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

Monday, April 8, 2013

The NEW BIRD FLU - AVIAN INFLUENZA, HUMAN (18): CHINA (JIANGSU) H7N9


Archive Number: 20130402.1616911
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A ProMED-mail post
http://www.promedmail.org
Date: Tue 2 Apr 2013
Source: The Washington Post, Associated Press report [edited]
http://www.washingtonpost.com/business/how-lesser-known-bird-flu-strain-killed-2-isnt-known-yet-but-human-spread-seen-as-unlikely/2013/04/01/ee4e7176-9b2e-11e2-9219-51eb8387e8f1_print.html
China reported Tuesday [2 Apr 2013] that 4 more people in one province were seriously sickened by a bird flu virus new to humans, while cities along the eastern seaboard stepped up public health measures to guard against a disease that has already caused 2 deaths.
The health bureau of eastern Jiangsu province said in a notice on its website that 3 women, aged 45, 48 and 32, and an 83-year-old retired man, from different cities in the province were all critically ill with H7N9 avian influenza virus infection, a diagnosis confirmed by the provincial disease prevention centre. Based on the bureau's statement, only one of the patients appeared to come into daily contact with birds, the 45-year-old woman, who was described as a poultry butcher. The 4 cases did not appear to be connected, and people who have had close contact with the patients have not reported having fevers or respiratory problems, it said. The provincial health bureau said it was strengthening measures to monitor suspicious cases and urged the public to stay calm, joining Beijing and China's financial capital, Shanghai, in rolling out new steps to respond to the relatively unknown virus.
The 4 latest cases follow 3 earlier ones reported Sunday [31 Mar 2013], including 2 men who died in Shanghai, resulting in the city activating an emergency plan that calls for heightened monitoring of suspicious flu cases. Under the contingency plan, schools, hospitals and retirement facilities are to be on the alert for fevers, and administrators are to report to health authorities if there are more than 5 cases of flu in a week. Cases of severe pneumonia with unclear causes are to be reported daily by hospitals to health bureaus, up from the weekly norm. The plan also called for stronger monitoring of people who work at poultry farms or are exposed to birds. The level-3 response plan, the 2nd-lowest in a 4-stage scale, reflects higher concern after the H7N9 bird flu virus led to the deaths of 2 men in Shanghai and seriously sickened a woman in the city of Chuzhou, 360 km (230 miles) [to the] west.
"The health bureau will take effective and powerful measures to prevent and control the disease, to make sure the flu epidemic is effectively guarded against, and to safeguard the health of the city's residents," said Xu Jianguang, head of the Shanghai Health Bureau.
The H7N9 avian influenza virus has previously been considered not easily transmitted to humans, unlike the more virulent H5N1 strain, which began ravaging poultry across Asia in 2003 and has since killed 360 people worldwide.
Health officials said this week there was no evidence that any of the 3 earlier cases, who were infected over the past 2 months, had contracted the disease from each other and no sign of infection in the 88 people who had closest contact with them.
Health authorities in Beijing also upped the capital's state of readiness, ordering hospitals to monitor for cases of bird flu and pneumonia without clear causes, the official Xinhua News Agency reported.

[Byline: Fu Ting]
-- Communicated by: ProMED-mail Rapporteur Kunihiko Iizuka

Sunday, April 7, 2013

In holiday season, PHI Bangalore has no stock of yellow fever vaccine


Kavitha K, March 24, 2013, DHNS:
Are you planning an African safari this summer? A getaway to the Serengeti in Tanzania to film the wildebeest and stalk the Big Five? Be warned. Your plans could go very wrong. All because of a seemingly small yet significant detail called the yellow fever vaccine. Rather, the lack of it in the State’s Public Health Institute.

The Public Health Institute, Bangalore, the only designated centre in the State authorised to administer the vaccine, has been pleading ‘No Stock’ for two months now.

Worse, the ‘No Stock’ syndrome seems to apply only to the PHI, where a dose of the vaccine costs Rs 200. In the open market, pharmacists not only have adequate stock of the vaccine, they also sell a single dose at Rs 1,534.

Desperate travellers have little choice but to fork out a small fortune for the vaccine, which they then carry to the PHI which administers it.

Why isn’t PHI being proactive in procuring the much-in-demand vaccine? “Yes, the number of people asking for the yellow fever vaccine is high during the holiday season. We give nearly 100 vaccinations every Wednesday, but for two months, we have had no stock. The vaccine comes to us from Kasauli in Himachal Pradesh,” says Dr Jaikumar, deputy director and in-charge joint director, PHI Bangalore.

Has the PHI been following up the shortage issue with the Central Research Institute (CRI), Kasauli? “Of course, but I cannot pressurise them,” he adds.

Pharmacies not hit


Paucity in the PHI is contrasted by plentiful stocks in some pharmacies in the City. Nearly 30-40 vaccines are sold a month during the holiday season in these pharmacies. They too say the vaccine is in short supply, but manage to get it on demand. A well-known pharmacy on Residency Road was able to procure three doses of the vaccine Stanmaril, manufactured by Sanofi Pasteur SA, based in Lyon, France, and imported and marketed in India by Sanofi Pasteur India Pvt Ltd, Navi Mumbai, in less than 12 hours of placing a request, at Rs 1,534 a dose.

“Perhaps they have unsold stocks,” suggests Dr Jaikumar.

Those who have air tickets booked and safari schedules blocked prefer buying the vaccine for a hefty price at a pharmacy rather than bite their nails in frustration after making daily calls to the PHI to check on the availability of the vaccine.

Travellers’ travails


“Every time I call the PHI, I am told, ‘No vaccine. We do not know when it will come’. The PHI website has no status updates on the availability of the vaccine,” says Sarah C, who is travelling with her family to Kenya in April.

The vaccination, valid for 10 years once taken, has a 20-day incubation period, which makes it necessary for first-time travellers to plan their vaccination schedule.
Failure to take the vaccination may get one past immigration, but would certainly mean quarantine for 10 days, on return, in a government hospital.

A travel agent said she has been advising her clients to take the vaccine in Mumbai or Chennai.

Interestingly, not many travel agents, including the biggies in the business, are aware of the availability of the yellow fever vaccine in pharmacies in the City.

Their best bet, if the PHI is out of stock, is to refer clients to the King Institute of Preventive Medicine, Guindy, Chennai, or the Institute of Preventive Medicine, Hyderabad.

“Not just the PHI, all designated government health centres across the country have no stock,” says Dr Jaikumar.

While the Institute of Preventive Medicine, Hyderabad, did say on the phone that they were out of stock, a phone call to King Institute in Chennai was answered with, “Yes, we have some vaccines. We cannot tell you how many. You need to come here and find out.”

Going by the growing requests to pharmacies and PHI’s ‘wait and see’ approach, holiday-goers have little choice but to swallow the cynicism and stretch the wallet so that they can board their flight in peace.
Comment: As stated in my last blog the shortage has now spread to the entire country, including the private sector, and the vaccine is no longer available anywhere, in government / private sector in any significant quantities. 

Saturday, April 6, 2013

Shortage of Yellow Fever Vaccine in India

There is a severe shortage of Yellow Fever Vaccine in India in the government as well as private sector leading to a lot of difficulty for travelers going to Africa & South America.
We had been getting reports of shortage from Ahmedabad, Chennai & Bangalore, but now the vaccines seems to have disappeared completely from all over India.
We have been unable to procure the vaccine in private sector from the vaccine manufacturer (Sanofi Pasteur) as well. According to highly placed sources in the comapny who declined to be identified, the shortage is the result of government of India delaying the sanction of the new batch of Yellow Fever Vaccine. According to them, the vaccine is likely to remain unavailable till at least May end/ June.
Our stock is likely to get exhausted very soon. We will intimate further availability of the Vaccine as soon as we get fresh stock.
Posted on 6th April 2013

Thursday, April 4, 2013

Lancet Study assesses links between travel and STIs


Article type: PRIMARY
From Lancet Infect Dis. 2013;13:205-13.
PMID 23182931


What factors increase the risk of acquiring sexually transmitted infections while travelling?

Background
Travel is thought to be a risk factor for the acquisition of sexually transmitted infections (STIs), but no multicentre analyses have been done. We aimed to describe the range of diseases and the demographic and geographical factors associated with the acquisition of travel-related STIs through analysis of the data gathered by GeoSentinel travel medicine clinics worldwide.
Methods
We gathered data from ill travellers visiting GeoSentinel clinics worldwide between June 1, 1996, and Nov 30, 2010, and analysed them to identify STIs in three clinical settings: after travel, during travel, or immigration travel. We calculated proportionate morbidity for each of the three traveller groups and did logistic regression to assess the association between STIs and demographic, geographical, and travel variables.
Findings
Our final analysis was of 112 180 ill travellers—64 335 patients seen after travel, 38 287 patients seen during travel, and 9558 immigrant patients. 974 patients (0·9%) had diagnoses of STIs, and 1001 STIs were diagnosed. The proportionate STI morbidities were 6·6, 10·2, and 16·8 per 1000 travellers in the three groups, respectively. STIs varied substantially according to the traveller category. The most common STI diagnoses were non-gonococcal or unspecified urethritis (30·2%) and acute HIV infection (27·6%) in patients seen after travel; non-gonococcal or unspecified urethritis (21·1%), epididymitis (15·2%), and cervicitis (12·3%) in patients seen during travel; and syphilis in immigrant travellers (67·8%). In ill travellers seen after travel, significant associations were noted between diagnosis of STIs and male sex, travelling to visit friends or relatives, travel duration of less than 1 month, and not having pretravel health consultations.
Interpretation
The range of STIs varies substantially according to traveller category. STI preventive strategies should be particularly targeted at men and travellers visiting friends or relatives. Our data suggest target groups for pretravel interventions and should assist in post-travel screening and decision making.
Matteelli A, Schlagenhauf P, Carvalho AC, et al. Travel-associated sexually transmitted infections: an observational cross-sectional study of the GeoSentinel surveillance database. Lancet Infect Dis. 2013;13:205-13.