Hepatitis A: The Dirty, Rotten, No-Good Torturer

In a world where everyone lives their lives differently from the next, you might find yourself sometimes surrounded by individuals who unbeknownst to you may have poor hygiene habits. The even scarier idea is that sometimes these kinds of people work at places where they touch and serve food. Even with protection such as gloves or head, it is still not a guarantee that what you eat outside is completely pure. 

Hepatitis A, as with other illnesses, can be spread in this manner. It is an infectious disease of the liver that though is not fatal in 95.5% of all cases, it can leave an individual with nausea, vomiting, fatigue, severe fever, dark urine, and permanent damage of the liver that can require transplant. It can be spread through contaminated food and water that contains traces of feces that contain the virus. An individual with poor hygiene is more prompt to spread it than one who has great hygiene. It has been known that the virus is most prevalent in poor hygiene regions.

In the media, we have seen this as one of the causes of Hepatitis A. In 2003, an outbreak occurred in the United States in Ohio and West Pennsylvania. More than 640 people were infected and three of the cases became fatal. Tainted green onions that were used at a restaurant in Monaca, Pennsylvania were blamed as the source and origin of the outbreak. Last month there was another outbreak that took place in 8 states as a result of contaminated frozen berries. About 118 people were infected with the virus. The berries were revealed to have come from the United States, Argentina, Chile, and Turkey. It is possible that the people who handled the berries before being transported to factories were already infected with the virus or it could have been transmitted by infected flies. Flies feed on feces and if the fecal matter is that of an infected individual, the fly can become contagious.

Could poor hygiene be the number one reason for the spread of Hepatitis A? No, but it is one of the prime reasons for the spread of the disease. Most high-income regions have low endemic levels while those that are low-income regions are known to have higher endemic levels probably in part due to lack of access to resources for combating the spread, proper sanitation, and lack of proper disposal of sewage in communities. The higher the income is in a region, the better the conditions are to afford proper healthcare, sewage disposal, and purification of water. Regions with high endemic levels have been reported to have cases where most children become infected before the age of 10. Surprisingly though, symptoms in children are not as severe as in adults and have been reported to be mild lasting between 1-3 weeks according to a report by the National Center for Biotechnology Information (NCBI). If a child recovers from infection, they can develop lifelong immunity.

Nevertheless, vaccination is highly recommended for travelers to take at least two weeks before traveling to a region where the disease is endemic. There is no specific treatment, but the vaccine can help prevent infection. At minimum, antibody responses can show within 12 days after taking a shot and at most about 4 weeks. The vaccine should not only be considered by travelers, but for people who live their day to day life as well. Outbreaks occur sometimes without warning, even here in the United States. Even after exposure to the virus, a single dose of the vaccine has protective effects even two weeks after exposure. However, manufacturers recommend two vaccine doses to increase the antibody levels for longer-term protection.

 

Millions of people worldwide have been vaccinated with no serious side-effects. The vaccine can also be given as part of regular childhood immunizations. If you are in New York City considering taking the Hepatitis A vaccine, especially if you are traveling outside of the United States, for information visit us at our website at www.travelclinicny.com or call us at 212-696-5900 to schedule an appointment.

Yellow Fever’s Home

Does every mosquito bite lead to illness? Would it pose a health risk if one single bite occurs? It’s the question that goes through many people’s mind and after years of reports of epidemic viruses being transmitted through mosquito bites, it comes to no surprise as to why one would have a reason to worry even just a little bit. This is an everyday worry for citizens of many tropical and sub-tropical regions throughout the world and because vaccination is expensive or sometimes not available, the mortality rate becomes high.

Yellow fever is a viral hemorrhagic disease that is carried by mosquitoes and transmitted through single bites. The disease principally infects the liver and if not treated, the virus can permanently damage it and eventually cause a cardiovascular shock along with a multi-organ failure which in turn can lead to death. 

In continents such as Central Africa and South America that contain countries in the tropics, more than 600 million people live in areas that are endemic and are at risk for infection. The virus is not contagious from human to human contact but if a mosquito bites an individual who has the virus and then moves on to bite another who does not, the virus can enter the person. Over the last 400 years, there have been periods of outbreaks that have lasted between 2-8 years in these countries. Even in recent memory, outbreaks have taken place. In the early 1990’s, an outbreak took place in Kenya that lasted nearly two years and then another in Sudan from 2003 to 2005. In South America, outbreaks took place in earlier periods of the 17^th and 19^th century with the latter believed to have taken place during the slave trades of that time.

In total, about 44 countries pose risks of infection if an individual has yet to have immunization of any sorts. Despite the advancement of medicine within the last two decades, yellow fever have seen increases over the years in the number of cases due to declining population immunity to infection, deforestation, urbanization, population movements, climate change, and the costs of immunization in the less developed countries. Some people, mostly the poor population of these countries, do not have the conditions or financial stability to afford medical care which also eliminates any chance for treatment should infection take place. In response to these conditions, the World Health Organization (WHO) is the secretariat for the International Coordinating Group for Yellow Fever Vaccine Provision (ICG). Its’ main purpose is to maintain emergency stockpiles of yellow fever vaccines to ensure rapid responses to outbreaks in countries that pose high risks for endemics. Since 2007, 12 countries have completed preventive yellow fever vaccination campaigns.

Rapid responses have taken place through emergency vaccination campaigns for controlling outbreaks, but under-reporting is still a prime concern despite initiative steps taken for prevention and combat of the virus. The true number of cases is estimated to be 10 to 250 times to what has been reported. So if you are planning to travel to regions where yellow fever is prominent, vaccination is a necessity and it is recommended that you contact your local health care provider in New York if you are considering Yellow Fever Vaccination. It poses no major health risks and is known to provide 10 years of immunity to the virus. For more information, visit us at our website at www.travelclinicny.com or call us at 212-696-5900 to schedule an appointment. As I always say, a clean bill of health is always bliss!

Japanese Encephalitis Fights For Territory: Vaccination’s Our Weapon!

This year, we have seen in news around certain parts of the world of unexpected outbreaks of diseases we thought were neutralized. Outbreaks and epidemics over the course of history has been responsible for many deaths. Many societies have taken precautions and drastic measures when it concerns threats to our health. For certain diseases for example, the World Health Organization (WHO) assists with providing emergency stockpiles of vaccination for rapid responses to countries that have high endemic rates.

Japanese Encephalitis is one of the deadly diseases that has recently made its presence known in Hong Kong, China. In the Tin Shui Wai district of Hong Kong, there have been three reported cases of the disease in only one week and a half. The third reported case occurred about two days ago in a 13-year old boy which has prompted many residents with symptoms of the disease to seek medical attention. Japanese Encephalitis is a viral infection that is transmitted through mosquito bites. The first symptoms are flu-like and occur during the incubation period. Later symptoms in the encephalitic stage are much worse. Neck stiffness, cachexia (loss of weight due to loss of appetite, fatigue), hemiparesis (the complete weakness of one side of the body), convulsions, high fever levels (100.4 to 105.8 °F), and neurological damage take place which in turn can lead to brain swelling, seizures, and long-term nerve and brain damage.

Even though cases of the disease have occurred around the world, it is endemic primarily in Asia. With cases ranging between 20,000 to 50,000 annually, it is the leading cause of viral encephalitis in Asia. WHO states that there could be many more unreported cases worldwide. Epidemics can take place in endemic regions and can increase mortality rates in unvaccinated humans and animals. Before the legalization of an effective vaccine in the 1950s, 4,000 people died during a 1924 epidemic in Japan, and nearly 2,500 died in South Korea in 1949. Though certain countries throughout Asia have controlled the spread of the disease with large-scale distribution of the vaccine, the Japanese encephalitis virus has slowly expanded its geographic range outside of Asia becoming endemic in certain parts of Australia and Indonesia. Increased risks of major epidemics can occur if the virus spreads to a new region. According to the Center for Food Security and Public, the virus has potential to become endemic in the United States.

There is no known treatment for the virus but certain drugs in recent years have been in development to either reduce viral replication or build up neuroprotection in cell lines. At this time though, no experiment or treatment has been approved for humans. Vaccination is recommended for those who are planning to travel to regions where the virus is prevalent or are planning to engage in outdoor activities in endemic regions. Vaccination has become so important in prevention and neutralization that in areas throughout Asia, vaccination programs have been launched. In April of this year, the health ministry of the Indian state of Bihar launched a vaccination drive for more than 1.8 million children against Japanese Encephalitis. To meet increasing demand for vaccines, a new plant was built in Beijing, China.

If you are planning to travel, be sure to research the health conditions of the region when you begin to make plans. Japanese Encephalitis Travel Vaccination should be taken approximately 6 weeks before travel. The vaccine is given in a two dose series with the final dose given 28-days later. For more information, visit us at our website at www.travelclinicny.com or call us at 212-696-5900 to schedule an appointment. A clean bill of health is always bliss!

Tyrannical Tetanus: Revolting Against Bacterial Royalty

Like any act of rebellion, warding off a tyrant means knowing his every move. When it comes to the bacterial pecking order, one particularly powerful figure is Tetanus. Tetanus, caused by the bacteria Clostridium tetani, is an infection that attacks the nervous system, causing a myriad of potentially life-threatening symptoms. Gain awareness and pursue prevention to take back your own bodily castle.

Causes of Corruption

Tetanus is caused by exposure to Clostridium tetani. This of course begs the question, “How does one become exposed to such bacteria”? The bacteria are predominantly found in soil, dust, and animal feces. Fortunately, the body’s protective layer – the skin – typically inhibits exposure to such things. However, when Clostridium tetani does manage to enter the body through cut, scrape, or other type of flesh wound, spores of the bacteria release a very powerful toxin called tetanospasmin. Tetanospasmin is the real culprit behind Tetanus, as it actively inhibits the motor neurons responsible for muscle control. Thus, it comes as no surprise that the common red flags for Tetanus are muscle spasms and stiffness.

Risking Revolt

Other than exposure to broken skin, there are a number of other factors that increase the risk of Tetanus. In particular, if the skin is broken by a foreign object such as a nails or splinters, there is a much higher likelihood of contracting the disease. Similarly, other forms of puncture wounds, including body piercings, tattoos, and intravenous drugs raise the likelihood of Tetanus exposure.

There are also a number of far less common risk factors, including gunshot wounds, compound fractures (fractures in which the bone breaks the skin), burns, surgical wounds, animal bites, and ear infections.

Broken skin and exposure to some source of Clostridium tetani constitute the fundamental elements for bacterial spores to propagate in the body and release the toxin that causes Tetanus.

Treatment and Prevention: Defending the Peace

Once the tetanus tyrant has taken control, there are a number of means of combating its harsh ways.

First and foremost is treating the location of exposure: upon breaking the skin, it is essential to thoroughly clean the site of the wound. This not only removes foreign objects and dirt from the wounds, but also prevents the growth and proliferation of tetanus spores.

If the infection persists after cleaning the wound, there are a number of treatment options available. Because the infection is bacterial, doctors often prescribe antibiotics to eradicate Clostridium tetani from the body.

Antitoxin is another treatment option. Common antitoxins, such as tetanus immune globulin, act to neutralize the toxin released by Clostridium tetani. Unfortunately, the antitoxin is only effective if the toxin has not yet bonded to nerve tissue. Thus, by the time symptoms start to show, it is too late for an antitoxin to have any significant effect.

Doctors may also prescribe sedatives or beta-blockers to minimize muscle spasms. These medications relieve irregularity in both skeletal muscle as well as the in the muscle tissue responsible for regulating heartbeat and breathing.

Like a number of other infectious diseases, the most effective means of avoiding Tetanus is prevention rather than treatment. Steering clear the disease entirely always trumps managing symptoms after already contracting the infection. Thus, preemptive vaccination is the best course of action. Vaccination is also a crucial option after already contracting Tetanus, as exposure to the disease does not render the body immune to future infections. Get your Tetanus shot at your local Travel Vaccination clinic today.