February 1, 2007

Parents and Team Members,

After MANY questions from team members and parents I wanted to send a message out to everyone about some medical issues for the mission trip.  I was hoping to be able to get on the agenda last Sabbath, but here it is!

Medication Pearls!

1. Only send enough pills to get your student through the trip!  Remember we are going to a 3^rd world county and bags get lost etc.
2. Ask your Pharmacist to put 14 days worth of medications in a “9 dram” bottle with a prescription label. à  TSA requires Rx labels!  ß
3. I must have ALL medications PRIOR to the 28th!  Bring them to the last meeting/packing time on the 25^th.  This will give me enough time to organize the meds before we leave.

Immunization Peals!

For immunization information go to http://www.cdc.gov/travel/camerica.htm for full text.  The following list is the CDC’s list of immunizations for travel to Belize.  I have noted which ones you can get from your primary care physician.  You can get all or none.  We will have a meeting with Passport Health in attendance to answer more questions and to give any immunizations you choose.

1. Hepatitis A
   1. “A virus that can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested in contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling”
   2. 2 shot immunization series
   3. I highly recommend!
   4. See if your primary care physician can give this one (save $$)
2. Hepatitis B
   1. Especially if you might be exposed to blood or body fluids have sexual contact with the local population” (NOT ON MY WATCH)
   2. 3 shot series
   3. I recommend! And is being phased as required for Maryland students
   4. See your PCP
3. Rabies
   1. “If you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities. “
   2. I am NOT planning on getting this one!
4. Typhoid vaccine
   1. Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors
   2. Symptoms are typically persistent, high fevers. Other common symptoms and signs include headache, malaise, loss of appetite, enlarged spleen and relative slow heart rate (usually from dehydration). Many mild and atypical infections occur.
   3. Up to you!
   4. Your PCP probably won’t have this one.
5. Yellow Fever
   1. “Viral disease that occurs primarily in sub-Saharan Africa and tropical South America, is transmitted to humans through the bite of infected mosquitoes. The virus is also present in Panama and Trinidad and Tobago. Yellow fever vaccination is recommended for travelers to endemic areas and may be required to cross certain international borders (For country specific requirements, see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country.)www2.ncid.cdc.gov/travel/yb/utils/ybBrowseO.asp#chapter5
   2. . Vaccination should be given 10 days before travel and at 10 year intervals if there is on-going risk.”
   3. Again up to you - Symptoms can be severe/fatal so I got this one
   4. Again your PCP will not have this one
6. Tetanus and MMR
   1. Should have been done for school
   2. PCP can get these.

Malaria

1. Malaria is always a serious disease and potentially a deadly illness.
   1. “Chloroquine is the recommended drug for Mexico, Belize, Guatemala, El Salvador, Nicaragua, Honduras, Costa Rica, and the Bocas Del Toro Province of Panama.”  National Center for Infectious Diseases, Division of Global Migration and Quarantine

                                                               i.      Adults— Aralen - 500 milligrams (mg) once every seven days

                                                             ii.      Start 2 weeks before travel and continue until 4 weeks after travel.

                                                            iii.      Very convenient!

                                                           iv.      Typical side effects see https://online.epoc­rates.com/u/10a401?src=PK

                                                             v.      Has been known to cause psychosis (very rare!)

2. Malarone

                                                               i.      https://online.epocrates.com/u/10a2449?src=PK

                                                             ii.      Once daily dosing

2. Prevention is the BEST medicine see Mosquito-borne diseases

Mosquito-borne disease

1. Malaria
2. West Nile Virus

1. DEET spray

                                                               i.      Sunny’s has a great spray that is odorless and works great

1.       Look for a repellent containing more than 20% DEET. Products with more than 50% DEET do not offer additional protection.

2. Permitherin spray (for treating items before you go)

                                                               i.      Sunny’s or REI

1.       Don’t treat pillows!

2.       Treat other bedding and all clothing

Sunburn

1. The #1 problem I treated last year (BY FAR).
2. Wear protective clothing or SPF15 sunscreen!

Drinking water

1. Don’t drink it unless you opened the bottle or it is from the water cooler we bought.

Dehydration and Diarrhea

1. It is VERY hot there
2. You may get diarrhea while there
3. Do NOT get dehydrated.
4. You must drink water, lots more than normal.
5. Bring some spending money for bottled water
6. Too much Powerade/Gatorade will cause diarrhea
7. Coke does NOT equal water!

Wash your hands!!!!

Want to bring medications in case you get Traveler’s Diarrhea?

1. No problem – just give it to me at or before the meeting on March 25.
2. If you start developing symptoms LET ME KNOW, together we will decide what the best course of action is.
3. Unless I am told otherwise I will plan to leave these medications as donations to the locals when we leave to come home.  (The hospital has been instructed to give these away free!)

If you have any questions jstriplets@gmail.com or 443-864-1142    DO NOT hesitate to contact me with questions or concerns.  The more you ask the more comfortable we will both be.