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Malaria hits back

The Hellenic Center for Disease Control and Prevention (Greek CDC, KEELPNO)  calmed down at  the end of August worries about malaria new transmissions occurrence in  the country, that peaked  near the hot spot areas and in the Northern Aegean islands. Τhe new cases were detected near the hot spot areas and in the Northern Aegean islands, ΑΝΔ   in large percentage in migrants and refugees 
The National Center for Blood Donation  set on blood donations quarantine for more than one year , 12 districts around Greece

O new cases of Malaria have been detected in the recent epidemiological surveillance  that is conducted by KEELPNO  in the accommodation centers and hot spots, nor has a malaria positive case been reported since the 24th of July  Find out on original report  

“There is absolutely no reason to have concerns over the possibility of a malaria outbreak,” the Secretary general of the Health Ministry Yiannis Baskozos said in an interview with the Athens – Macedonian News Agency on Tuesday. “There is not a proven outbreak, which has started from a refugee or a migrant,” adding that the state is taking action, monitoring the situation, and according to the latest updates, there is no reason for concern.



The KE.EL.P.NO.(Greek CDC),  stresses that Greece is a safe place, with a negligible risk of malaria, while international public health organizations estimate that any special precaution is not required from those visiting our country .

Greek CDC(HCDCP, KEELPNO) Press release, August 22,2016



“Drastic measures have to be taken to avert this strain from taking hold within the domestic population. The screening of migrants must also intensify.” 


Athanassios Tsakris, professor of microbiology at the University of Athens, August 23, 2016

Mosquitoes lay their eggs in water, or along river banks but the kind of water they prefer is warm, shallow, and still, like the kind of water that can be found in gutters,  in flower pots, unused kids pools etc.

Be Cautious with the rain!

After the rains and the  flooding in several areas of Greece in the first week of September, mosquitoes’ eggs are probably hatching more than any time of the year. Keep precaution measures! 


Caution! There are all the "bad" mosquitoes   in Greece 

spreads Malaria and Dengue Fever

Malaria is transmitted by Anopheles mosquitoes, and Zika, and dengue and yellow fever transmitted mainly by the Aedes aegypti.. West Nile Virus s transmitted by the Culex , Anopheles and Aedes . We have all of them in Greece

    • ZIKA, Dengue, yellow fever, and chikungunya vector mosquitoes bite mainly from dawn to dusk.
    • Malaria, West Nile, and Japanese encephalitis vector mosquitoes bite mainly from dusk to dawn.


Malaria in Greece by the CDCs


The CDC does not recommend antimalarial drugs for travel to Greece at this time. Travelers to these two affected areas of Greece should use mosquito avoidance measures, such as insect repellant and sleeping in either an air conditioned or well-screened setting or under a treated bed-net, to prevent malaria infection.
 
The Hellenic CDC continues to work with the European CDC and has responded by enhancing its surveillance systems for malaria cases and malaria vectors. In current- and previously affected- areas, mosquito control has been intensified, healthcare providers educated about early malaria diagnosis and treatment, and the public has been informed about the symptoms of malaria and the prevention of mosquito bites. ,CDC, Malaria in Greece 

The issue of the ECDC Communicable Disease Threats Report (CDTR)   of the period 14 to 20 August 2016 and includes updates on  malaria in Greece, as well as Zika virus, WNV and influenza A(H7N9).

Malaria in Greece
On 12 August 2016, two cases of malaria were diagnosed in the Aghios Vasileios community in Thessaloniki. Response measures are ongoing. Two previous possible locally acquired cases have been reported in the region of West Greece in 2016.

The risk for travellers is considered to be low. The use of standard mosquito biting prevention measures continues to be recommended. More so, ECDC’s conclusions from its previous Rapid Risk Assessment on malaria, October 2011, are still valid.
ECDC, August 12, 2016 


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The Late August 2016 Public Health Crisis

KEELPNO primer Guildeline for travelers

Stay covered

The always to follow Guideline to keep you safe in Greece, is
1. Sun Screen in the Day

2.Mosquito repellent 
on Day AND Night

President of Greek CDC (HCDCP, KEELPNO)

"No reason to worry, fears are exagerated"


"4 sporadically domestic transmission cases this season to date do not justify the extended media focus on the subject.", said on air the New President of Greek CDC Theofilos Rosenberg, written as well in the Press Release of the organization, KEELPNO


The extraordinary Press Relase by the Greek CDC, August 22


"Malaria transmission by domestic indications meaning that patients are presumed to be infected in Greece, systematically appear in the country since 2009", underlined the Greek CDC Press Release after the announcements for the blood donations quarantine that were made by the National Blood Donation Agency.

The diagram, though, of Malaria domestic cases appearance in Greece  shows a  rise from 0 to 6, last year on domestic infections,  which coincides with the refugees influx in the country Domestic Malaria infections in Greece reached a  peak between 2009 and 2011, and had been  successfully diminished by the National Malaria  Action  Plan  of the Greek CDC gradually year by year,  till cases were brought down to 0    in  the year  2014. 


To tackle malaria, the Greek CDC Press Release continues,  the Ministry of Health has developed a National Action Plan with the participation of the other Authorities in charge in Greece, which is continued with the cooperation of other Authoritis in Charge


A fatal budget cut

"The mosquito control programs, which are important but not the ne and only protection measure (for Malaria  elimination), are under the  responsibility of the Regional and Municipal authorities",

the Press Release on Aug 22, 2016, underlined, though avoiding to give exact data on how , really , systematically , the air spraying on the affected areas has been, or has not been done at all .

Officially no data has been presented by the government for any air spraying  despite the blood donations ban
Many municipal spraying protocols for the 
disinsectisation of the infected populations of 
mosquitoes which carry not only Malaria, but also for WNV, ZIKA , and Malaria Disease, were curtailed because of budget cuts.

The Greek CDC does have the authority to assess, forecast and prevent the spread of infectious and communicable diseases, as it is for  Malaria elimination and the new transmissions prevention, even by putting pressure on the stakeholders, or other authorities in charge, to better coordinate the operations fro the realization of the National Action Plans  The  Hellenic Center of Disease Control and Prevention has the authority to formally notice to the municipalities for the urgency  to complete air spraying on time , as was successfully done in the previous years resulting in bringing numbers down to 0  from 2011 to 2014.



The Risk forecast by the Greek CDC surveillance, inspection and assessment  

Public Health Emergency:Total closure of the "accommodation centers" says Greek CDC 


Refugees are being accommodated inside warehouses the report says

 and all areas  are over-crowded by  hundreds of people  

without adequate ventilation, 

with litter accumulation and waste, 

poor hygiene conditions,

, provision of potable water and fluctuations in quality and quantity of food, 

the report describes, stressing that the biggest problem  is that 

all the centers are in close range, both to major breeding grounds of the Anopheles mosquito...  


find article on greek2m news  


Recommendation document on March 11, 2016  of the Greek CDC, (HCDCP, KEELPNO) on  the "diseases transmitted by mosquitoes in areas that host or accommodate migrants or refugees", is highlighting since early March  the risk of malaria and the need for timely and systematic implementation of integrated mosquito management programs.

Among other features  this earlier Recommendation of the Greek CDC  was stating  that "particularly in areas that receive or host migrants-refugees, systematic mosquito control  programs must be implemented, and their intensification must become a high priority as a response to the  public health threats related to diseases transmitted by transmitters". 

find that 


 

Read more for
Blood Donations Safety in Greece
in our West Nile in Greece, Alert
Save me in Seconds Page 

From Peloponnese to Thessaloniki the districts affected  

Twelve districts of Greece have banned blood donations because of malaria, with four cases that have been  contracted this year so far, and  domestically 
The 12 districts affected are Farkadona, Trikala, Palamas, Tempe, Achaean and Thebes (central Greece); Evrotas and Andravida-Kyllini (Peloponnesus); Chalcis (Euboea); Marathon (Attica); and Lagada and Pylaia (Thessaloniki region).
By the ban residents employees and visitors in Greece, in 12 areas of the country's municipalities.
are t
emporary excluded from any blood donations



The Ellinikon Alert

The Greek  CDC intervention 


The Greek CDC (KE.EL.P.NO. recommends immediate commencement of work until the full restoration of

failures, and asks for the need to cover the sanitary needs of the refugees and migrants  populations in the Ellinkon hot spot, with a sufficient number of Hygiene facilities (toilets, showers, sinks). Non implementation to the KEELPNO autopsy conclusions and  recommendations

would pose a serious risk to public health in Greece. 

Additionally for this reason the KEELPNO, Greek CDC mobile units have distributed flyers and information for the migrants and refugee populations for Basic Hygiene Recommendations more 


 HCDCP in its March document draws attention to the local population (Alimos, Glyfada, Greek-Argyroupoli) for possible transmission of dangerous diseases (malaria, Dengue virus, Zika, chikungunya disease) and calls for Awareness among citizens  


The HCDCP being consistent in its mission to protect public health, releases a Warning for   the spread of communicable diseases, especially from this time of the year and on... find it  



Refugees , migrants already spread in the communities

Greek islands.


.The authorities on the islands, and especially in Lesvos

 allow asylum seekers to go in and out if they have been detained for more than 25 days due to the recent  law adopted by the Greek Parliament on April 2,  blanket “restriction of movement” on new arrivals inside closed facilities at border entry points – such as the islands – for up to 25 days during reception and identification . The paradigm again is Lesvos, the island of "Solidarity", which silently follows its fate this year , and unquestionably 'absorbs" the migrants and refugees that are allowed to move in the islands. You see them more and more often in the market, the cafeterias, at the beach , in the souvlaki shops, the squares, in the islands' streeets. Still, locals from the countryside, near the accommodation centers complaint for their domestic farms, where from the migrants, as they say, steal their chicken, goats, turkeys and ...even peacocks. Some laughter the animals in the farm. The vast majority of asylum seekers are unable to leave the islands.    Greek2m, August 2016


Remember with malaria

a single bite might be fatal

A single bite from the high-pitched whining insects is all it can take to become infected.



Are the migrant and refugees population to blame?

No, definely, refugees do not pose danger for malaria
Theofilos Rosenberg, President of the Greek CDC, (KEELPNO, HCDCP) live, on skai tv, August 22, 2016  


According to the official  data, announced on August 22, by the Greek CDC, 65 cases of malaria had been detected in Greece this year as of mid-August, compared to 85 for the whole of last year:


  • 4 cases , involved infection inside Greece, and are characterized domestic
  • 50 cases were (imported) among migrants from the Indian subcontinent or seven African states
    1. of the 50 cases, those concerning migrant and refugees populations, eight were recorded in refugee shelters and among migrant populations in the North Aegean islands
      • 42 of them outside the refugee shelters, meaning economic migrants, working as labour in Greece and being "intergrated" in some way in the Greek community, 
      •       or (UNSPECIFIED ), migrants waiting for the asylum approval, being free to move throughout the country , accommodate in community, e.tc.


  • 11 cases involved travelers returning from malaria-affected countries
Greek CDC President says today's malaria infections in Greece, are not due to refugees or migrants  entering  the country , but due to working migrants  

1. Are the migrants checked, or prescreened for malaria infetion or for being carriers?

2. Are they provided prophylaxis?
Do they have a card?

3. Are the at risk areas of the country aerial- sprayed

4.Are the communities being informed for prevention measures ?


Greek2m, August 22

It started by (working) 
migrants in 2011 in Greece 

Domestic cases of Malaria in Greece, were first reported four years ago - mainly through migrants originating from Pakistan,  nearly four decades after the disease was wiped out in Greece.

Found how malaria re-emerged in Greece after 2010 due  to migrant populations


Refugees influx Demographics in Greece

graphic on the left by  UNHCR
Afganistan :  Risk estimate for Malaria  in Afganistan is considered high by the cdc.gov,  based largely on cases occurring in US military see more
malaria in Pakistan You may need to take prescription medicine before, during, and after your trip to prevent malaria in Pakistan , especially if you are visiting low-altitude areas. See more


A Vintage Campaign 75 years old

Anopheles , the woman



Best tip in century 


 
HOW MUCH IS THE TRAVELER AT RISK?


Travel& Infections 
Travelers pick up resistant bugs from places they visit in less than 48h 

"..One traveller who visited South Korea, as well as another who visited India, picked up CTX-M genes, which make an enzyme called ESBL that can destroy penicillin, cephalosporins and related antibiotics. The percentage of people in South-East Asia who carry these genes has risen from two to 70 per cent over the past decade." more, go to source


Germs and Public Health

go to this Page



REFUGEES AND TOURISM

The Damaged Greece  

Drastic Drop in Tourism on Lesvos due to refugee crisis


Eastern Aegean islands, and primarily Lesvos ,has lost seven in 10 of last year’s tourists.

Air passenger arrivals in June 2016 dropped for a decline of 67.89 percent .The drop in arrivals was attributed directly to the migration crisis 

Kountoura: World Still Has Confidence in Greece

Refugee crisis affects the
image of Greece as a destination
SETE on Travel Survey

“I have been working closely with all tourism authorities and associations to ensure Greece continues to offer the highest quality of tourism services to its visitors.

We have daily updates here at the Ministry for Tourism, and we are all working 24/7 to provide solutions to any problems that may arise, with our first priority being to ensure that all visitors have a lovely holiday experience in Greece.

.

Welcome to Greece and thank you very much! “


In her message, Alternate Tourism Minister Elena Kountoura  invites visitors to contact the Tourism Ministry’s new special team which has been launched to address any possible problems related to tourism..


 

Malaria in
Hot Spots' recent data, KEELPNO epidemiological surveillance 15/8-21/8 results released


No case was recorded for Malaria  in the week 35/2016 (29/08 to 04/09) by the system of epidemiological surveillance of the Greek CDC (HCDCP,KEELPNO), in points of care for refugees/migrants in 46 centres hosting refugees/migrants that have been under surveillance  out of a total of 50 centres 


Pack with you for Greece

  • Insect repellent 
    Select an insect repellent 
(CDC recommendations: Avoid Bug Bites)

  • Permethrin 
    Permethrin is insect repellent for clothing. It may be needed if you spend a lot of time outdoors. Clothing can also be treated at home in advance.

  • Insect bite treatment
    Anti-itch gel or cream

What else? 

Health Information for Travelers to Greece
Healthy Travel Packing List
 Check  Traveler Information Center by the cdc.gov

Μake your Emergency Kit for Greece 

repellent

When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.

for all, all day long, Wear long

Cover Exposed Skin

As much as possible, wear long-sleeved shirts, long pants, socks, and a hat.

Tuck your shirt into your pants, and tuck your pants into your socks for maximum protection

Some bugs, such as tsetse flies, can bite through thin fabric.


On the photo Sophia Vergara with long shirt on the beach, almost swimming with it!!! Even though mosquitoes don't like to be at the sea, Vergara knew How Fashion in Greece should be health wise, Right. To Protect from sun And mosquiots..

Go  long, these days in Greece, it;s Fashionable 


 

Greek CDC to Travelers

Advice for Travelers and Malaria in Greece
 The HCDCP, based on the surveillance data available until now and the implemented prevention measures in the areas where locally-acquired P.vivax malaria cases have been reported, maintains that the risk to travelers for malaria infection in Greece is very low. Chemoprophylaxis for malaria is not recommended for visitors to areas where locally acquired malaria cases have occurred until today. Personal protective measures against mosquitoes are encouraged.

 Rooms to Stay 

Avoid Bugs Where You Are Staying

Choose hotel rooms or other accommodations that are air conditioned or have good window and door screens so bugs can’t get inside. 

If bugs can get into where you are sleeping, sleep under a permethrin-treated bed net that can be tucked under the mattress.

 When outdoors, use area repellents (such as mosquito coils) containing metofluthrin or allethrin.


Caution,Wherever malaria is present!

By CDC.GOV

Travelers to sub-Saharan Africa have the greatest risk of both getting malaria and dying from their infection.

However, all travelers to countries where malaria is present may be at risk for infection.


for residents 

  • Install or repair screens on windows and doors to keep mosquitoes outside.  -Use your air conditioning, if you have it.
  • Help reduce the number of mosquitoes around your home by emptying standing water from
  •  flowerpots, 
  • gutters, buckets, 
  • pool covers, 
  • pet water dishes, 
  • discarded tires, and
  • birdbaths on a regular basis.


Community Control Programs 


  Methods can include elimination of mosquito larval habitats, application of insecticides to kill mosquito larvae, or spraying insecticides from trucks or aircraft to kill adult mosquitoes 
  • Mosquito control activities are most often handled at the local level, such as through county or city government. 
  • The type of mosquito control methods used by a program depends on the time of year, the type of mosquitoes to be controlled, and the habitat structure

  • Local mosquito control programs should provide information about the type of products being used   by each area.

 


URGENT: You should cover yourself, 24/7 from the bites in Greece

 
 


Dengue Fever in Greece Man died from authocthonous infection


Check for Ticks  often in Greece, this time of the year, says cdc.gov 

  • Spread by tick bites, occasionally by unpasteurized dairy products
  • Risk present only in small areas in many countries
  • Most cases occur
    • in forested areas
    • in areas with <2,500 ft (750 m) elevation
    • from April through November; peaks in early and late summer
  • Higher risk: outdoor activities (such as camping, hiking, fishing, bicycling) and outdoor occupations (such as forestry, military training)

Specific Groups Bites' Protection Tips

Traveling with Children

Follow instructions for applying repellent on children:

  • Do not use insect repellents on babies younger than 2 months old.
  • Do not use products containing OLE or PMD on children younger than 3 years old.
  • Children should not touch repellent. Adults should apply it to their hands and gently spread it over the child’s exposed skin.
  • Do not apply repellent to children’s hands because they tend to put their hands in their mouths.
  • Keep repellent out of the reach of children.

For babies under 2 months old, protect them by draping mosquito netting over their carrier or car seat. Netting should have an elastic edge for a tight fit.


Pregnant women to be protected 


Pregnant women

pregnant women should strictly follow steps to prevent mosquito bites while traveling

When used as directed, EPA-registered insect repellents are safe and effective for pregnant and breastfeeding women.


. In the case of Zika, because infection in a pregnant woman is linked to serious birth defects and miscarriage, CDC recommends that pregnant women not travel to areas with Zika outbreaks.


Rapid Test Diagnostics via cell 

Microbiologist Blaine Mathison, one of two scientists who perform telediagnosis at the CDC, says he can even analyze an image of a blood smear straight off his BlackBerry. "I remember once, done diagnostics while watching a ballgame.", 

Greek CDC to travelers 
General guidelines


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