What you can’t see can hurt or kill you

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What you can’t see can hurt or kill you

No place is safe, so I always visit the CDC site before a trip ‐‐ even a short trip in the US or Europe. For example, look at the CDC map for mosquito born disease in the US …


West Nile Virus (WNV) • St. Louis Encephalitis (SLE) • Eastern Equine Encephalitis (EEE) • Western Equine Encephalitis (WEE) • La Crosse Encephalitis (LAC) • Powassan Virus (POW) • Dengue Fever (local) (DEN‐loc) • Dengue Fever (imported)(DEN‐imp)

A few Comments from the CDC Web site

Dengue Fever. Dengue fever is the most common cause of fever in travelers returning from the Caribbean, Central America, and South Central Asia. Dengue infections are commonly reported from most tropical countries of the South Pacific, Asia, the Caribbean, the Americas, and Africa. This disease is caused by four similar viruses (DENV‐1, ‐2, ‐3, and ‐4) and is spread through the bites of infected mosquitoes.

Although dengue transmission often occurs in both rural and urban areas, dengue infections are most often reported from urban settings.

Since early 2009, a higher number of dengue cases have been reported from countries throughout several regions of the world.


On July 8, 2010, the Massachusetts Department of Public Health (MDPH) notified CDC of a case of laboratory‐confirmed measles in an unvaccinated airline passenger aged 23 months (1). The child had arrived hours earlier on a flight fromSwitzerland and was contagious during the flight.

On July 28, the New York State Department of Health (NYSDOH) notified CDC and MDPH that one of the airline contacts had developed laboratory‐confirmed measles. The ill traveler came to the United States as a chaperone for students from Europe and Asia attending an educational program. During July 20‐‐23 (while contagious and before being isolated), he exposed 270 students and counselors in Massachusetts and New York.


Tajikistan. An outbreak of poliovirus imported from India is ongoing in the Republic of Tajikistan. This outbreak represents the first importation of polio into the World Health Organization (WHO) European Region since it was certified polio‐free in2002.

As of August 1, 2010, the Tajikistan Ministry of Health has reported 700 cases of acute flaccid paralysis (polio); the number of cases of paralysis per week has fallen substantially since four immunization campaigns were conducted in May–June. Of these cases, 452 have been laboratory‐confirmed as polio. Of the confirmed polio cases, 312 are in children 5 years old or younger. Twenty deaths have been reported among people with confirmed polio.

Russia. Russia has reported seven polio cases to date, five of which are linked to travelers, but there has not been substantial subsequent spread in the country.

Central Asia. Uzbekistan has reported an increase in cases of acute flaccid paralysis,

including near the country’s border with Tajikistan, but so far none has been

confirmed as polio. All countries in the Central Asian region are at risk of poliovirus

importation until this outbreak is over. Central Asian countries include Kazakhstan,

Kyrgyzstan, Turkmenistan, and Uzbekistan, in addition to Tajikistan.

Yellow Fever

Brazil. From December 2008 through April 2009, the state of Rio Grande do Sul, on the southern tip of Brazil, reported 20 confirmed human cases of yellow fever infection. Nine of these people died. This is the first time since 1966 that human yellow fever cases have been reported in Rio Grande do Sul. In response to the situation, the Brazilian Ministry of Health has added a number of municipalities to the yellow fever risk area, which now includes the state’s capital city of Porto Alegre.

So what! You say.

It is worth noting that most of the polio cases were in people who had not been vaccinated. There are generations of children in many countries who have not been vaccinated against polio (since it was eradicated, or so we thought). Traveling on an airplane we can be exposed for hours to people who are sick with measles, TB, or influenza. I travel a great deal, and I do sometime wear a mask over my face. While it may perturb others, I have written on the mask “It is you, not me.”

You need to take care to protect your charge, their family, and all security staff. More executives are laid low by disease than by accidents or intentional acts.


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