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From rubella to yellow fever: goats and soda: NPR



A popular zebra crossing in Shinjuku, Tokyo. Cases of rubella have been reported in Tokyo and other Japanese tourist destinations.

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TommL / Getty Images

A popular pedestrian crossing in Shinjuku, Tokyo. Cases of rubella have been reported in Tokyo and other Japanese tourist destinations.

TommL / Getty Images

The Dominican Republic's reputation for unparalleled beaches and affordable all-inclusive resorts is eclipsed by reports of deaths among tourists. At least eight Americans have died this year on the Caribbean island, including one this week. The FBI is helping Dominican Republic authorities investigate three of the deaths.

Some nervous tourists mix the target. However, the US Department of State's Centers for Disease Control has not issued any warnings so far.

Meanwhile, according to CDC, perhaps the greatest risk for travelers around the world is in … Traffic: "Motor vehicle accidents are the main cause of avoidable death among travelers."

However, in some tourist destinations, there are particular health concerns each year. The CDC Travel Health Notices and World Health Organization (WHO) Disease Outbreak News database provide an overview of global health issues this summer.

These sites are not designed specifically for tourists. Included are countries that are not typical holiday destinations, such as the Democratic Republic of the Congo (where there is a warning of the Ebola virus) and Cameroon (where there is an outbreak of polio).

We interviewed doctors who specialize in international travel to address health concerns for travelers this summer.

Worldwide: Measles

Measles are highly contagious diseases that can cause debilitating or fatal complications, including encephalitis, severe diarrhea and dehydration, pneumonia, ear infection and permanent vision loss. According to the WHO, the number of outbreaks in countries that may visit travelers, such as Brazil and India, and the number of outbreaks in tourist destinations such as France, Israel and Italy are increasing worldwide. The CDC offers international travelers the following advice: "You should schedule a full vaccination at least two weeks before your departure [against measles] If your trip is less than two weeks away and you are not protected from measles, you should still receive a vaccine Dose MMR vaccine (measles-mumps-rubella) Two doses provide 97% protection against measles, a dose 93% protection. "

Japan: Rubella

Rubella, also known as German measles, are viruses, which cause mild fever, sore throat and a rash that starts on the face and spreads to the rest of your body. In adults and children the symptoms are mild. However, if a pregnant woman gets a rubella disease, there is a risk of birth defects to the fetus. The outbreak in Japan is usually limited to Tokyo, Kanagawa, Chiba and Saitama, according to CDC. Rajiv Narula, travel medicine expert and internist at the MidHudson Regional Hospital, recommends an MMR-IgG test for women who are pregnant or are considering pregnancy to see if they have protective antibodies. Even someone who has been previously vaccinated may need a refresher shot, says Narula.

Brazil: yellow fever

This mosquito-borne tropical disease has been a recurring problem in several states, including Rio de Janeiro and São Paolo. according to CDC. Yellow fever can cause anything from fever with pain to severe liver disease with bleeding and jaundice. In early 2018, according to the WHO, a case of yellow fever was reported to a non-vaccinated Dutch traveler who had been in the vicinity of the São Paulo metropolitan area. Since then, there have been reports of other unvaccinated travelers to Brazil suffering from yellow fever. Many of them were infected on the island of Ilha Grande. Some of these travelers died, WHO reports. Health experts recommend a yellow fever vaccine at least ten days before travel – and a booster dose if a decade has passed since a previous vaccination. And if you are traveling to a country where mosquito-borne diseases occur, it is advisable to take action against mosquitoes.

Indonesia: Polio

Officials in Papua, the easternmost Indonesian province, have reported a polio outbreak caused by vaccine-related polioviruses. CDC also recommends that adults who have been vaccinated as a child receive "a single lifelong booster dose of polio vaccine" before traveling to the country.

Leptospirosis (Israel). Leptospirosis is a bacterial disease that can lead to kidney damage, meningitis, liver failure, respiratory distress and even death. The eruption is limited to the Golan Heights in northern Israel. According to the CDC, travelers are at greatest risk when exposed to contaminated fresh water during activities such as swimming, wading, kayaking or rafting. "The water is contaminated by the urine of sick animals," explains Carolyn Fernandes, an infectious disease doctor at the Schools of Health Sciences Travel Clinic, University of Pittsburgh. "There is a way to prevent the onset of disease when you have to engage in these activities, such as taking a preventive antibiotic called doxycycline, and there is currently no vaccine against leptospirosis."

Europe and India: Heat

Heatwaves in India and Europe have broken records and claimed lives.

"Do not pay attention only to warnings of disease outbreaks," says Robert Salata, chair of medicine and an infectious disease expert at Cleveland Medical Center, University Hospital. "Review any evidence related to ongoing violence or natural disasters." These can aggravate a health problem at your destination by complicating the supply.

M. Rizwan Sohail, a professor of medicine and an infectious disease expert at the Mayo Clinic College of Medicine and Science, recommends: "Travelers with pre-existing medical conditions should take out travel insurance, take their medications, and seek emergency treatment to develop new symptoms. You should probably consult a doctor before traveling abroad to check your ability to travel. "

Above all, keep the right perspective, health specialists say. "In general, overseas trips in the summer are more likely to have a common respiratory virus than any other infectious disease," says Luis Marcos, a professor of clinical medicine at the Department of Infectious Diseases at Stony Brook Medicine.

Christopher Elliott is the founder of Elliott Advocacy a non-profit organization that helps consumers solve their problems. Mail him with your questions to chris@elliott.org .


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