Traveling to Leh - question about mountain sickness & diamox

I am from Delhi, flying to Leh on 7th June. To avoid AMS everybody suggests Diamox, which is sulfer drug ( to which my wife has allergy). Any alternative ?? What about kids 10 yr. old, can they take diamox?? What dose??

Diamox does NOT cause allergy in most patients who have Sulfa drug allergies,

She can take the medicine if indicated starting a few days BEFORE flying to make sure that there is no problem.

If you are planning to stay in Leh, and not undergo rigorous treks/ climbs, then this may not be needed for most individuals though,

Talk to your doctor regarding the need for the same,

Dr Gupta

Travellers’ nightmare: Yellow fever vaccine stocks run out, production unit awaits repair in India !

With the only government-run production unit for yellow fever vaccine in Kasauli out of order for nearly two years, most authorised vaccine centres in the country are fast running out of stock. This has prompted the Ministry of Health to issue advisories allowing prospective travellers to purchase the vaccine from the market and get themselves injected at government centres.
The vaccine is mandatory for travel to African and South American countries considered endemic regions for the disease. Yellow fever is a viral haemorrhagic fever that is spread by mosquitoes.
With authorised vaccine centres only in a few metropolitan cities, many people travel hours to get the shots but have to often return empty-handed since supplies are running low.
Director General Health Services Dr Jagdish Prasad said: "Our indigenous vaccine supply has been affected for the last two years after our production unit in Kasauli broke down. We imported bulk stock of the vaccine from WHO in 2011, but now that stock is also running out."
Ministry officials said efforts to buy another stock from WHO have not met with success. With a crisis on hand, two immediate steps have been taken by the ministry. "About two-three weeks ago, we issued guidelines allowing prospective travellers to purchase the vaccine from private centres, bring them to government units and get themselves injected. But private centres are still not authorised to administer the shots," said Dr Sujeet Kumar Singh, Deputy Director General (International Health), Ministry of Health.
But ministry officials acknowledged that the cost of a vaccine in the private sector is between Rs 2,500-3,000 while it is available for Rs 150 at a government centre.
"We realise that if the government purchases the vaccine directly from a private manufacturer and supplies it to our centres, we can bring down the cost for the people. So, we are trying to bring about an arrangement to purchase the vaccine from a company like Sanofi Pasteur which produces standard, quality vaccine. The file has just been moved to Health Minister Ghulam Nabi Azad for final
Traveller's nightmare: Yellow fever vaccine stocks run out, production unit awaits repair approval," Dr Prasad said.
But many pharmacists said they have not been stocking the vaccine. "The vaccine has to be imported, and it is too expensive for most pharmacy shops to obtain. We have certain vaccine dealers who procure the vaccine from pharmaceutical companies and sell it directly to doctors, but not to the average user," Rajiv Bhatia, Organising Secretary of the Retailers and Distributors Chemist Association (RDCA), said.
While the vaccination centre near Delhi airport and the one run by the municipal corporation are already out of stock, the New Delhi Municipal Council (NDMC), which runs the third centre in the capital, will also run out of the vaccine soon.
Dr P K Bansal, Municipal Health Officer of the NDMC, said: "This last vaccine stock was sent to us in 2011. It will soon get over. We are short on supply for the last 2-3 months. We now have our very last lot left."
Ministry officials said Chandigarh, Bangalore, Mumbai and Pune have also reported shortage of the vaccine.
Meanwhile, authorities at Kasauli's Central Research Institute (CRI) said there was delay in trying to identify a company that could repair the imported machine purchased in 1994-95.
Dr Sunil Gupta, Director of CRI, said: "For the last one-and-half years, we have not been able to come out with the vaccine since a key part known as a freezer drier, which is used to dry the liquid form of the drug, has been out of order. Since it is an imported machine, it is very difficult to find a company that can do the repairs."
Dr Gupta said an open tender was floated but only one company responded. "As per government rules, we need at least three bidders in an open tender. We communicated our problem to the Ministry and they have granted this the status of a special case where we can proceed with the sole responder. We will finalise the details now," he said.
Source

At least 30 countries in Africa at risk of yellow fever: WHO

NAIROBI, May 17 (Xinhua) -- The UN World Health Organization (WHO) said on Friday that 30 countries in Africa with a total population of 508 million are considered to be at different levels of risk for yellow fever.

WHO Kenya Country Representative Dr Custodia Mandlhate told journalists in Nairobi that the global community should not be passive to this reality.

"Most of the estimated 200,000 yellow fever cases and deaths occurring annually are from African countries at risk," Mandlhate said during Kenya's launch of the Yellow Fever Risk Assessment Survey.

The field exercise runs from May 20 to June 2. "Kenya decided to carry the survey so as determine if there is circulation of the yellow fever virus," she said.

WHO said that the results will provide advice for implementation of the National Yellow Fever Control measures as well as help contribute to update the global WHO Yellow Fever Risk Map.

"Half of Kenya is currently classified by the WHO as high risk based on historical data and proximity to neighboring countries with recurrent outbreaks," the country representative said.

She noted that the most recent outbreak in the region occurred in South Sudan in 2003 and Uganda in 2011. WHO added that yellow fever was not reported from east Africa until the outbreak emerged in Kenya in 1992.

"Following the incident sentinel surveillance was established," she said. Mandlhate added that yellow fever is one of the acute infectious viral hemorrhagic diseases.

"If not detected and contained appropriately, it can cause explosive outbreaks particularly in high density areas which including urban centers," she said.

"It is therefore a disease of public health concern and can have a negative impact on the economy," the WHO official said.

Mandlhate said that despite yellow fever being preventable; it has re-emerged across the continent and some South American nations.

"At present, a high proportion of travelers visiting at risk areas are being immunized as required by the international health regulations," she said.

She added that WHO will continue to provide technical support to countries at risk, so that they can develop and monitor disease surveillance activities.

Ministry of Health Permanent Secretary Mark Bor said that the government, with the help of partners has concluded plans to conduct the risk assessment in 15 randomly selected points.

He added that the exercise will cost approximately 183,000 U.S. dollars.

"The assessment will involve conducting a zero-prevalence study in humans in order to determine the proportion of the population that has ever been infected with yellow fever," he said.

Bor added that the survey will also determine the presence of species, density, infectivity of yellow fever virus vectors in various ecological zones.

Ministry of Health Director of Public Health Shahnaz Sharif said that the public can also prevent infection by through wearing protective clothing or using bed nets and insect repellents.

"The survey results will also provide evidence based information that will assist the government to determine whether to include yellow fever vaccination into the routine immunization schedule," he said.

Sharif said that currently only two counties carry out routine immunization as they were affected in the last outbreak.

Ministry of Health Head of Division of Disease Surveillance and Response Dr Ian Njeru said that yellow fever is a viral infection with no specific treatment.

"Immunization is the primary means for preventing yellow fever while other measures taken are aimed at vector control," he said.

Njeru noted that approximately 85 percent of all cases involve the mild form while the rest can result in severe cases.

Kenya Tourism Board, Head of Finance Jonah Orumoi said that Kenya's classification as a risk area has had a negative impact on the tourism sector.

"It is therefore in our interest that the activity takes off and comes to a conclusion, so that Kenya like neighboring Tanzania is given a clean bill of health based on study finding," he said.

Orumoi noted that if Kenya is declared a no risk zone, citizens will not be required to have yellow fever vaccine whenever they travel abroad.

Single Yellow Fever Shot Offers Lifetime Protection, W.H.O. Says... However, Quick end unlikely for yellow fever boosters

By DONALD G. McNEIL Jr.Published: May 17, 2013One yellow fever shot confers lifetime protection and the customary “booster shot” given at 10 years is no longer necessary, the World Health Organization announced Friday. Yellow fever vaccine is relatively safe but causes more dangerous side effects than many other vaccines and is therefore normally given only to healthy people who are at risk. The mosquito-borne disease, for which there is no cure, strikes about 200,000 people worldwide each year and kills about 30,000 of them. Cases are increasing as deforestation increases contact with forest mosquitoes and the monkeys that harbor the virus. Only nine cases have been found in the United States over the past 30 years, all in travelers returning from Africa or Latin America, but eight were fatal, according to the Centers for Disease Control and Prevention. Dr. Thomas P. Monath, a yellow fever expert at the Harvard School of Public Health, said that the W.H.O. announcement made sense for almost all vaccine recipients, but that booster shots might still be needed for laboratory technicians working with the virus and for a few travelers who had one shot many years ago but whose immunity had waned.SourceA World Health Organisation advisory panel has confirmed that the protective effects of yellow fever vaccine are life-long, and that ten-yearly boosters are no longer needed to maintain immunity.This news comes just in time for the 66th World Health Assembly – the annual meeting of the WHO’s decision body taking place this week in Geneva; but even if the findings are fully embraced, travel health requirements will take at least two to three years to be updated.WHO regulations currently stipulate that yellow fever vaccination certificates are valid only for ten years, and every country will have to agree to any change.Yellow fever is the only remaining disease for which a formal international vaccination certificate requirement still exists; previously, when cholera vaccination certificates were abolished by the WHO in 1973, it took 17 years for all countries to change their entry requirements, while border officials at some remote outposts continued to hassle incoming travellers for even longer. Yellow fever is a dangerous virus infection transmitted by mosquitoes, occurring most often in parts of Africa – there is currently a serious outbreak in Sudan - and central and South America. Mosquito species capable of spreading the disease are found in many parts of the world that are currently free of infection, including many parts of Asia, which is why so many countries require travellers coming from risk areas to be vaccinated, in order to keep out the disease.In recent years, yellow fever vaccination has become a more complicated issue: official risk maps have been changed, a rise in the rate of vaccine side effects above the age of 60 has been recognised, and countries (notably South Africa) have toughened up entry requirements for passengers arriving from risk areas.
The prospect of reducing the need for yellow fever vaccination to a single lifetime dose – with just one vaccination certificate that border officials will ever need to see – will simplify vaccine decisions, and make tropical travel much easier, but this change will take some time to trickle through.

Source