Travel Blog

EBOLA in DRC

EBOLA in Democratic Republic of Congo (DRC)

Ebola fever is a deadly disease that causes outbreaks in several African countries. It is spread by direct contact with blood or body fluids of a person infected with Ebola virus. It is also spread by contact with contaminated objects or infected animals.
Symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. Skin rash, red eyes, and internal and external bleeding may be seen in some patients.

An outbreak of Ebola is occurring in the North Kivu (Kivu Nord) and Ituri provinces of the DRC, including the cities of Beni and Butembo. The provinces have been experiencing a prolonged humanitarian crisis and deteriorating security situation, which is limiting public health efforts to respond to this outbreak.
The risk to most travelers to DRC is low, with potential increased risk to those travelers going in or near the outbreak area and inadvertently coming in close contact with person infected with Ebola.

What can travelers do to protect themselves?
There is no FDA-approved or widely available vaccine or specific treatment for Ebola, and many people who get the disease die. Therefore, it is important to take steps to prevent Ebola:

  • Avoid contact with other people’s blood or body fluids. Do not handle items that may have come in contact with a person’s blood or body fluids (such as clothes, bedding, needles, or medical equipment).
  • Avoid contact with wild animals and bushmeat.
  • Avoid participating in burial rituals that require handling a dead body.
  • Before you go to a doctor’s office or emergency room, tell the doctor about your recent travel and your symptoms.
  • Advance notice will help the doctor care for you and protect other people who may be in the office or hospital.

Travelers who may have been exposed to Ebola or who become sick during travel should postpone further travel and get immediate medical attention. Any person with possible exposure or Ebola-like symptoms will not be allowed to travel unless the travel is part of an appropriate medical evacuation.

March Break 2019

Preparing for March Break 2019

As many of us prepare to get away the winter doldrums and seek warmer destination in the Caribbean and Mexico, it is important to remember that these destinations to pose significant risk for a number of diseases even at 5 star resorts. Travelers planning on a service trip or volunteerism to places like Ecuador, Peru, Guatemala and Africa should take good measures to protect against diseases like typhoid fever , Hepatitis A , Yellow Fever, Travelers Diarrhea and Malaria. Some locations also have risk for Dengue fever, Chikungunya fever and Zika Virus.

Now is the time to visit the travel clinic to ensure adequate time for all vaccines to work and ensure availability of the vaccines. Please note that there are several new recommendations and requirements for Yellow Fever Vaccine to some of these destinations.

Travelers should ensure adequate measures to prevent mosquito bites and should be well aware of all the potential pitfalls with diseases that may be spread from food and drinks.

Polio Vaccine Requirements

Polio Vaccine Requirements

In November 2018, WHO released updated Polio vaccine recommendations.
Temporary Polio vaccine recommendations affect the following countries: Afghanistan, Democratic Republic of the Congo, Kenya, Niger, Nigeria, Pakistan, Papua New Guinea, and Somalia.
Long-term travelers (staying >4 weeks) to Afghanistan, Nigeria, Pakistan, Papua New Guinea, and Somalia may be required to show proof of Polio vaccination when leaving these Polio-infected countries. To meet these requirements travelers should receive the Polio vaccine between 4 weeks and 12 months before the date of departure from these Polio-infected countries.

Service Trips

Service and Humanitarian Trips

Travelers planning on a service trip or volunteerism to places like Ecuador, Peru, Guatemala and Africa should take good measures to protect against diseases like typhoid fever , Hepatitis A , Yellow Fever, Travelers Diarrhea and Malaria. Some locations also have risk for Dengue fever, Chikungunya fever and Zika Virus.

Travelers should ensure adequate measures to prevent mosquito bites and should be well aware of all the potential pitfalls with diseases that may be spread from food and drinks.

Students going on these trips and their parents will have significant concerns about the risks in these areas. Each persons risk is different as it depends on your previous vaccination history, duration and location of travel and preexisting medical issues. Careful consultation with a physician who is an expert in travel medicine will ensure that the risks are managed in the best possible way and individualized for you.

Now is the time to visit the travel clinic to ensure adequate time for all vaccines to work and ensure availability of the vaccines. Please note that there are several new recommendations and requirements for Yellow Fever Vaccine to some of these destinations.

Yellow Fever in Brazil

Update on Yellow Fever in Brazil

There is a large, ongoing outbreak of Yellow Fever in many areas of Brazil.
Yellow Fever is caused by a virus that is spread through mosquitoes. The symptoms include fever, chills, headache, backache, and muscle aches and take 3–6 days to develop. It can lead to organ failure and death.

Travelers to Brazil should protect themselves from Yellow Fever by getting Yellow Fever vaccine at least 10 days before travel, and preventing mosquito bites.

People who have never been vaccinated against Yellow Fever should avoid traveling to areas of Brazil where Yellow Fever vaccination is recommended.
Travelers going to areas with ongoing outbreaks may consider getting a booster dose of Yellow Fever vaccine if it has been 10 or more years since they were vaccinated.

In response to the outbreak that began in early 2017, the World Health Organization has expanded the list of areas where Yellow Fever vaccination is recommended for international travelers to Brazil to include the following:

  • All of Espirito Santo State
  • All of São Paulo State, including the city of São Paulo and all coastal islands
  • All of Rio de Janeiro State, including the city of Rio de Janeiro and all coastal islands
  • All of Paraná State
  • All of Santa Catarina State
  • All of Rio Grande do Sul State
  • A number of cities in Bahia State

AS THERE IS A SEVERE SHORTAGE OF Yellow Fever VACCINE ACROSS ONTARIO, PLEASE VISIT THE TRAVEL CLINIC AS EARLY AS POSSIBLE BEFORE YOUR TRIP.

Rabies in Malaysia

Five human rabies cases and almost 800 cases of people being bitten by rabid animals have been reported in the Malaysian state of Sarawak. All five people infected with rabies have died.

Rabies is a deadly disease found in the saliva of infected animals. All mammals can get rabies. People usually get rabies from licks, bites, or scratches from infected dogs or other animals.

Rabies affects the nervous system causing brain disease and death. Once symptoms of rabies appear, the disease is nearly always fatal, so prevention is especially important.

Avoid touching all animals, including wild animals and pets. Pets in other countries, such as Malaysia, may not be vaccinated against rabies.

See your local travel clinic to get vaccinated for Rabies before traveling to an area of risk.

Zika virus

Caes of Zika virus have now been reported in many countries in the Caribbean , South and Central America and the Pacific islands.

Travellers to countries in these areas should protect themselves by using mosquito nets and applying insect repellant with D.E.E.T ( at least 22% strength) to exposed areas of skin to prevent mosquito bites.

There is no vaccine or treatment for the Zika virus infection.

Women should avoid becoming pregnant for 2 months after they visit and area with Zika virus.

Men should avoid fathering a child for 6 months after they visit an area with Zika virus.

Chikungunya Fever

There has been an increased number of cases of Chikungunya fever in Brazil and Italy.

Chikungunya fever is spread to people by mosquitoes. The most common symptoms of Chikungunya virus infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, and rash. Outbreaks have occurred in Africa, Asia, Europe, and the Indian and Pacific Oceans, and on islands in the Caribbean. There is no vaccine to prevent or medicine to treat Chikungunya virus infection. Travelers can protect themselves by using mosquito nets and applying insect repellant with D.E.E.T ( at least 22% strength) to exposed areas of skin to prevent mosquito bites.

Vaccine Shortages

Please note that there are currently severe shortages of injectable Typhoid vaccine and Yellow fever vaccine in the province in Ontario.

To ensure your best chances of receiving either of these vaccines if you need them , it is best to visit a travel clinic as early as possible. If the vaccine is not available at the time , your name can be put on a waiting list to receive the vaccine in priority.

Also note that Yellow Fever vaccine is a mandatory requirement for entry to certain countries

Plague in Madagascar

There is currently an outbreak of bubonic plague in widespread areas of Madagascar.

The Plague is a bacterial infection spread through bites by infected fleas. Plague causes high fever, swollen lymph glands and the infection can spread to the lungs

Plague pneumonia ( infection in the lungs) is the only way it that can be directly transmitted from one person to another. Plague can be treated with antibiotics. However, without prompt treatment, plague can cause serious illness or death.

No vaccine is available to prevent plague. But travelers can take steps to prevent plague, and complications of plague can be prevented with antibiotics.

Travelers to Madagascar should use insect repellent that lists protection against fleas on the label and contains at least 25% D.E.E.T. Avoid close contact with sick or dead animals. Avoid close contact with people who are coughing up blood.

Travelers who have had close contact with people with plague pneumonia should immediately contact a doctor. During or after travel to Madagascar, travelers should watch for symptoms of plague. If symptoms do appear, they should seek medical care and inform the provider about their travel to Madagascar. Antibiotics are available to treat the plague.

Polio outbreaks

There have increased number of cases of Polio ( Poliomyelitis reported in the Democratic Republic of Congo, Syria and Nigeria.

Travellers to these areas are urged to receive a booster dose of Polio vaccine ( on top of your child hood doses) prior to departure to these countries. It is also advised that you carry some documentation of proof of vaccination as this may be required prior to your exit from certain countries.