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Staying Safe Overseas—What You Need to Know

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Staying Safe Overseas—What You Need to Know

It's no fun to be the victim of a crime. At worst it can be a traumatic, life-changing event-or even deadly. At best, it can be frightening and inconvenient. All of these consequences are magnified if you're the victim of a crime in a foreign country. The good news is that if you're targeted while traveling, the assault is more likely to be of the "give me all your money" variety. The Most Dangerous Cities in the World Though most people take precautions every day to stay safe, they often let their guards down when they're on the road. Travelers...

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Zika Virus Alert: New York

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Zika Virus Alert: New York

Prevent Zika virus infections with the Zika Virus Prevention Kit. New York state has confirmed 537 cases of Zika so far - though officials say all appear to be connected to travel to affected areas and there's no evidence the virus is spreading through local mosquitoes. Of those cases, 414 were in New York City and 123 were upstate. Nearly all of them involved people who had visited regions affected by the mosquito-borne virus; five cases were sexually transmitted.This year five children have been born in New York City with Zika-related birth defects. For state-by-state Zika case totals, Click here.  ...

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The Most Dangerous Cities in the US and the World

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The Most Dangerous Cities in the US and the World

Attention travelers: Check these lists before you go. Remember that it's always best to walk in groups of 2-3, or more. Safety in numbers! Quite often, holdups and muggings occur in the better parts of a city (that's where the money is.)  A hidden money belt may be advisable. Don't wear fine jewelry or carry much cash. The Most Dangerous Cities in the US Kansas City Oakland Little Rock Baltimore Rockford, Ill. Milwaukee Memphis Birmingham, Ala. Detroit St. Louis   The Most Dangerous Cities in the World Rank City Murder Rate (per 100,000) 1 Caracas, Venezuela 119.87 2 San Pedro Sula, Honduras...

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How to Prevent the Zika Virus Infection.

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How to Prevent the Zika Virus Infection.

The Zika virus is now a risk worldwide in warmer climates—but it can be prevented. Here's how: Bed Net If your room is not well screened and air conditioned, use a bed net when sleeping or resting. Mosquitoes can live indoors and will bite at any time, day or night. Insect Repellent Use an EPA-registered insect repellent containing DEET, picaridin, IR3535, or oil of lemon eucalyptus. We recommend a minimum of 30% DEET. Always follow the directions on the bottle. Do not spray repellent under clothing. If you are also using sunscreen, apply sunscreen first and insect repellent second. When...

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Zika Virus Update for Florida

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Zika Virus Update for Florida

Guidance for Zika Cautionary Areas (Yellow Areas) (Order our Zika kit here) Travel Pregnant women should consider postponing travel to all parts of Miami-Dade County. Testing and Diagnosis Pregnant women who lived in, traveled to, or had sex without a condom with someone who lived in or traveled to Miami-Dade County after August 1, 2016, should be tested for Zika virus. Pregnant women with symptoms of Zika should be tested for Zika virus. Pregnant women without symptoms who live in or frequently travel (daily, weekly) to Miami-Dade County should talk to their healthcare provider about getting tested in the first...

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Post-Travel Illness—What You Should Do.

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Post-Travel Illness—What You Should Do.

If you are a short-term (1-3 weeks) traveler to a tropical or semi-tropical region, you could be incubating a tropical or infectious disease that becomes symptomatic only after you return. Failure to recognize the connection of your symptoms with travel can have serious—even fatal—consequences. Undiagnosed falciparum malaria is often the cause. If you have unexplained fever, abdominal pain, vomiting or diarrhea, chest pain and cough or weight loss, get checked ASAP. Typhoid fever is also a possibility.  Even if you do not feel sick, you should take steps to prevent mosquito bites for 3 weeks after visiting area with Zika so that you...

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New Warnings for Men on Zika Virus

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New Warnings for Men on Zika Virus

The Zika virus has been largely spread by mosquitoes, but it can also be spread by sexual intercourse. Men who may have been exposed to the Zika virus should wait at least six months before trying to conceive a child with a partner, regardless of whether they ever had any symptoms, federal health officials are recommending. The Centers for Disease Control and Prevention had previously recommended that only men with Zika symptoms had to wait that long. Those who may have been exposed to Zika but never developed any symptoms were told to hold off on trying to conceive for...

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Dengue Fever Risk Now in Florida

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Dengue Fever Risk Now in Florida

A person in Florida has caught a locally transmitted case of dengue fever. The case is the first in which a person caught dengue from a mosquito bite within Miami-Dade County in 2016. This is unusual, since most cases in US travelers are acquired in the Caribbean and elsewhere overseas.   The case is also Florida's second local dengue case of 2016, according to CBS Miami. In 2015, the state reported one locally transmitted case of dengue, and in 2014 it had six known locally acquired cases of the disease, according to the Florida Department of Health.    Dengue is...

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Ticks—More to Worry About with Lyme Disease

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Ticks—More to Worry About with Lyme Disease

We all know that ticks can spread Lyme disease and travelers to Europe and Russia may be familiar with tick-borne encephalitis. Another tick-borne illness has now appeared in Spain with the report of the first case of Crimean-Congo hemorrhagic fever (CCHF). See NY Times September 5, 2016. What is CCHF? It is a serious viral illness normally found in Africa, the Middle East, the Balkans and Central Asia south of Kazakhstan. A West African strain of the fever was first isolated from ticks feeding on Spanish red deer in 2011. While the threat to travelers to Spain is low, the illness...

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Testing for dengue fever, chikungunya fever and Zika virus. What you should know.

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Testing for dengue fever, chikungunya fever and Zika virus. What you should know.

Three mosquito-transmitted viruses that travelers want to avoid are dengue, chikungunya and Zika (if pregnant). You may have concerns about whether your primary doctor is familiar with these diseases and what the proper testing procedures are if you have symptoms. There are no vaccines.  I have enclosed those procedures done by the Massachusetts Department of Public Health. You can use their guidelines to be sure your healthcare provider is aware of the proper testing procedures. The MA State Public Health Laboratory uses a PCR test to detect the genetic material of Zika, dengue and chikungunya viruses and the Zika IgM MAC-ELISA to test...

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Caution travelers: Malaria strikes Venezuela.

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Caution travelers: Malaria strikes Venezuela.

This weeks's New York Times has a harrowing look at how a breakdown in the economy and public infrastructure in Venezuela has lead to a dramatic return of Malaria: "The promise of a different Venezuela — one where there is ample food and work that pays enough — led Yudani González to abandon a program to become a preschool teacher in Ciudad Bolívar, the provincial capital, where unemployment is rampant. Instead, she headed to a ramshackle jungle camp, where she cooks for miners with one hand and cares for her two young children with the other. And Reinaldo Balochi lost his job last year...

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CDC reports Zika virus spreading in the Caribbean.

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CDC reports Zika virus spreading in the Caribbean.

Local mosquito transmission of Zika virus infection (Zika) has been reported in the Turks and Caicos Islands as well as in Antigua and Barbuda. Local mosquito transmission means that mosquitoes in the area are infected with Zika virus and are spreading it to people. Because Zika virus is primarily spread by mosquitoes, CDC recommends that travelers to the Turks and Caicos Islands protect themselves from mosquito bites.    Zika Virus in Pregnancy A pregnant woman can pass Zika virus to her fetus. Infection during pregnancy can cause serious birth defects. CDC recommends special precautions for the following groups: Women who are pregnant: Should not travel...

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Here's why the Zika virus will spread.

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Here's why the Zika virus will spread.

Prior to 2015, Zika virus outbreaks occurred in areas of Africa, Southeast Asia, and the Pacific Islands. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil. Currently, outbreaks are occurring in many countries and territories. Zika virus will continue to spread and it will be difficult to determine how and where the virus will spread over time. The Zika virus is spread in the U.S. by two species of mosquitoes: Aedes aegypti and Aedes albopictus. Their range is shown on the map. Cases have just now been reported...

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What kills most travelers?

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What kills most travelers?

Cardiovascular events (including heart attacks and strokes) and injuries accounted for 49% and 25% of the overseas deaths of US citizen travelers, respectively. Infectious diseases other than pneumonia accounted for only 1% of the deaths. Eighty percent of injury deaths occurred outside of hospitals. Injury death rates for male travelers were greater than US age-specific death rates. CONCLUSIONS:  Travel increases the chance of dying in an accident for males, especially under the age of 55. You can have your heart attack anywhere, but road safety overseas is often much less than in the US. I tell all my travel clinic clients:...

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Zika Virus risk and transmission of the virus

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Zika Virus risk and transmission of the virus

Zika virus (ZIKV) infection during pregnancy has been linked to birth defects, yet the magnitude of risk remains uncertain. Investigators studying the 2013–2014 Zika outbreak in French Polynesia estimated that the risk of microcephaly due to ZIKV infection in the first trimester of pregnancy was 0.95% on the basis of eight microcephaly cases identified retrospectively in a population of approximately 270,000 people. The New England Journal of Medicine found a strong association between the risk of microcephaly and infection risk in the first trimester and a lesser association in the second and third trimesters, There is no ZIKV vaccine. The virus is transmitted...

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