Greek to me !

  #Health& #Wellness Travel to #Greece 

In 2014 no locally acquired case was recorded in Greece. 

 
The classification of all the malaria cases reported to the HCDCP in 2014 by place of residence/exposure and status of the patient (immigrants/traveller)  presented here


 Always fight that Bite in Greece

Caution:September, wet, as so, a peak Mosquito month

- malaria is more common in the wet season. 

Take  Care at Night!

The mosquitoes which transmit malaria commonly fly from dusk to dawn and therefore evenings and nights are the most dangerous time for transmission.


Malaria Greece in yellow  

If you are traveling to parts of the world where malaria transmission occurs, you could be at risk for malaria, says CDC Information for travelers, and shows Greece, unique one country from the western world in yellow, one pf the countries where malaria occurs in some parts 


Note to the traveler 

Before you go  

Although risk varies, all travelers to malaria-risk countries should take precautions to prevent malaria.



Take a repellent

You should use an effective insect repellent on clothing and any exposed skin 24/7

 Because you will definitly need sunscreen also, remember the reprellent comes after sunscreen  



Smart tip to follow 


 For example, back-packing or travelling to rural areas is generally more risky than staying in urban hotels.


Watch out for Season 

Watch out in Humidity Days and Season 

  • In some countries ( like Greece, as the paraites' infectiousness has proved in the recent years, ) the risk varies between seasons - malaria is more common in the wet season



Remember with Malaria


protect against mosquitos 


every single minute



if you do so, you are safe


A Single Bite 

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



MALARIA emerged BACK in 
GREECE in 2011 (36 years after it was erradicated )

In Greece, locally acquired cases of malaria have been occurring since 2009, with the highest number reported in 2011 when 42 autochthonous Plasmodium vivax cases acquired cases was observed in 2012, with 20 autochthonous Plasmodium vivax cases reported, following implementation of public health measures, such as systematic proactive and reactive case detection, strengthening of the surveillance system and  improving the diagnosis capacity of malaria
Preventing malaria - four steps

There is an ABCD for prevention of malaria. This is:


  • Awareness of risk of malaria.
  • Bite prevention.
  • Antimalarial medication - Chemoprophylaxis (taking antimalarial medication exactly as prescribed).
  • Prompt Diagnosis and treatment.

Jane Doe - Another Company, LLC



During Your Journey 


Where you sleep 

  • If you sleep outdoors or in an unscreened room, you should use mosquito nets impregnated with an insecticide (such as pyrethroid). The net should be long enough to fall to the floor all round your bed and be tucked under the mattress. 
  • Check the net regularly for holes. Nets need to be re-impregnated with insecticide every six to twelve months (depending on how frequently the net is washed) to remain effective. Long-lasting nets, in which the pyrethroid is incorporated into the material of the net itself, are now available and can last up to five years.
  • Sleeping in an air-conditioned room reduces the likelihood of mosquito bites, due to the room temperature being lowered. 
  • Doors, windows and other possible mosquito entry routes to sleeping accommodation should be screened with fine mesh netting. 

What you wear 


What you wear 
  • If practical, you should try to cover up bare areas with long-sleeved, loose-fitting clothing, long trousers and socks - if you are outside after sunset - to reduce the risk of mosquitoes biting. 
  • Clothing may be sprayed or impregnated with permethrin, which reduces the risk of being bitten through your clothes.
SOURCE :http://patient.info/health/malaria-prevention


The Repellent 

Insect Repellents


  • Diethyltoluamide (DEET) is safe and the most effective insect repellent and can be sprayed on to clothes.
  • It lasts up to three hours for 20%, up to six hours for 30% and up to 12 hours for 50% DEET. 

  • There is no further increase in duration of protection beyond a concentration of 50%
  • . When both sunscreen and DEET are required, DEET should be applied after the sunscreen has been applied.


  • DEET can be used on babies and children over 2 months of age. In addition, 
  • DEET can be used, in a concentration of up to 50%, if you are pregnant.
  •  It is also safe to use if you are breast-feeding.


  •  If you have sensitive skin you may find DEET irritating. Insecticides containing picaridin are a useful alternative.

What you spray 

  • You should spray the room before dusk with an insecticide (usually a pyrethroid) to kill any mosquitoes that may have come into the room during the day. If electricity is available, you should use an electrically heated device to vaporise a tablet containing a synthetic pyrethroid in the room during the night. 
  • The burning of a mosquito coil is not as effective.

Herbal remedies have not been tested for their ability to prevent or treat malaria and are therefore not recommended. Likewise, there is no scientific proof that homoeopathic remedies are effective in either preventing or treating malaria and they are also not recommended.


After You Return from your Journey 

Note: 


if you feel unwell and have recently visited an area in which there is malaria, you should seek prompt medical advice, even if you have taken your antimalarial medication correctly.


What the Greek CDC does for Malaria 
                        
         ***efficient elimination of the Locally Acquired Infections in three years  

 Greece has been malaria-free since 1974, but a number of significant factors may lead to the re-establishment of the disease, mainly: 

i) the large number of immigrants from malaria-endemic countries, who work mostly in the farming sector combined with 

(ii) the circulation of Anopheles mosquitoes, the competent vector of the disease, in many areas of Greece. 


Fewer locally-acquired malaria cases were recorded in 2012, compared with 2011 and minimal in 2013 


Overall 55% decrease in locally acquired cases was noted in 2012 compared to 2011 and

 72% decrease in locally-acquired cases in Evrotas, Lakonia.

 Furthermore, active case detection in Evrotas improved  significantly the timeliness of diagnosis of malaria in the area. 


  • Early detection, 
  • appropriate investigation and 
  • appropriate treatment of malaria cases combined with 
  • effective vector control (larviciding and IRS) represent the main components of the public health strategy to prevent further transmission and re-establishment of malaria in Greece. 



Malaria 

in Greece



Malaria in Greece occurs in well-defined agricultural areas which were known receptive areas for the disease, particularly in Evrotas municipality (Regional Unit Lakonia). Likewise, the three cases from 2013 are reported from similar agricultural areas where immigrants from malaria endemic countries reside and work. The occurrence of autochthonous these areas in 2013 is therefore not unexpected


  • .The current risk for malaria infectionin Greece is to persons residing and/or working in the affected areas of Greece. 

  • The risk for travellers is considered to be low since all areas from where malaria is currently reported are agricultural rather than areas which attract tourists.

  • The use of standard mosquito biting prevention measures continues to be recommended. 

  • Moreover, as the malaria transmission season is coming to an end, the risk will decrease even further.

sources: Greek CDC

 ( KEELPNO), ECDC)                                                                                                                Greek to me  November25/11/2013


Malraria on Call 

USA: In Case you were asking 

CDC.GOV MALARIA CALL FOR TRAVELERS


Some callers tell a story of becoming ill within two or three days of arrival at their destination and being told by a local healthcare provider they consulted that they have malaria, which is highly improbable given the short period of time between their arrival and when their symptoms occurred.


What happens when the caller to the hotline is a U.S. resident already traveling abroad who becomes ill with what could be malaria?


Each year, the hotline handles dozens of these calls.   



Contact the Greek CDC (HCDCP,KEELPNO)


My advice to the traveler who becomes ill abroad? See a reputable healthcare provider as soon as possible. 
It’s important to know whether it really is malaria and if not, to get appropriate diagnostics and treatment for whatever else the illness might be. I tell them to contact the U.S. embassy or consulate in their host country 
A U.S. consular officer can assist in locating medical services and informing family or friends .
cdc.gov


Stefanie Steele, RN, MPH, CPH, CDC Division of Parasitic Diseases and Malaria
Jane Doe - Another Company, LLC 
August 12th, 2013

Alert Links and Numbers

For immediate response, and alert emergency links in Greece and abroad, visit on Greek2m


Greece: Update by resources 

By CDC.gov,  Updated 12/21/2012 

The Hellenic CDC continues to work with the European CDC and has responded with enhanced surveillance, targeted testing and treating among migrants, and vector control activities. In current- and previously affected- areas healthcare providers have been educated about early malaria diagnosis and treatment, and the public has been informed about the symptoms of malaria and the prevention of mosquito bites.


Malaria Greek CDC 2013 Update 


Malaria epidemiologic surveillance data, until 14.10.2013 

 

In 2013 (up to 14/10/2013), a total of 16 laboratory confirmed cases of malaria have been reported to the Hellenic CDC,  of which 15 were classified as imported (10 cases in migrants from malaria- endemic countries and 5 in returning travellers). Of the 15 imported cases, 8 cases are confirmed as P. vivax infections (7 migrants from malaria- endemic countries and 1 in returning traveller) and 7 cases are confirmed as P. falciparum (3 migrants from malaria- endemic countries and 4 in returning travellers). The remaining one (1) case refers to a Greek patient with no travel history to a malaria endemic country and evidence of locally acquired infection in the municipality of Alexandroupolis. Symptom onset was in week 39/2013 (23-29/9/2013). 

The case classification by place of residence/exposure of all the malaria cases reported to the Hellenic CDC in 2013 is presented in Table 1. 

view the official  Greek CDC source 



Successfully in 2013, the  malaria locally acquired infections have been eliminated 
to 3 due to the Emergency Greek CDC Action Plans that have been implemented on the affected areas since the peak of the epidemic  in 2011 . According to the November 22 , ECDC Epidemiological Assessment,

On 16 November 2013, the Greek Centres for Disease Prevention and Control (KEELPNO) reported three autochthonous cases of Plasmodium vivax malaria in the country. 
Two cases were reported from the municipality of Alexandroupolis (Regional Unit Evros) and one case from Sofades (Regional Unit Karditsa). The cases had onset of symptoms in weeks 39 (23-29 September 2013), 43 (21-27 October 2013) and 44 (28 October ±3 November 2013) respectively. 
An additional 17 imported cases have been reported in 2013, 10 among immigrants from malaria endemic countries and seven among Greek travellers. 
Of the imported cases, eight were Plasmodium vivax infections and nine were due to Plasmodium falciparum.  



Greek CDC on  Malaria 


Epidemiologic data, 2011


In 2011, a total of 96 laboratory confirmed cases of malaria were recorded in Greece, of which 54 imported (9 in returning travelers and 45 cases in migrants from malaria-endemic countries, classified based on their arrival date in Greece and/or past history of malaria) and 42 without reported travel history to malariaendemic areas (34 Greeks and 8 immigrants from non-endemic countries). A cluster of 36 P. vivax malaria cases with no travel history to malaria-endemic areas was reported in the Municipality of Evrotas (Lakonia District) along with 6 P. vivax sporadic cases in 4 other Regional Units (Evia, Larissa, East Attiki and Viotia) 


More specifically in Evrotas, Lakonia 28 cases of P. vivax malaria were recorded in Greek citizens and 8 in migrant farm workers from non-endemic countries (Morocco (2), Poland (1) and Romania (5, 2 of which were diagnosed in Romania). In addition, 23 P. vivax cases were reported from the same area in migrant farm workers from malaria-endemic countries (Pakistan (21), Afghanistan (2)) with unclear travel history.



go to full report by cases and regions of malaria transmissions in Greece, at the official Greek CDC website 

Epidemiologic data, 2012

In 2012, a total of 92 laboratory confirmed cases of malaria were reported in Greece, of which 73 have been classified as imported (9 in returning travelers and 64 in migrants from malaria-endemic countries based on their arrival date in Greece and/or past history of malaria). Of the 70 imported cases with known Plasmodium species, 54 cases are confirmed P.vivax infections, 15 P.falciparum (8 in migrants from malariaendemic countries and 7 in returning travelers) and 1 case is a P. vivax and P. falciparum co-infection. For the immigrants from endemic countries, P. vivax infections most likely represent relapses of past malaria infection from their country of origin.


The remaining nineteen (19) cases refer to patients with no history of travel to a malaria endemic country (13 Greek, 2 Moroccan, 3 Romanian, 1 Albanian) with evidence that they have acquired the infection locally during transmission period 2012. All locally acquired cases were confirmed with Plasmodium vivax infection. 


Four additional malaria cases reported in 2012 were attributed to previous transmission periods and are  not included in the analysis of this report. Specifically, 2 P. vivax cases were attributed to the 2011 transmission periods: one case referred to a Moroccan migrant (diagnosed in April 2012), resident of the Municipality of Evrotas (Lakonia District), and the other referred to a 7 year old Greek girl with onset of  symptoms in August 2012 and a history of 4-week stay in Evrotas, Lakonia during the transmission period 2011. 

Moreover, 2 P. malariae cases were also reported in elderly patients, attributed to exposure many years ago.


to Travelers by the Greek CDC


Greek CDC advise to Travellers 

        to areas in Greece with reported locally-acquired malaria cases:


The Hellenic CDC, based on the surveillance data available until now and the implemented control measures in the areas where locally-acquired malaria cases have been reported, maintains that the risk to travelers for malaria infection in Greece is very low. 


For this reason, chemoprophylaxis for malaria is not recommended for visitors to areas where locally acquired malaria cases have occurred until today. 


However, personal protective measures against mosquitoes are strongly encouraged.

September 2013, Greek CDC Announcement 


To Travelers 

Which travelers need to be concerned 
about malaria prevention?

All travelers! Anyone, child or adult,  
who goes to a country 

where malaria transmission occurs should take precautions 

against contracting malaria. This includes

tourists, 

business travelers, 

long-term travelers, 

missionaries, 

airline crew,

\students, and 

immigrants returning to their home countries to visit friends and relatives.



Consider Bed Net  

Why not, Plus it's Sexy!


Baby? 

Can I put insect repellent on my baby? 

• Do not put insect repellent on babies younger than 2 months of age.
 • Protect small babies under the age of 2 months by placing a fitted mosquito net around their infant seat or carrier.

some of the protective tools travelers can use for malaria 

  • malaria pills;
  • insect repellent;
  • long-sleeved clothing;
  • bednet; 
  • and flying insect spray. 


(Not shown, but also protective: air conditioned or screened doors)


What are the symptoms and what should I do if I have them?


Symptoms of malaria include 

  • fever and flu-like illness, 
  • including shaking chills, headache,     muscle aches, and tiredness.
  • Nausea, vomiting, and diarrhea may also occur. 


Malaria is potentially life-threatening if it is not immediately treated. Untreated malaria can cause mental confusion, 

seizures, coma, kidney failure, and death.


Malaria symptoms occur at least 7 to 9 days after infection. 


Fever in the first week of travel is unlikely to be malaria, but any illness should be promptly evaluated.


It is critical to get immediate treatment of malaria. 


Any traveler who becomes ill with a fever or flu-like illness while traveling, or up to 1 year after returning home, should immediately seek professional medical care. 



Inform your health care provider 

that you have been in a malaria-endemic area and should be tested for malaria infection.


anti malaria drugs

Watch out for Medication 
  • The main type of parasite and the amount of resistance to medication vary in different countries. 
In  case that while being in Greece you might needAntimalaria Drug treatmernt , be cautious for counterfeit or generic medications and make sure you will be given the proper pharmaceutical product  on proper doses. The Public Health system in Greece, due to the austerity measures might be found inadequate to provide on time life saving treatments

When Buying Drugs, Take the Following Precautions


  • Travelers should buy in their home country all the medicines they will need before their trip.

  • Travelers should write down the drug's generic and brand names as well as the name of the manufacturer. In case they run out, they can look for the correct product.

  • Make sure that the drug is in its original packaging.

  • Inspect the packaging because many times poor quality printing indicates a counterfeited product
.
  • Be suspicious of tablets that have a peculiar odor, taste, or color, or that are extremely brittle.

  • Several medications are available for chemoprophylaxis.

  1.  When deciding which drug to use, consider
    • specific itinerary,
    •  length of trip, 
    • cost of drug, 
    • previous adverse reactions to antimalarials,
    •  drug allergies

    • current medical history. 

  1. All travelers should seek medical attention in the event of fever during or after return from travel to areas with malaria.

Refer your symptoms to the Greek CDC, in case of Emergency
(info@keelpno.gr, +302105212000)

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TREATMENT HOPE NEW!


NEW ! Novartis AG : New malaria target identified with potential to prevent, block, and treat multiple stages of the malaria life cycle 

- Novartis scientists have discovered a new drug target for treating malaria. The discovery, which is published online in the journal Nature,[2] identifies phosphatidylinositol-4 kinase (PfPI4K) as the target of the imidazopyrazines, a novel experimental antimalarial compound class that inhibits the development of multiple malaria-causing Plasmodium species at each stage of infection in the human host.

The on-going research to develop imidazopyrazines as a new treatment for malaria is supported by the Welcome Trust and Medicines for Malaria Venture.



EMERGENCY


Travelling?

 Make sure you protect yourself from Malaria

The Basics to Know

Counterfeit, avoid them
anyway

especially in Greece
Antimalaria Drug Prevention you
 NEED to know

Which traveler? 

 All travelers! Anyone, child or adult, who goes to a country 

malaria occurs 

cdc.gov