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H1N1 pandemic no reason to cancel travel plans, say experts

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  • H1N1 pandemic no reason to cancel travel plans, say experts

    H1N1 pandemic no reason to cancel travel plans, say experts

    By Tom Spears , The Ottawa CitizenAugust 29, 2009Be the first to post a comment
    StoryPhotos ( 1 )

    Go by planes, trains, automobiles or by boat... there are no travel advisories about the flu to any international location, experts say.Photograph by: Justin Sullivan, Getty ImagesThis is a great time to hop on a plane to somewhere, experts tell us. Just wash your hands along the way.

    Sure, there are hazards abroad, they say ? malaria, hepatitis, political mayhem. But the H1N1 flu is not among the big threats.

    One cheerful travel medicine expert this summer, despite all the questions he?s fielding about flu, is Dr. David Colby. He runs a travel medicine clinic in London, Ont., teaches medicine at the University of Western Ontario, and serves as acting medical officer of health for Chatham-Kent.

    ?There are always places where you really shouldn?t go because of political instability and that type of thing,? he said.

    ?But overall, in terms of travelling, this is not any worse than any other time.

    ?And because of the (recession), the economic opportunities for travel have probably not been this good in some time. So this is a great time to travel.?

    He?s often asked: Should people delay their trips till after the flu pandemic?

    ?Absolutely not. This flu is incredibly mild. It has a lower mortality than our regular seasonal influenza, so I wouldn?t let this dissuade me from travelling anywhere.?

    Even to Mexico, where H1N1 began?

    ?Sure. It (the number of deaths there) still wasn?t very high. It was higher, and we don?t know why, but there seem to have been pockets of influenza that have struck particularly unhealthy people. They are never going to do as well (with the flu). But if you?re healthy enough to travel, you?re going to be fine.?

    Another leading travel medicine expert shares this view. Dr. Shariq Haider runs the international health and tropical medicine clinic at McMaster University Medical Centre, and teaches medicine at the university.

    ?There are no travel advisories (i.e. government health warnings about flu) at present to any international location ? and I don?t believe one has to alter their international plans,? he said.

    He added that travellers should ?certainly exercise common-sense preventive measures,? such as handwashing while abroad, and stay home if they suspect they have the flu, as suggested by the Public Health Agency of Canada. But it?s still safe to travel.

    As well, the U.S. Centers for Disease Control and Prevention say that H1N1 has spread from person to person less effectively than other flu viruses.

    The H1N1 strain attaches inefficiently to cells in the human respiratory tract, the team from CDC and the Massachusetts Institute of Technology reported in the July 2 online edition of Science.

    But viruses can mutate fast, so a poor ability to spread today doesn?t guarantee that the virus will behave that way next winter, they note.

    But they say their genetic analysis confirms that the virus doesn?t spread as easily as many flu bugs. Most outbreaks have occurred in limited clusters, sometimes within a family or a school, but not spreading much beyond that.

    Still, flu happens. One thing to consider: It?s not just an inconvenience. Your liberty could be affected by some countries? governments:

    ? China has routinely quarantined travellers this summer after checking their temperatures at the airport. Some had flu; others were simply travelling in groups where one person became ill. By late July, the U.S. embassy in Beijing reported 1,800 Americans had been detained ? only 200 of whom were actually sick.

    ? Also in late July, the British government announced it had provided assistance to 160 Britons quarantined in China, Singapore, India and Egypt.

    ? Saudi Arabia has announced it will soon require a health certificate for all pilgrims to Mecca, showing they have had flu shots. (There is some question about how effective this will be, since these shots would have to be ordinary ?seasonal? flu vaccine; the vaccine for H1N1 has not been fully tested yet and is not available commercially.)

    ? Iran has banned its citizens from the annual Mecca pilgrimage.

    The U.S. Centers for Disease Control and Prevention doesn?t bother to tell travellers how to avoid flu abroad, noting that the bug is all over the United States anyway. It counsels people with flu-like symptoms not to travel, or, if they?re already abroad, to cover their sneezes, wash often, and stay in their hotel rooms.

    Against this background ? an unusual virus, but one that doesn?t seem too dangerous to healthy people ? there?s a nagging question of whether it might get worse. This happened in 1918-1919, when a mild virus mutated into a killer.

    You can?t assume that the 1918-1919 Spanish flu virus behaved the way this one will, Dr. Colby argues. Structurally, the two viruses are different.

    ?There?s been nothing really like the Spanish influenza. It had its highest mortality in the young and healthy,? while the new swine flu is most dangerous to people who are already sick.

    The reason why Spanish influenza was deadliest in young, healthy adults is still debated. One theory is that it caused the immune system to overreact and flood the lungs with fluid, and young adults have strong immune systems to begin with. Another is that a staph infection ? a bacterial lung infection ? attacked along with the virus.

    ?Certainly this H1N1 is nothing like that Spanish influenza.

    ?And we?re also dealing with a large body of relatively immune people.?

    That?s because the world has seen variations on this bug in the recent past.

    Waves of H1N1 flu went around the world between 1946 and 1957, and another came in 1977. They weren?t identical to this year?s virus, but they were similar.

    That doesn?t make people with past exposure completely bulletproof. It does mean that they have some resistance.

    ?Luckily it?s a very mild strain. It doesn?t have one of the major virulence proteins? (pieces of internal machinery that make a virus more dangerous), Dr. Colby says.

    Another reason not to avoid travel: The virus has spread into practically every part of the world already (though not Antarctica.) You can?t avoid it by staying home, and you won?t contaminate a foreign country by going there.

    Travellers do face other diseases that are probably worth much more attention. It?s hard to give a simple list, Dr. Colby notes, because the type of travel is as important as the list of countries a person visits.

    ?Adventure travellers have a set of risks that are not the same as the urbane, museum-surfing type of thing.?

    In dealing with patients, Dr. Colby will ask them: ?Are they going into malarial areas? Are they going to rural areas at night where the mosquitoes are bad? There?s a different answer for every person and every trip.?

    Still, there are diseases to watch for.

    Hepatitis A is a threat in warm areas, he says. ?That?s the food- and water-borne viral hepatitis. And we have an excellent immunization for that. Really it?s underutilized, but just about everybody should get hepatitis-A immunization? before travelling.

    The next most common would be travellers? diarrhea. That has an oral immunization called Dukoral.

    ?I answer a lot of questions about this latest influenza and I suspect I will be giving a lot of vaccinations for it when that vaccine becomes available,? he said.

    ?I often bring up the topic of influenza because the type of travel that probably puts you at the greatest risk for that is a type of travel that really is one of the lowest-risk types otherwise. And that?s cruise ship travel.

    ?Influenza can spread very rapidly in cruise ships and can put all the vulnerable people flat on their backs for several days. What a way to ruin a nice holiday.?

    Cruise ships are vulnerable, he says, because groups of people are travelling in close quarters ? narrow passageways, groups sitting together at meals, plenty of mingling.

    ?You?re always shaking hands and meeting people. A lot of organized activities. They?re very social things.?

    He recommends a flu shot before cruising.

    ? Copyright (c) The Ottawa Citizen

  • #2
    Re: H1N1 pandemic no reason to cancel travel plans, say experts


    "Still, flu happens."


    High associative sentence ...

    Could we aspect an cancelation of the main human earth mingling travel vehicle now (which was unknown a century ago) when the virus attacks every region, and even if that was not implemented when all this was at it's begining?

    I'm joking.