Travel and vaccination... 7 years of Africa w/o the poisoned needle...

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This in reply to a post by Brandegee....Yes, Liz... great information from Sherri... your post not bad either. Let me tellyou a few things about 7 years I spent in West Africa -- a few things about malaria prophylactics, about cholera and yellow fever vaccinations and how to get away without the shots and yet never miss a beat. I went with World University Service. Before we left, we had a session with amedical briefer. He had me scared long before he was finished. Did not take long,after we got to Africa -- north-west Nigeria -- for me to understand that Africa wasnot a different universe and that the healthful lifestyle I had practiced at home wouldserve me well in Africa too. That, plus home-made yogurt (I've been making myown yogurt for more than 30

years), lots of vitamin C (I had taken half a ton with me)and garlic, along with a predominantly raw-food diet saw me through.We had all been given chloroquin (malaria prophylactic) before we left. I took a coupleof the weekly doses after I got there. Then I stopped. I saw that people on chlorquin gotmalaria as surely as those without. When our team leader told us we'd all have to go through a bout of tourista, I bet him thatI would not, and I won my bet. Cholera and yellow fever shots were mandatory then, not so much to get into Africa butto get back into the US or Canada. I was teaching at the University of Maiduguri then.Since, during the long vacation between the winter-spring and the fall-winter terms, Iregularly traveled either to Europe or to North America, I needed proof that had beenvaccinated. In Nigeria a bribe will get you almost anything,

even a stamp in the yellowvaccination booklet. That's what I did -- I slipped my booklet, a couple of Naira tucked inmiddle of it, to the medical orderly and he understood. Gave me the required cholera andyellow fever stamps and a smallpox stamp to boot. That's how I got around the poisoned needles. Nnor did I come down with any of the ills the poisoned needles were supposed to protect me from.I drank the local water everywhere I went, unboiled, unfiltered and untreated with the chemical tablets the rest of the crew used. During one of my travels I went to Timbuktu. Along the NigerRiver Valley, the Niger River was the only reliable source of water. Towns along the river used a sort of macro-filter system that filtered out visible debris – insects, bits of straw, bits of grass, etc.. No kind of chemical treatment. Though I drank the water all through there, I did not

miss a beat.As for malaria, I took lots of B1, which makes you exude a smell the human nose cannotdetect but which the mosquitoes don't like. And I made sure my mosquito net was inplace before I bedded down to sleep. And, though I did not take the de-rigeur chloroquin, Iwent through the seven years of Africa without a brush with the dreaded malaria.Almost forget. Our medical briefer had told us that in the tropics skin injuries tend notto heal. During one of my first longer walks -- I wore rubber-thong sandals -- I tripped onsomething and scratched my right foot against a sharp rock. Left a nasty gash. Ithought I'd had it. "In the tropics, things don"t heal" reverberated through the echochambers of my memory. I was scared. But it didn't take any longer for the gash to healthan it would have taken at home. That marked the beginning of the end of my being

scared.So I went through the seven years of West Africa, without the required shots, withoutchemicalizing the water I drank, and yet without missing a day of work. When my wife andI returned to Canada, we had ourselves checked out at the Institute of Tropical Medicinein Ottawa. She was diagnosed with amoeba in her system. I was clean. What had servedme well at home served me well in Africa too.PS: If you have seen ’s message, you need not read on.... Unless you wantto have a glance at the interlinear comments I applied here and there. From: Brandegee <lightspirals@...> Subject: Re: Travel and vaccination no-forced-vaccination

Received: Monday, September 22, 2008, 2:26 AM Great information from Sherri Liz > Far-Off Adventures: Vaccinations And Overseas Travel > By Sherri J. Tenpenny > Issue 120, September/October 2003 > > The time has finally arrived for the highly anticipated trip out of > the country. The plans began long ago... Your doctor is recommending a variety of vaccines. Are they necessary? How do you evaluate the risks? > > VACCINES IN THE US > Currently, eight different vaccines are recommended for children in > the US: Hepatitis B, polio, diphtheria-tetanus- pertussis (DTaP), > measles-mumps- rubella (MMR), chickenpox, HiB, Prevnar, and,

most > recently, an annual influenza vaccine. (HiB and Prevnar are given to > prevent bacterial infections caused by H. influenza and Strep. > pneumonia, respectively. Some of these vaccines are also recommended > for international travel. But are the risks of getting these diseases > any greater when traveling than they are at home? Let's take a closer > look at the more worrisome infections that might be encountered while > traveling abroad. > > Hepatitis B is a viral infection that is spread through contact with > blood. In the US, Hepatitis B is primarily found in adults, and is > spread through intimate contact or through sharing needles used with >

illicit drugs. Hepatitis B is more common in the general population in > East and Southeast Asia and in Sub-Saharan Africa. Even in these > areas, the risk for contracting the infection is very low, but if you > do, Hepatitis B can make you very ill. Still, the risk of long-term > complications is much less than we are generally led to believe. More > than 95 percent of those who contract Hepatitis B fully recover, and > an infection will result in lifetime immunity for that person. Unless > you plan to spend extended periods in close contact with infected > persons, the risk of contracting Hepatitis B while traveling is nearly > the same as in the US. > > Polio, or poliomyelitis, is

an infectious disease caused by a virus > that attacks the nervous system. The disease is seen primarily in > children under five years of age; the initial symptoms include fever, > fatigue, headache, vomiting, stiffness in the neck, and pain in the > limbs. Paralysis results in approximately 1 to 2 percent of children > who contract the viral infection, though the vast majority recovers > completely from this paralysis. A few, however, go on to have > permanent, lifetime disability. > > While polio was once common throughout the undeveloped world, today > only seven countries continue to have polio-endemic rural areas: > Afghanistan, Egypt, India, Niger, Nigeria, Pakistan, and

Somalia. The > disease is no longer a threat and will soon be completely eradicated. > Although the Western Hemisphere was certified "polio-free" by the > World Health Organization in 1994 and there have been no cases of wild > polio in this region since 1991, the US vaccination schedule still > includes four doses of the polio vaccine. 1 The reason given for this > is that, until polio is eradicated entirely, the risk of reintroducing > polio into this country is "only a plane ride away." However, an > examination of the data reveals only six cases of imported polio > documented between 1980 and 1998, the last in New York City in 1993.2 > The risk for contracting polio is negligible, even at

home. > > Tetanus is an acute, spastic paralytic illness caused by a toxin > released from the bacterium Clostridium tetani. The bacterium is found > in soils and animal feces throughout the world. > > There are several forms of tetanus: neonatal, cephalic, localized, and > generalized. In infants, neonatal tetanus is the most common and most > deadly. However, the vast majority of these cases occur following > childbirth, as a result of using nonsterile equipment to cut the > umbilical cord. Cephalic tetanus, the least common, causes muscle > spasms in the face, leading to the classic case of "lockjaw." > Localized tetanus is recurring muscle contraction

near the original > site of the infection; recovery can take many weeks. > > Generalized tetanus, the most common, is the slowest to develop. The > disease is characterized by a gradual increase in skeletal muscle > rigidity and muscle spasm. Deep, dirty punctures are at greatest risk > for developing the infection because the bacterium thrives only in > areas that are deprived of oxygen. > > The symptoms of any type of tetanus infection develop slowly. The > incubation period-the time between when the injury occurred and the > development of a full-blown infection-can range from five days to two > months, but the initial symptoms most commonly begin to

appear within > 14 days. Early symptoms of infection include restlessness, headache, > and localized itching or pain at the site of the injury. It is > generally believed that tetanus is a highly fatal disease, but an > examination of the data proves otherwise. In the most recent > evaluation of tetanus data by the CDC, it was found that the death > rate associated with tetanus was 11 percent, nowhere near the "nearly > 100 percent fatal" so widely believed.3 It is also commonly accepted > that a tetanus shot will prevent the onset of tetanus. Again, the data > show that, even if a person has three or more tetanus shots, it is > still possible to contract the disease.4 A recent issue of the

British > Medical Journal reported that tetanus can occur "despite adequate > immunization and [adequate] levels of neutralizing antibodies." 5 > > Frequent tetanus shots may give a false sense of security; the best > way to protect from the disease is to thoroughly clean the wound with > copious amounts of warm, soapy water, and to encourage the injury to > bleed profusely. Prophylactic antibiotics, such as metronidazole and > penicillin, are effective against the bacterium that releases tetanus > toxin into the bloodstream. It might be a good idea to carry these > with you in your travel kit if you are going to off-beat places. If > you have access to medical care when traveling, a

shot of tetanus > immune globulin (TIG) can be given for severe injuries. Equivalent to > a "dose of antibodies," TIG continues to circulate in the body for up > to three weeks, and can effectively neutralize any toxin that might be > released by the tetanus-causing bacterium. > > WHAT ABOUT EXOTIC DISEASES? > When traveling overseas, it is possible to encounter some illnesses > not generally seen in the US. The Centers for Disease Control lists > the following infections as possible concerns for anyone traveling to > any destination around the globe:6 > > Typhoid Fever, an acute, febrile illness caused by the bacterium > Salmonella

typhi, is characterized by fever, headache, and enlargement > of the spleen. The greatest risk is for travelers to the Indian > subcontinent and to developing countries in Asia, Africa, and Central > and South America who will have prolonged exposure to potentially > contaminated food and drink. > > Yellow Fever is a mosquito-borne viral illness that can vary in > severity from a flu-like syndrome to severe hepatitis and hemorrhagic > fever. The disease occurs only in sub-Saharan Africa and rural, > tropical South America. > > Japanese Encephalitis, another mosquito-borne viral infection, is > found throughout Asia, particularly in rural or agricultural areas

of > the temperate regions of China, Japan, Korea, and eastern Russia. The > risk to short-term travelers and those who confine their travel to > urban centers is very low. > > Tick-borne Encephalitis, also known as spring-summer encephalitis, is > a tick-borne viral infection that causes inflammation of the central > nervous system. Although the disease is common throughout Europe, > travelers are at low risk unless they visit forested areas and/or eat > nonpasteurized dairy products. > > Hepatitis A is a viral disease that has an onset of fever, malaise, > nausea, and diarrhea, followed within a few days by jaundice. The > disease

ranges in clinical severity from no symptoms at all to a mild > illness lasting one to two weeks. Although endemic throughout the > world, Hepatitis A can be prevented by carefully following the hygiene > and food recommendations listed in the sidebar "Minimizing Risks." > > WHAT'S RECOMMENDED? WHAT'S REQUIRED? > Although the CDC recommends that all travelers obtain vaccines when > traveling abroad, it is important to realize that, with one exception, > no vaccine is required before you travel anywhere in the world: they > are only "recommended. " You will not be required to have a vaccination > record to enter a country, nor will you be required to obtain vaccines > to return

home. > > The sole exception is the Yellow Fever vaccine, which may be required > if you travel to or from a South American or African country infected > with Yellow Fever. The recommendations can vary from country to > country; if such a destination is part of your travel plans, you > should look up the Yellow Fever requirements for that specific > country. The CDC's Comprehensive Yellow Fever Vaccination Requirements > are available at www.cdc.gov/ travel/yelfever. htm#yfcert. > > I have been a globe-trotter for most of my adult life. In the past 25 > years, I have traveled to more than 40 countries. I have never been > asked for a vaccine record, nor have

I ever felt the need for any > vaccines, even when traveling to remote, exotic destinations. > > ARE THERE OTHER HEALTH RISKS TO CONSIDER? > Vaccines are available for all diseases mentioned above, should you > choose to vaccinate. Infections that are a concern worldwide, and for > which there are no vaccines, include malaria and Traveler's Diarrhea. > > Malaria is a serious, sometimes fatal disease caused by a parasite > that is injected into the body by an infected mosquito. The parasite > grows in the liver, then infects circulating red blood cells. Symptoms > of malaria include fever, shaking chills, headache, muscle aches, > vomiting, diarrhea, and

extreme fatigue. If untreated, death from > malaria can occur due to dehydration and kidney failure. > > For most people, the symptoms of malaria begin ten days to four weeks > after they become infected, although the symptoms may not develop > until as much as a year later. Anyone who begins to have recurring, > shaking chills up to one year after returning home should seek > professional medical care. Be sure to tell your healthcare provider > that you have visited a malaria-risk area. > > Prescription drugs for the prevention of malaria are sometimes > recommended for those traveling to malaria-endemic countries. Some > antimalarial drugs are more

effective in some parts of the world than > others, but all of them have side effects and potential complications. > In addition, a medical condition may prevent your child from taking > certain drugs. > > An alternative to taking drugs is to use mosquito precautions (see > sidebar). It is important to obtain a natural mosquito repellant, one > that is free of DEET, the toxic additive found in most insect > repellants. My favorite is Natural Mosquito Repellant, made by Royal > Neem. It is free of chemicals and contains many natural ingredients: > aloe vera; the oils of coconut, neem, lemongrass, citronella, > cedarwood, and rhodiumwood; and extracts of myrrh, barberry,

thyme, > goldenseal, and chamomile. Further suggestions for additional natural > insect repellents can be found at www.mercola. com. > > If you contract malaria, a natural treatment is available that is > perhaps even more effective than pharmaceuticals, and is certainly > less toxic. During an archeological dig in the 1970s, instructions for > treating malaria with an herb called wormwood, or artemisia, were > found in a 2000-year-old Chinese tomb. Shortly thereafter, Western > scientists isolated the herb's active component and called it > "artemisinin. " Studies in China and Vietnam have confirmed that > artemisinin is a highly effective compound, with a close to

100 > percent response rate in the treatment of malaria. Outside the US, > artemisinin is the No. 1 natural herb used to treat malaria. The World > Health Organization is investigating the use of this herb worldwide > for malaria treatments. Because there can be a wide variation in > quality, it is important that artemisinin be purchased from a > reputable source, such as Allergy Research Group, > www.allergyresearch group.com. It should be noted that this company > only sells to licensed healthcare practitioners. > > Traveler's Diarrhea This is, by far, the most common illness affecting > those traveling outside the US. It is estimated that between 20 and 50

> percent of travelers-nearly 10 million people each year-develop > diarrhea. Although a variety of viral and parasitic pathogens can be > the cause, by far the most common source of Traveler's Diarrhea is the > bacteria E. coli. > > Symptoms usually begin abruptly and increase over several days. The > typical experience includes four or more watery bowel movements each > day, associated with nausea, vomiting, abdominal cramping, fever, and > malaise. Most cases are benign and resolve in one to two days without > treatment. Although rarely life-threatening, Traveler's Diarrhea can > bring a sudden halt to the fun and mystique of international travel. > >

The best way to avoid Traveler's Diarrhea is by strict adherence to > food and water precautions (see sidebar, "Minimizing Risks"). In > addition, studies have shown that taking two tablespoons of > Pepto-Bismol four times a day (for adults) can decrease the incidence > of Traveler's Diarrhea. The dosage for children nine to 12 is one > tablespoon four times a day, children six to nine, two teaspoonfuls; > three to six, one teaspoonful; under three, consult a physician before > taking. (People allergic to aspirin, pregnant women, and those on the > blood thinner Coumadin should not take Pepto-Bismol. Also, large doses > of Pepto-Bismol can temporarily blacken the tongue and stool.) >

> The most important treatment for Traveler's Diarrhea is oral > rehydration to replace lost fluids and electrolytes. Clear liquids are > routinely recommended for adults, and, for children, electrolyte- based > liquids such as Gatorade. On rare occasions, antibiotics may be > required if the symptoms persist for more than a few days. > > The Best Medicine > The best medicine for any type of infectious disease is always > prevention. For most diseases around the world, common-sense > precautions are the best way to stay healthy. Since for nearly every > destination in the world vaccinations are only recommended, not > required, a trip to your doctor for vaccines is one item you

can cross > off your pre-trip "To Do" list. Go and have fun! > > MINIMIZING RISKS > 1. Eat only cooked foods hot to the touch. Avoid eating food from > street vendors.I ate food from street vendors everywhere I went. > 2. Avoid eating raw fruits and vegetables unless you peel them yourself.At Nigerian markets, young boys sell peeled oranges... not peeled the usual way...with super-sharp knives they peel away the outer layer of the skin, cut a little holeinto the top of the orange and hand it to you... you'd then suck

the juice out of thefruit while sqeezing the body of the fruit with your fingers. I used to eat all of it soas not to miss the bioflavonoids. Wasn't worried about the fruit having been touchedby native hands. > 3. Drink only "safe" beverages: sealed bottled water, carbonated > beverages, hot tea, coffee, beer, wine, and boiled water.Yes, my companions would not think of drinking local water. When thirsty, they'ddrink only "safe beverages" like coke, pepsy, beer, wine and boiled or chemicalizedwater, things I'd shy away from, in Africa as well as at home. > 4. Don't drink beverages with ice.Why? Because the ice cubes may have been made with unsafe water. I avoided ice cubes too but for a different reason: I don't drink iced water at any time. Not goodfor the ecology of the stomach. > 5. Avoid eating raw or undercooked meat and seafood. > 6. Avoid all tap water, and be careful of getting shower water in your > mouth. When dining in restaurants, ask whether the salad greens have > been washed in

boiled or distilled or bottled water.A lot of good it would do you to ask in Africa "wether the greens have been washed in boiled or distilled or bottled water." They either would not know what you were talking about or, if they did, they'd swear the greens had been washed in safe water. I put my bets onmy super-fit and super-healthy body's ability to defend itself. > 7. Avoid nonpasteurized milk and dairy products.Not sure here. I wonder pasteurizing milk and derivative dairy products is notthe greater risk factor. I ate local yogurt or local goat cheese

everywhere I found it. > > PROTECT YOURSELF FROM MOSQUITO BITES > o Pay special attention to mosquito protection between dusk and dawn. > o Wear long-sleeved shirts, long pants, and hats. > o Frequently apply natural insect repellant. I go along with this except that I would add B1 to my defenses. > NOTES > 1. CDC, "Certification of Poliomyelitis Eradication- The Americas," > MMWR 43 (1994): 720-722 > 2. CDC, "Poliomyelitis Prevention in the United States Update," MMWR > 49 (2000, RR05): 1-22 > 3. CDC, "Tetanus Surveillance, " MMWR

47 (July 1998, 55-2): 13. > 4. Ibid. > 5. Letter to the Editor, British Medical Journal 320 (5 February > 2000): 383. > 6. CDC Travelers' Health, www.cdc.gov/ travel/destinat. htm. > > Sherri J. Tenpenny, DO, is board-certified in Emergency Medicine. She > is CEO of OsteoMed II, located in Strongsville, Ohio, an Integrative > Medicine clinic that treats ADD/ADHD, autism, and a wide variety of > autoimmune disorders seen in children and adults. An advocate for > healthcare choice, including the right to refuse vaccination, Dr. > Tenpenny speaks nationally and internationally on the unspoken health > risks of vaccines.,_._,___

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This in reply to a post by Brandegee....Yes, Liz... great information from Sherri... your post not bad either. Let me tellyou a few things about 7 years I spent in West Africa -- a few things about malaria prophylactics, about cholera and yellow fever vaccinations and how to get away without the shots and yet never miss a beat. I went with World University Service. Before we left, we had a session with amedical briefer. He had me scared long before he was finished. Did not take long,after we got to Africa -- north-west Nigeria -- for me to understand that Africa wasnot a different universe and that the healthful lifestyle I had practiced at home wouldserve me well in Africa too. That, plus home-made yogurt (I've been making myown yogurt for more than 30

years), lots of vitamin C (I had taken half a ton with me)and garlic, along with a predominantly raw-food diet saw me through.We had all been given chloroquin (malaria prophylactic) before we left. I took a coupleof the weekly doses after I got there. Then I stopped. I saw that people on chlorquin gotmalaria as surely as those without. When our team leader told us we'd all have to go through a bout of tourista, I bet him thatI would not, and I won my bet. Cholera and yellow fever shots were mandatory then, not so much to get into Africa butto get back into the US or Canada. I was teaching at the University of Maiduguri then.Since, during the long vacation between the winter-spring and the fall-winter terms, Iregularly traveled either to Europe or to North America, I needed proof that had beenvaccinated. In Nigeria a bribe will get you almost anything,

even a stamp in the yellowvaccination booklet. That's what I did -- I slipped my booklet, a couple of Naira tucked inmiddle of it, to the medical orderly and he understood. Gave me the required cholera andyellow fever stamps and a smallpox stamp to boot. That's how I got around the poisoned needles. Nnor did I come down with any of the ills the poisoned needles were supposed to protect me from.I drank the local water everywhere I went, unboiled, unfiltered and untreated with the chemical tablets the rest of the crew used. During one of my travels I went to Timbuktu. Along the NigerRiver Valley, the Niger River was the only reliable source of water. Towns along the river used a sort of macro-filter system that filtered out visible debris – insects, bits of straw, bits of grass, etc.. No kind of chemical treatment. Though I drank the water all through there, I did not

miss a beat.As for malaria, I took lots of B1, which makes you exude a smell the human nose cannotdetect but which the mosquitoes don't like. And I made sure my mosquito net was inplace before I bedded down to sleep. And, though I did not take the de-rigeur chloroquin, Iwent through the seven years of Africa without a brush with the dreaded malaria.Almost forget. Our medical briefer had told us that in the tropics skin injuries tend notto heal. During one of my first longer walks -- I wore rubber-thong sandals -- I tripped onsomething and scratched my right foot against a sharp rock. Left a nasty gash. Ithought I'd had it. "In the tropics, things don"t heal" reverberated through the echochambers of my memory. I was scared. But it didn't take any longer for the gash to healthan it would have taken at home. That marked the beginning of the end of my being

scared.So I went through the seven years of West Africa, without the required shots, withoutchemicalizing the water I drank, and yet without missing a day of work. When my wife andI returned to Canada, we had ourselves checked out at the Institute of Tropical Medicinein Ottawa. She was diagnosed with amoeba in her system. I was clean. What had servedme well at home served me well in Africa too.PS: If you have seen ’s message, you need not read on.... Unless you wantto have a glance at the interlinear comments I applied here and there. From: Brandegee <lightspirals@...> Subject: Re: Travel and vaccination no-forced-vaccination

Received: Monday, September 22, 2008, 2:26 AM Great information from Sherri Liz > Far-Off Adventures: Vaccinations And Overseas Travel > By Sherri J. Tenpenny > Issue 120, September/October 2003 > > The time has finally arrived for the highly anticipated trip out of > the country. The plans began long ago... Your doctor is recommending a variety of vaccines. Are they necessary? How do you evaluate the risks? > > VACCINES IN THE US > Currently, eight different vaccines are recommended for children in > the US: Hepatitis B, polio, diphtheria-tetanus- pertussis (DTaP), > measles-mumps- rubella (MMR), chickenpox, HiB, Prevnar, and,

most > recently, an annual influenza vaccine. (HiB and Prevnar are given to > prevent bacterial infections caused by H. influenza and Strep. > pneumonia, respectively. Some of these vaccines are also recommended > for international travel. But are the risks of getting these diseases > any greater when traveling than they are at home? Let's take a closer > look at the more worrisome infections that might be encountered while > traveling abroad. > > Hepatitis B is a viral infection that is spread through contact with > blood. In the US, Hepatitis B is primarily found in adults, and is > spread through intimate contact or through sharing needles used with >

illicit drugs. Hepatitis B is more common in the general population in > East and Southeast Asia and in Sub-Saharan Africa. Even in these > areas, the risk for contracting the infection is very low, but if you > do, Hepatitis B can make you very ill. Still, the risk of long-term > complications is much less than we are generally led to believe. More > than 95 percent of those who contract Hepatitis B fully recover, and > an infection will result in lifetime immunity for that person. Unless > you plan to spend extended periods in close contact with infected > persons, the risk of contracting Hepatitis B while traveling is nearly > the same as in the US. > > Polio, or poliomyelitis, is

an infectious disease caused by a virus > that attacks the nervous system. The disease is seen primarily in > children under five years of age; the initial symptoms include fever, > fatigue, headache, vomiting, stiffness in the neck, and pain in the > limbs. Paralysis results in approximately 1 to 2 percent of children > who contract the viral infection, though the vast majority recovers > completely from this paralysis. A few, however, go on to have > permanent, lifetime disability. > > While polio was once common throughout the undeveloped world, today > only seven countries continue to have polio-endemic rural areas: > Afghanistan, Egypt, India, Niger, Nigeria, Pakistan, and

Somalia. The > disease is no longer a threat and will soon be completely eradicated. > Although the Western Hemisphere was certified "polio-free" by the > World Health Organization in 1994 and there have been no cases of wild > polio in this region since 1991, the US vaccination schedule still > includes four doses of the polio vaccine. 1 The reason given for this > is that, until polio is eradicated entirely, the risk of reintroducing > polio into this country is "only a plane ride away." However, an > examination of the data reveals only six cases of imported polio > documented between 1980 and 1998, the last in New York City in 1993.2 > The risk for contracting polio is negligible, even at

home. > > Tetanus is an acute, spastic paralytic illness caused by a toxin > released from the bacterium Clostridium tetani. The bacterium is found > in soils and animal feces throughout the world. > > There are several forms of tetanus: neonatal, cephalic, localized, and > generalized. In infants, neonatal tetanus is the most common and most > deadly. However, the vast majority of these cases occur following > childbirth, as a result of using nonsterile equipment to cut the > umbilical cord. Cephalic tetanus, the least common, causes muscle > spasms in the face, leading to the classic case of "lockjaw." > Localized tetanus is recurring muscle contraction

near the original > site of the infection; recovery can take many weeks. > > Generalized tetanus, the most common, is the slowest to develop. The > disease is characterized by a gradual increase in skeletal muscle > rigidity and muscle spasm. Deep, dirty punctures are at greatest risk > for developing the infection because the bacterium thrives only in > areas that are deprived of oxygen. > > The symptoms of any type of tetanus infection develop slowly. The > incubation period-the time between when the injury occurred and the > development of a full-blown infection-can range from five days to two > months, but the initial symptoms most commonly begin to

appear within > 14 days. Early symptoms of infection include restlessness, headache, > and localized itching or pain at the site of the injury. It is > generally believed that tetanus is a highly fatal disease, but an > examination of the data proves otherwise. In the most recent > evaluation of tetanus data by the CDC, it was found that the death > rate associated with tetanus was 11 percent, nowhere near the "nearly > 100 percent fatal" so widely believed.3 It is also commonly accepted > that a tetanus shot will prevent the onset of tetanus. Again, the data > show that, even if a person has three or more tetanus shots, it is > still possible to contract the disease.4 A recent issue of the

British > Medical Journal reported that tetanus can occur "despite adequate > immunization and [adequate] levels of neutralizing antibodies." 5 > > Frequent tetanus shots may give a false sense of security; the best > way to protect from the disease is to thoroughly clean the wound with > copious amounts of warm, soapy water, and to encourage the injury to > bleed profusely. Prophylactic antibiotics, such as metronidazole and > penicillin, are effective against the bacterium that releases tetanus > toxin into the bloodstream. It might be a good idea to carry these > with you in your travel kit if you are going to off-beat places. If > you have access to medical care when traveling, a

shot of tetanus > immune globulin (TIG) can be given for severe injuries. Equivalent to > a "dose of antibodies," TIG continues to circulate in the body for up > to three weeks, and can effectively neutralize any toxin that might be > released by the tetanus-causing bacterium. > > WHAT ABOUT EXOTIC DISEASES? > When traveling overseas, it is possible to encounter some illnesses > not generally seen in the US. The Centers for Disease Control lists > the following infections as possible concerns for anyone traveling to > any destination around the globe:6 > > Typhoid Fever, an acute, febrile illness caused by the bacterium > Salmonella

typhi, is characterized by fever, headache, and enlargement > of the spleen. The greatest risk is for travelers to the Indian > subcontinent and to developing countries in Asia, Africa, and Central > and South America who will have prolonged exposure to potentially > contaminated food and drink. > > Yellow Fever is a mosquito-borne viral illness that can vary in > severity from a flu-like syndrome to severe hepatitis and hemorrhagic > fever. The disease occurs only in sub-Saharan Africa and rural, > tropical South America. > > Japanese Encephalitis, another mosquito-borne viral infection, is > found throughout Asia, particularly in rural or agricultural areas

of > the temperate regions of China, Japan, Korea, and eastern Russia. The > risk to short-term travelers and those who confine their travel to > urban centers is very low. > > Tick-borne Encephalitis, also known as spring-summer encephalitis, is > a tick-borne viral infection that causes inflammation of the central > nervous system. Although the disease is common throughout Europe, > travelers are at low risk unless they visit forested areas and/or eat > nonpasteurized dairy products. > > Hepatitis A is a viral disease that has an onset of fever, malaise, > nausea, and diarrhea, followed within a few days by jaundice. The > disease

ranges in clinical severity from no symptoms at all to a mild > illness lasting one to two weeks. Although endemic throughout the > world, Hepatitis A can be prevented by carefully following the hygiene > and food recommendations listed in the sidebar "Minimizing Risks." > > WHAT'S RECOMMENDED? WHAT'S REQUIRED? > Although the CDC recommends that all travelers obtain vaccines when > traveling abroad, it is important to realize that, with one exception, > no vaccine is required before you travel anywhere in the world: they > are only "recommended. " You will not be required to have a vaccination > record to enter a country, nor will you be required to obtain vaccines > to return

home. > > The sole exception is the Yellow Fever vaccine, which may be required > if you travel to or from a South American or African country infected > with Yellow Fever. The recommendations can vary from country to > country; if such a destination is part of your travel plans, you > should look up the Yellow Fever requirements for that specific > country. The CDC's Comprehensive Yellow Fever Vaccination Requirements > are available at www.cdc.gov/ travel/yelfever. htm#yfcert. > > I have been a globe-trotter for most of my adult life. In the past 25 > years, I have traveled to more than 40 countries. I have never been > asked for a vaccine record, nor have

I ever felt the need for any > vaccines, even when traveling to remote, exotic destinations. > > ARE THERE OTHER HEALTH RISKS TO CONSIDER? > Vaccines are available for all diseases mentioned above, should you > choose to vaccinate. Infections that are a concern worldwide, and for > which there are no vaccines, include malaria and Traveler's Diarrhea. > > Malaria is a serious, sometimes fatal disease caused by a parasite > that is injected into the body by an infected mosquito. The parasite > grows in the liver, then infects circulating red blood cells. Symptoms > of malaria include fever, shaking chills, headache, muscle aches, > vomiting, diarrhea, and

extreme fatigue. If untreated, death from > malaria can occur due to dehydration and kidney failure. > > For most people, the symptoms of malaria begin ten days to four weeks > after they become infected, although the symptoms may not develop > until as much as a year later. Anyone who begins to have recurring, > shaking chills up to one year after returning home should seek > professional medical care. Be sure to tell your healthcare provider > that you have visited a malaria-risk area. > > Prescription drugs for the prevention of malaria are sometimes > recommended for those traveling to malaria-endemic countries. Some > antimalarial drugs are more

effective in some parts of the world than > others, but all of them have side effects and potential complications. > In addition, a medical condition may prevent your child from taking > certain drugs. > > An alternative to taking drugs is to use mosquito precautions (see > sidebar). It is important to obtain a natural mosquito repellant, one > that is free of DEET, the toxic additive found in most insect > repellants. My favorite is Natural Mosquito Repellant, made by Royal > Neem. It is free of chemicals and contains many natural ingredients: > aloe vera; the oils of coconut, neem, lemongrass, citronella, > cedarwood, and rhodiumwood; and extracts of myrrh, barberry,

thyme, > goldenseal, and chamomile. Further suggestions for additional natural > insect repellents can be found at www.mercola. com. > > If you contract malaria, a natural treatment is available that is > perhaps even more effective than pharmaceuticals, and is certainly > less toxic. During an archeological dig in the 1970s, instructions for > treating malaria with an herb called wormwood, or artemisia, were > found in a 2000-year-old Chinese tomb. Shortly thereafter, Western > scientists isolated the herb's active component and called it > "artemisinin. " Studies in China and Vietnam have confirmed that > artemisinin is a highly effective compound, with a close to

100 > percent response rate in the treatment of malaria. Outside the US, > artemisinin is the No. 1 natural herb used to treat malaria. The World > Health Organization is investigating the use of this herb worldwide > for malaria treatments. Because there can be a wide variation in > quality, it is important that artemisinin be purchased from a > reputable source, such as Allergy Research Group, > www.allergyresearch group.com. It should be noted that this company > only sells to licensed healthcare practitioners. > > Traveler's Diarrhea This is, by far, the most common illness affecting > those traveling outside the US. It is estimated that between 20 and 50

> percent of travelers-nearly 10 million people each year-develop > diarrhea. Although a variety of viral and parasitic pathogens can be > the cause, by far the most common source of Traveler's Diarrhea is the > bacteria E. coli. > > Symptoms usually begin abruptly and increase over several days. The > typical experience includes four or more watery bowel movements each > day, associated with nausea, vomiting, abdominal cramping, fever, and > malaise. Most cases are benign and resolve in one to two days without > treatment. Although rarely life-threatening, Traveler's Diarrhea can > bring a sudden halt to the fun and mystique of international travel. > >

The best way to avoid Traveler's Diarrhea is by strict adherence to > food and water precautions (see sidebar, "Minimizing Risks"). In > addition, studies have shown that taking two tablespoons of > Pepto-Bismol four times a day (for adults) can decrease the incidence > of Traveler's Diarrhea. The dosage for children nine to 12 is one > tablespoon four times a day, children six to nine, two teaspoonfuls; > three to six, one teaspoonful; under three, consult a physician before > taking. (People allergic to aspirin, pregnant women, and those on the > blood thinner Coumadin should not take Pepto-Bismol. Also, large doses > of Pepto-Bismol can temporarily blacken the tongue and stool.) >

> The most important treatment for Traveler's Diarrhea is oral > rehydration to replace lost fluids and electrolytes. Clear liquids are > routinely recommended for adults, and, for children, electrolyte- based > liquids such as Gatorade. On rare occasions, antibiotics may be > required if the symptoms persist for more than a few days. > > The Best Medicine > The best medicine for any type of infectious disease is always > prevention. For most diseases around the world, common-sense > precautions are the best way to stay healthy. Since for nearly every > destination in the world vaccinations are only recommended, not > required, a trip to your doctor for vaccines is one item you

can cross > off your pre-trip "To Do" list. Go and have fun! > > MINIMIZING RISKS > 1. Eat only cooked foods hot to the touch. Avoid eating food from > street vendors.I ate food from street vendors everywhere I went. > 2. Avoid eating raw fruits and vegetables unless you peel them yourself.At Nigerian markets, young boys sell peeled oranges... not peeled the usual way...with super-sharp knives they peel away the outer layer of the skin, cut a little holeinto the top of the orange and hand it to you... you'd then suck

the juice out of thefruit while sqeezing the body of the fruit with your fingers. I used to eat all of it soas not to miss the bioflavonoids. Wasn't worried about the fruit having been touchedby native hands. > 3. Drink only "safe" beverages: sealed bottled water, carbonated > beverages, hot tea, coffee, beer, wine, and boiled water.Yes, my companions would not think of drinking local water. When thirsty, they'ddrink only "safe beverages" like coke, pepsy, beer, wine and boiled or chemicalizedwater, things I'd shy away from, in Africa as well as at home. > 4. Don't drink beverages with ice.Why? Because the ice cubes may have been made with unsafe water. I avoided ice cubes too but for a different reason: I don't drink iced water at any time. Not goodfor the ecology of the stomach. > 5. Avoid eating raw or undercooked meat and seafood. > 6. Avoid all tap water, and be careful of getting shower water in your > mouth. When dining in restaurants, ask whether the salad greens have > been washed in

boiled or distilled or bottled water.A lot of good it would do you to ask in Africa "wether the greens have been washed in boiled or distilled or bottled water." They either would not know what you were talking about or, if they did, they'd swear the greens had been washed in safe water. I put my bets onmy super-fit and super-healthy body's ability to defend itself. > 7. Avoid nonpasteurized milk and dairy products.Not sure here. I wonder pasteurizing milk and derivative dairy products is notthe greater risk factor. I ate local yogurt or local goat cheese

everywhere I found it. > > PROTECT YOURSELF FROM MOSQUITO BITES > o Pay special attention to mosquito protection between dusk and dawn. > o Wear long-sleeved shirts, long pants, and hats. > o Frequently apply natural insect repellant. I go along with this except that I would add B1 to my defenses. > NOTES > 1. CDC, "Certification of Poliomyelitis Eradication- The Americas," > MMWR 43 (1994): 720-722 > 2. CDC, "Poliomyelitis Prevention in the United States Update," MMWR > 49 (2000, RR05): 1-22 > 3. CDC, "Tetanus Surveillance, " MMWR

47 (July 1998, 55-2): 13. > 4. Ibid. > 5. Letter to the Editor, British Medical Journal 320 (5 February > 2000): 383. > 6. CDC Travelers' Health, www.cdc.gov/ travel/destinat. htm. > > Sherri J. Tenpenny, DO, is board-certified in Emergency Medicine. She > is CEO of OsteoMed II, located in Strongsville, Ohio, an Integrative > Medicine clinic that treats ADD/ADHD, autism, and a wide variety of > autoimmune disorders seen in children and adults. An advocate for > healthcare choice, including the right to refuse vaccination, Dr. > Tenpenny speaks nationally and internationally on the unspoken health > risks of vaccines.,_._,___

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