is priced at Rs 1,534. A person can bring it to the centre and we will administer it and issue a certificate," said P M Gaikwad, airport health officer at Mumbai. The firm has already received one shipment of the vaccine. "A major part of the first shipment that arrived has already been provided to government institutions. We are expecting further shipments and are working to ensure that the vaccine is made available in required quantities as soon as possible," said a spokesperson from Sanofi Pasteur, the firm which sourced the vaccine. 

The vaccine was earlier distributed solely by the government to authorized centres across the country. The shortage started after production of the vaccine was halted two years ago at the Central Research Institute in Kasauli, Himachal Pradesh, the only manufacturing unit. In the last two months, various centres across India have reported a shortage of the vaccine. "The shortage wasn't addressed in the beginning and now most centres have run out of stock," said an official at one of the centres at Mumbai. The vaccine centre at Ballard Pier in Mumbai ran out of stock a couple of months ago, leaving the centre at the airport to face the rush. 

The shortage has not only inconvenienced travellers by forcing them to come to Mumbai, but has allegedly opened up avenues for corruption. The health centre at Mumbai airport gives only 70 vaccinations per day on a first-come-first-serve basis and anxious travellers start queuing outside the centre from 2am. However, some travelers claimed there was a "VIP" queue if one paid Rs 2,500 for the vaccine. On June 24, the centre reportedly vaccinated 70 more people from the queue for an extra charge. People kept trickling in till 4pm, three hours after the scheduled vaccination time, paying extra for the vaccinations. A sailor, scheduled to set sail next week, had to pay the 'extra charges' despite standing in the queue since 4.30am at Mumbai. "I queued up at 4.30am and still I was 93rd in the queue," said the sailor who didn't want to be named. He said he was among the next 70 people who got the vaccination after paying Rs 2,500. A family of six said they got their vaccination without standing in the queue as their travel agent "had arranged it". However, doctors at the centre refuted these charges. 

Some travelers were forced to cancel their holiday plans due to the vaccine shortage. Dr Sanjay Marathe, a paediatrician from Nagpur, told TOI he was to travel to Tanzania on a holiday with his family but had to give up the idea as Hope Hospital, the only certified one in Nagpur to give the vaccine, didn't have the vaccine.
Source

Wednesday, June 12, 2013

Yellow fever vaccination booster not necessary, says WHO

The ten-year yellow fever ‘booster’ vaccination is no longer needed, according to the World Health Organization (WHO). This is important news for yellow fever endemic countries and travellers. There is an estimated 200 000 cases of yellow fever each year.
WHO’s Strategic Advisory Group of Experts on immunization (SAGE) has reviewed the latest evidence and concluded that a single dose of vaccination is sufficient for life-long immunity against yellow fever.  The report can be found in WHO’s Weekly Epidemiological Record (WER).
“The conventional guidance has been that the yellow fever vaccination has had to be boosted after ten years,” says Dr Helen Rees, chair of SAGE. “Looking at really very good evidence, it was quite clear to SAGE that in fact a single dose of yellow fever vaccine is effective. This is extremely important for countries where yellow fever is endemic, because it will allow them to reconsider their vaccine scheduling. It is also important for travellers.”
Yellow fever is a viral disease that is transmitted by infected mosquitos. The number of people infected with yellow fever has been on the increase throughout Africa, the Americas and several Caribbean islands. Yellow fever has emerged as a serious public health problem once again.
Yellow fever gets its name from two of its most obvious symptoms: fever and yellowing of the skin. The yellowing occurs because the virus can damage the liver and other internal organs. Infection causes a wide spectrum of sickness, from mild symptoms to severe illness and death.
Yellow fever is often very difficult to accurately diagnose. It is often confused with severe malaria, dengue hemorrhagic fever, viral hepatitis and other viruses such as West Nile, Zika virus as well as other hemorrhagic conditions.
The first symptoms of the disease usually appear 3 to 6 days after being infected. Initial symptoms include fever, muscle pain, headache, shivers, loss of appetite, nausea and vomiting. These symptoms disappear after 3 to 4 days in most patients.
About 15 per cent of patients enter a second, more toxic phase of yellow fever. This phase is characterized by the rapid development of yellow skin, abdominal pain and vomiting. Bleeding can occur from the mouth, nose and eyes. Internal bleeding often becomes visible through bloody vomit and feces.
There is no cure for yellow fever and any treatments are aimed to reduce dehydration, respiratory distress and fever. Fatality rates for reported cases range from 15 to 50 per cent.
“At present, 33 countries, with a combined population of 468 million, are at risk in Africa. In the Americas, yellow fever is endemic in ten South American countries and in several Caribbean islands. Bolivia, Brazil, Colombia, Ecuador and Peru are considered at greatest risk,” says the WHO.
Vaccination is considered to be the most important and effective measure against yellow fever. Immunity develops within 30 days for 99 per cent of people receiving the vaccination.
Since the yellow fever vaccination was first introduced in the 1930s, only 12 known cases of yellow fever post-vaccination have been identified. Over 600 million doses have been effectively dispensed and utilized.
People who are not recommended to be vaccinated include children aged less than 9 months, pregnant women and people with severe immune system impairment due to symptomatic HIV/AIDS.
Dr Cory Couillard is an international healthcare speaker and columnist for numerous newspapers, magazines, websites and publications throughout the world. He works in collaboration with the World Health Organization's goals of disease prevention and global healthcare education. Views do not necessarily reflect endorsement.
Email: drcorycouillard@gmail.com
Facebook: Dr Cory Couillard
Twitter: DrCoryCouillard

Tuesday, June 11, 2013

Yellow Fever Outbreak Prompts Emergency Mass-Vaccination Campaign In Ethiopia

There has been six laboratory confirmed yellow fever cases from South Omo, in the Southern Nations, Nationalities and Peoples’ region in Ethiopia as of May 7, prompting the Ministry of Health of Ethiopia to launch an emergency mass-vaccination campaign that will cover more than a half-million people, according to a World Health Organization outbreak update May 31.The mass yellow fever vaccination campaign will commence on June 10 and will immunize more than 527, 000 people in the following six districts: South Ari, North Ari, Benatsemay, Selamago, Hammer, and Gnangatom and one administrative town (Jinka) in South Omo Zone of the Southern Nations, Nationalities and Peoples’ region (SNNPR) of Ethiopia.
The International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG) will provide over 585,800 doses of yellow fever vaccine for the mass vaccination campaign run by the Ministry of Health in Ethiopia, with support from the GAVI Alliance and other partners.
The positive cases were discovered through the national surveillance program for yellow fever.
According to the CDC, yellow fever virus is found in tropical and subtropical areas in South America and Africa. The virus is transmitted to humans by the bite of an infected mosquito.
Illness ranges in severity from a self-limited febrile illness to severe liver disease with bleeding. Yellow fever disease is diagnosed based on symptoms, physical findings, laboratory testing, and travel history, including the possibility of exposure to infected mosquitoes.
There is no specific treatment for yellow fever; care is based on symptoms. Steps to prevent yellow fever virus infection include using insect repellent, wearing protective clothing, and getting vaccinated.

Thursday, June 6, 2013

Chikungunya cases suspected in Karnataka, India

Published Date: 2013-06-03 13:04:20
Subject: PRO/EDR> Chikungunya (18): India (KA) susp 
Archive Number: 20130603.1751840
CHIKUNGUNYA (18): INDIA (KARNATAKA) SUSPECTED
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Date: Sat 1 Jun 2013
Source: The Times of India, Times News Network (TNN) [edited]
http://timesofindia.indiatimes.com/city/bangalore/8-suspected-case-of-Chikungunya-reported-in-four-villages-of-Hukkeri-Taluk/articleshow/20386735.cms


As many as 8 suspected cases of chikungunya were reported from 4 villages of Hukkeri Taluk on Saturday [1 Jun 2013]. District health officials have taken all precautionary measures to control the disease. 

According to district health official sources, there have been no cases of chikungunya [virus infections] in the district for the past 2 years, but this year [2013] already the district has reported 6 cases. There are 8 suspected chikungunya cases in 4 villages of Hukkeri Taluk: Gejapati, Guthugutti, Rajagatti, and Yellapur villages with populations of 1200, 2700, 2000, and 600 people respectively. The 4 villages come under the care of Islamphur Public Health Centre.

When many people came to the health centre with similar symptoms, health officials became alert and when they inspected the villages [they suspected] cases of chikungunya [virus infections]. The district administration has taken all precautionary measures to tackle the disease. The district health officer Dr Dileep Kumar Munoli, Dr Jagadish Nuchin, district surveillance officer, and Dr Rajanish Meti, district epidemiologist visited the villages, [assessed the situation], and made necessary arrangements to tackle the disease. The health officials also conducted house-to-house larvae surveys and fogging. The health department has also set up mobile clinics in the villages.

Due to the scarcity of water, people in villages store water for longer periods without proper cover, which favors mosquito [reproduction]. Hence, health officials have called upon the people to keep water containers properly and tightly closed.

[byline: R Uday Kumar]

--
communicated by:
ProMED-mail from HealthMap Alerts


[No mention is made of the clinical symptoms observed in these cases, and especially of acute arthralgia, a common symptom of most chikungunya virus infections. Joint pain can be so severe that it is incapacitating, and may last for weeks or months. It is not stated if samples have been sent for laboratory tests. This is important to know if this outbreak is really due to chikungunya virus or to dengue virus infections, or to a mixed outbreak of both. Interestingly, there is another outbreak of chikungunya virus infections in south east Karnataka state, far from the one described above.

Cholera cases continue in Haiti

Archive Number: 20130603.1753128
CHOLERA, DIARRHEA & DYSENTERY UPDATE (19): MARTINIQUE ex HAITI, HAITI
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ProMED-mail is a program of the
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[1] France: (Martinique Overseas Region) ex Haiti
Date: Sat 1 Jun 2013
Source: DOMactu [mach. trans., edited]
http://www.domactu.com/actualite/135312243345124/martinique-cas-confirme-de-cholera-en-martinique/


A man, aged 63 from Haiti, presented on Thursday, 30 May 2013, night at the emergency department of the CHU of Fort-de-France, in a state of dehydration. The tests quickly confirmed that he was suffering from cholera. So far, this does not imply the risk of an epidemic, according to the regional health agency.

The man was immediately placed in isolation room and was seriously ill as judged by doctors. The clinical signs appeared several hours after his aircraft landed from Port-au-Prince. Any contamination of other passengers on the flight is therefore excluded, according to the doctor.

Health authorities remain on alert for the people that would have been in contact with the patient upon his arrival in Martinique. But, for the moment, no disturbing symptoms have been reported.

[byline: Philippe Daniel]

communicated by:
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[A HealthMap/ProMED map can be accessed at http://healthmap.org/r/3EpV]

******
[2] Haiti (Port-au-Prince)
Date: Fri 24 May 2013
Source: Peoria (IL) Journal Star [edited]
http://blogs.pjstar.com/haiti/2013/05/24/cholera-alive-and-well-in-cite-soleil-may-24-2013/


At the Cholera Treatment Center-Saint Mary on the Soleil Wharf this afternoon, 24 May 2013, there are 6 inpatient pediatric cases being treated with IV fluids and 1 toddler being treated with oral rehydration solution. All of these kids are from Soleil except one who is from Drouillard (a zone just outside of Soleil).

There are 6 adult inpatient cholera patients in the adjoining room.

Like clockwork, 6 to 12 hours after the rain comes in the late afternoon, patients present to this CTC with vomiting and diarrhea. And it is clouding up right now and raining almost every day now during Haiti's rainy season.

[byline: John A Carroll, MD ()]

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[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/22DW]

[Whether spread of cholera will occur when introduced into a non-endemic area depends a lot on the degree of sanitation that is present there. In the developed world, there is little chance of much spread but, as seen in Haiti and to a lesser extent in the Dominican Republic and Cuba, poor infrastructure begets the spread of waterborne diseases such as cholera and typhoid. - Mod.LL]

Wednesday, June 5, 2013

Outcomes following novel influenza A H7N9 virus infection - Lancet 2013 - Worrying signs of emerging Antiviral Resistance

The Lancet. 2013; doi:10.1016/S0140-6736(13)61125-3.

Background
On March 30, a novel influenza A subtype H7N9 virus (A/H7N9) was detected in patients with severe respiratory disease in eastern China. Virological factors associated with a poor clinical outcome for this virus remain unclear. We quantified the viral load and analysed antiviral resistance mutations in specimens from patients with A/H7N9.


Methods
We studied 14 patients with A/H7N9 disease admitted to the Shanghai Public Health Clinical Centre (SPHCC), China, between April 4, and April 20, 2013, who were given antiviral treatment (oseltamivir or peramivir) for less than 2 days before admission. We investigated the viral load in throat, stool, serum, and urine specimens obtained sequentially from these patients. We also sequenced viral RNA from these specimens to study the mutations associated with resistance to neuraminidase inhibitors and their association with disease outcome.


Findings
All patients developed pneumonia, seven of them required mechanical ventilation, and three of them further deteriorated to become dependent on extracorporeal membrane oxygenation (ECMO), two of whom died. Antiviral treatment was associated with a reduction of viral load in throat swab specimens in 11 surviving patients. Three patients with persistently high viral load in the throat in spite of antiviral therapy became ECMO dependent. An Arg292Lys mutation in the virus neuraminidase (NA) gene known to confer resistance to both zanamivir and oseltamivir was identified in two of these patients, both also received corticosteroid treatment. In one of them, wild-type sequence Arg292 was noted 2 days after start of antiviral treatment, and the resistant mutant Lys292 dominated 9 days after start of treatment.


Interpretation
Reduction of viral load following antiviral treatment correlated with improved outcome. Emergence of NA Arg292Lys mutation in two patients who also received corticosteroid treatment led to treatment failure and a poor clinical outcome. The emergence of antiviral resistance in A/H7N9 viruses, especially in patients receiving corticosteroid therapy, is concerning, needs to be closely monitored, and considered in pandemic preparedness planning. 
Hu Y, Lu S, Song Z, et al. Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance. The Lancet. 2013; doi:10.1016/S0140-6736(13)61125-3.

Hepatitis A cases spread to Hawaii - due to frozen berries

HEPATITIS A - USA (02): FROZEN BERRIES
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Date: Mon 3 Jun 2013
Source: Food Safety News [edited]
http://www.foodsafetynews.com/2013/06/outbreak-of-rare-strain-of-hepatitis-a-spreads-to-hawaii/#.UazBiNK-2So


Outbreak of rare strain of hepatitis A spreads to Hawaii
--------------------------------------------------------
Another Western state was touched by the outbreak of a rare strain of hepatitis A [virus], adding two more individuals to the list of those sickened nationwide. Hawaii is the sixth state to be added to the growing outbreak. State health officials in Hawaii say two adults, one from the island of Oahuand and the other from Kauai, are among those sickened with the liver disease.

Like at least another 30 victims on the mainland, the Hawaii residents are believed to have consumed a frozen organic berry mix purchased at local Costco outlets. The national warehouse outlet based in Seattle has removed the product from its shelves, and contacted members who purchased the mixed berry product. But the weekend passed without any official recall by manufacturer of the suspect product, Townsend Farms, based in Oregon.

Townsend Farms Organic Anti-Oxidant Blend contains berries from multiple locations (Argentina, Chile, and Turkey) and a pomegranate seed mix from Egypt, according to health officials. On Friday, the federal Centers for Disease Control and Prevention (CDC) in Atlanta said the outbreak strain (Hepatitis A virus, genotype 1B,) usually isn't seen in the Western Hemisphere, but is commoner in the Middle East and Northern Africa. The US Food and Drug Administration (FDA) expanded its ongoing investigation over the weekend to include Hawaii in addition to the original five sticker states of Arizona, California, Colorado, New Mexico, and Nevada.

Anyone who ate the Townsend Farms Organic Antioxidant Blend frozen berries in the last 14 days should contact their personal physician or public health department about getting a vaccination or immune globulin injections, which are administered prophylactically. Individuals requiring those treatments can become part of a class action lawsuit being filed against Townsend Farms today by the national foodborne illness law firm of Marler Clark. "Consumers of organic frozen berries should not have to worry about their safety," said William Marler, attorney for the plaintiffs. (Marler is also publisher of Food Safety News).

(byline: Dan Flynn)

--
communicated by:
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[Recently outbreaks of hepatitis A associated with consumption of meals prepared with frozen berries have been reported from British Columbia, five mainland US states, several countries in Northern Europe, and now Hawaii. In all cases the outbreak strain was identified as hepatitis A virus, genotype 1B, a genotype rarely seen in the Americas, but commoner in the Middle East. In the previous incidents the source of the berries was not determined, but in the most recent incident in Hawaii the origin of the frozen berries was reported to be from multiple locations (Argentina, Chile, and Turkey). The outbreaks in the United States appear to have been traced to a single supplier, but as yet there has been no recall of the product. - Mod.CP

Updated list of Government Yellow Fever Vaccination Centers with Contact Information

List of Yellow Fever Vaccination Centres 

(APHO - Airport Health Organization, PHO - Port Health Orgnization)

1. APHO, New Delhi - Tuesday & Thursday - 2:00 PM – 4:00 PM - 011-25655081 (O) 011-25655079 

2. PHO, Chennai - Monday & Wednesday - 044-25260038 (O) 044-25243939 (O) 044-25225858

3. PHO, Cochin - Wednesday & Friday - 10 AM – 02:30 PM - 0484-2666060 (O) 0484-2666060

4. PHO, Visakhapatnam - Monday & Thursday - 10 AM – 01:30 PM* - 0891-2562681 (O) 0891-2562681

5. PHO, Kandla Thursday 02839-270220 (O) 02839-270189

6. PHO, Kolkata Monday, Wednesday & Friday - 033-22230904 (O) 033-22230435

7. APHO, Kolkata Tuesday & Thursday - 12:00 – 02:30 PM - 09831047763 (M), 033-25119044 (O)
033-25119370

8. APHO, Mumbai Monday, Tuesday, Wednesday, Thursday & Friday - Registration: 10:00 AM – 
11:30 AM - Vaccination timings: 12:00 – 02:00 PM
022-28392302 (O), 022-28322353 (O), 022-28392429 

9. PHO, Marmagoa (Goa) - Thursday - 09:00 AM – 12:00 - 0832-2520292(O) 0832-2520292

10. PHO, Mumbai Monday, Tuesday, Wednesday, Thursday & Friday - 10 AM – 02:30 PM - 
022-22020027(O), 022-22612256, 022-22020814

11. General Hospital, Gandhinagar, Ahmedabad, Gujarat - Monday - 09:00 AM – 12:00 - 
079-23221931-32, 079-23221913, 079-2322733

12. Bhavsinhji (General) Hospital, Porbandar - Thursday - 9:30 AM - 12:30 PM 
09099079101 (M), 0286-2242910, 0286-242910

13. Armed Force Clinic, Dalhousie Road, New Delhi - Monday – Friday - 09:00 AM - 05:00 PM 
011-23019405 011-23792356

14. A.M.C., Health E.P.I. Department, Ahmedabad - Tuesday & Thursday - 11:00 AM – 5:00 PM 
079-25391811 Ext. 698 

15. MCD, Public Health Department, Civic Centre, New Delhi - Monday & Friday - 10:00 AM – 12:00 
011-23226913, 011-23226920

16. Urban Health Centre, Panaji, Goa - Every 2nd & 4th Wednesday of month - 09:00 AM – 1:00 PM 
09011025021 (M), 0832-2225668, 0832-2225646, 0832-2225561, 0832-2225538 

17. Public Health Institute, Sheshadri Road, Bengaluru - Wednesday - 10:30 AM – 12:00 
080-22210248, 080-22213824, 080-22277389

18. Dr. RMLH, New Delhi Wednesday – 10 AM - 11.30 AM, Saturday 9.30 AM – 11.00 AM 
09818118398 (M), 011-23404668, 011-23361164

19. AIIH&PH, C.R. Avenue, Kolkata - Friday 11:00 AM- 01:00 PM - 033-22412888 033-22418717

20. Treatment Centre, Central Research Institute, Kasauli, HP - Monday & Thursday 2:00 PM – 4:00 PM 
01792-272538, 01792-273209, 01792-272016

21. Health Department, International Inoculation Centre, Mandir Marg, New Delhi - Wednesday & Friday
2:00 PM – 4:00 PM
09811547118 (M), 011-23362284, 011-23742752

22. Commandant, Base Hospital, Delhi Cantt. PO Kirby Place, Delhi - Monday-Friday - 08:00 AM – 01:00 PM
011-25693422, 011-25693423, 011-25281531

23. King Institute of Preventive Medicine and Research, Guindy, Chennai - Friday 10:00 AM – 1:00 PM 
044-22501520, 044-22501521, 044-22501263

24. Balrampur Hospital,  Lucknow (U.P.) - Thursday 8:00 AM - 1:00 PM
09335281326 (M) 0522-2629949

25. Institute of Preventive Medicine, Public Health,  Labs and Food (Health) Admn., Narayanaguda, Hyderabad - Tuesday and Friday - 09:00 AM – 02:00 PM
09441152515 (M), 040-27557728, 040-27567894

26. Guru Gobind Singh Govt. Hospital, Jamnagar - Monday and Thursday - 03:00 PM – 05:00 PM 
09426233477 (M), 0288-2554629, 0288-2679592

27. Station Health Organisation (Navy), Old Navy Nagar, Colaba, Mumbai-400005 
Daily only for serving persons - 09:00 AM – 1:00 PM* 
09757403517 (M), 022-22152080 (O), 022-22152080
* Contact the centre before visiting vaccination centre.

Source

28. YELLOW FEVER VACCINATION IS NOW AVAILABLE IN SASSOON HOSPITAL (OPD BUILDING - ROOM NO. 80), PUNE. ONLY ON MONDAY 0900 TO 1200 HRS LIMITED ONLY FOR 30 PERSONS. COST RS.310/- PER PERSON (as personal communication)

Advisory: The list is provided on an as is basis, no guarantees can be made regarding its accuracy. Government numbers are notoriously difficult to reach, so please be patient.

TravelSafe Clinic launches in Mumbai now!

On popular demand TravelSafe Clinic has finally launched in Mumbai.
Details of the same will be posted in subsequent posts, but suffice to say that International level Travel Health services, Yellow Fever Vaccines, other travel vaccinations and medical consultations are now available to residents of Mumbai, and travelers to & from Western India as well. For everyone in Maharashtra (especially Pune), Gujarat, & the rest of South India, please get your travel consultations done at our Mumbai Clinic now. 
Our address is

TravelSafe Clinic Mumbai,
Shop no. 3, 
Navratan apartments
Near four wheel world showroom
Maitri park, 
Sion Trombay Road,
Chembur, Mumbai -400071





View Larger Map 

DOCUMENTS REQUIRED - copy of passport
YELLOW FEVER CERTIFICATE by WHO IS ISSUED IMMEDIATELY .

Office Hours: By appointments between 1000 and 1100 and 1800 and 1900, Mondays through Saturdays. Sunday Closed
DirectionsWe are located in the heart of Chembur (E), a suburb of Mumbai. We are on Sion Trombay Road, at Maitri Park Signal, that is beyond Diamond Garden (two minutes drive) when going towards Vashi.


Please contact Malini- 9867694813 for appointments
For general queries you can contact our Central Office (in Chandigarh) too at 0172-5092585, 0172-4663775, 09872303775


Tuesday, June 4, 2013

Rubella Epidemic continues in Japan

Archive Number: 20130604.1754725
RUBELLA - JAPAN (07): UPDATE
****************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 4 Jun 2013
From: Kentaro Iwata [edited]


[This report is an update and revised version of previous reports by Dr Mugen Ujiie, Tokyo, Japan. - Mod.CP]

A rubella epidemic still continues in Japan. The epidemic was mainly in Tokyo, the capital of Japan, but now has spread to almost all over Japan. According to the National Institute of Infectious Diseases, as of week 21, 2013 [week ending 25 May 2013], Osaka area, on the west side of Japan, exceeded Tokyo in regards to the number of rubella cases. 204 cases of either clinically or laboratory-confirmed rubella cases were reported from Osaka that week, followed by Tokyo (112 cases), Hyogo (85 cases), and Kanagawa (61 cases). 672 cases of rubella were reported on week 21 from all over Japan. As of this week, 8507 cases of rubella were reported in total, which is far more than the total number of rubella cases reported in 2012 (2392). The majority of the patients are males in their 30's, who often missed rubella vaccination (vide infra).

As of [10 May 2013], 5 new cases of congenital rubella syndrome (CRS) have been reported in 2013. In the last decade, 25 cases of CRS were reported in Japan, including those reported this year [2013]. Some municipalities decided to subsidize vaccination fees for those who are at risk. However, Japan's Government has not moved forward to change the current status; it will not subsidize vaccination fees for anybody beyond children on the routine vaccination schedule, nor develop catch-up vaccination program for adolescents or adults at risk.

Generally, rubella is common in the spring to summer. Therefore, the number of patients may continue to rise. Urgent vaccinations against rubella need to be promoted for all of people who have never had rubella before and have not been immunized against it.

The original information sources for this report include:
- National Institute of Infectious disease
http://www0.nih.go.jp/niid/idsc/idwr/diseases/rubella/rubella2013/rube13-21.pdf (partly in Japanese),
http://www.nih.go.jp/niid/en/iasren/2930-inx393-e.html
- Tokyo Metropolitan Infectious Disease Surveillance Center
http://idsc.tokyo-eiken.go.jp/assets/weekly/2013/10e.pdf

Rubella is an acute, viral infection spread via droplets. While the illness is generally mild in children, it has serious consequences in pregnant women, causing fetal death or congenital defects known as congenital rubella syndrome (CRS). When an adult woman is infected with rubella virus early in pregnancy, she has a 90 percent chance of passing the virus on to her fetus. This can cause miscarriage, stillbirth, or severe birth defects known as CRS. Infants with CRS may excrete the virus for a year or more. Children with CRS can suffer hearing impairments, eye and heart defects, and other lifelong disabilities, including autism, diabetes mellitus, and thyroid dysfunction, many of which require costly therapy, surgeries, and other expensive care.

Rubella vaccine is normally included as a component of the MMR (measles, mumps, rubella) triple vaccine administered in early childhood. The rubella component of the MMR triple childhood vaccine is a live [naturally] attenuated strain that has been in use for more than 40 years. A single dose gives more than 95 percent long-lasting immunity, which is similar to that induced by natural infection. Because of the occurrence of aseptic meningitis after injection of MMR in 1980's to early 1990's, which was believed to be caused by the mumps component in MMR, the coverage rate of rubella immunization decreased significantly in Japan, particularly in the male population. The Ministry of Health (back then) was intimidated by scores of lawsuits, and was not willing to encourage vaccination programs since then. Japan still has occasional outbreaks of measles and sporadic cases of bacterial meningitis or Japanese encephalitis. These are believed to be partly due to defective vaccination policy and programs in Japan.

--
Communicated by:
Kentaro Iwata, MD, MSc, FACP, FIDSA
Division of Infectious Diseases Therapeutics
Kobe University Graduate School of Medicine
Kusunoki-cho 7-5-2, Chuo-ku, Kobe, Hyogo 650-0017
Japan

[ProMED-mail thanks Kentaro Iwata for provision of this update. It is surprising that under the prevailing circumstances the Japanese government has decided against financing catch-up vaccination. - Mod.CPArchive Number: 20130604.1754725
RUBELLA - JAPAN (07): UPDATE
****************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 4 Jun 2013
From: Kentaro Iwata [edited]


[This report is an update and revised version of previous reports by Dr Mugen Ujiie, Tokyo, Japan. - Mod.CP]

A rubella epidemic still continues in Japan. The epidemic was mainly in Tokyo, the capital of Japan, but now has spread to almost all over Japan. According to the National Institute of Infectious Diseases, as of week 21, 2013 [week ending 25 May 2013], Osaka area, on the west side of Japan, exceeded Tokyo in regards to the number of rubella cases. 204 cases of either clinically or laboratory-confirmed rubella cases were reported from Osaka that week, followed by Tokyo (112 cases), Hyogo (85 cases), and Kanagawa (61 cases). 672 cases of rubella were reported on week 21 from all over Japan. As of this week, 8507 cases of rubella were reported in total, which is far more than the total number of rubella cases reported in 2012 (2392). The majority of the patients are males in their 30's, who often missed rubella vaccination (vide infra).

As of [10 May 2013], 5 new cases of congenital rubella syndrome (CRS) have been reported in 2013. In the last decade, 25 cases of CRS were reported in Japan, including those reported this year [2013]. Some municipalities decided to subsidize vaccination fees for those who are at risk. However, Japan's Government has not moved forward to change the current status; it will not subsidize vaccination fees for anybody beyond children on the routine vaccination schedule, nor develop catch-up vaccination program for adolescents or adults at risk.

Generally, rubella is common in the spring to summer. Therefore, the number of patients may continue to rise. Urgent vaccinations against rubella need to be promoted for all of people who have never had rubella before and have not been immunized against it.

The original information sources for this report include:
- National Institute of Infectious disease
http://www0.nih.go.jp/niid/idsc/idwr/diseases/rubella/rubella2013/rube13-21.pdf (partly in Japanese),
http://www.nih.go.jp/niid/en/iasren/2930-inx393-e.html
- Tokyo Metropolitan Infectious Disease Surveillance Center
http://idsc.tokyo-eiken.go.jp/assets/weekly/2013/10e.pdf

Rubella is an acute, viral infection spread via droplets. While the illness is generally mild in children, it has serious consequences in pregnant women, causing fetal death or congenital defects known as congenital rubella syndrome (CRS). When an adult woman is infected with rubella virus early in pregnancy, she has a 90 percent chance of passing the virus on to her fetus. This can cause miscarriage, stillbirth, or severe birth defects known as CRS. Infants with CRS may excrete the virus for a year or more. Children with CRS can suffer hearing impairments, eye and heart defects, and other lifelong disabilities, including autism, diabetes mellitus, and thyroid dysfunction, many of which require costly therapy, surgeries, and other expensive care.

Rubella vaccine is normally included as a component of the MMR (measles, mumps, rubella) triple vaccine administered in early childhood. The rubella component of the MMR triple childhood vaccine is a live [naturally] attenuated strain that has been in use for more than 40 years. A single dose gives more than 95 percent long-lasting immunity, which is similar to that induced by natural infection. Because of the occurrence of aseptic meningitis after injection of MMR in 1980's to early 1990's, which was believed to be caused by the mumps component in MMR, the coverage rate of rubella immunization decreased significantly in Japan, particularly in the male population. The Ministry of Health (back then) was intimidated by scores of lawsuits, and was not willing to encourage vaccination programs since then. Japan still has occasional outbreaks of measles and sporadic cases of bacterial meningitis or Japanese encephalitis. These are believed to be partly due to defective vaccination policy and programs in Japan.

--
Communicated by:
Kentaro Iwata, MD, MSc, FACP, FIDSA
Division of Infectious Diseases Therapeutics
Kobe University Graduate School of Medicine
Kusunoki-cho 7-5-2, Chuo-ku, Kobe, Hyogo 650-0017
Japan

[ProMED-mail thanks Kentaro Iwata for provision of this update. It is surprising that under the prevailing circumstances the Japanese government has decided against financing catch-up vaccination. - Mod.CP