The Plague Closes Los Angeles Forest

Angeles National Forest
CDC

Officials evacuated and closed parts of the Angeles National Forest after finding a dead squirrel that was infected with bubonic plague, the BBC reports.

Scientists are currently examining the squirrel to see if it died of the disease or of other causes. Park officials are using insecticides on squirrel burrows to kill off any fleas, which is how the disease spreads from one animal to another. The Twisted Arrow, Broken Blade and Pima Loops of the Table Mountain campgrounds are closed until further notice, although hiking is still permitted.

The plague killed about a third of Europe’s population in the 14th century but is not nearly as active these days. Only four people have contracted the disease in Los Angeles County since 1984. This map from the Center for Disease Control and Prevention shows each case of the plague in the United States since 1970. About 80% were of the bubonic variety and most cases were not fatal, since antibiotic treatment is usually successful. In related news, researchers at the Max Planck Institute in Germany are developing an easy test to detect the plague in its early stages.

As you can see, there are two main clusters. New Mexico gets about half of all the human infections in the U.S. In the 1980s, the worst plague decade, it had slightly more than a hundred cases. Worldwide, most plague cases are in south central Africa and east Asia. People tend to get it while engaged in outdoor activities.

Thirty years of AIDS: Smithsonian remembers the start of a pandemic

AIDSThirty years ago this summer, the first official reports were released about a new virus that destroyed the human immune system. The virus was the Human Immunodeficiency Virus (HIV), which causes AIDS.

Since that time HIV/AIDS has become a global pandemic, claiming millions of lives and seriously damaging several developing economies.

The Smithsonian’s National Museum of American History is marking this grim anniversary with a special two-part exhibition at the Washington, DC, museum. HIV and AIDS Thirty Years Ago looks at the initial public and government response to HIV/AIDS from 1981-1987, and how the virus was first isolated. Archiving the History of an Epidemic: HIV and AIDS, 1985-2009 takes the story forward to look at society’s growing awareness of the problem and oral histories of those affected. There’s also an online exhibition.

For more information on how HIV/AIDS and how to protect yourself, go to the U.S. Department of Health and Human Services HIV/AIDS information page or the government’s AIDS page for basic information about HIV/AIDS.

[Photo courtesy Wikimedia Commons]

Top five things to look for in a travel doctor, and why you should have one

travel doctorsDespite writing about food and adventure travel for a living, I used to be somewhat blasé about the concept of travel medicine. Multiple incidents of Giardia/dysentery/traveler’s diarrhea/full-body outbreaks of mosquito and sand fly bites just taught me to carry a serious stash of antibiotics in my first-aid kit. At least I’ve always been conscientious about travel immunizations and educating myself about the primary diseases indigenous to my destination.

When you’re young and healthy, it seems silly to have a travel medicine specialist. Although this article is primarily directed at adventure travelers, odds are, the worst thing you’ll come home with is a backpack full of crappy souvenirs. But no one’s invincible, and should you require a specialist for something not responding to conventional treatment or with progressive symptoms, time is of the essence. Many “exotic” diseases progress rapidly, and can cause irreversible damage or death if not properly diagnosed and treated. Even with incurable diseases, the earlier you catch them, the easier it will be to manage symptoms and prevent them for worsening.

No, I’m not a doctor, although I come from a medical family. But I got seriously schooled after visiting Ecuador two years ago. After a fantastic month of adventure activities in remote parts of the Andes and Amazon Basin, I fell seriously ill the last day my trip. Two years of at-times crippling symptoms, 10 CT scans, five medical facilities, dozens of specialists, four surgical procedures, two surgeries, one cancer diagnosis, and near-medical bankruptcy later, I’ve become an expert at being my own advocate.

My infectious disease doctor believes that I contracted a form of bartonellosis called Oroya Fever after being bitten by sand flies. The good news: My health is currently stable, but we don’t know if the disease is in remission or not. But I have permanent cognitive damage, scarring or tumors on most of my internal organs, and intermittent arthritis. But believe me, I feel lucky.

I don’t want anyone to go through the health and medical nightmare I’ve endured, so I’ve compiled a list of essentials in a travel medicine doctor. Ergo, number one with a bullet:

1. Is he/she a travel or tropical medicine specialist?
Pre-bartonella, I used an internist as my GP/prescriber of antibiotics. If you can find an internist, gastroenterologist, or infectious disease doctor who is also a specialist in travel medicine, that’s a huge plus.travel doctors 2. Does he/she have personal experience traveling or practicing in developing nations?
There are a lot of practicioners who aren’t globally aware, so to speak. You can’t diagnose what you don’t understand, know about, or have first-hand experience with. Period.

3. Is he/she a good listener and empathetic?
It’s difficult to find these qualities in any doctor, especially in today’s medical climate. But it’s imperative to find someone you can communicate with, and who understands what you’re going through if you’re suffering from a mystery travel ailment. Don’t settle, even if you need to travel to another state or country to seek treatment (what stumps doctors here is often commonplace in the country of origin).

4. Does he/she have a good network of colleagues in multiple specialties (including travel/tropical medicine) to consult for additional opinions?
My current mantra is to seek a third opinion, from at least two different medical facilities. That, and to have a travel physician who actively consults colleagues and does additional research to assist with a diagnosis and/or treatment. My infectious disease doctor talked to specialists at a medical school in Peru on my behalf, and even tracked down a relevant medical paper from 1897 as he honed in on a diagnosis. And while I wouldn’t consider it a deal-breaker if the answer is no, see if your doctor is an active and participating member of the International Society of Travel Medicine.
travel doctors
5. Does he/she return your calls/provide you with email, pager, or office number so you can get in touch directly?
I’ve learned that a good doctor who is invested in your recovery will provide an open line of contact to address questions, concerns, and exchange pertinent information. Tip: Please don’t abuse this privilege. Physicians work insanely long hours, under constant stress. And don’t expect to hear back immediately if you leave a non-urgent message; be realistic. A couple of days, fine (many specialists aren’t in clinic every day). A week? Make a polite follow-up.

Whether or not you end up getting a travel doctor, the International Association for Medical Assistance to Travelers (IAMAT) provides loads of useful information, including a directory of global travel medicine clinics with English-speaking staff, and a destination-specific travel health planner. And depending upon what you plan to do on your trip, where you’re traveling, and your financial situation, you may want to invest in travel insurance.

[Photo credits: blood transfusion, Flickr user CarynNL;patient, Flickr user kk+; legs, Laurel Miller]

The Ultimate Travel First Aid Kit

Lariam Dreams (which pills do you pop?)

If you’ve traveled to a tropical country, you’ve probably heard of Mefloquine. It is the most popular prophylactic against malaria, and is often sold under its trade name, Lariam. Lariam can have some serious side effects such as depression, anxiety, paranoia, nightmares and insomnia. You might say, “having nightmares is better than catching malaria and ending up in a hospital or worse.” I’m sure everyone would agree with that.

But when you wake up in a strange foreign land after a Lariam-induced nightmare…and you aren’t quite sure if you are really awake or if your waking state is just another extension of your dream, it can be pretty unnerving.

After such an experience, you might ask yourself if it is really necessary to ingest Mefloquine every time you enter a tropical region. I’ve known people who pop the little pills once a week when they are in Hong Kong or Singapore where the chance of catching malaria is akin to the chance that you will win the lottery. I guess some travelers choose to err on the side of caution when they enter any unfamiliar place.I haven’t even mentioned the host of shots and other pills that some guidebooks and doctors say you might want to consider. Typhoid is a big one. Cholera is another. Neither of these have vaccines that are 100% effective and they can bring about particularly nasty side effects. That doesn’t stop doctors from recommending them and people from getting the shots.

So what do you really need when you are traveling in a developing, tropical country? I guess it depends on how apprehensive you are. For me, Lariam and obscure vaccines are out unless I find that I am entering an area where a particular disease is truly a threat (see the WHO web site if you want to research a country you plan to visit). I also keep up to date on basic immunizations like tetanus and Hep B. And keep in mind, no matter how Lariam happy you get, there are diseases like SARS and H5N1 out there to remind us that health concerns are always going to be a scary part of traveling. And so I ask you, Gadling readers: what do you consider a necessary part of your travel-sized medicine cabinet?