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Injections for Kenya?

Injections for Kenya?

Old Dec 8th 2004, 2:23 am
  #16  
Riverman
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Default Re: Injections for Kenya?

"Hans-Georg Michna" <[email protected]> wrote in message
news:[email protected]...
    > On Mon, 6 Dec 2004 15:18:16 +0100, "riverman" <[email protected]>
    > wrote:
    >>What an idiotic and academically wasteful argument.
    > riverman (and Claude),
    > do your sums. Estimate the likelihood of side effects. Compare
    > it of the likelihood of contracting yellow fever. Both can kill.
    > Without the numbers your statement has no meaning. The argument
    > that it can't hurt to get the shots is simply not true.

First of all, I'm not saying 'it cant hurt to get the shots' any more than
you are saying 'it cant hurt to skip them'. The shots can kill, the disease
can kill. We are talking about probable outcomes and acceptable risks.

Additionally, I'm saying that choosing to spend $5 on bug dope <instead> of
a vaccine is a false economy, and that WAS the academically wasteful point
of your post. My suggestion: get both, and get a mosquito net too.

But OK, I'll do the sums, and provide my sources.

The CDC and WHO have documented exactly 7 patients worldwide who developed
severe side effects from the YF vaccine between 1996 and 2001*. This is out
of 30 million who have had the vaccine, so that makes the odds of getting
really sick, sometime in a 5-year period, about .000023%. (I am disregarding
the less than 5% chance of getting headaches, muscle aches or a temporary
rash as a 'serious illness' on par with getting Yellow Fever.)

Although the vaccine is not required, the WHO considers Kenya one of their
'at risk' countries**, and recommends a vaccine for anyone who enters Kenya
and goes outside the urban area****, considering that there was a serious,
and unexpected, outbreak as recently as Sept 92-March 93***.

This outbreak was attributed to the poor vaccination program
in-country...you speak of the altruism of helping a native Kenyan with your
money...I'd offer that participating in the vaccination program to eliminate
any chance of helping start another epidemic is much more altruistic.

These stats are for Yellow Fever only. Do the sums for all the other
diseases of that region, then add them up. Or just take your chances...the
traveller just might be sitting next to someone coming from Nigeria (20,000
cases between 1982 and 1996).

--riverman

* http://www.cdc.gov/ncidod/dvbid/yell...cine/index.htm
** http://www.who.int/vaccines-surveill...s/htmls/YF.htm
http://www.who.int/vaccines/globalsu...cidenceyel.htm,
page 48.
*** http://www.who.int/vaccines-document...DF/www9842.pdf
**** http://www.travmed.com/maps/country.epl?c=Kenya
 
Old Dec 9th 2004, 7:05 am
  #17  
Hans-Georg Michna
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Default Re: Injections for Kenya?

On Wed, 8 Dec 2004 16:23:21 +0100, "riverman" <[email protected]>
wrote:

    >Although the vaccine is not required, the WHO considers Kenya one of their
    >'at risk' countries**, and recommends a vaccine for anyone who enters Kenya
    >and goes outside the urban area****, considering that there was a serious,
    >and unexpected, outbreak as recently as Sept 92-March 93***.

Riverman,

so how many tourists died from yellow fever then?

Probably none, and we still have no reasonable statistics at
all. It's all wild guesswork, except for the doctors and the
pharma industry. For them it works out well. (:-)

Hans-Georg

--
No mail, please.
 
Old Dec 9th 2004, 8:37 pm
  #18  
Riverman
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Posts: n/a
Default Re: Injections for Kenya?

"Hans-Georg Michna" <[email protected]> wrote in message
news:[email protected]...
    > On Wed, 8 Dec 2004 16:23:21 +0100, "riverman" <[email protected]>
    > wrote:
    >>Although the vaccine is not required, the WHO considers Kenya one of their
    >>'at risk' countries**, and recommends a vaccine for anyone who enters
    >>Kenya
    >>and goes outside the urban area****, considering that there was a serious,
    >>and unexpected, outbreak as recently as Sept 92-March 93***.
    > Riverman,
    > so how many tourists died from yellow fever then?
    > Probably none, and we still have no reasonable statistics at
    > all. It's all wild guesswork, except for the doctors and the
    > pharma industry. For them it works out well. (:-)
    > Hans-Georg


So thats your point? That the recommendation to have yellow fever
vaccinations, and the defination of 'at risk zones' is merely a conspiracy
by doctors and the pharma industry to pad their pockets, while in real life
the vaccine poses a measurable and inherent threat to the patients?

Then why would the WHO and CDC, who have no allegiences to pharma industries
(and in fact battle them constantly for affordable medications for AIDS,
etc), be taking their preventative stance about YF? Why would they risk
their entire organization by supporting saomething with no basis, that could
so completely discredit them?

Look at how many people have died from Yellow Fever before vaccinations were
made available, as opposed to how many people have died from the vaccine. If
your implications are correct, you're pretty much sitting on a time bomb,
with your fortune to be made. Not to mention the lawsuits for wrongful
death, personal injury, etc.

I'm waiting to see any evidence for your claims, as that would be
fascinating.

--riverman
 
Old Dec 9th 2004, 9:46 pm
  #19  
Riverman
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Posts: n/a
Default Re: Injections for Kenya?

"Hans-Georg Michna" <[email protected]> wrote in message
news:[email protected]...
    > On Wed, 8 Dec 2004 16:23:21 +0100, "riverman" <[email protected]>
    > wrote:
    >>Although the vaccine is not required, the WHO considers Kenya one of their
    >>'at risk' countries**, and recommends a vaccine for anyone who enters
    >>Kenya
    >>and goes outside the urban area****, considering that there was a serious,
    >>and unexpected, outbreak as recently as Sept 92-March 93***.
    > Riverman,
    > so how many tourists died from yellow fever then?
    > Probably none, and we still have no reasonable statistics at
    > all. It's all wild guesswork, except for the doctors and the
    > pharma industry. For them it works out well. (:-)

From
http://patients.uptodate.com/topic.a...=Travel+Advice
Yellow fever in expatriates and travelers to Africa and South America has
been rare since the introduction of routine vaccination after World War II.
Since that time, eleven recorded cases have been published, including two
fatal cases in 1996 in unvaccinated American and Swiss tourists who acquired
the infection in Brazil and died after returning home. An additional fatal
case was reported in an unvaccinated Californian who had traveled in the
rainforests of Venezuela with six others; five of these six companions had
been vaccinated against yellow fever. A tenth (fatal) case occurred in a
German tourist in 1999. An eleventh fatal case occurred in November 2001 in
an unvaccinated Begian tourist exposed to yellow fever in the Gambia. A
previously healthy Texan who traveled with a group to fish on the Rio Negro
in rural Brazil was also reported to have died with yellow fever on March
14, 2002; the patient had not been vaccinated against yellow fever. These
events emphasize the risk of exposure in the endemic zone, where:

a.. The virus may circulate silently between nonhuman primates and
mosquitoes
b.. Surveillance for human disease is minimal
c.. The indigenous population may be protected by vaccination.
--riverman
Google under "yellow fever tourist deaths"
 
Old Dec 13th 2004, 12:36 am
  #20  
Hans-Georg Michna
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Posts: n/a
Default Re: Injections for Kenya?

On Fri, 10 Dec 2004 11:46:31 +0100, "riverman"
<[email protected]> wrote:

    >From
    >http://patients.uptodate.com/topic.a...=Travel+Advice
    >Yellow fever in expatriates and travelers to Africa and South America has
    >been rare since the introduction of routine vaccination after World War II.
    >Since that time, eleven recorded cases have been published, including two
    >fatal cases in 1996 in unvaccinated American and Swiss tourists who acquired
    >the infection in Brazil and died after returning home. An additional fatal
    >case was reported in an unvaccinated Californian who had traveled in the
    >rainforests of Venezuela with six others; five of these six companions had
    >been vaccinated against yellow fever. A tenth (fatal) case occurred in a
    >German tourist in 1999. An eleventh fatal case occurred in November 2001 in
    >an unvaccinated Begian tourist exposed to yellow fever in the Gambia. A
    >previously healthy Texan who traveled with a group to fish on the Rio Negro
    >in rural Brazil was also reported to have died with yellow fever on March
    >14, 2002; the patient had not been vaccinated against yellow fever. These
    >events emphasize the risk of exposure in the endemic zone, where:
    > a.. The virus may circulate silently between nonhuman primates and
    >mosquitoes
    > b.. Surveillance for human disease is minimal
    > c.. The indigenous population may be protected by vaccination.
    >--riverman
    >Google under "yellow fever tourist deaths"

Riverman,

thanks for the good find! We have at least some data now.

The numbers are extremely low, apparently not a single one was
reported from east Africa in that article. It would be
interesting to set them in relation to other tourist deaths.
(Actually nothing related to anything is still nothing, as far
as east Africa is concerned, so we cannot, for example,
calculate the cost of a saved life.)

Data on deaths and debilitating sickness from vaccination side
effects will be much more difficult to come by, because there is
a very strong interest from all sides (doctors, pharma
industry), not to let them be known.

Yet another factor is how well you protect yourself from
mosquito bites. The more conscientious you are, the less likely
you will get yellow fever.

And finally yellow fever usually comes in known outbreaks that
are published, at least in Kenya. If there is no such outbreak,
your risk is again lower.

I think that's all we can do here. Everybody who read this
thread has all information and even opinions from all sides and
can now make up his mind in an educated way.

Hans-Georg

--
No mail, please.
 
Old Dec 14th 2004, 4:14 am
  #21  
Riverman
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Posts: n/a
Default Re: Injections for Kenya?

"Hans-Georg Michna" <[email protected]> wrote in message
news:[email protected]...
    > On Fri, 10 Dec 2004 11:46:31 +0100, "riverman"
    > <[email protected]> wrote:
    >>From
    >>http://patients.uptodate.com/topic.a...=Travel+Advice
    >>Yellow fever in expatriates and travelers to Africa and South America has
    >>been rare since the introduction of routine vaccination after World War
    >>II.
    >>Since that time, eleven recorded cases have been published, including two
    >>fatal cases in 1996 in unvaccinated American and Swiss tourists who
    >>acquired
    >>the infection in Brazil and died after returning home. An additional fatal
    >>case was reported in an unvaccinated Californian who had traveled in the
    >>rainforests of Venezuela with six others; five of these six companions had
    >>been vaccinated against yellow fever. A tenth (fatal) case occurred in a
    >>German tourist in 1999. An eleventh fatal case occurred in November 2001
    >>in
    >>an unvaccinated Begian tourist exposed to yellow fever in the Gambia. A
    >>previously healthy Texan who traveled with a group to fish on the Rio
    >>Negro
    >>in rural Brazil was also reported to have died with yellow fever on March
    >>14, 2002; the patient had not been vaccinated against yellow fever. These
    >>events emphasize the risk of exposure in the endemic zone, where:
    >> a.. The virus may circulate silently between nonhuman primates and
    >>mosquitoes
    >> b.. Surveillance for human disease is minimal
    >> c.. The indigenous population may be protected by vaccination.
    >>--riverman
    >>Google under "yellow fever tourist deaths"
    > Riverman,
    > thanks for the good find! We have at least some data now.
    > The numbers are extremely low, apparently not a single one was
    > reported from east Africa in that article. It would be
    > interesting to set them in relation to other tourist deaths.
    > (Actually nothing related to anything is still nothing, as far
    > as east Africa is concerned, so we cannot, for example,
    > calculate the cost of a saved life.)
    > Data on deaths and debilitating sickness from vaccination side
    > effects will be much more difficult to come by, because there is
    > a very strong interest from all sides (doctors, pharma
    > industry), not to let them be known.
    > Yet another factor is how well you protect yourself from
    > mosquito bites. The more conscientious you are, the less likely
    > you will get yellow fever.
    > And finally yellow fever usually comes in known outbreaks that
    > are published, at least in Kenya. If there is no such outbreak,
    > your risk is again lower.
    > I think that's all we can do here. Everybody who read this
    > thread has all information and even opinions from all sides and
    > can now make up his mind in an educated way.

Another thing we really haven't explored, and which is VERY relevant, is the
bureaucracy a traveller will encounter in many places when they see a visa
from an 'at risk' country but no yellow fever stamp, and they try to explain
that they do not actually <need> a YF stamp. Also, the situation when a
traveller is in-country, and decides to take a side trip to somewhere that
YF is known, and they are forced to get the vaccine from some doctor
in-country. I'd be much more concerned about having a doc in Nariobi stick
me with a needle than one in GB or the US.

OK: good debate.

--riverman

--riverman
 

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