Stay Away from Mosquitoes and Aware of Yellow Fever

Are you looking forward to exotic travels, having finally found that chance to make your way to South America or Africa? Well, while you’re deciding what to pack for your next adventure, be sure to consider taking the vaccine for yellow fever before you leave.

What’s Yellow Fever?          

It’s important for travelers to central and western Africa as well as parts of Latin America to be knowledgeable of the risks posed by yellow fever. This illness is transmitted by mosquitoes, which acquire a virus from infected primates or humans and then pass it on to others who are bitten. Yellow fever is marked by three types of transmission cycles, and may be acquired in jungle (sylvan), savannah (intermediate), and city (urban) settings.

How can it affect me?

The majority of individuals infected by the yellow fever virus show no symptoms; but each year, many do suffer signs of the illness following an incubation period of three to six days after infection. Affected individuals often experience a sudden fever, chills, intense headache, back pain, body aches, nausea, vomiting, fatigue, and weakness. Once the virus does develop into the illness, the only course of action is to treat symptoms in order to provide comfort, meanwhile allowing the immune system to fight the fever.

Many patients improve after this “acute” phase, which lasts three to four days; but, 15% of patients go on to develop a more severe hemorrhagic fever after an initial remission period of about 24 hours. The high fever characteristic of the illness returns, and now affects multiple body systems. Yellow fever’s victims quickly develop the jaundice for which the virus is named, and may experience abdominal pain as well as vomiting. Bleeding can occur from the mouth, nose, eyes, or stomach, and appears in the vomit and feces. Kidney function deteriorates, and up to half of all patients who enter this toxic phase expire within two weeks.

How can I protect myself?        

Due to the difficulty of diagnosing yellow fever from its initial symptoms, and the potentially dire effects of disease progression, it is absolutely necessary for at risk travelers to protect themselves against the illness. Mosquito repellent is always recommended, but the best course of action is to get the yellow fever vaccination before embarking! The yellow fever vaccine is safe, affordable, and highly effective. A single dose of the vaccine can provide immunity within 30 days, and remains effective for a lifetime without an additional booster shot!

If you are affected by HIV, have primary immune deficiency, or are engaging in an immunosuppressive therapy, it is not appropriate to receive the yellow fever vaccination. Additionally, the vaccine should not be given to children under six months of age or individuals with allergies to albumin. If you are over 60 years of age, may be pregnant, or are breastfeeding, please consult a doctor before vaccination. In all other circumstances, be sure to visit your closest immunization clinic a month before traveling!

Hepatitis A Virus and Why You Should Get Vaccinated

Hepatitis A is an acute infectious disease of the liver that is caused by the virus of the same name, hepatitis A virus or HAV.  Hepatitis A is an RNA virus that spreads in most cases by the fecal-oral route.  In short, the virus is heavily transmitted from person to person through the ingestion of food or water that has been previously contaminated.  Unfortunately, one who eventually contracts the virus may never know when or how he or she even came in contact with it, which makes the virus completely spontaneous.   Individuals can also become contaminated with the virus through directed contact with an infected person. 

This year alone, tens of millions of people will be contaminated.  The inability to immediately discern whether someone has become infected allows the virus to harbor undetected for a few weeks.  There is a space of time between the initial contraction of the infection and the appearance of its symptoms known as the incubation period that can consist of around two weeks to six.  The incubation period greatly aids the virus’s spread, because someone who has been contaminated infects food or water unknowingly and unwillingly; thereby infecting others who are also unaware of the potential risks.  The incubation period of Hepatitis A usually lasts for around twenty-eight days. 

Because of usually poor hygiene standards, developing countries are much more susceptible to the virus.  A source of water is not always privately consumed or distributed in poorer countries like here in the United States.  This allows for a large group of people to come contact with an infected source, whereas in more developed countries, those contaminated aren’t as likely to spread the disease as easily.  The higher the countries wealth, the lower the likelihood of contracting the virus, but that does not mean those in first world countries are immune from contraction.

Another worrying factor of the Hepatitis A virus is that children are the most likely to become infected; because when one is infected he or she is essentially immune afterwards.  The risk of the virus is directly proportional with the age of the contaminated.  Adults have a much more severe response to the virus and 80% of those infected have symptoms that are compatible with acute hepatitis, whereas children are more likely to have either a asymptomatic or unrecognized infection.  Although it is rare, there have been cases of relapse.  Luckily, there is a vaccination to treat the danger of HAV.  

 

The first successful Hepatitis A vaccine was created by Maurice Hilleman and with a success rate of 95%, the vaccine goes a long way in stifling the virus and its symptoms: fatigue, fever, jaundice, nausea.  There are currently two types of vaccines. One contains the inactivated Hepatitis A virus, and the other a live, attenuated virus.  The injection takes place in the upper arm region and is usually given in two doses.  The vaccine gives immunity to its host for fifteen to twenty-five years.  If you are ever traveling to a developing country, vaccination is greatly recommended, especially if a child is present.  Although mortality for Hepatitis is low, one can never exude too much caution when dealing with such a transmittable virus. Contact the office of a local travel clinic to set up an appointment!

“B” Sure You’re Safe from Hep B

Did you know that Hepatitis B, a virus 50-100 times more infectious than HIV, can be contracted both in the United States and abroad? To remain safe, “B” sure to take a moment to learn about this disease.

What is Hepatitis B?                  

Inflammation of the liver can be the result of many causes, including contraction of the Hepatitis B Virus (HBV). Hepatits B is the most serious type of viral hepatitis because HBV can survive outside the body for at least seven days and lead to infection during this time. If you are exposed to HBV, the virus could go on to cause acute and/or chronic disease.

How could I be exposed?

• Hepatitis B is transmitted through bodily fluids such as blood, semen, and vaginal fluid. Common points of contraction are:
• Birth (spread from an inflected mother to her baby)
• Unprotected sex with an infected partner
• Sharing needles, syringes, or other drug-injection equipment
• Exposure to blood from needle sticks or other sharp instruments
• Sharing items such as razors or toothbrushes
• Direct contact with the blood or open sores of an infected individual

Hepatitis B can also be an occupational hazard in the healthcare profession, though it’s important to note that HBV cannot be spread casually in the workplace, or through contaminated food and water.

What symptoms should I be aware of?  

Acute illness occurs in the first six months after exposure to HBV, during which time the disease may show itself in symptoms including jaundice, dark urine, extreme fatigue, fever, loss of appetite, nausea, vomiting, abdominal pain, and joint pain. These symptoms occur in 70% of exposed individuals and last several weeks in those whom they appear, though not all who contract Hepatitis B may experience symptoms. However, individuals who do not show symptoms may still spread the virus.

For some, Hepatitis B may progress from a short-term illness to a lifelong disease. Chronic Hepatitis B is most commonly seen in individuals who have had exposure to HBV during infancy and the beginning of childhood. Chronic illness often leads to cirrhosis or cancer of the liver. Currently, the regions of the world most affected by chronic Hepatitis B are China, East Asia, the Amazon, and the southern parts of Central and Eastern Europe.

What’s the best treatment?

Care for individual’s affected by Hepatitis B is limited to maintaining comfort during the progression of symptoms. In addition, the conditions caused by chronic Hepatitis B can be fatal. If you are concerned you may have been exposed, please consult a medical professional at a travel clinic for testing. Infected pregnant women risk passing the virus to their newborns, but this can be prevented by treating the infant with Hepatitis B immunoglobulin (HBIG) and administering the first vaccination shortly after birth.

It’s recommended that all infants undergo a course of vaccination as part of existing routine immunization schedules. If you are above 18 and have not been vaccinated, it’s important to consider your points of exposure. Individuals who may require blood or organ transplants, who are travelers to countries with high rates of Hepatitis B, and who are in relationships with or belong to the household of infected people, should certainly take steps to become vaccinated.

The Hepatitis vaccine is given in a course of three or four separate doses over a six-month period. Vaccination has no side effects beyond mild soreness at the site of injection. After completing the series, you have 90% immunity from the virus, and can rest assured that you have taken the best course towards preventing spread of this disease.  

Don’t Get Locked into Tetanus/Lockjaw!

What is tetanus?

 

Tetanus, also known as lockjaw, is an infection caused by the bacteria Clostridium tetani. Illness results from a potent neurotoxin that is made during the growth of this bacterium in dead tissues. Tetanus is not transmitted from person to person, but can enter the body through many other commonplace means.

How could I be exposed?

The tetanus bacterium, found in dust, soil, and manure, is pervasive in any environment and is therefore almost unavoidable. The most likely points of exposure are as follow:

• Wounds contaminated by dirt, feces, or saliva
• Wounds caused by an unclean object (such as a nail, knife, splinter, or needle) puncturing the skin
• Animal bites
• Burns
• Crush injuries

Dirt can enter the wound in any of these situations, and tetanus is the last thing you want to worry about in addition to an injury.

What are the symptoms?   

The most common initial symptom of tetanus is spasms of the jaw muscles, or “lockjaw.” Those affected by the bacteria also experience jaw cramping, sudden involuntary muscle tightening, painful muscle stiffness throughout the body, difficulty swallowing, spasms of the vocal cords, seizures, fever, headaches, high blood pressure, and increased heart rate.

In addition, these symptoms can lead to other more serious conditions. Muscle spasms and seizures may cause bone fractures. In addition, some patients experience a pulmonary embolism, in which a blood clot becomes dislodged from another part of the body and travels to the lungs, resulting in a blockage. Finally, in 10-20% of cases, breathing difficulties result in fatality.

What can I do?      

If you think you may have contracted the tetanus bacterium, you must receive treatment for the symptoms as well as become vaccinated. The average incubation period of the bacteria is about ten days, and the disease is likely to show itself within two weeks of bacterial exposure. It’s important to seek medical attention as soon as possible.

In terms of general protection, immediate and thorough wound care should always be practiced. But, because tetanus can be found nearly everywhere, the best way to be proactive is to receive the vaccine before these bacteria affect you negatively.

I’ve heard there are various forms of vaccination…     

The tetanus vaccine is given as an injection into the shoulder muscle. However, the vaccine administered in children and adults differs slightly.

For children, the Advisory Committee on Immunization Practices (ACIP) recommends five doses of the diphtheria & tetanus toxoids and acellular pertussis (DTaP) vaccine. One dose of DTaP should be given at the following ages: 2 months, 4 months, 6 months, 15-18 months, and 4-6 years. DTaP is a part of regular immunization schedules and may be given at the same time as other vaccines.

However, children who have serious illnesses or suffer negative reactions to DTaP should not receive the vaccine. Parents should consult a pediatrician in the latter case, as some of these children should not get another dose of the pertussis vaccine, but may have a DT shot without the pertussis component. DTaP should not be given to anyone above 7 years of age.

Older children and adults also need protection from tetanus. If you have not received a booster shot in over 10 years, consult a travel clinic to receive the Tdap vaccine, a tetanus booster that also provides protection against pertussis. Expectant mothers should also receive Tdap during the third semester. If you were never vaccinated as a child, you should receive a series of three tetanus shots as soon as possible.