Yellow Fever

After the past Fourth of July weekend, summer is felt in full bloom: BBQ get-togethers, summer vacations at exotic places, long lines outside Haagen-Dazs on a hot and humid day, the beautiful late-setting sun. And unfortunately, with the full bloom of summer comes the full bloom of mosquitoes.  The daunting humming noise they make as they fly around waiting for the exact moment to strike at our epidermis and the grotesque, sleep-disrupting bumps that result from their blood-sucking activities are enough visuals to make anyone cringe. 

While most mosquitoes are just annoying and not dangerous (thank goodness - otherwise we'd all be suffering from West Nile or some other scary disease), one type of mosquito to be aware of is the Aedes aegypti - or A. aegypti. These nuissances can be easily recognized by white markings on their legs and a marking in the form of a lyre on their thorax - not that ugly, right? Originating in Africa, they now inhabit various tropical and subtropical regions throughout South and Central America and Africa. Seems pretty harmless. So why do we care about them? They are commonly connotated with carrying the YELLOW FEVER VIRUS, an acute viral hemorrhagic disease. 

Perusing the WebMD page for yellow fever may be a little worrying; descriptions of the disease include "damage to the liver, kidney, heart, and gastrointestinal tract" and major symptoms include "jaundice and hemorrhages". The Wikipedia article is even more intimidating: the symptoms list expands to include "fever, chills, anorexia, nausea, muscle pain (with prominent backache) and headache" with "no causative cure." The Wiki page then proceeds to throw descriptions like "positive sense single-stranded RNA is approximately 11,000 nucleotides long and has a single open reading frame" (translation: the viruses have single-stranded genetic material that are directly translated into proteins in a certain pattern after the genetic material enters the nucleus of the host cell; the resulting protein consists of about 3000 amino acids, which isn't huge for a protein); "viruses affect... 

monocytes, macrophages and dendritic cells... attach to the cell surface via specific receptors and are taken up by an endosomal vesicle" (translation: viruses attach to the surface of large white blood cells, foreign particle-engulfing cells, and immune system messenger cells at specific locations in order to insert their genetic material into the nucleus of the host cell); and "the viral genome is replicated in the rough endoplasmic reticulum (ER) and in the... vesicle packets" (translation: the protein that this 'scary' virus codes for is produced in the endoplasmic reticulum, an accordion-like structure that houses little round organelles called ribosomes, which translate the jumbled A's, C's, G's, and U's of RNA into proteins). 

Seen in the translated light, the yellow fever virus isn't that bad. The best part? This disease is easily preventable through vaccination, which are available at designated vaccination centers (AND they'll give you proper verification paperwork). This preventative measure is highly advised for people 9 months through 59 years of age traveling to a location where the risk of yellow fever is known to exist. In addition to receiving the vaccine, the CDC also highly advises people in areas where the pesky A. aegypti are to take preventative to avoid mosquito bites. 

If you're a traveler living in New York City and would like to take care of yellow fever vaccination, visit Travelclinicny.com to avoid painful symptoms during an exotic vacation. Log on to find out all the information you need, or simply dial 1-212-696-5900 to speak to a friendly staff member and arrange an appointment today. Located in midtown Manhattan, Walk In Clinic of New York is easily accessible by bus and subway.

B Forewarned: The Do’s and Don'ts of Hepatitis B

If there is anything worse than a liver infection, it’s a viral liver infection. Unlike bacterial infections, viruses cannot be directly treated or eradicated from the system with medication or surgical procedures. For this reason, prevention is always a better course of action than treatment after exposure to the disease. Fortunately, when it comes to the Hepatitis B virus, a simple vaccine can eliminate the risk of contracting not only the disease, but also a number of its potentially dangerous symptoms. Read on to discover the do’s and don'ts of avoiding, preventing, and treating Hepatitis B. 

B-ing Risky: Potential Causes of Hepatitis B

There are a number of activities and situations that may cause the spread of the Hepatitis B virus from person to person. The virus is typically passed between individuals in blood, semen, or other bodily fluids. For these reasons, it is important to know whether or not your sexual partner may have Hepatitis B. The virus can also spread through the shared use of needles or syringes. Thus, intravenous drug use fundamentally heightens your risk of getting the disease. Hepatitis B can also be passed from mother to child during childbirth.

Fortunately, there are a number of effective precautions that can help you avoid exposure to the virus. Other than knowing the Hepatitis B status of your sexual partner, consistently using a new latex or polyurethane condom during intercourse significantly reduces the risk of contracting the disease.

Stopping the use of illicit intravenous drugs is another essential precautionary measure. If you are unable to stop, however, it is nevertheless critical that you use a sterile syringe with every injection, and that you never share needles.

If you plan on getting a tattoo or a body piercing, it is also important to find a reputable shop where you can inquire about cleaning practices, as tools in tattoo and piercing parlors are occasionally contaminated by the virus and not properly cleaned.

The virus is also more prominent in certain geographic regions, such as Africa, parts of Central and Southeast Asia, and Eastern Europe. If you are planning a trip to any of these areas, it is important to receive the Hepatitis B vaccination well in advance.

Types of Hepatitis B

There are two basic manifestations of the Hepatitis B virus: either acute infection or chronic infection. Acute infection is far more common, and may last up to six months. Chronic Hepatitis B, on the other hand, lasts six months or longer. Although it shares a number or symptoms with the acute form of the infection, it may also be lifelong and cause a number of far more serious illnesses such as liver cancer, cirrhosis, and other liver diseases. Chronic Hepatitis B occurs far more frequently in infants and children who are exposed to the virus at a very young age.

B Proactive: Prevention and Treatment Options

If the disease is already contracted, there are ways of treating certain symptoms. In many acute cases, however, the body is able to eventually eliminate the virus on its own. In chronic cases, however, a doctor may prescribe anti-viral medication. In the event that Chronic Hepatitis B causes extreme liver damage, a liver transplant may be the best option.

Of course, prevention trumps these treatment options. The best way to protect yourself from Hepatitis B is vaccination. The Hepatitis B vaccine is administered as a series of three or four shots over a six-month period. It is recommended that children be vaccinated at birth or between the ages of 1 and 5. If you have yet to receive the vaccination as an adult, it is highly recommended that you get your Hepatitis B vaccination while you're in New York before traveling into regions with a greater risk or engaging in risky behavior.

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!