Measles Awareness Report

In 2007, when Japanese tourists were restricted from the flight home from Canada due to 1-2 members of the group contracting the measles disease, every person in the 42-person group who did not have a record of being vaccinated for measles had to be quarantined for 3-5 days before being allowed to complete their trip back to Japan. In 2004, 25% of students contracted measles while on a trip to India and the containment efforts have been estimated to cost $142,452 (Dayan GH, Ortega-Sanchez IR, LeBaron CW, et al. Iowa, 2004. Pediatrics 2005; 116:e1-e4).

Due to low vaccine coverage in areas with high reports of the disease and the increase of tourism travel to these areas, eradication programs continue to be complicated and face resistence. Many people aren’t fully aware of the disease itself, much less the need for vaccination against it. Even in the United States, measles are starting to outbreak due to people who have not been properly vaccinated coming back from overseas travel to areas where the disease is prevelant. The latest report of outbreak is ongoing in Arizona and is linked to importation; the alert was sent on April 3, 2008 via a Health Advisory to all healthcare providers.

Measles is a highly contagious infectious diseas, with potentially fatal complication, and still stands as a cause of public health concern in developing countries (ISTM, Journal of Travel Medicine, Volume 15, Issue 2, 2008, pp124-125). It is recommended that anyone born after 1957 get properly vaccinated with a primary series as a pediatric and one booster as an adult. Passport Health Colorado offers the MMR (Mumps, Measles, Rubella) vaccine in all of our locations along the Front Range, please call us at: 303-442-8728 or 719-387-5528 if you have further questions or concerns.

Top Ten Health Tips for International Travel

Michelle Reesman, RN, Executive Director of Passport Health Colorado says far too many international travelers, from business travelers to the more adventurous types, leave home without taking the basic steps she suggests below. “People need to put the same kind of preparation into their health as they do into their destination choice, passport acquisition or flight plans,” Reesman advises.

1. Get advice from a travel health professional. Four to six weeks before departure, consult a travel medicine specialist for the most up-to-date immunization, malaria recommendations and consultation. They can answer your questions and prepare you for a safe and healthy trip. It’s important to get your immunizations early, as some of the medication take time to effectively immunize you.
2. Protect yourself from disease-bearing insects. Wear protective clothing and use products containing 20-30% DEET, the insect repellent permethrin and bed nets.
3. Never go barefoot, even on the beach.
4. Make sure your water is purified. Do not use tap water when brushing your teeth.
5. Consume only well-cooked food. Fruits and veggies? Peel it, boil it or forget it!
6. Pre-fill your prescriptions, they may not be available at your destination. Take extra in case your trip is extended. In some countries counterfeit medications can be a problem. Carry medications in their original packaging and pack in your carry-on luggage.
7. Don’t swim in rivers, lakes, ponds or streams. Well-chlorinated pools and salt water are usually considered safe.
8. Take a basic first aid kit. Include medications for pain relief, such as ibuprofen and Tylenol, topical preparations for minor skin wounds and infections, and medications for allergic reactions (Benadryl). Consider presumptive treatment (Imodium and an antibiotic) for traveler’s diarrhea. Discuss the appropriate antibiotics for your destination with a travel health specialist.
9. Motor vehicle accidents are the leading cause of medical problems among tourists. Avoid riding motorcycles, or wear a helmet, and don’t drink and drive. Wear a seat-belt and only travel during daylight hours.
10. Purchase travel insurance that includes emergency medical evacuation. Most medical insurance plans aren’t accepted when you travel internationally. One travel insurance company we recommend, called Seven Corners (formerly known as Liaison International) It can also be accessed from our website, just scroll to the bottom and the link will be on the right-hand side.

Here at Passport Health Colorado, our travel health professionals assess your individual needs, prescribe and administer immunizations and medication, and discuss any precautionary measures for dietary and recreational activities. You will also receive the latest information of health risks and requirements for each destination on your travel itinerary. We use a variety of resources including the Center for Disease Controls (CDC), World Health Organization (WHO) and the U.S. Department of State so that we can stay abreast of the latest developments in travel medicine and safe travel and give you the most current education to help you make an informed decision regarding your health.

Yellow Fever Update

Due to the recent alerts about outbreaks of Yellow Fever, specifically throughout South America, and the vaccine being required in more countries as this current time, we want to be sure that travelers are as protected as possible and are aware of the recent outbreaks in the areas and regions they will be visiting. Please see our previous post about the differences in Required vs. Recommended here.

Yellow Fever is also found in some areas of Africa and Southern Central America, so it is not a disease restricted to areas where alerts are currently being released. At Passport Health Colorado, we offer the Yellow Fever vaccine in a couple of ways. First, we offer a multi-dose vial which contains 5 doses of the vaccine and is perfect to give to a group of travelers who all need the vaccine or are traveling to the same place. Second, we offer the single-dose Yellow Fever as well for the individual traveler. We currently have the Yellow Fever vaccine in stock, in both forms, at all of our locations along the Front Range.

As for the latest alerts, you can see the newest press release and alert for Paraguay here from the Pan American Health Organization.

The alert for Brazil is here from Folha Online (the site is in Portuguese, but I’ve written the English version, sent from the International Society of Infectious Diseases, below):

“The Department of Health of Parana (Brazil) confirmed this Weds (12 Mar 2008) 2 cases of autochthous yellow fever (contracted in the state itself). One person died.

This is the 1st record of a case, and death, due to the disease in Parana since 1966. In that year, there were 32 deaths, according to the government.

According to the State Secretary of Health, Gilberto Martin, the 2 patients — who contracted the sylvan form of the disease — were infected in Laranjal, 423 km from the state capital, Curitiba.

One man, 35 years old, died on 29 Feb 2008. The other, 27 years old, is hospitalized in Ivaipora and not at risk of death. The 2 brothers were infected and worked in the rural area of Laranjal in the logging business.

This year (2008), 2 other cases had already been recorded in the state, but both were imported. On 8 Jan 2008, a retired banker died in Maringa, but he was infected in Caldas Novas (Goias state).

Vaccination has begun in Laranjal, where the 2 cases were confirmed. In the municipality, 84.7% of the 7400 inhabitants live in the rural area. Beyond the area of risk, some 127 municipalities of a total of 399 in Parana have been included in the areas of transition of the disease. The government of Parana wants to achieve 100% vaccination of the population that lives in the area of risk.

The distribution of the municipalities considered areas of risk is wide in Parana, reaching the regions in the west, centre, centre-south, southwest and northwest. As of Monday (17 Mar 2008), house to house vaccination will be started throughout the rural area of 157 municipalities, that are considered at risk for sylvan yellow fever.

The urban population of the municipalities will be attended at health posts. Vaccination in the area of risk will be massive and will extend until 4 Apr 2008. In counties considered areas of transition, vaccination will be held until 25 Apr 2008. In those regions, the majority of the population is already vaccinated against yellow fever.

Byline: Jose Maschio, Agencia Folha, Londrina & Dimitris Valle, Agencia Folha, Curitiba”

Botswana: Capturing the Chase

Every day was the most awe inspiring thing I’ve ever seen, but the day we took a boat ride through the Okavango Delta with our guide, K.D., was like being in the Garden of Eden! We left Xiegra Camp in the morning and traveled with K.D. toward Chiefs Island, it was about a 3 hour drive. As we got deeper into the delta, the thicker the birds became. There were Kingfishers, Great White Egrets, Herons, Herons, Herons (of all sizes), Pelicans, Whistling Ducks, Spoonbills, and so on. There were thousands of them! In the background were zebras, impalas, hippos, baboons and elephants, among other wild animals. We stopped for lunch and the zebra and giraffe slowly walked away. We sat under a huge tree with these animals and birds in front of us and on all sides. It was a beautiful gourmet lunch the camp had brought in another boat. 

After lunch, we continued up the delta. We were still in awe of the many birds flying in front of us when K.D. yelled “LION RUNNING, IMPALA!” We all looked and right in front of us, a female lion was chasing a herd of impala. One ran into the water not 40 feet from us and the lioness brought it down. She sat on it in the water and then another lioness came sauntering up. Then the king himself came out and he just grabbed it from the 2 females and walked off with the impala in his mouth. He was the first to have lunch behind a bush. The two females just stood and stared at us, then they left. The whole encounter took about 6 minutes! We were stunned!

Back at camp, we shared our photos on our computer with the other guides. They said that some people come on 10-20 safaris to see what we saw. I guess it was just first time luck!

Written by: Peggy Romano, client of Passport Health Colorado

Required vs. Recommended Vaccines

Many people try to look on-line to see what kind of vaccines or prescriptions they will need for their particular destination. However, there is no resource available to find out this information in it’s entirety. There are general guidelines for most countries, but that is not always accurate information for the region within the country you may be traveling to.

For example, someone might look on the CDC website and see that the only vaccine which is required to enter or leave the country is Yellow Fever. However, there are major misconceptions roaming around about this requirement. Most people don’t realize that that Yellow Fever requirement has nothing to do with their personal health. What the country officials are doing is protecting their citizens from you. Many times, this means that there is currently NO Yellow Fever in the country or area, and they want to keep it that way so they require everyone traveling there to have proof of vaccination. This ensures that Yellow Fever will not become a problem.

Another scenario on why a vaccine may be required or highly recommended is if there is an outbreak that results in deaths or reported hospitalizations and treatment from a particular disease.

When thinking of ‘Required vs. Recommended’ vaccines, remember that just because only one vaccine may be required, does NOT mean that it’s the only disease that may be a problem at your destination, if it’s present at all.

Recommended vaccines are a larger list of precautions that help protect you from any and all other diseases that are present in the area. If there are outbreaks, we will discuss those and all other information you may need to have a safe trip and return healthy.

Here at Passport Health, we want to make sure that you are as protected as possible, and that means giving you a complete list of any required and recommended vaccines and prescriptions for your particular trip.

Surfing Costa Rica

Costa Rica was awesome. We stayed at Hotel Las Tortugas in Playa Grande on the Nicoya Peninsula, just north of Tamarindo (Pacific Coast). This area is a preserved beach for the nesting of leather-back turtles, thanks to the owner of the hotel. The hotel is set back far enough from the ocean as to not disturb the natural ecosystem, and the staff was fabulous (Note: this isn’t a hotel geared for the tourist, but rather the traveler who isn’t looking for a pool or beach side service, or room service), and the room offered a view of the jungle. We awoke most mornings to the sounds of howler monkeys, which was pretty sweet.

Playa Grande has one of the most consistent waves for surfing in the areas. The locals were friendly and deserve respect. The waves were as high as or higher than your head most of the week, and it’s best around high tide. There are nearby beaches within 20-30 minutes hike that offer complete seclusion, but with a small price. You have to cross over an estuary with crocodiles around, which is only a problem at high tide. During low tide, you are safe. There is a black sand beach about 45 minutes north and is only accessible by hike (Playa Carbon), with awesome little tide-pools for a quick cool down dip. Make sure to time it right, because if high tide comes in, you might get stuck!

Between surfing, two “day trips” into the jungle for some waterfalls, canopy tours and the variety of animals we got to see, we had an amazing 10-day adventure; most of the days we were up by sunrise and in bed by 8:30pm. There isn’t much of a night life unless you want to hang outside with some friendly locals and learn their customs. But there is so much nature to enjoy and plenty of good surf.

The main tourist spot is Tamarindo, just south of Playa Grande, if you want fancy hotels and a busy nightlife. But if you want to relax and be somewhat secluded, then Playa Grande is the right place. We also met some really nice travelers from Wales, Montreal, France, Spain, Texas and California; mostly surfers and surf families. One of the benefits being a traveler (and not a tourist) is the chance to meet people from all over the world. I would definitely recommend this spot.

Written by: Ricardo Khan, client of Passport Health

Colorado Flu Report

It has been reported that Colorado is the #1 state in the country for Widespread Influenza Outbreaks, with the highest number of hospitalized flu being reported in Adams, Arapahoe, Denver and Jefferson Counties. Here is a map depicting the peak of Flu Seasons and why it is still an optimal time for you to receive your Flu Shot.

Click here for the Denver News Channel’s report on Colorado’s Flu Season.

For more information or to keep up with the latest information, please see the CDC’s Weekly Influenza Surveillance Report (CDC Flu View).

For the latest map of outbreaks, please see this site from the CDC as well.

Finally, the CDC has put together a great resource for Frequently Asked Questions (FAQs) that may be helpful in answering any concerns you might have.

You also may want to be on the lookout for the symptoms associated with Influenza, which usually have a sudden onset and may include the following:

• Fever (usually high)
• Headache
• Tiredness (can be extreme)
• Cough
• Sore Throat
• Runny or stuffy nose
• Body Aches
• Diarrhea and vomiting (more common among children rather than adults)

Having these symptoms does not always mean you have the flu. Many different illnesses, including the common cold, have similar symptoms. Generally the common cold comes on gradually over time, you will “feel” yourself getting sick before actually coming down with increased symptoms.

Please call Passport Health at: 303-442-8728 or 719-387-5528 to set up your appointment for the Flu Vaccine in any of our 4 offices along the Front Range. We offer the Flu Vaccine for $25.

Photo of the Week

This photo was taken by Kitty Brigham in Africa.

 

Congratulations for winning the $10 gift certificate to Amazon.com, Kitty!

You can be a part of the contest as well by submitting any photos of your travels to community@passporthealthco.com

Timing of Flu Vaccination

Here at Passport Health, we want to be available to help the public be as protected as possible when it comes to being immunized for common illnesses, such as Influenza. That’s why we think it’s important to let you know that it is not too late to get your Flu Shot for this season! In fact, 60-70% of recorded diagnosed flu in the general public happens in the months of January and February.

In addition, the duration of the Flu Season can last up to several months, as long as October – April, and may not even appear in some areas until February and March. Some people who get immunized in October, may want to receive a second vaccination 3-4 months later so they are protected against influenza for the entire season. It is also recommended that frequent travelers get vaccinated for flu routinely.

We still have the Flu Vaccine available for $25 at any of our office locations. If you’d like more information regarding the frequency and timing of the Flu Vaccine, please read this article from the CDC. Feel free to call us at: (303) 442-8728 or (719) 387-5528 to set up an appointment to receive your flu shot!

Botswana: Vervet Monkey Adventure

 

One of the first things they tell you when you arrive at camp is to make sure to close your doors tight or the monkeys will get in your room and haul away your clothes, etc. Since my husband, Joe, was busy taking 7000 photos of the trip, he didn’t realize when he came back into the room carrying his huge camera, that the door was closed… but not tightly!

So, off we go, with our guide, Gift, to the elephant hide. Kings Pool was the first camp we stayed at and they have buried a container with 4 windows in it next to a man-made watering hole that they pumped water into. It’s a short drive from camp and we arrived there with our friends Jane and Steve. Within 2 minutes a large group of elephants arrived to drink, bathe and play in the watering hole. We were watching and taking photos, they were just a couple feet from our hide. They were aged between 1 month and 30 years old, it was mind blowing to say the least. What a treat! We watched them for an hour and then they slowly wandered off.

We then headed back to camp for a little siesta before taking off for our 4:30pm drive. When Joe opened the door to our room, he saw, in a flash, at least 5 Vervet Monkeys scatter right out the door they had come in. Our vitamins and malaria pills were sprayed all over the room, they ate all the herbal vitamins! Needless to say we had to throw everything out in case the monkeys had tasted our malaria pills, but we borrowed enough from our friends to make it back to Passport Health to purchase more. We took all the precautions advised but really had no mosquitoes or tsetse flies; the government of Botswana sprays for the tsetse fly.

If you look up the description of the Vervet Monkey in the Wildlife Book of the Okavango, it says “Inquisitive, agile primate. Often enters camps“. Live and Learn!

Written by: Peggy Romano, Passport Health Client