Yellow fever is a viral and dangerous disease transmitted by mosquitos of the Aedes, Haemagogus or Sabethes family. Diagnosis, especially at the early stages can be confused with other viruses as malaria, dengue, viral hepatitis or other diseases as well as poisoning. Blood test can detect fever antibodies, tests require specialised equipment and staff.

Transsmissions can regard people working in the jungle – infected mosquitos that feed on monkeys infect humans, semi-domestic mosquitos that breed in the wild and around households infect monkeys and people. That outbreak is common type in Africa. The third one – urban means that epidemics occur when infected people introduce the virus into a populated area with high number of non-immune people.

The virus incubates for 3 to 6 days and is followed by infection. The first phase usually causes fever, muscle pain with backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve after that and the symptoms disappear after several days. Nonetheless – about 15% of patients enter a second, toxic phase within 24 hours of the initial remission. There is again high fever and body systems gets affected. Such patients develop jaundice very quickly. They complain of abdominal pain and vomit. There might be bleeding from the mouth, nose, eyes or stomach, then blood appears in the vomit and faeces. There is malfunction of kidneys. Important: half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage. It is a dangerous disease and cannot be underestimated. There is no specific treatment – only supportive care to dehydration, respiratory failure and fever. Antibiotics are used to treat associated bacterial infections.

Vaccine – it is safe for children over 9 months, quite affordable and single dose can provide life-long immunity against the disease. Sometimes a booster dose is needed after 10 years. They are noted by a physician in the so called “Yellow book”. If you plan travelling to Africa or via Africa do vaccine yourself. It is required as well in some parts of Americas.
STAMARIL – produced by Sanofi Pasteur – price ca. 50€
YFbook

An outbreak of disease was detected in Angola at the end of 2015. It spread quite significantly through the country with an alert situation now, in May with over 2400 suspected cases. There has been consequently confirmed cases in other countries in connection to Angola. Democratic Republic of Congo – almost 50 laboratory confirmed cases, 60 suspect cases in Uganda. Risk in Angola is still high, despite a large number of vaccinated people, especially in areas hard to reach and highly populated. Due to crossborder economic and social activities yellow fever with connection to Angola was confirmed in Kenya and China.

This outbreak has even raised concerns about the global supply and its adequacy in case of large epidemic. There has been about 10 million doses diverted to Angola between March and May 2016 of emergency stockpiles. The general demand for preventive campaigns increased from ca. 5 million per year to over 60 million per year. Production of the vaccine is at the level of 35 million per year.

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Sources: 

http://apps.who.int/iris/bitstream/10665/206548/1/yellowfeversitrep_20May2016_eng.pdf?ua=1
https://www.medicines.org.uk/emc/medicine/9846
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According to the WHO the rate of dengue fever increased in the second half of the twentieth century, almost thirty times. This huge leap is caused by urbanization, population growth, the increasing popularity and number of travellers and global warming. Dengue is currently the second most commonly diagnosed infection after malaria in this group of diseases.

Research to overcome the disease and find an effective vaccine for dengue has been sought for for a long time. In December 2015, Sanofi Pasteur as the first company announced success in the field. Yet, it is worth mentioning that there are five other potential vaccines during trials, of which two are currently undergoing Phase III of clinical tests.

Dengvaxia (Sanofi Pasteur) is designed to stimulate the immune system by producing antibodies to all four serotypes of dengue virus. But then again it is not 100% effective – in clinical tests, the vaccine reduced the risk of infection by about 60%. The positive news is that the observed efficacy of the vaccine was higher for the two more dangerous dengue serotypes. Doubts regard effectiveness of the vaccine for children, particularly under 9 years of age, and the elderly people. Therefore, the vaccine has been registered and approved in the Philippines, Brasil, and Salvador and in Mexico only for patients between 9 and 45 years old.

In early April, a program of vaccination of approximately one million public school students from areas where dengue is endemic has been launched in the Philippines. The vaccine is administered in three doses according to 0/6/12 months scheme.

Undoubtedly, this is a big step forward and if further studies prove the effectiveness of the vaccine it is likely that it will become available for travellers going to Southeast Asia, South America or Africa.

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Description of the disease
Dengue is an infectious disease – caused by a virus (Flaviviridae, type: Flavivirus). The most dangerous are serotypes 3 and 4 of the virus (there are a total of four) causing hemorrhagic fever. Important information: The infection of one serotype, though it gives a person lifetime immunity on this particular serotype of the virus, at the same time increases the risk of complications in case of infection of other serotypes of the virus.

Dengue is transmitted by the bite of infected mosquitoes of the genus Aedes, usually Aedes aegypti. They typically live on the area between 35 ° N and 35 ° S and under 1000 m.n.p.m. Mosquitos are able to bite and therefore spread the virus at any time of day and year, though usually they bite in the morning and evening. The virus cannot be transmitted from human to human.

The disease is a bit harder for adults, but children are at greater risk of serious complications. The incubation period is between a few up till 14 days – that means that travelers, who observed uncomplicated fever after more than 2 weeks since returning home from endemic areas have a low probability of dengue.
Symptoms: fever, bone – joint pain, headache, swollen lymph nodes and liver. Typical dengue fever is two-phased: high temperature and joint pain, especially the knee joints. Than fever decreases after 2-4 days. After a short (up to 20-30 hours) remission, the fever returns, and this time accompanied by a maculopapular rash on the hands and feet passing on the limbs, trunk, rarely face. The most severe clinical form of dengue is hemorrhagic fever. This is a severe form and is characterized by high mortality rate. The initial symptoms are stronger and include vomiting, after 2-3 days comes abdominal pain, enlarged liver and hemorrhagic diathesis – petechiae caused by the cracking of blood vessels. It can lead to coma. Bleeding into body cavities appear after 4-5 day of the disease – in the absence of treatment shock and following even death may occur. However, it should be noted that most patients recover after Dengue (all serotypes) without serious consequences – yet it is necessary to implement the treatment. You really cannot take this disease too lightly.

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At the beginning of this month the World Health Organization declared a Public Health Emergency of International Concern to initiate a coordinated international response to minimize the threat in affected countries and reduce the risk of international spread of the Zika virus. Sounds serious, doesn’t it? And it is quite serious – for the most vulnerable group are pregnant women or women who plan to get pregnant. WHO hasn’t found health justification for restriction on travel or trade, there are concerns regarding spreading of the virus.

Let’s start with basics.

What is Zika virus and how does a person become infected?

Zika is a mosquito borne virus that is closely related to dengue. It can be found in animals in many parts of Asia or Africa and without any outbreaks in humans. Between 2013 and 2015 large outbreaks of Zika took place in a number of Pacific countries. In 2015 and continuing in 2016 large outbreaks were observed in Americas.

It spreads by the bite of an infected Aedes-species mosquito, especially Aedes aegypti called also the dengue mosquito. These mosquitos live often around buildings in urban areas.
There are also isolated cases of transmission through sexual contact or blood transfusion.  The virus remains in the blood for about a week.  How long the virus remains in semen is currently not known.

mosqito zika

Symptoms

They include but are not limited to: mild fever, skin rashes, conjunctivitis, muscle and joint pain, malaise or headache. Sic! Symptoms are mild and last up to a week. Only 1 in 5 people infected with the Zika virus will develop symptoms.

Women trying to become pregnant or who are thinking about becoming pregnant are strongly advised to consult their doctor before traveling to these areas and they need to strictly follow steps to prevent mosquito bites during the trip.

Treatment

At the moment there is no specific treatment for Zika, but supportive medical care can be provided if required (e.g. rest, fluids).

Map Zika

Prevention

Currently there is no vaccine for Zika. Prevention relies on avoiding mosquito bites in areas affected by Zika.

Due to concerns about the possibility of severe outcomes for unborn babies, women who are pregnant or seeking to become pregnant should consider avoiding or postponing their travel to areas with outbreak of Zika. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly.

The risk of Zika transmission through sex is low, the use of condoms should be considered as a precaution.

Travellers should follow recommendations to avoid mosquito bites at all times when travelling to countries where there is risk of mosquito-borne diseases. Techniques :

  • Insect repellents containing either DEET, picaridin, IR3535, or certain oil of lemon-eucalyptus or para-menthane-diol products (citronella)
  • Applying first sunscreen and then insect repellent
  • Treating clothing with permethrin or purchase permethrin-treated clothing
  • Wearing long-sleeved shirts and long pants
  • Staying in air-conditioned rooms or using window/door screens
  • Sleeping under a mosquito bed net
  • Emptying standing water from containers (e.g. vases, flowerpots, buckets)
Sources:
http://www.who.int/mediacentre/factsheets/zika/en/ 
http://www.health.gov.au
http://www.cdc.gov 
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Brainstorming

Summer coming to a close is a perfect time for some brainstorming. So many new projects and ideas – brilliant and those less shiny – were discussed, laughed out and talked over during Safe Water Safe Land Foundation meeting. The flying object in the back is Staś – our future rescuer and helper :) Already taking a visible and vivid part in our meetings.

spotka IX

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CPR on the Beach – Final Show!

CPR on the Beach project has reached its finale - great and hot final scene took place in the city of Hel. Spectacular diver rescue scenario with RIB boats on the water and firefighters on land. The objective of the whole action was to encourage people who travel and spend their time doing water sports or other activities to practice regularly first aid training. Other goal was to promote safe recreation – to be aware of the emergencies and threats for health and life. Safe Water Safe Land instructors has driven through the whole Hel peninsula to organize sunny beach trainings and invite kite surfers, wakeboarders, boaters and sunbathers to care for their safety and security.

 

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CPR on the Beach pre-release

CPR on the Beach pre-release – it was a hot evening at Wawa Wake’s Beach!
The mission of Safe Water Safe Land is to promote safety and rescue skills among people who travel and do water sports. That is why we invited wakeboarding fans, wakeboarding instructors and cable operators to participate in a rescue event. There are two 2.0 wake cables in Wawa Wake – one of Warsaw’s wake parks, both are with water obstacles (kickers, slider, and fun box) and although everything was organized with concern for security, it’s not hard for an accident to happen as in all other sports. So we performed our actions at full speed – training was conducted on the water and on the beach. There were lifebuoys, rescue buoys, lifebelts and AEDs in action! We showed how to extract and transport the injured rider from the water using the proper equipment. Afterwards we practiced resuscitation on dummies and the use of AED. Emotions were running high! We now look forward with energy and enthusiasm to July – see you at the Hel Peninsula!

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Exemple

Earthquake in Nepal

The whole world was following the rescue action in Nepal. The country was hit by the effects of an earthquake that took place on the 25th April. The force of the earthquake was almost 8 degrees on the Richter scale. We thought of all the rescuers who rushed to help those trapped in the rubble, the wounded and the victims of this disaster.

TVN24 reported that „it was the worst earthquake in Nepal for over 80 years; shocks were felt in various parts of India, Bangladesh, Tibet and Pakistan. The devastating earthquake of 1934 also measured 8 on the Richter scale and almost completely destroyed the city of Kathmandu, Bhadgaun (Bhaktapur) and Patan, 8.5 thousand people were killed. (…)

Polish Humanitarian Action collects money to help the victims of the disaster. You can pay directly through the PAH.

 

 

 

fot. www.time.com

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Meeting – Africa

Winter meetings with Alice (our Africa expert) regarding the route of our training expedition Africa 2016. Ethiopia and Djibouti are being considered. We talk about the means, the route, about languages, schools and organization of first aid workshops. Each subject brings up ten more, all of them significant, all of them noteworthy. It is late at night, when we go out to wintery Warsaw. Yet our minds are still in 40 degrees heat of sunny Africa.

 

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AdrenaLTika Asia Tour

It took 1.5 months for the journey first by sea from Phuket during which time training took place for the sailors and then the land leg of the journey which stretched from Bangkok to Kelantan. It was our Partners that made it possible: To go diving and OrtemSailing with those great people that we met along the way. Everything would be different without them.

We have trained several groups of tourists and divers, the Polish crew on the cruise around the Phang Nga Bay in Thailand and several groups of residents in Kelantan – the area affected by flooding in northern Malaysia. The flood was a complete surprise to us. In the places where we had planned our training nothing was left.

The biggest flood in a century literally washed away roads, houses, schools and bridges. For a week we have waited for the „weather window” to get to the North of the country. What we saw there, changed our perspective! We got involved in the transport of basic food parcels, transferred bread and clothes from hand to hand. Basic assistance, basic needs, even time ticked at a different pace.

 

 

 

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CPR on the Beach

CPR on the Beach project is getting closer! Sand, beach, water and surfing – we have just confirmed our July action at the Hel Peninsula. Together with our partners – eg Yachting Academy, Wakeprojekt, Fundacja Surferskiej Pomocy, Dive Land, AdrenaLTika, and Kluczka we plan our rescue project from Puck toHel. It is wonderful to plan projects with kite surfers, wakeboarders and sailors during the long January, winter evenings.

The start of the project will be in Sławutówko Wakepark on July 13 at noon.

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