Another query about breast feeding mother & Yellow Fever vaccination

Question:

We are planning to visit Kenya on 18^th August, my wife has given birth to a baby on 16^th Feb 2014,just want to see if it’s still necessary for her to get vaccinated as the doctor suggests no vaccination till she is breast feeding .. please suggest.

Answer: 
No Vaccination till at least the baby is 6 months old, and preferably 9 months old.

At this age, vaccination can be administered to the baby.

TALKING ABOUT THE MOTHER

Vaccination of breastfeeding women should be avoided where possible. Ideally, the mother should postpone her visit to a yellow fever area so as to avoid the risk in herself & the baby to get yellow fever disease. However, if the risk of YF during travel is considered sufficiently high they may be vaccinated. Where an infant less than 9 months of age is breastfeeding, and the mother needs YF vaccination for personal protection, one option is to discontinue breastfeeding and replace feeds with formula on the day of vaccination and for a further two to three weeks (minimum 10 days) (expressing and disposing of breast milk during that time). Breast feeding can be recommenced after this time.

Warm regards

Dr Gaurav Gupta

Source: http://www.nathnac.org/pro/factsheets/yellow.htm

Litchi virus kills 8 kids in Malda, West Bengal, India

Subhro Maitra,TNN | Jun 8, 2014, 01.40AM IST

At least eight children have died of encephalopathy spreading from litchi in the last 24 hours in Malda Medical College and Hospital. 

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MALDA: At least eight children have died of encephalopathy spreading from litchi in the last 24 hours in Malda Medical College and Hospital.

The abundant production of litchi in Malda this year and its falling price have naturally led to huge consumption of the fruit. But now it has turned into a nightmare with the number of ailing children rising by the day. The health department, not sure about the prevention, was waiting for a medical team from Kolkata that was expected to reach on Saturday evening.

The district administration sent a team to affected villages on Saturday morning to talk to the villagers.

Among the children who died of the litchi syndrome are Tariqul, Jahir Sk, Siddiki, Ayesha Khatun, Khurshia Khatun, Sarfaraz and Rahul Pramanik. All of them belonged to villages of Kaliachak and are in the age group of 3 to 5 years. These villages have produced the most litchis this year.

Dr M A Rashid, vice-principal of Malda Medical College, confirmed that the victims got high fever and their brains were affected. With the sudden rise in temperature, they began to vomit and had convulsions. "We appeal to people that whenever you see such symptoms, bring the children to hospital immediately," Rashid said.

At present, six children with the symptom are being treated at the medical college. They have been kept with other children in the same ward. While guardians are panicking, not knowing what to do, the administration has not been able to give them specific advice either.

"This kind of encephalopathy virus spreads from litchi. The disease originated in China and Vietnam years ago. Later it was seen at Muzaffarpur in Bihar," said Rashid.

This is not the first time Malda has been affected with the disease. "In 2012, more than 100 children died of encephalopathy," conceded a health official. It is feared that the number of victims who reached medical college is only a small section of the huge number affected.

Minister of food processing and horticulture, Krishnendu Choudhury, who was also the chairman of the Medical College Patients' Welfare Committee, expressed his concern.

"I've heard that the virus spreads from litchi. We will do everything required to prevent an epidemic. A four-member team from the School of Tropical Medicine in Kolkata is on its way to Malda. After getting their report, we'll take steps accordingly," he said on Saturday.

Priest died after suffering 'very rare adverse reaction' to yellow fever vaccine

A priest died after suffering a very rare adverse reaction to the yellow fever vaccine, an inquest heard.

Fr Gerard Cusack (71), prior of the Holy Trinity Abbey, Kilnacrott in Ballyjamesduff, Co Cavan, died at Beaumont Hospital on March 18 last year, 11 days after he had been given the vaccine in advance of a trip to central Africa.

Dublin Coroner’s Court heard that there have been only 60 documented cases of death due to the vaccine worldwide since its introduction in the 1930s.

Fr Cusack was due to travel to Tanzania to inspect works on a church roof paid for through fundraising efforts.

His sister Marie Crossan said that he was generally in good health with no medical complaints.

He attended the Tropical Medical Bureau (TMB) clinic on Grafton Street on March 7 where he was initially seen by Dr William Yap and subsequently a member of the nursing staff.

Dr Graham Fry, medical director at the TMB, said that Fr Cusack reported no health issues, previous or at the time, on the medical questionnaire that the clinic requires patients to complete nor did he do so during his consultation with Dr Yap.

He was prescribed medication for his upcoming trip and given a number of vaccinations including yellow fever.

When he left the practice 20 to 30 minutes later, Fr Cusack appeared to be in good health, he said.

The court heard that Fr Cusack subsequently presented at Cavan General Hospital on March 15, complaining of feeling ill for one week.

His GP had prescribed an antibiotic but this had no effect.

His condition deteriorated rapidly over the following 36 hours and he was transferred to Beaumont Hospital where he died from multi-organ failure on March 18.

Professor Peter Conlon, consultant nephrologist at Beaumont, told the court that there is no treatment for yellow fever other than “supportive” measures and the disease is fatal in 20 per cent of cases.

The post-mortem confirmed the presence of yellow fever in the liver and that the strain of the disease was the same as the one administered to Fr Cusack in the vaccine.

The cause of death was acute liver and kidney failure due to an adverse reaction to the yellow fever vaccine.

Dr Fry said yellow fever is a “live vaccine” with a higher instance of side effects in people over 60.

As a result, a risk-benefit analysis must be done considering a number of factors including what parts of the country the person intends to visit, he said.

There are approximately 60 cases of deaths as a result of the vaccine in international travellers since it was introduced, he told the court.

The TMB treats 3,000 people annually with the vaccine and this is the first time they have seen an adverse reaction, he added. 

The inquest was adjourned to August 19 to hear direct evidence from Dr Yap.

Source

My son aged 12 years have Egg allergy. Can he get the Yellow Fever Vaccine?

Sir,

My son aged 12 years have Egg allergy. He generally gets 'Red Itchy spots'(chapaki) and sometime swelling on face after eating Boiled egg. 

Since he wish to Travel Africa and for that Yellow Fever Vaccination is required.

Please advice how to get Waive off Yellow fever vaccination based upon Egg allergy test and immigration clearance. Is the test done at your clinic?

Rgds

ANS: Here is what I would recommend.

Can he eat cakes/ bakery items containing eggs without any problems? If so the vaccine should not be a problem at all.

You can get blood tests done for confirming the egg allergy if needed. Assuming these are positive, they can help you clear immigration. If these are negative I believe that the Yellow Fever Vaccination can probably be administered in a hospital setting in this situation.

Regards

Dr Gupta