The Travel Doctor

The Travel Doctor/Corporate Health Management was founded over 20-years ago by Internal Medicine phy The company offers a variety of convenient on-site preventive, workplace wellness and executive healthcare programs to help reduce healthcare costs.

The Travel Doctor/Corporate Health Management specializes in providing a complete international preparedness program that includes pre- and post-travel consultations, immunizations and healthcare recommendations for individuals and employees traveling to developing countries. Helping clients understand the benefits of managing healthcare costs and liability directly leads to workforce wellness and

Operating as usual

06/21/2013

Outbreak Sickens Yellowstone Campers

By GILLIAN MOHNEY Jun 20, 2013, 4:28 PM
PHOTO: The National Park Service is cautioning visitors to Yellowstone and Grand Teton national parks about an increase in stomach-related illnesses.

Those heading on a camping trip this summer might want to be just as wary of crossing paths with the wrong bacteria as they would a hungry bear.

After 200 park employees and visitors reported bouts of gastrointestinal illness at Yellowstone National Park and nearby Grand Teton National Park this month, national park officials have warned visitors to be vigilant about hygiene.

The outbreak started on June 7, when a group touring the Mammoth Hot Springs complained of stomach flu and other gastrointestinal problems. After the tour group members reported their illnesses, about other 50 visitors and 150 park employees reported similar symptoms.

Preliminary reports found that they had norovirus, or "stomach flu," which affects up to 21 million people, every year according to the Centers for Disease Control and Prevention.

Doctors Warn of New Stomach 'Superbug' Hitting U.S.

Al Mash, spokesman for Yellowstone National Park, said campers who were worried about the outbreak should take care to properly store their food and wash their hands with soap and water before eating. "Don't rely on hand sanitizer. It's good for a while if you don't have access to water," said Mash. "But sanitizer is a poor second to washing your hands."

According to the CDC, the norovirus can be very contagious and is usually passed from contaminated surfaces or food.

Mash said that while it might be more difficult to wash hands before and after meals on camping trips, sporting goods stores sell soap slivers or biodegradable soap that can be used on camping trips. "My manta is be aware but not afraid," said Mash.

Employees at Yellowstone and nearby Grand Teton park have been cleaning and disinfecting the areas where the illnesses were first reported. Yellowstone National Park regularly has 20,000 visitors a day.

The norovirus outbreak is just the latest one to hit the national parks. Last year, Yosemite National Park experienced an outbreak of the deadly hantavirus. Infection with hantavirus, often contracted through contact with contaminated mouse f***s or urine, can lead to hantavirus pulmonary syndrome, which can be fatal, according to the CDC.

For Hantavirus Survivors, Yosemite a Painful Reminder

During last summer's outbreak, eight people were sickened and three died. To stop the spread of disease the National Park Service tore down the buildings where the outbreak was centered and are currently trapping and testing mice for the hantavirus.

Kathy Kupper, a spokeswoman for the National Park Service, said if campers were worried about becoming sick they should be sure to check in with the park's website or information line before they arrive. Any potential hazards from disease outbreaks from high concentrations of ticks, for example, will be listed in each national park's newsletter or on its website.

"Always pay attention to the information. Don't just take the [informational pamphlet] and throw it in the glove box," said Kupper.

Kupper said the one piece of camping safety advice, which is most often forgotten, is to stay put if lost.

"Otherwise it's like a wild goose chase," said Kupper. "Stop moving. That way you're conserving energy, and rescuers have a better chance to find you."

HEALTH


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news.yahoo.com 05/29/2013

GSK bets on chimp virus with $321 million vaccines buy

news.yahoo.com y Ben Hirschler LONDON (Reuters) - GlaxoSmithKline is betting on a new vaccine technology based on chimpanzee viruses by acquiring Swiss-based Okairos for 250 million euros ($321 million) - the latest bolt-on biotech buy by a big drugmaker. Britain's largest pharmaceuticals group said on Wednesday t...

news.yahoo.com 05/24/2013

New bird flu strain may be capable of spreading from human to human: study

news.yahoo.com By Lavinia Mo HONG KONG (Reuters) - The H7N9 bird flu virus may be capable of spreading from human to human and can be transmitted not only through direct contact but also through airborne exposure, researchers at the University of Hong Kong have found. The researchers found in a study, presented at...

news.yahoo.com 05/16/2013

Saudi health workers sickened by SARS-like virus

news.yahoo.com NEW YORK (AP) — A deadly new respiratory virus related to SARS has apparently spread from patients to health care workers in eastern Saudi Arabia, health officials said Wednesday.

05/13/2013

9 May 2013

An outbreak of rubella (“German” measles) inJapanshows no signs of relenting. In March we reported that since January this year there had been some 2500 cases in adults. According to Japan's NHK broadcaster the prevalence has doubled in the last month to more than 5400 cases. Indeed the incidence has been rising to 500 pere week since the beginning of April.



All travellers toJapanshould ensure that they have had the full schedule of Mumps-Measles-Rubella vaccinations or have antibodies to these diseases.

05/03/2013

CURRENT SITUATION OF AVIAN FLU IN CHINA

On April 1, the World Health Organization (WHO) announced that avian influenza A (H7N9), a type of flu usually seen in birds, has been identified in a number of people in China. Cases have been reported in the following provinces and municipalities: Anhui, Beijing, Fujian, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Shanghai, and Zhejiang. A case in Taiwan also has been reported in a person who had traveled to an area of China where other H7N9 cases have been reported.

This is the first time this virus has been seen in people. Symptoms include fever, cough, and shortness of breath. Infection with the new virus has resulted in severe respiratory illness and, in some cases, death. Chinese authorities are conducting animal and human health investigations to learn more about this situation. Available evidence suggests that most people have been infected with the virus after having contact with infected poultry or contaminated environments.

05/03/2013

THE CURRENT MALARIA SITUATION IN GREECE

Cases have occurred in areas of Greece where malaria had not been previously reported. Malaria has been reported from the Attica, Karditsa, Laconia, Viotia, and Xanthi regions of Greece. Cases have occurred in the cities of Evrotas, Marathon, Markopoulo, and Selino. No cases have been reported in Athens. The Hellenic (Greek) CDC and the European CDC are improving surveillance for malaria cases. In affected areas, mosquito control has been intensified, health care providers have been educated, and the public has been informed.

05/03/2013

THE CURRENT CHOLERA SITUATION IN THE DOMINICAN REPUBLIC

An outbreak of cholera has been ongoing in the Dominican Republic since November 2010. According to the Dominican Ministry of Health (Ministerio de Salud Publica y Asistencia Social [MSP]), 7,860 suspected cholera cases and 66 suspected cholera-related deaths have been reported for all of 2012. As of April 6, a total of 892 suspected cholera cases and 14 suspected cholera-related deaths have been reported for 2013.

04/26/2013

NEW 4-STRAIN INFLUENZA VACCINE AVAILABLE FOR 2013-2014 FLU SEASON

The FDA has approved GlaxoSmithKline's 4-strain flu vaccine, the first of its kind. It will protect against the 2 A strains and 2 B strains. The currently administered 3-strain influenza vaccine helps guard against the 2 A strains and the B strain expected to be predominant in a given year. The new quadrivalent vaccine will include an additional B strain.

04/25/2013

April 25 is World Malaria Day

World Malaria Day is commemorated each April 25 and provides an opportunity to reflect on the status of global efforts to "roll back malaria." This year's theme, "Invest in the future: Defeat malaria," is a reminder of the need to continue to make progress and defeat malaria.

abcnews.go.com 04/24/2013

Bird Flu Crosses Strait to Taiwan

abcnews.go.com A Taiwanese man has contracted a deadly strain of bird flu once confined to mainland China, health officials said today.

abcnews.go.com 04/24/2013

Bird Flu a 'Truly Nasty Virus'

abcnews.go.com A new strain of bird flu is sickening people in China.

who.int 04/24/2013

WHO | Improving measles control in India

who.int India is building on its polio eradication campaign experience to ensure more children get vaccinated against measles.

04/22/2013

WHO: China bird flu not spreading easily in humans
Posted: 04/19/2013 12:46:30 AM MDT
April 19, 2013 8:40 AM GMTUpdated: 04/19/2013 02:40:43 AM MDT

By GILLIAN WONG Associated PressAssociated Press

BEIJING—There's no evidence a new bird flu strain is spreading easily among people in China even though there may be sporadic cases of the virus spreading to people who have close contacts with patients, the World Health Organization said Friday.

Fifteen global and Chinese health experts are on a mission in Beijing and Shanghai to learn more about the H7N9 bird flu virus that has killed 17 people and sickened 70 others, said Dr. Michael O'Leary, head of WHO's office in China.

O'Leary says a major focus is to learn how the virus infects humans. "The evidence suggests still that poultry is a vehicle for transmission but epidemiologists haven't yet been able to establish a clear and strong link," O'Leary told reporters in Beijing.

The source of the virus remains unclear because only a handful of birds—out of tens of thousands that have been tested—have been found to carry the H7N9 virus. Also, many of the patients have no reported history of contact with birds.

Still, Chinese health and agricultural authorities have closed live poultry markets and slaughtered birds as preventive measures based on suspicion that sick people had contact with infected fowl.

On Thursday, the State Forestry Administration said wild bird sales have been suspended to prevent the spread of the virus.

The team of WHO, Chinese and global experts will also study a few "clusters" of confirmed and potential infections that have emerged in the past three weeks, O'Leary said.

O'Leary maintained that there has been no evidence of sustained human-to-human transmission but that it remained unclear how in a few cases, caregivers or neighbors of patients have also become ill.

Even within the rare and isolated examples of potential clusters it is hard to determine if one person got it from another or if they were all exposed to the same source of infection, he said.

This week, Chinese health authorities confirmed that a son of an 87-year-old man in Shanghai who was the earliest known H7N9 case was also infected with the virus. The man had fallen sick in mid-February and died in early March.

At the time, two of his sons, aged 69 and 55, had also been hospitalized with pneumonia. His younger son died and no samples were available for later testing but the older son, who recovered, tested positive for the virus.

O'Leary said, however, that Chinese health authorities have closely monitored hundreds of family members, caregivers, health workers and friends who have been in contact with patients and that only a handful have signs of H7N9 infections.



As reported from the Associated Press, 04192013

news.xin.msn.com 04/18/2013

New test can predict more accurately dengue fever complications

http://news.xin.msn.com/en/singapore/new-test-can-predict-more-accurately-dengue-fever-complications?sharedfrom=scptmy

news.xin.msn.com New test can predict more accurately dengue fever complications

sciencedaily.com 04/18/2013

Surprising finding could alter the face of dengue vaccine development

http://www.sciencedaily.com/releases/2013/04/130415094456.htm#.UW7OgNo6Uo0.email

sciencedaily.com As efforts to create a strong and effective vaccine for the dreaded dengue virus continue to hit snags, a new study offers surprising evidence that suggests the need for a revamped approach to dengue vaccine design. The finding runs counter to current scientific understanding of the key cells that n...

vitals.nbcnews.com 04/15/2013

Deaths from new bird flu underscore grim fears, reports show

http://vitals.nbcnews.com/_news/2013/04/12/17713083-deaths-from-new-bird-flu-underscore-grim-fears-reports-show?lite

vitals.nbcnews.com A new report on three of the first patients in China to contract a novel strain of bird flu has U.S. officials worried about a grim scenario that includes severe illness with pneumonia, septic shock, brain damage and multi-organ failure. All three of the patients died, according …

state.gov 03/20/2013

Web Sites of Foreign Embassies in the U.S.

Bringing Medications or Filling Prescriptions Abroad

A traveler going abroad with a preexisting medical problem should carry a letter from the attending physician, describing the medical condition and any prescription medications, including the generic names of prescribed drugs. Any medications being carried overseas should be left in their original containers and be clearly labeled. Travelers should check with the foreign embassy of the country they are visiting to make sure any required medications are not considered to be illegal narcotics. A listing of foreign embassies and consulates in the U.S. is available on the Department of State’s website at http://www.state.gov/s/cpr/rls/dpl/32122.htm. Foreign embassy and consulate contact information can also be found on the Country Specific Information for each country.

If you wear eyeglasses, take an extra pair with you. Pack medicines and extra eyeglasses in your hand luggage so they will be available in case your checked luggage is lost. To be extra secure, pack a backup supply of medicines and an additional pair of eyeglasses in your checked luggage.

If you have allergies, reactions to certain medications, foods, or insect bites, or other unique medical problems, consider wearing a "medical alert" bracelet. You may also wish to carry a letter from your physician explaining required treatment should you become ill.

Information on filling a prescription abroad and other health issues may be found at http://travel.state.gov/travel/tips/brochures/brochures_1215.html.

state.gov Home » Bureaus/Offices Reporting Directly to the Secretary » Office of the Chief of Protocol » Foreign Embassy Information & Publications » Diplomatic List » Web Sites of Foreign Embassies in the US

03/20/2013

INDIA TRAVEL ADVICE

Have a look at the most up-to-date travel advice for India from any of the following sites: UK travel advice for India, US State Department travel warnings for India or Canadian government travel advice for India.
Purchase an appropriate travel insurance for India to pay hospital treatment, medical evacuation and any sort of pursuits, for instance adventure sports, in which you wish to India.
In advance of travelling to India register your travel and contact particulars on the net or at your local embassy or consulate as soon as you arrive in India, so they are able get hold of you in an emergency.
Observe the Indian law. Consular assistance is not able to override local Indian laws and regulations, even where local laws seem to be extreme or unfounded by your country’s standards.
Check to see if you require visas for India or countries you are visiting or transiting. Keep in mind a Indian visa doesn't guarantee entry into India.
Make copies of your passport details, travel insurance policy, travellers cheques, visas and credit card numbers. Keep one copy in a separate location to the originals and leave a copy with a friend or relative at home.
Confirm with doctors for facts about recommended vaccinations or some other precautions for India and see about India procedures on travelling with prescription drugs.
Leave a copy of your trip itinerary with a friend or relative at home and maintain regular contact with family and friends while in India.

03/20/2013

Protection offered by GSK malaria vaccine fades over time

news.yahoo.com By Kate Kelland and Gene Emery LONDON/NEW YORK (Reuters) - The effectiveness of an experimental malaria vaccine developed by GlaxoSmithKline wanes over time, with the shot protecting only 16.8 percent of children over four years, according to trial data. The disappointing results for RTS,S - the wor...

bbc.co.uk 03/18/2013

Drug-resistant pandemic flu warning

bbc.co.uk Australian experts are concerned about a new type of drug-resistant pandemic flu that is circulating in the community and could spread globally.

businessweek.com 03/18/2013

Tamiflu Resistance in 2% of H1N1 Flu Cases Globally, Study Finds

businessweek.com Tamiflu-resistant swine flu is turning up in about 2 percent of cases globally, researchers in Australia found, raising the risk that Roche Holding AG’s pill may become ineffective in fighting the pandemic H1N1 virus.

03/04/2013

We are frequently asked about medical evacuation insurance. The Department of State urges Americans to consider purchasing medical coverage for emergency expenses such as medical
evacuation during their trip. The Social Security Medicare Program and most private insurances do not provide coverage for hospital or medical costs outside the USA. Most importantly, your provider here is unable to logistically ensure you receive proper care abroad. In choosing a provider, you may want to consider TravelCare Plans. They are recommended by International SOS.

For under $5 per day, TravelCare Plans offers:

1. Unlimited Medical Evacuation coverage to your hospital of
choice
2. $100,000 Security Evacuation coverage
3. $500,000 Medical Expense Insurance (underwritten by
Nationwide Insurance)
4. No deductibles and no copay
5. 24/7/365 Travel Assistance (your access to English speaking
experts to direct you to the best local help and to coordinate
your care)

For a free online quote, go to:
http://www.travelcare.com/evac/ and enter this number:
900964699

For questions, call 800.753.1000, option 6

webmd.com 02/15/2013

Your Travel Vaccine Checklist

webmd.com Before you pack your bags, find out which shots you need to protect your health when visiting other countries.

newsatjama.jama.com 02/11/2013

Researchers Uncover the Genetic Mechanism That May Help Lead to a Dengue Virus Vaccine

newsatjama.jama.com People who become infected with the dengue virus are at increased risk of experiencing a more severe infection later in life, and researchers are beginning to understand why. Such knowledge may pla...

news.yahoo.com 01/29/2013

Recaptured crocodiles lie in pens after about 15000 of the animals escaped from a crocodile farm dur

news.yahoo.com

abcnews.go.com 01/24/2013

CDC: New Version of Stomach Bug Causing US Illness

abcnews.go.com The 'Ferrari of viruses' has a new model, and it's becoming a leading stomach bug in the US

cdc.gov 01/14/2013

CDC - Seasonal Influenza (Flu) - What You Should Know for the 2012-2013...

A Great guide straight from the CDC: What You Should Know for the 2012-2013 Influenza Season http://ow.ly/gNF7a

cdc.gov CDC Centers for Disease Control and Prevention Influenza Flu: Question and Answer for the general public regarding basic information about the...

myfoxdfw.com 01/09/2013

Officials warn worst of flu season still ahead

myfoxdfw.com Health officials say when it comes to the flu this year the worst is yet to come.

foxnews.com 01/07/2013

Flu season in full swing, could get worse, experts say

foxnews.com More than half of the states in the U.S. are experiencing high levels of flu-like illness, and flu activity continues to be on the rise, according to the CDC

who.int 01/04/2013

WHO | Rift Valley fever in Mauritania

who.int The Ministry of Health (MoH) in Mauritania declared an outbreak of Rift Valley Fever (RVF) on 4 October 2012. From 16 September 2012 (the date of onset of the index case) to 30 October 2012, a total of 34 cases, including 17 deaths have been reported from 6 regions.

wwwnc.cdc.gov 01/04/2013

Yellow Fever in Sudan - Travelers' Health - CDC

wwwnc.cdc.gov Yellow Fever in Sudan

eurosurveillance.org 01/04/2013

Eurosurveillance - View Article

Eurosurveillance, Volume 17, Issue 45, 08 November 2012
Rapid communications
Ongoing outbreak of an acute muscular Sarcocystis-like illness among travellers returning from Tioman Island, Malaysia, 2011-2012
D H Esposito ()1, D O Freedman2, A Neumayr3, P Parola4

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
GeoSentinel Program Office, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States
TropNet Coordinating Center, Swiss Tropical and Public Health Institute, Basel, Switzerland
EuroTravNet Coordinating Center, University Hospital Institute for Infectious and Tropical Diseases, Aix-Marseille University and Assisitance-Publique Hôpitaux de Marseille, Marseille, France

Citation style for this article: Esposito DH, Freedman DO, Neumayr A, Parola P. Ongoing outbreak of an acute muscular Sarcocystis-like illness among travellers returning from Tioman Island, Malaysia, 2011-2012. Euro Surveill. 2012;17(45):pii=20310. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20310
Date of submission: 05 November 2012

As of 4 November, 2012, 100 patients with an acute muscular Sarcocystis-like illness associated with travel to Tioman Island, Malaysia, have been identified. Thirty-five travelled there mostly during July and August 2011 and 65 mostly during July and August 2012, suggesting an ongoing outbreak. Epidemiological investigations are ongoing. Public health agencies and practicing clinicians should be aware of this rarely-reported disease in humans and consider it as differential diagnosis in travellers returning from Tioman Island.
From 27 July to 4 November 2012, GeoSentinel [1], working with EuroTravNet [2] and TropNet [3], has identified 65 patients with an acute muscular Sarcocystis-like illness after recent travel to Tioman Island. All of these patients had traveled to Tioman, located off the east coast of peninsular Malaysia, mostly during July and August, 2012. Reports originated from Germany (n=25), France (n=20), the Netherlands (n=12), Switzerland (n=3), Belgium (n=2), Spain (n=2), and Singapore (n=1). These patients appear to represent the second wave of an outbreak that started in 2011 [4]. An epidemiologic investigation, initiated in November 2011, is ongoing.

Outbreak description

Starting from October 25, 2011, 35 patients with an acute muscular Sarcocystis-like illness were identified by early 2012; all traveled to Tioman Island, mostly during July and August of 2011. Following months without reports, new patients have been identified since late July 2012, and 65 have been reported to GeoSentinel by 4 November 2012. Cases presented here with limited, preliminary data, are patients reported to GeoSentinel with suspected acute muscular sarcocystosis, defined as an acute illness characterised by prominent musculoskeletal complaints with or without fever, with unexplained eosinophilia and recent travel to Tioman Island.

Although data collection is incomplete, the clinical presentation appears to be identical to that seen last year: almost all patients have experienced fever and myalgia while fewer have complained of arthralgia, asthenia, headache, cough, and diarrhoea. Only some had pruritic rash or edema of the face or an extremity. At least four patients were hospitalised.

Laboratory investigations showed that in many cases, at the onset of symptoms absolute eosinophil counts and serum creatinine phosphokinase (CPK) levels can be normal but begin to be moderately elevated approximately 30 days or more after departure from Tioman Island. Maximum absolute eosinophil counts and serum CPK levels from patients with data available, have typically been

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