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

Saturday, December 27, 2014

Sid, the wanderer's story regarding Yellow fever vaccination at the Government centers in Mumbai, india

Source

MY PERSONAL EXPERIENCE

I started from Pune at before 4am and reached a little after 6.30am at the building for vaccination. Everyday there are only 100 visitors who get vaccinated and I was number 104 in the list (where you put in your name and passport number). I decided to take a chance and wait. By eight there were 132 names. Initially we were all in an old room of Nav bhavan on the ground floor, but around 9.30 am they asked us to move out and line up. The line was made on the basis of the list and one of the visitors actually volunteered to help in this. I was well within 100 at this time, as about 12 people were gone already.

Nav Bhavan Building Seaman hospital Mumbai
Waiting inside early in the morning...
Nav Bhavan Building Seaman hospital Mumbai
The crowd waiting before forming a line...
Nav Bhavan Building Seaman hospital Mumbai
Some notices on wall - none are followed

They take two batches of 50 each (or so I think) and so you basically have to wait for a long time to even know if you will get a chance. I was in the line from 9.30 to 12.30 and only then go to know that I won’t get my turn today. It seems many who were not in the line originally, managed to sneak in. Unfortunately no one was in the line after no 85 could vaccinated – despite standing in alternative sun and intense rains!

After trying unsuccessfully at the Seaman Hospital, I decided to book a confirmed ticket to my destination and try again the next morning at Airport Health Organization building. I was super frustratedafter my first attempt and so went to the best five star hotel around, sat in AC, ordered black coffee and chilled for a while! I also came to the Airport building once to check the timings and locate the place so that I do not struggle in the morning and waste some precious minutes. The guard told me to come around 8am.

However, after my experience at the Nav Bhavan Building, I came here at 6am and entered my name in the list right away – I was number seven there :) You can sit at the canteen and sip tea till 8.30am when they open the seating area and you can wait there till 10.00am when the vaccination actually starts.There is a TV, air conditioning and food - what more can one ask? The vaccination process takes almost no time, and its super well organized. You go in batches of ten and the doctor takes less than ten seconds to vaccinate, and before you even know you are out in the open and happy with the day :)

Airport Health Organisation yellow fever vaccination
Airport Health Organisation building 
The canteen :)

Friday, December 26, 2014

Take those shots before hitting wild spots - Times of India

Bengaluru: It's time to explore the unexplored and for a healthy, happy journey. As Bengalureans head in droves to destinations literally in the wild this holiday season, they are also making sure it's a safe trip. So a visit to a doctor and then to the pharmacist to keep a medical kit ready is now a must. 

The concern is understandable. Hot on tourists' itinerary this season are back-of-the-beyond destinations like Kamchatka in far-east Russia; Svalbard off Norway; Pantanal in Brazil; Masai Mara in Kenya and Tanzania. 

Accessing these destinations is in itself a challenge for Bengalureans who live in year-round air-conditioned comfort. Kamchatka calls for a 75-minute chopper ride from Petropavlovsk and Svalbard, a 10-day sail. But the brown bears of Kamchatka, polar bears of Svalbard and wetlands of Brazil, not to speak of African safaris are worth all the trouble if travellers carry medicines and get vaccinated too. 

Manipal Hospitals says they get at least seven patients a week seeking travel advice. "These hitherto unexplored, off-beat nature and wildlife destinations are now being preferred by Bengalureans. They need to be on their guard against sea-sickness, diarrhoea and fever," says Dr Mabel Vasnaik, head of emergency at the hospital. 

Tour operators too give similar advice. "We tell all travellers to carry medicines as often these places are cut-off from cities and people tend to develop certain illnesses," said Giri Cavale, who conducts photography tours across the globe. 

The first travel medicine consultation happens two weeks before the trip. During this, doctors understand the medical history of the individual, the places they intend to travel and nature of travel. "We ask them to come again four weeks after they return," says Dr Swati Rajagopal, consultant, Infectious Diseases and Travel Medicine, Columbia Asia Referral Hospital, Yeshwantpur. She gets 5-6 people daily seeking travel advice. A list of clinics in those destinations is also given. 

BOXES 

LOCALES AND ADVISORIES 

Kamchatka 

Complete with glaciers, rivers, springs and lakes, Kamchatka has 28 active volcanoes and an exotic wildlife. Tourists must watch out for infections and diarrhoea among other things. 

Svalbard 

80 degrees north in the icy Arctic is Svalbard. It is the northernmost part of Norway. Freezing temperatures can leave tourists febrile. 

Immunization 

Vaccinations are recommended for typhoid, Hepatitis A, Hepatitis B, diphtheria, TB, rabies, cholera, yellow fever and Japanese encephalitis depending on the destinations 

GUARD AGAINST 

Fever, fatigue, respiratory tract infections 

Travel diarrhoea 

Gastritis, travel sickness, sea-sickness and allergy 


Source

Sunday, December 7, 2014

Can travel restrictions actually stop spread of diseases?

Travel Restrictions Slow, but Do Not Stop, Pandemic

Sealing international borders, a tactic debated as a way to slow the spread of other contagious diseases, delayed the spread and peak of influenza pandemics from a few days to 4 months but, ultimately, on its own, it could not prevent dissemination of influenza, according to a systematic review.
Dr. Ana L.P. Mateus, from the Field Epidemiology Training Programme, Public Health England (East Midlands Office), Nottingham, United Kingdom, and colleagues report the findings of their metaanalysis online September 29 in theBulletin of the World Health Organization.
According to the authors, the World Health Organization (WHO) in 2007 included travel restrictions in an interim protocol aimed at rapidly stemming the initial emergence of pandemic influenza. Once a pandemic is established, however, WHO takes a dim view of such travel restrictions because of their effect on global travel and trade. Nonetheless, the strategy gained favor in 2009 as countries attempted to avert the arrival of A(H1N1) influenza virus.
In their review of 23 studies, the authors found initially positive outcomes with "extensive travel restrictions" that limited more than 90% of movement, but those beneficial effects were erased when the transmissibility of the viral strain increased. Internal travel bans could delay pandemic spread by roughly 1 week, but international travel restrictions reduced pandemic attack rates by less than 0.02%. Banning air travel by children may be effective but, the authors argue, is "socially impractical."
At the local level, travel restrictions "appeared to have limited effectiveness in the containment of influenza," the authors write. In Mongolia, for instance, a simulation restricting road and rail travel by 95% resulted in a 0.1% reduction in the pandemic attack rate. Likewise, in the United States, travel restrictions that were 99% effective in barring entry of infected travelers resulted in a delay of pandemic spread by just 2 to 3 weeks.
In densely populated England, Scotland, and Wales, a combination of internal and international travel could help to stagger the effect of the pandemic across the United Kingdom, the authors write, but at the international level, travel restrictions had "limited effectiveness," with a 40% restriction of air travel delaying by less than 3 days the march of A(H1N1) from Mexico to other countries.
A pandemic that began in Sydney, Australia, or Hong Kong would take 2 to 3 weeks longer to arrive in the United States if 95% of air travel were restricted. Selectively canceling one quarter of flights connecting between 500 of the globe's major cities, however, would pack more bang for the preventive buck, with an additional 19% reduction in infected travelers.
Travel restrictions that exceeded 90% could delay the spread of pandemics by up to 4 months for low to moderately transmissible strains, but with highly transmissible strains, such travel bans "appeared ineffective."
"The results of our systematic review indicate that overall travel restrictions have only limited effectiveness in the prevention of influenza spread, particularly in those high transmissibility scenarios," the authors write. "Only extensive travel restrictions — i.e. over 90% — had any meaningful effect on reducing the magnitude of epidemics. In isolation, travel restrictions might delay the spread and peak of pandemics by a few weeks or months but we found no evidence that they would contain influenza within a defined geographical area."
The authors reviewed evidence from modeling studies published before May 2014 and excluded studies that only examined disease spread among animals. The researchers included 23 studies, 19 of which were mathematical modeling studies.
"It seems likely that, for delaying the spread and reducing the magnitude of an epidemic in a given geographical area, a combination of interventions would be more effective than isolated interventions," the author conclude. "Travel restrictions per se would not be sufficient to achieve containment in a given geographical area, and their contribution to any policy of rapid containment is likely to be limited."
The University of Nottingham Health Protection and Influenza Research Group, which employs three of the study authors, disclosed receiving research funds from GlaxoSmithKline and unrestricted educational grants for influenza research from F Hoffmann-La Roche and Astra Zeneca. Among those three authors, one author further disclosed receiving funding before October 2010 to attend influenza-related meetings, give lectures, and received research funding from several manufacturers of antiviral drugs and influenza vaccines. This same author disclosed being an employee of SmithKline Beecham, Roche Products, and Aventis-Pasteur MSD before 2005. The remaining authors have disclosed no relevant financial relationships.
Bull World Health Organ. Published online September 29, 2014. Full text

Friday, November 28, 2014

Traveling to Nairobi, Kenya. What vaccines to take & how soon before traveling?

Q: Need to travel to Nairobi shortly. Would like to know the vaccinations required and its cost and how many days prior it needs to be taken?

A: For travel to Kenya, Yellow Fever & Polio Vaccination is mandatory,
Yellow Fever needs to be taken at least 10 days before traveling, and Polio drops should be ideally completed 1 month before coming back to India.
You can contact our central helpline at 08010777722 for more information,
Warm regards
Dr Gupta, MD
TravelSafe Clinics, India

Saturday, November 15, 2014

Multiple Ebola cases reported from Mali, CDC director says we are 'nowhere close to being out of the woods'

Released: November 13, 2014
The purpose of this alert is to notify travelers that a few Ebola cases have been reported in Bamako, Mali, and to inform them of actions they can take to reduce their risk of getting the disease.
CDC recommends that travelers to Mali protect themselves by avoiding contact with the blood and body fluids of people who are sick, because of the possibility they may be sick with Ebola. Although a cluster of cases has been reported only in Bamako, travelers to all parts of Mali should be alert for reports of possible further spread within the country.

What is the current situation?

As of November 12, 2014, the World Health Organization reported a cluster of Ebola cases in Bamako, Mali (see box for case counts). (An unrelated death from Ebola occurred in Kayes, Mali on October 24, 2014 and no additional cases related to that person have been reported.) The cluster in Bamako is linked to a man who had been in a clinic in Bamako after becoming sick in Guinea. Since that time, a small number of Ebola cases linked to this patient have been reported in Bamako. The Malian government has taken actions to contain further spread. CDC recommends that travelers to Mali protect themselves by avoiding contact with the blood and body fluids of people who are sick and following the other recommendations listed below.
The cases of Ebola in Bamako, Mali, are related to an ongoing Ebola outbreak that has been occurring since March 2014 in GuineaLiberia, and Sierra Leone and is the largest outbreak of Ebola in history.
For more information about the ongoing outbreak in West Africa, visit 2014 Ebola Outbreak in West Africa on the CDC Ebola website.
In an interview with the US netwrok PBS, Dr Thomas Freiden has said that there is a long way to go before Ebola can be labeled as under control,
Read/ watch more here

Friday, October 24, 2014

Yellow fever and Ebola: similar scourges, centuries apart


The disease is terrifying. Many of the stricken are left in the streets to die horrible deaths, their bodies unclaimed. Thousands flee. The government appears helpless to stop the scourge from spreading. Physicians and nurses offer care, but have no effective methods of treatment or means to prevent the disease.
Ebola in West Africa? No, yellow fever in the United States. Both are hemorrhagic fevers.
For centuries, yellow fever appeared in the U.S., spreading from port cities and coming most often to the American south. The epidemic of 1793 in Philadelphia claimed an estimated 4,000 lives between Aug. 1 and Nov. 9 alone, with thousands more deaths in the years that followed. “The Great Fever,” a documentary that is available in many public libraries, tells the history of this disease and its conquest. There is still no cure for yellow fever, which is endemic is some parts of the world, but there is a vaccine and we now know how the disease is spread—by the Aedes Aegypti mosquito, which also carriesdengue and chinkungunya, first seen in the Americas only last year.
Physician-historian Margaret Humphreys, one of the experts who appears in the film, teaches the history of medicine at Duke University in Durham, N.C., and has published on the history of yellow fever and malaria in the U.S., and on medicine during the Civil War. I interviewed Dr. Humphreys about yellow fever in the United States back then—and about Ebola today:
Can you describe what happened during yellow fever outbreaks?
Yellow fever outbreaks always created panic. While physicians debated whether the disease was contagious, the people voted with their feet. Yellow fever causes a dramatic, painful, messy death, with patients screaming in agony and vomiting blood. Physicians had little to offer and were themselves terrified of infection. Such terror shut down communities, including all commerce and most jobs, leaving the poor even more destitute than usual.
What were the consequences of these outbreaks?
Short term, the epidemics of yellow fever in the United States caused thousands of deaths. The commercial impact was even more severe, because fear of the disease blocked trade in places where the virus failed to penetrate. The horrible events forced government response, leading to the funding of a state board of health in Louisiana, the first such entity in the country, in 1859. After the particularly damaging yellow fever outbreak in 1878, Congress created the National Board of Health, the first federal public health agency. It was housed in the Treasury Department, as its duties involved regulating interstate commerce (and stopping the entrance and flow of disease). It survived only a few years but in the late 1880s the fledgling U.S. Public Health Service emerged from the yellow fever outbreak of 1888, and proved its worth in the 1905 outbreak in New Orleans.
What parallels do you see between yellow fever epidemics of the past and the Ebola epidemic today?
I heard a report on NPR about the impact of Ebola on the economies of the countries most affected (Liberia, Sierra Leone, Guinea). Liberian workers usually cross the border into the Ivory Coast to harvest cocoa at this time of year, but that border is sealed to prevent the importation of Ebola. Commercial enterprises within the affected countries are taking a hit that may take years to rebound from. For these very poor countries, as in the 19th century American South, poverty in turn breeds disease. Malaria control has been set back, for example, as unpaid workers can’t afford medication.
Other parallels are tragically obvious—this is a horrible disease, with a high death rate, and its contagiousness seems obvious to caregivers. The choice of abandoning loved ones, and of abandoning the usual death rituals to avoid contagion, must be tearing families apart. I have also heard reports of people blaming the foreign doctors and aid workers who are there to help, claiming that they are in fact a cause of the outbreak. In 1905 New Orleans, when public health workers were treating the neighborhood cisterns to prevent mosquito breeding, Italian immigrants were sure they were poisoning the water, and attacked the water treatment teams. When a disease is this deadly, and the population affected is interacting with medical personnel who hold a different world view on disease causation, such frightening and heartbreaking scenes are likely.

Read more about The Public's Health.

A great achievement - Nigeria is now free of Ebola virus transmission

World Health Organization: Media Centre: October 20, 2014: Summary
 
Nigeria is now free of Ebola virus transmission
The lines on the tabular situation reports, sent to WHO each day by its country office in Nigeria, have now been full of zeros for 42 days.
WHO officially declares that Nigeria is now free of Ebola virus transmission.
This is a spectacular success story that shows that Ebola can be contained. The story of how Nigeria ended what many believed to be potentially the most explosive Ebola outbreak imaginable is worth telling in detail.
Such a story can help the many other developing countries that are deeply worried by the prospect of an imported Ebola case and eager to improve their preparedness plans. Many wealthy countries, with outstanding health systems, may have something to learn as well.
The complete story also illustrates how Nigeria has come so close to the successful interruption of wild poliovirus transmission from its vast and densely-populated territory.


Comment: This is really important news since we have more than 45000 Indian living in Nigeria, and this would hopefully reduce the risk of Ebola transmission into India.

Saturday, October 18, 2014

The outbreak of Ebola virus disease in Senegal is over, claims World Health Organization

While Ebola continues to claim many victims in its epicenter in Western Africa, there is some good news as per the latest WHO press release.
 
Senegal is now free of Ebola virus transmission
Forty-two days have now passed since the last contact of Senegal’s single confirmed case of Ebola virus disease completed the requisite 21-day monitoring period, under medical supervision, developed no symptoms, and tested negative for the virus.
WHO officially declares Senegal free of Ebola virus transmission.
The response to Senegal’s first case, confirmed on 29 August, on the part of President Macky Sall, the Ministry of Health and Welfare, headed by Dr Awa Coll-Seck, and several other sectors of government, carries some instructive lessons for many other developing countries that are now wisely preparing to respond to an imported case.
Other lessons come from staff at the WHO country office, senior epidemiologists sent to investigate and support the response, and WHO’s many institutional partners in outbreak response.
WHO treated the first case in Senegal as a public health emergency, and responded accordingly.
The most important lesson for the world at large is this: an immediate, broad-based, and well-coordinated response can stop the Ebola virus, carried into a country in an infected traveller, dead in its tracks.
 
The first case is quickly detected, tested and laboratory-confirmed
The outbreak in Senegal was announced on 29 August, when a case of Ebola virus disease was confirmed in a young man who had travelled to Dakar, by road, from Guinea, where he had had direct contact with an Ebola patient.
Dakar was in a fortunate position: it is home to a world-class Senegalese foundation, the Pasteur Institute and its laboratory. The laboratory is fully approved by WHO to test quickly and reliably for viral haemorrhagic fevers, including a biosafety level IV pathogen like Ebola.
WHO immediately dispatched 3 senior epidemiologists: Dr Guénaël Rodier, Dr Florimont Tshioko, and Dr Amada Berthe. Dr Rodier, a French national and WHO staff member, brought especially extensive frontline experience in containing some of history’s largest Ebola outbreaks.
These epidemiologists worked shoulder-to-shoulder with staff from the Ministry of Health, headed by Dr Papa Amadou Diack, the country’s Director-General for health, the WHO country office, headed by Dr Alimata Jeanne Diarra-Nama, and other partners, especially Médecins sans Frontières and the US Centers for Disease Control and Prevention (CDC).
With outbreaks raging just across its borders, Senegal was well-prepared, with a detailed response plan in place as early as March. From the outset, the response was led and coordinated, across multiple government, by Senegal’s President and Prime Minister.
A National Crisis Committee provided the “nerve centre” for the emergency response. Local funds were immediately mobilized to support its work. These funds, supplemented by technical, material, and financial support from multiple partners, enabled immediate activation of the plan.
Despite the fact that a single case had been detected in Dakar, the government decided to deploy the plan nationwide. The whole country moved into a heightened state of alert.
Also critically important early on was the government’s decision to open a humanitarian corridor in Dakar to facilitate the movement and activities of humanitarian agencies. This decision meant that food, medicines, and other essential supplies could seamlessly and efficiently flow into the country.
 
Senegal defeated the disease. The Ebola virus is gone – for now – from its territory
 


Wednesday, October 1, 2014

What happens when (not if) Ebola comes to India?

Ebola in India is not a matter of "IF" but "WHEN".
Given that USA has reported the first case of Ebola today ( Times of India - US confirms first case of Ebolaand the fact that there are more than 45000 Indians living in Nigeria which is now in the front lines for Ebola disease, we are going to get it sooner than later. 
According to CDC estimates it is likely that more than a million cases of Ebola are going to happen by 2015 (Fox news - Estimating Ebola cases in 2015). Given that US with all its rigorous standards and effective quarantine, and relatively smaller number of individuals in Africa has already reported a diagnosed case of Ebola, I believe that the first confirmed is not far off in India as well.
In fact, what worries me more is that there is possibly already someone infected with Ebola that has slipped through the airport and is infecting people in the community and getting mistreated!
Here is the reason why I think this scenario is scary but possible....

1. We have very poor quarantine & screening facilities. Here is a report from Maharashtra that a PIL had to be filed in the high court for screening facilities to be set up by the Government in Pune & Nagpur airports ! 
2. Our quarantine centers are dilapidated and understaffed and have poorly motivated and under trained people. While Delhi has created an updated Ebola screening facility , the practical experience of travelers is not very enthusiastic. The facility is crowded, since before the Ebola epidemic it used to cater to about 10-20 patients a month, while now it is required to cater for more than 30 people a day! Also people who are politically connected or serve in high posts in the government have got out of the quarantine without staying the required number of days (as per personal communication)
There are 3-4 beds in every room, and people who have absolutely no fever are also being quarantined in the same facility (for having non govt approved Yellow Fever certificate, or any other medical reason).
Given the close contact of these people, there is every chance that Ebola transmission may actually INCREASE in these quarantine centers if god forbid a case comes to these facilities.
And this is the situation in the 'best' quarantine center in the country! The other centers are likely to be even more poorly equipped and have less chances of containing the disease when it comes here.
3. The incubation period of Ebola is long ... up to 3 weeks. This means that a person coming from Africa may be completely without any symptoms when they are seen at the airport and may develop symptoms like fever, diarrhea vomiting etc even a couple of weeks after landing in India. This is exactly what happened in the case reported from USA
Now it is very likely that any person falling ill after 2 weeks after coming from Africa will not make a connection between the possibility of Ebola and is even more likely that they would not inform the doctors about the travel from Africa, who would in any case NOT suspect Ebola in this situation. The patient would be inappropriately treated for things like Typhoid and even suspected Dengue, but Ebola is unlikely to be diagnosed in most Indian settings.
By the time this is thought and tests done, others in the family or the hospital may be infected and this could lead to an epidemic of Ebola cases.
We can all imagine what would happen if the disease spreads in our overcrowded country with poor diagnostic facilities, and ramshackle health network. Given a complete absence of any vaccine or specific treatment for Ebola, I can foresee a huge tragedy that is likely to happen in the near future. 
Panic stricken people reporting in chaotic surroundings to overburdened government facilities, and overcrowding of our barely functional infectious disease hospitals may actually lead to such a serious problem that our economy may stall, and Modiji's laudable initiative to "Make in India" to improve our Indian economy may be affected as well.
I would recommend a strengthening of our detection infrastructure, separating people in quarantine - those with fever and those without fever are kept in different areas, and telling every one who is coming from Africa to make sure that they report back for any fever related symptom over the next 3 weeks, and following up each of these people diligently.
I believe that only a minor miracle can prevent Ebola from spreading in our country.

Thursday, September 25, 2014

More than 1 million Ebola cases may hit West Africa by January - CDC Estimate

 The Ebola epidemic in West Africa could reach up to 1.4 million cases by late January 2015 under a worst-case scenario, says a report by the U.S. Centers for Disease Control that comes as experts from the World Health Organization call for drastic improvements in measures to prevent the virus from becoming endemic.
In a worst-case scenario, Liberia and Sierra Leone could have 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20, the CDC model suggests, assuming that effective control measures aren’t put into place.
"A surge now can break the back of the epidemic," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, told reporters on Tuesday.
The model also shows the severe cost of delay, which not only increases the risk of deaths and further infections but makes the job of stamping out Ebola more difficult, Frieden said.
The CDC analysis focuses on data available in August from Liberia and Sierra Leone, two of the three worst affected countries. Guinea, where the epidemic started, was not included.
The analysis is based on a mathematical model that allows researchers to test how different actions affect the course of the epidemic.

Value of immediate action

The World Health Organization published another analysis of data from the first nine months of the epidemic in all three countries late Monday in the New England Journal of Medicine.
"If we don't do anything immediately then the exponential growth that has been forecast will continue, so far as we can see, and we'll have not a few thousand cases but probably tens of thousands of cases," said Christopher Dye of the World Health Organization in Geneva.
Dye said they’re beginning to see signs in the response that offer hope the increase in cases won’t happen. For example, when Ebola entered Lagos in Nigeria, a city of 20 million people, health officials were able to stop transmission, he said.
Speed is of the essence, both CDC and WHO stressed. Had there been more interventions in Guinea between March and July, for example, control could have been achieved, the WHO researchers said.
Dye’s team also calculated the death rate to be about 70 per cent among hospitalized patients. Part of the difficulty in estimating the fatality rate is that many Ebola cases were only identified after death.
The researchers used data from informal case reports, diagnostic labs and burial records for the study.
The case fatality rate among hospitalized patients could differ from patients who are never seen by a doctor, the researchers said.
The WHO researchers said they infer that the epidemic is "exceptionally large" not because of the biological characteristics of the virus itself but rather features of the affected population  such as the highly interconnected populations in the three worst-affected  countries and insufficient control efforts so far.
Ebola virus temperature checks
Tundunwada Secondary School principal Enenwan Essien checks a student's temperature for Ebola during an assembly in Abuja, Nigeria, on Monday. Health officials were able to stop transmission in Lagos, Nigeria, Doctors Without Borders says, a hopeful sign. (AFP/Getty)
Dr. Armand Sprecher, an infectious diseases specialist at Doctors Without Borders, questioned WHO’s projections.
"It's a big assumption that nothing will change in the current outbreak response," Sprecher said. He noted that Ebola outbreaks usually end when people stop touching the sick and practise safe burial, which local health officials in West Africa now emphasize in education campaigns.
Gayle Smith, special assistant to U.S. President Barack Obama and senior director of the National Security Council, also stressed that there’s been a tremendous surge in resources and response to the Ebola outbreak in the last few weeks.
The surge includes a pledge from the U.S. to build more than a dozen medical treatment centres in Liberia and to deploy 3,000 troops to help. Britain and France have also pledged to build treatment centres in Sierra Leone and Guinea. The World Bank and UNICEF have sent more than $1 million worth of supplies to the region.
The African Union is deploying health-care workers, and Asian countries, South Africa and Cuba have also responded, Smith said.
To stop transmission in the community, the WHO team said, the period from when symptoms appear to hospitalization needs to be reduced from the average of five days reported in the study. Surprisingly, the researchers said, the average time was not shorter among health-care workers, who are both at higher risk of infection themselves as well as transmitting it to others.
So far, about 2,800 deaths have been attributed to the Ebola virus in the current outbreak.
In Sierra Leone, officials said they found 130 confirmed cases of Ebola infection during a weekend lockdown designed to slow the spread of the outbreak.
About 70 more suspected cases are still being tested, said Deputy Minister for Political and Public Affairs Karamoh Kabba.
With files from The Associated Press and Reuters

Tuesday, September 9, 2014

Polio cases reported from Cameroon, Ethiopia, Equatorial Guinea & Somalia - CDC Alerts

Cameroon
Updated: August 11, 2014

Nearby Polio Outbreaks:

What is the current situation?

According to the Global Polio Eradication InitiativeExternal Web Site Icon, as of August 11, 2014, 5 cases of polio have been reported in Cameroon for 2014. There were also 4 cases reported in 2013. This outbreak of polio is the first reported in Cameroon since 2009.
CDC recommends that all travelers to Cameroon be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Cameroon for longer than 4 weeks may be required to show proof of polio vaccination when departing Cameroon. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Cameroon and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Cameroon.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Central African Republic (CAR), Chad, Republic of Congo, and Gabon to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.
For travelers to the bordering country of Nigeria, where polio remains endemic, CDC also recommends that all adults receive a single lifetime booster dose of polio vaccine.
Equatorial Guinea
Updated: July 25, 2014

Nearby Polio Outbreaks:

What is the current situation?

According to the Global Polio Eradication Initiative,External Web Site Icon as of July 15, 2014, 5 cases of polio have been reported from Equatorial Guinea. Before 2014, no cases had been reported in Equatorial Guinea since 1999.
CDC recommends that all travelers to Equatorial Guineabe fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Equatorial Guinea for longer than 4 weeks may be required to show proof of polio vaccination when departing Equatorial Guinea. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Equatorial Guinea and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Equatorial Guinea.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Gabon to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.
Ethiopia

What is the current situation?

According to the Global Polio Eradication InitiativeExternal Web Site Icon, in 2013, 10 cases (1 case in 2014) were reported from the Somali Region of Ethiopia. These are the first wild poliovirus cases reported in Ethiopia since 2008.
CDC recommends that all travelers to Ethiopia be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Ethiopia for longer than 4 weeks may be required to show proof of polio vaccination when departing Ethiopia. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Ethiopia and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Ethiopia.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Djibouti, Eritrea, Kenya, Sudan, South Sudan,* and Yemen to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.
Somalia

What is the current situation?

According to the Global Polio Eradication InitiativeExternal Web Site Icon, as of July 21, 2014, 4 cases have been reported in Somalia for 2014. In 2013, 194 cases of polio were reported from Somalia. These are the first wild poliovirus cases reported in Somalia since 2007.
CDC recommends that all travelers to Somalia be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. As of May 5, 2014, people of all ages staying in Somalia for longer than 4 weeks may be required to show proof of polio vaccination when departing Somalia. Polio vaccine must be received between 4 weeks and 12 months before the date of departure from Somalia and should be officially documented on a yellow vaccination card (International Certificate of Vaccination or Prophylaxis). Travelers should talk to their doctor about making sure they are properly prepared for any requirements they may face exiting Somalia.
Because of the risk of cross-border transmission, CDC recommends a single lifetime booster dose of polio vaccine for fully vaccinated adults who are traveling to Djibouti, Kenya, and Yemen to work in health care facilities, refugee camps, or other humanitarian aid settings. This kind of work might put people in contact with someone who has polio.

What is polio?

Polio is a disease caused by a virus that affects the nervous system and is mainly spread by person-to-person contact. Polio can also be spread by drinking water or other drinks or eating raw or undercooked food that are contaminated with the feces of an infected person.
Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. Most people recover completely. In rare cases, polio infection causes permanent loss of muscle function in the arms or legs (usually the legs) or if there is loss of function of the muscles used for breathing or infection of the brain, death can occur.
New: Documenting Polio Vaccine
When you get the polio vaccine, you should be given a yellow card called the International Certificate of Vaccination or Prophylaxis (ICVP) that states when you were vaccinated.  

What can travelers do to prevent polio?

  • Get the polio vaccine:
    • Ask your doctor or nurse to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before traveling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure that you are protected. See individualdestination pages for vaccine recommendation information.
    • Make sure children are vaccinated.
    • See Vaccine Information Statements (VIS) for more information.
  • Eat safe foods and drink safe beverages: Follow the Food and Water Safety tips to avoid exposure to any food and drinks that could be contaminated with the feces of a person infected with polio.
  • Practice hygiene and cleanliness:
    • Wash your hands often.
    • If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

Traveler Information

Clinician Information

All travelers to any country should be up-to-date on routine vaccinations, including polio vaccine. CDC recommends a single lifetime inactivated poliovirus vaccine (IPV) booster dose for travelers to certain countries. See the Vaccine section in Chapter 3, PoliomyelitisCDC Health Information for International Travel, for specific vaccination details.
See our Clinical Updates for more guidance on polio vaccination to polio-infected countries:

Additional Information