Traveling abroad this summer - here are some tips from CDC?

Summer Travel Abroad

Escaping to an overseas retreat this summer? It’s the time of year when people start planning their summer vacation. If you venture abroad for some summer fun, there are health and safety risks you should be aware of. No matter where you go—majestic mountains, secluded beaches, or bustling cities—kick off your travel adventure by getting prepared with our summer vacation tips.

Before You Trip

• Check your destination for health concerns. Even if you’re familiar with the place, there may be new and important health risks you should be aware of.
• Make an appointment with a travel medicine specialist or your healthcare provider to get important advice, vaccines, and medicine at least one monthbefore you leave.
  • CDC recommends all travelers be up to date on routine vaccines, including measles, mumps, and rubella (MMR), varicella (chickenpox), and your seasonal flu vaccine, which you should be able to get from your doctor.
• Pack a travel health kit with your prescription and over-the-counter medicines (enough to last your whole trip, plus a little extra), first aid supplies, your health insurance card, and more.
• Prepare for the unexpected.

• Enroll in the State Department’s Smart Traveler Enrollment Program (STEP) to get the latest safety updates and help in an emergency.
• Leave copies of your itinerary, contact information, credit cards, and passport with someone at home, in case you lose them during travel.
• Find out if your health insurance covers medical care abroad—many plans don’t!
• Consider buying additional insurance that covers health care and emergency evacuation, especially if you will be traveling to remote areas.

Health Risks and Outbreaks

Zika, Dengue, and Malaria Risks

• Zika. Many popular summer travel destinations still have a risk of Zika. Check CDC’s Zika Travel Information to find out if there is a risk of Zika at your destination and how to protect yourself during and after travel. Zika can cause serious birth defects if a woman is infected during pregnancy. Pregnant women shouldnot travel to an area with a Zika outbreak. Pregnant women considering traveling to other areas with Zika risk should discuss travel plans with their doctor, the risks and consequences of possible Zika infection, and their willingness to accept that risk if they choose to travel.
• Dengue viruses are spread to people primarily through the bite of an infected mosquito. Symptoms of mild dengue include fever with any of the following: nausea, vomiting, rash, aches and pains (eye pain typically behind the eyes, muscle, joint, or bone pain). Mild dengue symptoms can become severe within a few hours. Severe dengue is a medical emergency. There is no vaccine to prevent dengue, and there is no treatment. Protect yourself by preventing mosquito bites.
• Malaria is a parasitic disease spread by mosquitoes. It can lead to serious illness and can be fatal if left untreated. Symptoms of malaria can include fever, chills, nausea, vomiting, and body aches. If symptoms of malaria occur, travelers should seek medical attention immediately. Before you leave home, check your destination for a risk of malaria. If malaria is present, consult your doctor to assess your risk and choose the most appropriate anti-malarial medicine. Pregnant women infected with malaria can transmit the parasites to their child during pregnancy or delivery. CDC recommends that pregnant women talk to their doctor if traveling to areas with risk of malaria. When used as directed, EPA-registered insect repellents are safe for pregnant and breastfeeding women.

Measles Outbreaks

Where? There are measles outbreaks in many popular destinations.

What are the consequences? Measles is highly contagious and can cause serious long-term health complications.

What should you do? Before you travel, talk to your doctor to make sure you and your traveling companions are up to date on the MMR (measles, mumps, and rubella) vaccine. Don’t put yourself and others at risk!

During Your Trip

• Always wear seat belts and choose safe transportation. Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.
  • Ride only in marked taxis or ride-sharing vehicles.
  • While walking, be alert when crossing the street, especially in countries where people drive on the left.
  • Avoid overcrowded, overweight, or top-heavy buses or vans.
• Eat and drink safely. Contaminated food or drinks can cause travelers’ diarrhea, the most common travel-related illness, and other diseases. If you are traveling to a developing country, you are especially at risk.
  • When possible, choose food that is cooked and served hot, washed in safe water, or peeled.
  • Stick to drinks that are bottled and sealed, or very hot coffee or tea, and avoid ice.
• Protect yourself from hot temperatures and sun exposure.
  • Wear SPF 15 or higher sunscreen to protect yourself from the sun’s harmful UV rays when enjoying outdoor activities.
  • Follow the instructions on the label and reapply as directed.
• Prevent insect bites. Using insect repellent can protect you from serious diseases spread by mosquitoes, such as Zika, dengue, yellow fever, and malaria.
  • Use an EPA-registered insect repellent with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone.
  • Apply sunscreen first, then repellent.
  • Follow the instructions on the label and reapply as directed.
  • If you’re sleeping in a room without screens or air conditioning, or a tent- sleep underneath a mosquito net and make sure it’s tucked into your mattress.
• Avoid Animals. We know that this advice is no fun- but any animal, even if it appears to be friendly or harmless, can be dangerous.
  • Never try to pet, handle or feed unfamiliar animals, even pets, as they may not be vaccinated against rabies.
  • If you are bitten or scratched, immediately wash the wound with plenty of soap and water and see a doctor as soon as possible!

After Your Trip

Some travel-related illnesses may not cause symptoms until after you get home. If you get sick after your trip, call your doctor and be sure to tell them about your travel, including where you went and what you did on your trip. This will help your doctor consider infections that are rarely found in the United States.

• If you need help finding a travel medicine specialist, find a clinic here.
• For more information, see Getting Sick after Travel.

Two British people DIE after receiving yellow fever vaccines - Apr 2019

• Two patients developed a complication called viscerotropic disease 
• Yellow fever is spread by mosquitoes mostly in Africa and the Americas
• Vaccines can cause illness in some people because they use live viruses 

By SAM BLANCHARD HEALTH REPORTER FOR MAILONLINE

PUBLISHED: 14:51 BST, 18 April 2019 | UPDATED: 01:27 BST, 19 April 2019

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Two people in the UK have died after being given a vaccine to protect against the potentially fatal yellow fever.

The tropical illness is spread by mosquitoes and found in Africa, South and Central America, and the Caribbean, so the jab is recommended for people travelling to those areas.

But in extremely rare cases – approximately one in a million – the vaccine can trigger viscerotropic disease, which can be deadly.

Both the unidentified victims were in categories of people who shouldn't always be given the vaccine – one was aged over 60 and the other had had their thymus gland removed.

Travellers should not be put off getting the vaccine, health chiefs said, and medics have been warned to check it's safe to give their patient the jab, which can cost around £60 on the NHS.

 Two patients in the UK have died after being given the yellow fever travel vaccine, which went on to cause a disease which can lead to multiple organ failure (stock image)

The UK's Medicines and Healthcare products Regulatory Agency (MHRA) revealed the cases in a report this week but could not say when the two people died.

Both of them died 'shortly' after receiving the vaccine because of yellow fever vaccine-associated viscerotropic disease (YEL-AVD). 

One of them was 67 years old – the life-saving jab is not recommended for people over the age of 60, according to the NHS. This person died 16 days after their injection. 

One of the UK's leading cancer scientists and a consultant at the Royal Marsden NHS trust in London, Professor Martin Gore, 67, died after having a yellow fever vaccine in January, The Guardian reported – but the MHRA would not confirm the identity of the patient. 

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The vaccine is also not recommended for people who have had surgery to remove their thymus gland, a gland in the chest which is part of the immune system.

The other victim, who was in their 40s, had had this operation and died just eight days after having the yellow fever jab.

The vaccine is known to give safe and effective life-saving protection from a deadly infection, and the MHRA said travellers should continue to get it because of the danger of yellow fever. 

An MHRA spokesperson said 'Yellow fever is serious and potentially fatal. 

'Protection against the disease is essential for anyone travelling to an area where it is known to exist, and vaccination is the best form of protection. 

'The risk of serious, life-threatening reactions is rare, at around 1 in 100,000 vaccinees.

CAN VACCINES MAKE YOU ILL?

Live vaccines, such as the one given to protect against yellow fever, work by injecting a weakened but still living form of the virus into the body.

The purpose of this is to train the body how to make the right antibodies to fight off the virus, so it can remember how to do so in future.

However, if someone's immune system is weakened – by cancer, pregnancy, HIV or age, for example – it may be unable to destroy even the weakened form of the virus.

If this happens, it's possible the injected virus can survive, take hold and cause the infection it was intended to prevent.   

If this happens the symptoms are usually milder than the real disease.

People who have had live vaccines may also be able to transmit an illness to someone with a weakened immune system, so should stay away from them after the jab. 

Live vaccines given in the UK include those for: rotavirus, MMR, flu (nasal only), shingles, chickenpox, tuberculosis, yellow fever and typhoid (oral only). They are all proven to be effective and side effects are rare.

Source: Vaccine Knowledge Project, University of Oxford 

'The potential risks associated with yellow fever vaccines must be balanced with the benefits in terms of protection from infection.

'Vaccine safety is of paramount importance and we continually monitor the safety of vaccines.'  

And the government body warned medics to thoroughly check all patients before giving it to them.   

In a report it said: 'When a person presents for yellow fever immunisation, it is important that healthcare professionals clearly discuss with them the individual risks and benefits of the vaccine based on their specific travel itinerary. 

'Sufficient time should be set aside to ensure that the person is immune competent and has no [reasons they shouldn't have] the vaccine, including a review of full medical history and any available medical records.'

YEL-AVD triggers a similar illness to yellow fever caught from a mosquito, which leaves patients with fevers, headaches, vomiting and muscle pain.

In severe cases it can progress to uncontrollable bleeding and lead to multiple organ failure and death.

While wild yellow fever has a death rate of around 50 per cent among patients with symptoms, YEL-AVD kills more than 60 per cent of patients, according to the US Centers for Disease Control and Prevention (CDC).

The vaccine can trigger yellow fever in people with particularly weak immune systems because it uses a live form of the virus.

A healthy body destroys the weakened virus and remembers how to do it, making the person immune, but if the body is too feeble to do this the virus can take hold and trigger illness.

Other people who may be too unprotected to have the yellow fever vaccine include pregnant women, HIV or cancer patients and babies under nine months old.

As many as one in three people may have side effects such as headache, soreness or mild fever after having the jab, but these should pass within a fortnight. 

The yellow fever vaccine, known as Stamaril, is given in a single injection and is not freely available on the NHS – it usually costs between £60 and £80.

Hancock believes government must do more on anti-vaccination myths

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WHAT IS YELLOW FEVER?

Yellow fever is a tropical viral disease usually spread by mosquito bites. 

The virus is most commonly found in sub-Saharan Africa, South and Central America, and the Caribbean.

It is believed to infect around 200,000 people each year and to kill 30,000 of them. Most of these cases – around 90 per cent – happen in Africa.

As many as 50 per cent of people who develop severe symptoms, which include fever, muscle pain and soreness, bleeding and vomiting, end up dying of the disease.

People die as a result of the disease causing multiple organ failure and potentially triggering shock.

There is no medicine which can cure yellow fever after someone is infected, but there is a very effective vaccine – which travellers to at risk areas can buy – which gives most people lifelong immunity from a single dose.

Source: Centers for Disease Control and Prevention

Source

Ebola Spread Concentrated in Congo, Not a Wider Emergency - WHO, April 2019

GENEVA/LONDON (Reuters) - An outbreak of Ebola in the Democratic Republic of Congo (DRC) that has killed more than 700 people and is continuing to spread does not constitute an international emergency, the World Health Organization said on Friday.

Declaring the epidemic a "public health emergency of international concern" would have signalled that greater resources and international coordination are needed.

The WHO's independent Emergency Committee, which analysed the latest data, said the disease was entrenched in several epicentres in the northeast and was being transmitted in health care settings.

It had not spread across borders to Uganda, Rwanda or South Sudan, but neighbouring countries should shore up their preparedness, the experts said.

"It was an almost unanimous vote that this would not constitute a PHEIC (public health emergency of international concern) because we are moderately optimistic that this outbreak can be brought into control - not immediately, but still within a foreseeable time," panel chairman Professor Robert Steffen told a news conference.

Dozens of new cases reported this week have been mainly in the epicentres of Butembe, Katwe and Vuhovi, said Mike Ryan, head of the WHO's health emergencies programme.

"It's quite a focused amplification of disease in a very specific geographic area," Ryan said.

"But the disease there has risen because of lack of access to that community, we've fallen behind in starting vaccination rings," he said, referring to attacks on health centres by armed groups in February that cut-off hotspot areas.

"Vaccine is proving to be a highly effective way of stopping this virus but if we can't vaccinate people we cannot protect them," he added, noting that nearly 100,000 people have been vaccinated.

Experts have declared four emergencies in the past decade: the H1N1 virus that caused an influenza pandemic (2009), a major Ebola outbreak in West Africa (2014), polio (2014) and Zika virus (2016).

Some experts expressed concern that the Emergency Committee was too narrowly interpreting WHO guidelines.

"This is a deeply concerning event, due to the pathogen itself, the total number of cases, the increase in cases just this week, and the difficulty of coordinating the response due to conflict - that needs to receive the appropriate level of attention," health experts Rebecca Katz and Alexandra Phelan of Georgetown University in Washington D.C. said in a statement.

The Ebola outbreak - by far the biggest Congo has seen, and the world's second largest in history - was declared by national authorities in August. It is concentrated in Congo's North Kivu and Ituri provinces.

It has already infected at least 1,206 people, of whom 764 have died - giving a death rate of 63 percent.

They include 20 new cases reported by the health ministry on Thursday, another one-day record after 18 on Wednesday. Two workers at the Butembo airport tested positive, it said.

Reuters Health Information © 2019 

Cite this: Ebola Spread Concentrated in Congo, Not a Wider Emergency - WHO - Medscape - Apr 12, 2019.

Source

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 

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