We are NOT authorized by Govt of India for Yellow Fever Vaccination

Monday, February 22, 2016

Vaccination FAQs India Parents - IPV Polio Injection Not Available - Why & what to do?

Query : 

Answer : 
 IPV vaccine is in short supply since the Govt of India is purchasing it in bulk quantity for use in govt vaccination schedule.
The alternative is Oral Polio vaccine which is almost as good, and has been available for many years.
Very soon the IPV will become available again.
We get a few doses every few weeks in our clinic that are used up within a couple of days.

Saturday, February 13, 2016

WHO: Zika virus infection – Region of the Americas: Update - Feb 2016

World Health Organization:  Disease Outbreak News 8 February 2016
Between 27 and 30 January 2016, PAHO/WHO was notified of cases of Zika virus infection in Costa Rica, Curaçao, Jamaica and Nicaragua.
Costa Rica
On 27 January, the National IHR Focal Point of the United States reported of a case of Zika virus infection in a patient returning from Costa Rica.
On 28 January, the National IHR Focal Point of the Netherlands reported the first autochthonous case of Zika virus infection in Curaçao. Curaçao is an independent state and part of the Kingdom of the Netherlands and is situated in the southern part of the Caribbean region just north of the Venezuelan coast.
On 30 January, the National IHR Focal Point of Jamaica reported a case of Zika virus infection.
On 27 January, the National IHR Focal Point of Nicaragua reported the country’s first 2 laboratory-confirmed cases of locally-acquired Zika virus infection.
WHO advice
The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for Zika virus infection. Prevention and control relies on reducing the breeding of mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people. This can be achieved by reducing the number of natural and artificial water-filled habitats that support mosquito larvae, reducing the adult mosquito populations around at-risk communities and by using barriers such as insect screens, closed doors and windows, long clothing and repellents. Since the Aedes mosquitoes (the primary vector for transmission) are day-biting mosquitoes, it is recommended that those who sleep during the daytime, particularly young children, the sick or elderly, should rest under mosquito nets (bed nets), treated with or without insecticide to provide protection.
During outbreaks, space spraying of insecticides may be carried out following the technical orientation provided by WHO to kill flying mosquitoes. Suitable insecticides (recommended by the WHO Pesticide Evaluation Scheme) may also be used as larvicides to treat relatively large water containers, when this is technically indicated.
Basic precautions for protection from mosquito bites should be taken by people traveling to high risk areas, especially pregnant women. These include use of repellents, wearing light colored, long sleeved shirts and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering.
WHO does not recommend any travel or trade restriction to Costa Rica, Curaçao, Jamaica and Nicaragua based on the current information available.

Friday, February 12, 2016

Angola says 37 dead in yellow fever outbreak, China giving financial assistance to fight Yellow Fever - Feb 2016

LUANDA (Reuters) - A yellow fever outbreak in Angola has killed 37 people since December with eight new cases reported in the last 24 hours, the country's national director of health Adelaide de Carvalho said late on Wednesday.
The outbreak of yellow fever, which is transmitted by mosquito bites, began in the Luanda suburb of Viana but has spread to other areas of the southern African country with 191 people infected so far.
De Carvalho said health officials were monitoring suburbs around the capital of Luanda where infections have been worsened by unsanitary conditions caused by a garbage collection backlog.
"Actions should be developed for the improvement of public sanitary and garbage collection," de Carvalho said.
Symptoms of yellow fever include sudden fever, severe headache, nausea, vomiting and fatigue, according to the Centre for Disease Control and Prevention.
(Reporting by Herculano Coroado; Writing by Mfuneko Toyana)
The Chinese government is to give a financial assistance of USD 500,000 to Angola for this African country to purchase yellow fever vaccines, aimed to fight the recent outbreak in the country.
A note from the Chinese Embassy in Angola, which reached ANGOP on Monday, states that the donation happens in response to a request from the Angolan authorities that intend to put an end to the yellow fever outbreak, which has already claimed several lives.
Last week, 38 cases of yellow fever were recorded in Luanda, ten of which ended in death.  
The investigations on the disease began on 30 December, 2015, after the appearance of six cases, four of which ended in death.
Most of the cases were recorded in Viana Municipality, in Luanda, reason why the Angolan authorities launched last week a campaign against this disease, which includes sensitisation activities with the citizens aimed at reinforcing preventive measures.  
Yellow Fever is a disease transmitted to humans by the Aedes Aegypti mosquito.
In Angola, before the current outbreak, the last cases were recorded in 1988.

Tuesday, February 2, 2016

New testing guidelines for infants with possible Zika virus infection released by CDC - Feb 2016

The Centers for Disease Control and Prevention has released interim guidelines for U.S. clinicians caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy.
The guidelines, released Jan. 26, address the evaluation and testing of infants with possible congenital Zika virus infection, and follow the Jan. 19 release of similar guidelines for the care of pregnant women with possible exposure to the mosquito-borne virus. Most importantly, the new guidelines say Zika virus testing should be performed for infants with microcephaly or intracranial calcifications who are born to women with possible Zika virus exposure during pregnancy, and for infants born to women with positive or inconclusive Zika virus test results.
“Pediatric health are providers should work closely with obstetric providers to identify infants whose mothers were potentially infected with Zika virus during pregnancy (based on travel to or residence in an area with Zika virus transmission),” according to the guidelines, which were published in Morbidity and Mortality Weekly Report (MMWR. 2016 Jan 26;65[Early Release:1-5]).
Infants with laboratory evidence of a possible congenital Zika virus infection should undergo additional clinical evaluation, and state or territorial health departments should be contacted to facilitate testing. Zika virus disease is an arboviral disease and thus is a nationally notifiable condition, according to guideline authors Dr. J. Erin Staples and her colleagues at the CDC, Atlanta.
Both molecular and serologic tests are recommended for infants undergoing evaluation for possible congenital Zika virus infection, they noted.
Serum specimens for reverse-transcription-polymerase chain reaction testing should be collected from the umbilical cord or directly from the infant within 2 days of birth, and cerebrospinal fluid collected for other studies, as well as frozen and fixed placenta obtained at delivery, should also be tested by RT-PCR.
IgM ELISA for Zika virus and dengue virus should also be performed on infant serum, infant CSF, and maternal serum, but results from these assays can be falsely positive because of cross-reacting antibodies, the authors noted.
Other tests that can be considered include a plaque reduction neutralization test to measure virus-specific neutralizing antibodies and to discriminate between cross-reacting antibodies and closely related flaviviruses, and immunohistochemical staining to detect the virus antigen on fixed placenta and umbilical cord tissues.
Further clinical evaluation and laboratory testing is recommended for infants with microcephaly or intracranial calcifications detected prenatally or at birth if the mother was potentially infected during pregnancy, they said.
In infants with possible Zika virus exposure during pregnancy, but without microcephaly or intracranial calcification, subsequent evaluation depends on maternal testing results. Routine care is recommended if maternal test results are negative, and testing for a possible congenital infection is recommended if maternal results are positive or inconclusive.
If all of an infant’s tests are negative for Zika virus infection, no further Zika virus testing or evaluation is recommended. In the event of any positive or inconclusive test, further evaluation and follow-up is recommended.
Abnormal eye findings have been reported in infants with possible congenital infection, therefore an opthalmologic evaluation, including retinal examination is advised during the first month of life, as is a repeat hearing screen at age 6 months – even if the initial screen was normal, the authors said.
The infant should be followed to assess for long-term sequelae, and the case should be reported. Follow-up should include a cranial ultrasound to assess for subclinical findings, unless a third trimester ultrasound showed no brain abnormalities, they added.
No specific antiviral treatment or vaccine exists for Zika virus infection; treatment is supportive and should address specific medical and neurodevelopmental issues, and mothers should be encouraged to breastfeed infants regardless of exposure, as available evidence suggests the benefits of breastfeeding outweigh the theoretical risks of transmission through breast milk, they said.
The authors stressed that prevention of maternal infection is the only way to prevent congenital Zika virus infection and is achieved by avoiding areas with ongoing Zika virus transmission or by strictly following steps to avoid mosquito bites by using air-conditioning or window and door screens, wearing protective clothing, and using insect repellents.
Environmental Protection Agency–registered insect repellents are safe for pregnant women when used according to the product label, they noted.

Monday, February 1, 2016

With no testing facility, doctors see Zika threat in India; Western Ghats, coasts at risk

ter dengue and Chikungunya, the Zika virus, which has caused a global scare, is seen as a threat to people in Indian subcontinent. The reason: the virus spreads through the bite of an infected mosquito Aedes Egypty, which breeds in fresh water, and given India's poor public hygiene, such pools are in abundance.

Doctors in Bengaluru are getting themselves up updated themselves about the disease by sharing messages on WhatsApp groups. But the Union health ministry and the state health department are yet to take concrete action. There are no testing facilities in place, no screening procedures at airports, no guidelines on how to tackle it if it begins to spread.

Bengaluru, doctors say, may be at a risk as a large number of people travel to South America and other countries where the virus has struck. Contributing to it would be the city's garbage menace and the resultant mosquitoes.

Dr GM Vamadeva, director, health and family welfare department, said, "There is no need to fear.The virus has not yet come to India. We have no power to issue guidelines. The Centre must do it . We are yet to understand what kind of surveillance needed to screen travellers coming from the affected countries."

Dr Satish Amar nath, head of quality compliance and outreach programmes at Manipal hospital, said India is vulnerable to Zika infection. "It's definitely going to be a threat. A lot of Indians travel to South America. The government must set up systems at airports to screen those coming from the affected areas. We do not have facilities to test, identify and monitor Zika. Commercial testing kits are the need of the hour," he told STOI.

Dr Satish, who monitors occupational clinics, said there are many cases wherein travellers who have come from South America showing symptoms of onset of fever. "But we do not know the cause of their fatigue, and at present no mechanism to test for Zika virus," he added.

Top Comment

Zika virus : Bengaluru, western ghats, c�tes en danger, disent les docs 1454300083576Je Suis

"It's high time we protected ourselves from mosquito breeding," said Dr SM Prasad, paediatrician and assistant professor at Dr BR Ambedkar Medical College."It is said that the infection is mild in 80% of cases and goes unnoticed in many. It's the travellers who are going to spread the virus and we must be careful with the screening at the airports.If the virus hits India, there are chances that the worst affected places will be the western ghats and coastal areas due to extreme temperatures," he added.


We've known mosquitoes are responsible for chikungunya and dengue but are cavalier in tackling their breeding pools. Now, Zika joins this list and we seem clueless how to tackle it. Even as the West struggles to firefight this latest scourge, health authorities must move swiftly to ensure the staff on the ground are well trained to detect the disease and are well versed with treatment measures.The fight against Zika looks like a long and tough one.