Wednesday, August 28, 2013

Vacationing? With vaccination, stay Hep A free and happy.

What is Hepatitis A?

“Hepatitis” means inflammation of the liver, and severe liver disease can be caused by exposure to the Hepatitis A Virus (HAV). Although HAV is contained in feces, the disease can be contracted by the consumption of even microscopic amounts of fecal waste. The illness is commonly acquired through personal contact with an infected person, and through contaminated food or water.

Who needs the vaccination?

Hepatitis A has been on the decline in the United States, due to the recommended vaccination of all children at one year of age. However, the virus remains a common problem in countries with poorly controlled sanitation. Regardless of the caution you may exercise with food and accommodations on your upcoming trip, it remains extremely important for travelers to receive the Hepatitis A vaccination before entering areas where the virus is common. These regions include Africa, Asia with the exception of Japan, the Mediterranean, Eastern Europe, the Middle East, Central and South America, Mexico, and parts of the Caribbean. While Hepatitis A is a pressing concern for travelers, other lifestyle choices may also expose you to HAV, so please consult a complete list of risk factors and talk to your healthcare provider if you are concerned.

When and how can I be vaccinated?

The Hepatitis A vaccination is administered in two doses, given as shots. Your protection from the disease begins about 2-4 weeks after receiving the initial dosage, so be sure to visit your preferred travel clinic to get the first shot at least one month before traveling. The second booster shot should be taken 6-12 months after the primary vaccination. Once administered, the Hep A vaccine lasts about 15 years, so you can be assured of protection on this summer’s vacation and beyond!

Tuesday, August 20, 2013

Planning For Healthy Travel: Yellow Fever Vaccine

The Centers for Disease Control and Prevention state that approximately 4 million travelers to developing regions are ill enough to seek health care, either while abroad or upon returning home. While traveling internationally is already a painstaking process, involving visas, careful planning, packing, itineraries, a trip to the travel clinic must also be added to this list.

 The CDC notes that in order to ensure a healthful business or tourist excursion, one must adopt some preventative measures. In accordance with the Travel Health Notices they publish consistently, are necessary travel vaccinations. One such is the yellow fever vaccine. Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The "yellow" in the name refers to the jaundice that affects some patients once bitten. According to the World Health Organization, 50% of severely affected persons will die if left untreated. Given these sorts of statistics, preventative measures are most responsible.
While there are many reasons to get vaccinated for yellow fever, the acute rapidity of the illness is most alarming. Once bitten, symptoms will ensue within 3 to 6 days. The symptoms of Stage 1 infection include  Headache, muscle and joint aches, fever, flushing, loss of appetite, vomiting, and jaundice are common. Though symptoms often go away briefly after about 3 to 4 days and stage 2 may be possible remission, some persons worsen drastically within 24 hours. Stage 3, called intoxication is marked by problems with many organs including heart, liver, and kidney failure, bleeding disorders, seizures, coma, and delirium.

In order to prevent these caustic symptoms and possible death, a yellow fever vaccine should be prearranged at a certified travel clinic about 10 to 14 days before traveling. Ultimately, alongside the three pairs of bright swimsuits you’re packing, sunscreen and new shoes you bought yesterday just for this excursion, should be travel vaccines. The yellow fever vaccine is but one that may be necessary.

Tuesday, August 13, 2013

Rabies Is Not Bliss! How to Prevent Infection

One of the deadliest diseases in the world that by many is feared is not one that is transmitted by insects, or a mere cough from another individual. This virus in nearly all cases does not even show symptoms until it has finally throughout most of the body and central nervous system. Rabies is a viral disease that infects the central nervous system causing brain disease and death within a matter of days after the virus has completely consumed the nervous system.
            Why is the virus feared by people? As I stated in the beginning, rabies rarely shows any symptoms after infection. In humans, the incubation period can last many months in humans. An individual may not even know they are infected until months after transmission. Transmission of the virus may occur when an individual is bitten by an infected animal, most commonly dogs, raccoons, monkeys, wolves, coyotes, cattle, and bats. Rabies can also be transmitted through domesticated farm animals and wild carnivores. Due to widespread animal vaccination though, rabies infected dogs has become extremely rare in the United States but in developing countries is still prevalent.
            Once an individual is infected, symptoms begin to show after the long incubation period which can last between 3-12 weeks. This the average but sometimes even longer periods have been documented (Some people have gone years without any symptoms showing!) depending on the location of the bite and transmission, the severity of the wound, and the amount of the virus induced. Once symptoms begin to show, the chances of survival are very low and death can occur between 2-10 days.
            When symptoms do begin to show, within a matter of days, they can become extremely severe. The first symptoms are flu-like around the first day and then move on to anxiety, mania, hallucinations, depression, convulsions, uncontrolled drooling, muscle spasms, and delirium due to the infected central nervous system. Days before death, final symptoms can range from partial paralysis, hydrophobia, inability to swallow, violent movements, to coma, loss of muscle function, and respiratory failure which in turn leads to death.
            In the U.S., the Center for Disease Control and Prevention (CDCP) recommends for patients to take a series of vaccines during a two-week period after exposer or a bite. You might think, “But how will I know if I am infected if there are no chances of finding symptoms within the first days?” Your best option would be to consult with your doctor for examination right after you have been bit or exposed to wild bats, foxes, and skunks in rural areas. Most patients receive immunoglobulin (HRIG) the first day and then a 4-series rabies vaccination process is given to the patient. Sometimes a 5-dose series is given within a 28-day period.
             If you have any pets such as dogs, cats, rabbits, and ferrets, be sure to have them vaccinated and always keep them under supervision. Never handle any wild animals especially those that are stray. If you come upon a wild animal or a stray that is acting strangely (very little movement, biting or scratching a wound, foam and drooling at the mouth) contact an animal control officer immediately. If you are bitten by an animal, wash the wound with soap and water thoroughly for 10 to 15 minutes and then contact a healthcare provider to determine if post-exposure prophylaxis is required. For more information, visit us at our website at or call us at 212-696-5900 for updates and appointments at our certified travel clinic.

Wednesday, August 7, 2013

The Afterthought That Should Not Be: Japanese Encephalitis Vaccination

Every year here in the United States, especially in New York City which many consider the capital of the world, more than 60 million tourists visit coming from countries all around the world. It is an incredible number that many would be surprised to learn about, but considering the 100 million+ people that leave this country to travel, whether it is for business or for pleasure, sometimes health concerns and the conditions of the environment they are visiting becomes an afterthought.
 Take Asia for example. Many people are fascinated by the beaches, the major historical landmarks such as the Great Wall of China and Tiananmen Square, but many are unaware of their vulnerability to certain epidemics that are existent. Japanese Encephalitis is one of the most common viruses that is prevalent throughout most of Asia and certain parts of Africa (specifically the northeast and the sub-Saharan) and is also one of the deadliest with no known cure for it. If an individual who is infected does not seek medical attention of any sorts in time, the virus can become fatal. The virus is transmitted through mosquitoes. Symptoms that accompany the virus are flu-like (headaches, fever, malaise) in its first days of infection but this is during its incubation period which lasts between 5 to 15 days.
Once the virus advances to the encephalitic stage, the symptoms worsen greatly causing neck stiffness, cachexia (loss of weight due to loss of appetite, fatigue), hemiparesis (the complete weakness of one side of the body), convulsions and increased body temperature to critical levels (100.4 to 105.8 °F). Neurological damage can be severe as well including swelling of the brain, seizures, and long-term nerve and brain damage which in turn can lead to mental retardation and even coma. The risks of Japanese Encephalitis varies depending on the individual’s destination, duration of visit, season of the year, and planned activities.
            As with many other viruses that have no cure, vaccination is being highly recommended to prevent infection especially for travelers. Many of those who take the Japanese Encephalitis vaccination are bestowed with life-long immunity to the virus. A couple of minutes at an appointment to receive vaccination is definitely worth it. Especially if you are traveling this summer to the far-east or are a visitor from Asia or other countries where the virus is prevalent and are planning to return there at some point in the summer later in the year.
It is very important to take the vaccination 6 weeks before you travel so the vaccine can be given time to work through the body. Side-effects are not severe and range from swelling and redness in the area of the vaccine shot to fever. The vaccine’s effects may last between a one to three year duration and there is no evidence that the effects last beyond that, so boosters are recommended every three years for individuals at risk.
            It is a priority to never let health risks become an afterthought. Of course, this doesn’t mean that we are all of sudden going to live in a state of paranoia. On the contrary, this is a means to take care of your health which as I have said before is the most precious yet the most sensitive entity we have. Many times, individuals become ill when least expected and don’t know how or when it occurred. Due to the fact that many illnesses in their primitive stages display flu-like symptoms, it is hard to detect whether the illness is a common cold or something else and Japanese Encephalitis is no different. Vaccination is considered one of the most important factors in preventing infection. For more info, visit us at our website at or call us at 212-696-5900 to schedule an appointment if you are considering vaccination at a certified NYC travel clinic. A clean bill of health is always bliss!