WHO report highlights health risks of international travel

The World Health Organization (WHO) issued the latest 2012 edition of International Travel and Health report on Wednesday, saying that massive global travel exposes many people to a range of health risks, a UN spokesman told reporters here.

The report "says more than 900 million international journeys are undertaken every year," UN spokesman Martin Nesirky said at a daily news briefing here. "Global travel on this scale exposes many people to a range of health risks, which can be minimized by precautions taken before, during and after travel."

"WHO stresses that depending on the characteristics of both the traveler and the travel, people may encounter sudden and significant changes in altitude, humidity, microbes, and temperature, which can result in ill-health," Nesirky said.

"In addition, serious health risks may arise in areas where accommodation is of poor quality, hygiene and sanitation are inadequate, medical services are not well developed and clean water is unavailable," he said.

"The 2012 edition of International Travel and Health provides updated information on vaccines and their requirements, malaria and yellow fever risks, and new information for last minute travelers," he said.

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There are two 'Bibles' for Travel related vaccination and illnesses that we like to use as reference books. International Travel & Health 2012, released a couple of days ago by WHO is one of these. The other is the Yellow Book 2012 by CDC, USA.  The Yellow Book is published every two years by CDC as a reference for those who advise international travelers about health risks. The Yellow Book is written primarily for health professionals, although others will find it useful.

I am breastfeeding, can I take the Yellow fever vaccine ?

Lactation and Yellow Fever vaccine..Here is what the scientific evidence says regarding Yellow Fever Vaccination during breast feeding.

Whether this vaccine is excreted in human milk is unknown. However, at least 2 cases of yellow fever vaccine-associated neurologic disease have been documented in infants, presumably associated with breastfeeding transmission of yellow fever vaccine virus. No testing has been done to detect the yellow fever vaccine virus in breast milk, so it can only be said that the vaccine virus was transmitted through breastfeeding, but it has not been definitively determined that transmission occurred via the breast milk. Therefore, breastfeeding is a precaution to yellow fever vaccination, and women should be cautioned to avoid this vaccination while breastfeeding. Since risk exists and there are many gaps in knowledge, breastfeeding mothers should be discouraged from traveling to yellow fever–endemic areas. However, if travel to a yellow fever–endemic area cannot be avoided or postponed, then the mother should be vaccinated.

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As per this study, in case the vaccine is given, avoiding Breast feeding for 10 days and then resuming it should be more than sufficient in avoiding any small risk to the baby

My opinion : Given that most mother's traveling to Yellow Fever vaccination designated areas are unlikely to be going to a very high risk area, I would believe it best if they could 

1) Avoid travel during this period

2) Preferably avoid the vaccine, given the small theoretical risk to the baby.

If they plan to stay for a long time, or go to a high risk area, then they should consider taking the vaccine, either before traveling, or take it later once the child is off breastfeed.The best thing would be to discuss these issues individually with your travel physician, or visit us @ Charak Clinics, Mohali.

A common question - Should vegetarian's be routinely testes for egg allergy before Yellow Fever Vaccination ?

I received a related question the other day, & I am posting the same here
Question : "Dear Sir,
Yesterdar, I along with my family and friends went for yellow fever vaccination.For being vegetarian they did egg allergy test for all of us before vaccination.One friend from our group found allergic to egg in that test and denied for yellow fever vaccination.We have already booked everything to travel to Kenya and South Africa.
PLEASE ADVICE ME TO OVER COME THIS SITUATION."

My reply to the same is as follows ...

Answer : Doing egg allergy testing is NOT recommended for vegetarians routinely, and I would not have done it.
Here is my post that discusses the same issue,
http://yellowfevervaccine.blogspot.in/2011/08/can-people-with-egg-allergy-take-yellow.html
Now given that the test has been done, and the person found ? allergic, there are two options,
1. He can ask the doctor who has done the test to give a certificate saying that the person is allergic to egg and hence the vaccination is not being given,
2. He can take the vaccination after discussing this with the doctor, in a hospital based setting.
I would recommend that the first option is easier to do, and you can ask carry the original allergy testing report and the doctor's certificate during immigration.
Warm regards
Dr Gupta 

I am traveling to Sudan, do I need the Yellow Fever Vaccination ?

It is Recommended for all areas south of the Sahara Desert. 

It is not recommended for the city of Khartoum. 

Also one must remember that it is required that travelers arriving from a country with risk of yellow fever transmission should take the vaccine.

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