Thursday, December 27, 2007

Diseases Spread North, Global Warming to blame?

This is an intereting article from the New York Times published on December 23, 2007.

CASTIGLIONE DI CERVIA, Italy — Panic was spreading this August through this tidy village of 2,000 as one person after another fell ill with weeks of high fever, exhaustion and excruciating bone pain, just as most of Italy was enjoying Ferragosto, its most important summer holiday.

Officials set out insect traps and were surprised by what they caught: tiger mosquitoes.
“At one point, I simply couldn’t stand up to get out of the car,” said Antonio Ciano, 62, an elegant retiree in a pashmina scarf and trendy blue glasses. “I fell. I thought, O.K., my time is up. I’m going to die. It was really that dramatic.”

By midmonth, more than 100 people had come down with the same malady. Although the worst symptoms dissipated after a couple of weeks, no doctor could figure out what was wrong.
People blamed pollution in the river. They denounced the government. But most of all they blamed recent immigrants from tropical Africa for bringing the pestilence to their sleepy settlement of pastel stucco homes.

“Why immigrants?” asked Rina Ventura, who owns a shop selling shoes and purses. “I kept thinking of these terrible diseases that you see on TV, like malaria. We were terrified. There was no name and no treatment.”
Oddly, the villagers were both right and wrong. After a month of investigation, Italian public health officials discovered that the people of Castiglione di Cervia were, in fact, suffering from a tropical disease, chikungunya, a relative of dengue fever normally found in the Indian Ocean region. But the immigrants spreading the disease were not humans but insects: tiger mosquitoes, who can thrive in a warming Europe.

Aided by global warming and globalization, Castiglione di Cervia has the dubious distinction of playing host to the first outbreak in modern Europe of a disease that had previously been seen only in the tropics.
“By the time we got back the name and surname of the virus, our outbreak was over,” said Dr. Rafaella Angelini, director of the regional public health department in Ravenna. “When they told us it was chikungunya, it was not a problem for Ravenna any more. But I thought: this is a big problem for Europe.”

The epidemic proved that tropical viruses are now able to spread in new areas, far north of their previous range. The tiger mosquito, which first arrived in Ravenna three years ago, is thriving across southern Europe and even in France and Switzerland.
And if chikungunya can spread to Castiglione — “a place not special in any way,” Dr. Angelini said — there is no reason why it cannot go to other Italian villages. There is no reason why dengue, an even more debilitating tropical disease, cannot as well.

“This is the first case of an epidemic of a tropical disease in a developed, European country,” said Dr. Roberto Bertollini, director of the World Health Organization’s Health and Environment program. “Climate change creates conditions that make it easier for this mosquito to survive and it opens the door to diseases that didn’t exist here previously. This is a real issue. Now, today. It is not something a crazy environmentalist is warning about.”
Was he shocked to discover chikungunya in Italy, his native land? “We knew this would happen sooner or later,” he said. “We just didn’t know where or when.”

It certainly caught this town off guard on Aug. 9, when public health officials in Ravenna received an angry call from Stefano Merlo, who owns the gas station. “Within 100 meters of my home, there were more than 30 people with fevers over 40 degrees,” or 104 Fahrenheit, said Mr. Merlo, 47. “I wanted to know what was going on. I knew it couldn’t be normal.”
August is not the season for high fevers, Dr. Angelini agreed, and within days of interviewing patients she was intrigued. “The stories were so similar and so dramatic,” she said. “But we had no clue it was something tropical.”

Hard-working shopkeepers could not get out of bed because their hips hurt so much. Able-bodied men could not lift spoons to their mouths. (Months later, many still have debilitating joint pain.) From the start, doctors suspected that the disease was spread by insects, rather than people. While almost all homes had one person who was ill, family members seemed not to catch the disease from one another. They initially focused on sand flies, since the disease clustered on streets by the river.

Canceling their traditional mid-August vacations (in Italy, a true sign of panic), health officials sent off blood samples, called national infectious-disease experts, searched the Internet and set out traps to see what insects were in the neighborhood. The first surprise was that the insect traps contained not sand flies but tiger mosquitoes, and huge numbers of them. The scientific survey confirmed what residents of Castiglione had come to accept as a horrible nuisance, though not a deadly threat.

“In the last three or four years, you couldn’t live on these streets because the mosquitoes were so bad,” said Rino Ricchi, a road worker who fell ill, standing at the entrance to his neatly tended garden, where mosquito traps have now replaced decorative fountains. “We used to delight in having a garden or a porch to eat dinner. You couldn’t this year, you’d get eaten alive.”

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Wednesday, December 12, 2007

Tips for Holiday Travel

December 7, 2007

Beginning prior to Thanksgiving and lasting through the New Year, we experience this annual phenomena of stress with traveling over the holidays. Here are some helpful tips to help lessen the stress involved with waiting in lines and going through security checks. “It’s not a new message, but it’s even more applicable this year: If you’re flying this holiday season, be sure to allow plenty of time. And if you are traveling internationally, do not forget to visit your local Passport Health office to get the latest information on diseases and receive the vaccines you need to remain healthy while you travel.

‘We’ve said it every year, and we’re saying it again this year,’ Dan Melfi, Denver International Airport's (DIA) holiday spokesperson, ‘Travelers should be in the airline check-in lines in the terminal at least 2 hours before their flights are to depart. Add an additional hour if you’re traveling internationally.’

A number of airlines offer self-service check-in kiosks that can save travelers some time. But those are generally for people traveling only with carry-on luggage. If you’re checking bags, you may still need to go to a ticket counter after using the kiosk. Also, the federal government says wait times for security screening are getting longer at DIA as well.

Even though new TSA carry-on restrictions have been in place for more than a year, some travelers are still confused. To remember the rules, just think “3-1-1″: 3 ounces or smaller containers of liquid or gel are allowed in carry-on luggage; 1 quart-sized clear, plastic, zip-top bag holding ALL of the 3-oz containers; 1 bag per traveler. You must take these bags out of your carry-on luggage and place it in a separate security bin for screening. Travel tips concerning security-screening - including a list of items that cannot be taken on the aircraft - are available at the TSA’s Website.

Other travel suggestions include:
Check with your airline before leaving home to confirm that status of your flight.
Check-in online if possible. Checking bags at curbside may save time, but some airlines charge a small fee for this service.
Leave Christmas packages unwrapped. The TSA may open wrapped packages to see what’s inside.
Travelers are allowed only 1 carry-on bag and 1 personal item (purse, laptop, etc.), so check as much luggage as possible. Put medications and other required items in your carry-on bag.

Parking or stopping along any airport roadway is illegal and dangerous, and violators are subject to towing and a fine.

All of us here at Passport Health wish you safe & happy travels this 2007 holiday season!