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

Saturday, June 30, 2018

Singapore tightens entry regulations to prevent yellow fever, June 2018

Singapore (VNA) – The Singaporean Ministry of Health is considering adjustments to the Infectious Disease Act’s articles, especially those on denied entry to the country to prevent yellow fever virus.

The Southeast Asian country has listed Congo, Ethiopia, Paraguay, Brazil, Argentina and Peru among 42 African and South American countries in the endemic areas of the yellow fever virus.

Accordingly, all passengers, comprising children from one year old, from those nations, or international tourists once residing and transiting through the 42 countries for more than 12 hours in the latest six days, have to show up proof of yellow fever vaccination, or else they will be denied entering the country.

The ministry said that although there are yet no reported cases of yellow fever in Singapore, any importation of the disease to the nation will make it soon become an epidemic there due to the presence of Aedes mosquito vector.

Yellow fever is a mosquito borne acute viral haemorrhagic disease caused by the yellow fever virus. It is transmitted by the bite of an infected Aedes aegypti mosquito.
The disease, which is popular in African and South American countries, is characterised by high fever, nausea and jaundice. It can become more serious, causing heart, liver and kidney problems along with bleeding. Up to 50 percent of people with more-severe form of the fever die.-VNA 

Friday, June 29, 2018

A Global Guide For Leery Travelers - Goats and Soda by NPR

With its tropical beaches and a memorable national park, Venezuela was a popular destination for American tourists a decade ago. But years of political and economic turmoil have left its tourism industry in tatters.
Now there's an even more pressing reason to stay out of the country. The Centers for Disease Control and Prevention (CDC) last month issued a rare "Level 3" warning, urging Americans to avoid nonessential travel to Venezuela. The CDC notes that the country is "experiencing outbreaks of infectious diseases, and adequate health care is currently not available in most of the country." Cases of measles, diphtheria and malaria have been reported.
"Venezuela's totalitarian regime has made health very tenuous, with many risks, both infectious and noninfectious," says Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
While skipping Venezuela this summer seems like a no-brainer, other health dangers lurk in both mainstream and off-the-beaten-track destinations. Here are some of those threats, along with advice on how to check your destination in advance and take the proper precautions.

Is my destination too dangerous?

How do you know if your destination is too hazardous for your health? Checking the CDC's Travel Health Notices and the World Health Organization's Disease Outbreak News database will give you an overview of the global health problems this summer.
For popular tourist destinations, these include:
Yellow fever and malaria in Brazil. There's a large, ongoing outbreak of yellow fever in multiple states of Brazil, according to the CDC. The agency recommends vaccinations at least 10 days before travel to affected areas and urges you take precautions to ward off mosquito bites. The malaria warning is confined to the town of Wenceslau GuimarĂ£es, in Brazil's Bahia state.
Malaria and listeriosis in South Africa. U.K. health authorities in March reported cases of malaria in residents who had returned from the Waterberg district municipality of Limpopo Province. Malaria is most common along South Africa's borders with Zimbabwe and Mozambique. Listeriosis, a bacterial infection, is contracted by eating contaminated foods. The CDC has warned travelers to avoid certain foods, such as soft cheese made from unpasteurized milk, to reduce their risk of infection.
Zika in the Caribbean. The mosquito-borne Zika virus remains a problem in tourist hot spots like Antigua and Barbuda, Aruba, the British Virgin Islands, St. Martin, St. Vincent and the Grenadines, and Turks and Caicos. The CDC has warned travelers to take steps to protect themselves from mosquito bites.
For travelers headed to remote places, whether for business or adventure, there are significant warnings to consider. These include an Ebola Virus Disease outbreak in the Democratic Republic of the Congo, a cholera outbreak in Cameroon, and a danger of Middle East respiratory syndrome coronavirus infection, or camel flu, in Saudi Arabia.

A decision to travel is 'complicated'

An Ebola outbreak is a reason "for sure" to cancel a trip, says Robert Salata, chairman of medicine and an infectious-disease expert at University Hospitals Cleveland Medical Center. But it's not the only reason. If a place you're planning to visit this summer is on the warning list for cholera, other hemorrhagic fevers or Zika, you should strongly consider adding it to your no-visit list, says Salata.
"Don't just pay attention to the warnings about disease outbreaks," Salata adds. "Review any notices related to ongoing violence or natural disasters." Those can exacerbate a health problem at your destination by making it more difficult to obtain care.
Travelers should also consider their own health and other individual concerns, says Dan Strickman, a medical entomologist and a senior project officer at the Bill & Melinda Gates Foundation. (The Gates Foundation is a funder of NPR and its global health team.)
"It's complicated," he says.
Take Zika, for example. The mosquito-borne virus, which can cause birth defects, could be a reason to reconsider your travel plans. But if you aren't of childbearing age, it might not be, says Strickman. A few preventative measures — such as using mosquito repellent and wearing clothing with mosquito-repellent qualities — can substantially reduce the risk of infection.

How to protect yourself — and your vacation

If you're traveling this summer, it's vital to have a big-picture understanding of health and safety, says Louis Weiss, a professor of pathology at Albert Einstein College of Medicine in New York. For a primer on the subject, he recommends a section of the CDC site devoted to such risks. "Research the health risks and requirements for travel," he advises.
Another good resource is the U.S. Department of State website. Earlier this year, it overhauled its advisories to more clearly warn travelers of various dangers. (Afghanistan, the Central African Republic, Iran, and Iraq, for instance, rate "do not travel" warnings.)
"Travelers leaving the country should be well aware of any travel advisories for their intended destination," says Justin Tysdal, the CEO of Seven Corners, a travel insurance company. That includes popular destinations like England, France and Greece, each of which has its own CDC measles warnings.
Travel insurance may also be a worth considering. But you have to pore over the fine print before you buy. Medical evacuation coverage on travel insurance can be limited, so you might consider additional coverage through a medical-transport and travel-security membership program such as Medjet. Airfare, activities, or excursions booked through and prepaid to a travel supplier would generally be protected, as long as a health warning isn't already in effect in the destination.
But experts warn that if a health warning has already been issued, insurance usually won't cover an evacuation or cancellation.
"You might consider a 'cancel for any reason' policy, which addresses those types of concerns," says Beth Godlin, president of Aon Affinity Travel Practice, a travel insurance company. Those policies are typically more expensive than standard, named-exclusion insurance policies and will refund only a percentage of your vacation costs.
But whatever kinds of precautions you take, say the travel specialists, don't procrastinate. Once you've bought the tickets, getting a refund may not be possible.
Christopher Elliott is the founder of Elliott Advocacy, a nonprofit organization that empowers consumers to solve their problems and helps those who can't. Email him with your questions at chris@elliott.org.

Friday, June 15, 2018

Yellow fever: A new method for testing vaccine safety, June 2018

Scientists from the Institut Pasteur, the CNRS and Sanofi Pasteur have recently developed a novel alternative method to animal testing that can be used to verify the safety of vaccines such as the yellow fever vaccine. This original approach is based on the development of an in cellulo device using a 3D culture model, the "BBB-Minibrain", to evaluate the safety of live vaccines for human use. The model was developed by the Institut Pasteur and a patent application has been filed by the Institut Pasteur and Inserm. It raises hopes for a reduction in the use of animals in quality control, especially in the tests carried out by the pharmaceutical industry to meet the requirements of regulatory authorities. The results of this research were published in the journal Biologicals in May 2018, and online on March 24th.
For several years now, following the adoption of EU Directive 2010/63/EU,1 the scientific community has been actively seeking to reduce the practice of animal testing. But in many cases, these efforts are hindered by a lack of acceptable alternatives that satisfy regulatory authorities. This is particularly the case for the regulatory testing required for live viral vaccines, such as the yellow fever vaccine; suppliers must demonstrate that the seed lots used to produce vaccine batches sold on the market do not represent a risk of neurotoxicity. These tests are currently performed on animals, which are monitored for the emergence of any clinical signs in the central nervous system that may suggest neurotoxic side effects.
Against this backdrop, Institut Pasteur scientists developed a 3D culture model mimicking the human blood-brain interface, the "BBB-Minibrain", in 2014. This model, formed of a blood-brain barrier (BBB) associated with a mixed culture of neurons, astrocytes and microglia (a "minibrain"), can be used to detect when viruses enter the brain through the BBB, their multiplication in the minibrain and the emergence of any neurotoxic effects. A patent application (WO2016038123) was filed for the model.
The scientists set out to test the BBB-Minibrain's ability to pinpoint and amplify any rare mutant particles with neuroinvasive and neurovirulent properties that are found in seed lots for live viral vaccines. They chose to use two yellow fever virus vaccine strains, including the strain currently used to produce the vaccine, which does not cause neurotoxicity.
Working with Sanofi Pasteur research teams, they demonstrated that the BBB-Minibrain can be used to identify any rare viral particles in vaccine preparations that have acquired the ability to enter the brain and multiply there. This test therefore paves the way for the rejection of any seed lots containing mutant viruses capable of entering the brain and becoming neurovirulent.
As Monique Lafon, lead author of the study and Director of the Virology Department at the Institut Pasteur, explains, "replacing animal testing is a major challenge for research. The BBB-Minibrain model is an ingenious tool that will facilitate our analysis of the basis for neurovirulence in these viruses, which colonize the brain via the bloodstream."
These findings represent a first proof of concept and feasibility for the development of an alternative test that complies with the "3Rs" principle. Work to develop this test is ongoing. The long-term aim is to secure approval for the new test from regulatory authorities.
The BBB-Minibrain model raises hopes for the development of an alternative method that can be used by the pharmaceutical industry to perform regulatory tests on live viral vaccines. The aim of this method is to reduce the use of animals while ensuring strict monitoring of any scientific benefits and breakthroughs in the area of human health.

Saturday, June 2, 2018

MOH Singapore seeks measures to curb spread of infectious diseases

The Ministry of Health (MOH) wants more powers to curb the spread of infectious diseases here, including stopping individuals who break quarantine from leaving the country, and turning back visitors with a high risk of yellow fever without first offering vaccination.
Instead of tracking cases, carriers of infectious diseases or contacts in person, the ministry also wants to be able to carry out surveillance remotely, such as through phone calls and video-conferencing.
MOH, which is seeking public feedback on these changes, said yesterday that as Singapore is a major global trade and travel hub, it is imperative for the country to remain vigilant against new and emerging infectious diseases such as avian influenza, Ebola and the Middle East respiratory syndrome.
In coming up with the amendments to the Infectious Diseases Act, MOH said it looked at recent public health threats, including last year's death of a Bangladeshi worker here due to the respiratory disease diphtheria, and the yellow fever outbreak in Brazil, which has affected more than 400 and killed more than 100 since last July.
A key proposal is to stop high-risk individuals who break isolation or movement restriction orders from leaving the country and to isolate them. This will better reduce the risk of transmissions, compared with the current practice of arresting them.
There are an average of about two such cases a year, said MOH, citing the example of a patient who repeatedly absconded from the Communicable Disease Centre in 2014 while being treated for tuberculosis. The patient was eventually arrested and charged.
There will also be a more calibrated approach in restricting the movement of cases or carriers. Those who pose a lower risk of transmission may be allowed to visit certain places without strict home quarantine, and to continue working instead of facing a blanket stop-work order.
Currently, non-citizens from yellow fever-affected countries entering Singapore will have to be vaccinated against yellow fever. Otherwise, they will be subjected to vaccination, isolation or surveillance here.
MOH wants to have the discretionary powers to return unvaccinated non-citizens from yellow fever-affected countries to their place of embarkation without first offering vaccination, isolation or surveillance, saying that this is in line with international practice.
Yellow fever, an acute viral disease transmitted by mosquitoes, can be fatal and is found mainly in Africa and Central and South America. There have not been any cases here.
Experts said the proposed changes are timely. "Modern surveillance using calls or video calls would allow more potential contacts to be screened than a traditional in-person examination," said Associate Professor Alex Cook, vice-dean (research) of the National University of Singapore's Saw Swee Hock School of Public Health.
Senior consultant Dale Fisher of the National University Hospital's Division of Infectious Diseases said a risk-calibrated surveillance approach is not only more convenient, but also likely less stressful for the individual.
The public consultation exercise will run until Aug 7.
Further information can be found on www.reach.gov.sg and www.moh.gov.sg/ida2018