Health Tips For Travelers To China

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Health Tips For Travelers To China
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In just one month a ceremonial torch will light the Olympic flame to open the 2008 Beijing Summer Games. It 's estimated nearly 2.5 million visitors will attend the games in China, which run from August 8-24. If you're heading to Beijing, you should be aware of the latest tips to ensure healthy and safe travels. Beaumont's InterHealth program specializes in travel outside the U.S. and can assist world travelers year-round with such tips.

InterHealth, Beaumont's international health care program, offers many services, including immunizations, counseling and up-to-date information on overseas health risks. Through the program, each traveler receives a custom health plan based on their intinerary. Jeffrey Band, M.D., medical director of InterHealth, shares the following advice for the Beijing 2008 Olympics:

# Travelers should make certain they have had a recent medical and dental exam, especially if pre-existing conditions exist. A copy of one's medical profile listing medical conditions, allergies, medications and special needs should be carried at all times.

# Bring an adequate supply of all prescriptions (carefully labeled) and other medication. Pack medications in carry-on bags only.

# Take an extra pair of prescription eyeglasses or lens prescription, hearing-aid batteries and other important personal items.

# Make sure routine vaccinations are up-to-date:

* A tetanus-diphtheria booster is recommended for everyone every 10 years.

* A polio booster may be needed unless previously vaccinated.

* If you have not had chickenpox, vaccination should be provided.

* Measles is quite active in China. All travelers should be immune to measles, mumps and rubella. If not, a vaccine called MMR will be needed.

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# Travelers to China should receive protection against both hepatitis A and typhoid (these are infections that can be food borne, as well as passed from person-to-person).

* Travelers should not drink tap water or use ice. All water for drinking, brushing teeth and making ice cubes should be bottled water or purified by boiling first. Milk and dairy products should not be considered safe. All meat, poultry, seafood and vegetables must be cooked well and served hot. Fruits with skin intact should be peeled by you, not someone else. Salads and cold buffets should be avoided.

* Travelers to China may experience diarrhea. Take antidiarrheal medications with you on the trip. If you develop mild diarrhea, take Pepto-Bismol tablets as directed. If diarrhea continues but if not associated with vomiting, severe cramps or high fevers, add the antidiarrheal medication Imodium to the Pepto-Bismol. If diarrhea persists for more than 8-12 hours, a prescription antibiotic may be warranted. This should be discussed with the travel medicine specialist and filled before traveling. If illness persists or if high fevers are present, seek medical advice (our embassy can be contacted for assistance).

* Mosquitoes and other insects can transmit a number of diseases. To protect against insect bites, especially when in the desert or in rural areas, use a repellent containing 28-35% diethyltoluamide (DEET). Also, consider wearing long-sleeved shirts and pants at dusk or at other times insects are more likely to be prevalent

* Take antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol with you.

* If extending travels to rural areas, medication to prevent malaria may be needed. Discuss this with your travel medicine physician.

* Bird flu (avian influenza) is a viral infection that usually affects birds but rarely people. People catch bird flu from touching sick or dead birds and rarely by visiting "wet" markets where recently killed birds are on display. Only 3 cases have occurred in China in 2008. If visiting a "wet" market stay approximately 6-12 feet from the birds themselves. Wash your hands after the visit and do not consume undercooked poultry.

* Air pollution can worsen breathing problems. If you have asthma, allergies or lung problems, discuss this with your primary care provider and travel medicine physician.

* Be careful. Don't drink and drive, wear seat belts at all times and stay alert in crowds. Avoid political protests and rallies.

These recommendations are only intended as general guidelines. They should not be regarded as a substitute for consultation with a travel medicine specialist.

For more information on InterHealth services or to make an appointment call 248-551-0495. InterHealth is located in suite 305 of the Medical Office Building next to Beaumont, Royal Oak. Free, covered parking is available in the hospital's North Parking Deck.

China is a vibrant and beautiful country with wonderful sites to visit and friendly people. The 2008 Olympics will be exciting --- let the games begin!

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CUT THE CHAIN OF INFECTIONS ! Spread of avian flu by drinking water: Proved awareness to ecology and transmission is necessary to understand the spread of avian flu. For this it is insufficient exclusive to test samples from wild birds, poultry and humans for avian flu viruses. Samples from the known abiotic vehicles as water also have to be analysed. Proving viruses in water is difficult because of dilution. If you find no viruses you can not be sure that there are not any. On the other hand in water viruses remain viable for a long time. Water has to be tested for influenza viruses by cell culture and in particular by the more sensitive molecular biology method PCR. Transmission of avian flu by direct contact to infected poultry is an unproved assumption from the WHO. There is no evidence that influenza primarily is transmitted by saliva droplets: “Transmission of influenza A in human beings” http://www.thelancet.com/journals/laninf/article/PIIS1473309907700294/abstract?iseop=true. There are clear links between the cold, rainy seasons as well as floods and the spread of influenza. There are clear links between avian flu and water, e.g. in Egypt to the Nile delta or in Indonesia to residential districts of less prosperous humans with backyard flocks of birds and without a central water supply as in Vietnam: http://www.cdc.gov/ncidod/EID/vol12no12/06-0829.htm. See also the WHO web side: http://www.who.int/water_sanitation_health/emerging/h5n1background.pdf. That is just why abiotic vehicles as water have to be analysed. The direct biotic transmission from birds, poultry or humans to humans can not depend on the cold, rainy seasons or floods. Water is a very efficient abiotic vehicle for the spread of viruses - in particular of fecal as well as by mouth, nose and eyes excreted viruses. Infected humans, mammals, birds and poultry can contaminate drinking water everywhere. All humans have very intensive contact to drinking water. Spread of avian flu by drinking water can explain small clusters in households too. Avian flu infections may increase in consequence to increase of virus circulation. Human to human and contact transmission of influenza occur - but are overvalued immense. In the course of influenza epidemics in Germany, recognized clusters are rare, accounting for just 9 percent of cases e.g. in the 2005 season. In temperate climates the lethal H5N1 virus will be transferred to humans via cold drinking water, as with the birds in February and March 2006, strong seasonal at the time when (drinking) water has its temperature minimum. The performance to eliminate viruses from the drinking water processing plants regularly does not meet the requirements of the WHO and the USA/USEPA. Conventional disinfection procedures are poor, because microorganisms in the water are not in suspension, but embedded in particles. Even ground water used for drinking water is not free from viruses. In temperate regions influenza epidemics recur with marked seasonality around the end of winter, in the northern as well as in the southern hemisphere. Although seasonality is one of the most familiar features of influenza, it is also one of the least understood. Indoor crowding during cold weather, seasonal fluctuations in host immune responses, and environmental factors, including relative humidity, temperature, and UV radiation have all been suggested to account for this phenomenon, but none of these hypotheses has been tested directly. Influenza causes significant morbidity in tropical regions; however, in contrast to the situation in temperate zones, influenza in the tropics is not strongly associated with a certain season. In the tropics, flood-related influenza is typical after extreme weather. The virulence of influenza viruses depends on temperature and time. Especially in cases of local water supplies with “young” and fresh influenza-contaminated water from low local wells, cisterns, tanks, rain barrels, ponds, rivers or rice paddies, this pathway can explain H5N1 infections. At 24°C, for example, in the tropics the virulence of influenza viruses in water exists for 2 days. In temperate climates with “older” water from central water supplies, the temperature of the water is decisive for the virulence of viruses. At 7°C the virulence of influenza viruses in water extends to 14 days. Ducks and rice (paddies = flooded by water) are major factors in outbreaks of avian flu, claims a UN agency: Ducks and rice fields may be a critical factor in spreading H5N1. Ducks, rice (fields, paddies = flooded by water; farmers at work drink the water from rice paddies) and people – not chickens – have emerged as the most significant factors in the spread of avian influenza in Thailand and Vietnam, according to a study carried out by a group of experts from the United Nations Food and Agriculture Organization (FAO) and associated research centres. See http://www.un.org/apps/news/story.asp?NewsID=26096&Cr=&Cr1 The study “Mapping H5N1 highly pathogenic avian influenza risk in Southeast Asia: ducks, rice and people” also concludes that these factors are probably behind persistent outbreaks in other countries such as Cambodia and Laos. This study examined a series of waves of H5N1, a highly pathogenic avian influenza, in Thailand and Vietnam between early 2004 and late 2005. Through the use of satellite mapping, researchers looked at several different factors, including the numbers of ducks, geese and chickens, human population size, rice cultivation and geography, and found a strong link between duck grazing patterns and rice cropping intensity. In Thailand, for example, the proportion of young ducks in flocks was found to peak in September-October; these rapidly growing young ducks can therefore benefit from the peak of the rice harvest in November-December, at the beginning of the cold: Thailand, Vietnam, Cambodia, Laos – as opposed to Indonesia – are located in the northern hemisphere. These peaks in the congregation of ducks indicate periods in which there is an increase in the chances for virus release and exposure, and rice paddies often become a temporary habitat for wild bird species. In addition, with virus persistence becoming increasingly confined to areas with intensive rice-duck agriculture in eastern and south-eastern Asia, the evolution of the H5N1 virus may become easier to predict. Dipl.-Ing. Wilfried Soddemann - Epidemiologist - Free Science Journalist [email protected] http://www.dugi-ev.de/information.html