Address #9 Pre-flight Address: Ara.

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Brazil Studies Program, DRCLAS, Harvard University. Destinations. Survey the most predominant ... wellbeing and sickness aversion in light of travel pharmaceutical practices ...
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Synergistic Course on Infectious Diseases January 2008 LECTURE #9 Pre-flight Lecture: Araçatuba and Jequitinhonha Jessé Alves and T a nia Chaves Harvard School of Public Health Faculdade de Ciências Médicas da Santa Casa de São Paulo Brazil Studies Program, DRCLAS, Harvard University

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Objectives Assess the most pervasive wellbeing dangers in view of neighborhood the study of disease transmission Provide data about wellbeing and malady aversion in light of travel solution hones

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Basic travel prescription assessment Who Health history, past inoculation, sensitivity Where Detailed data about agenda, settlement When Amount of time preceding takeoff, season, span of outing Why Reasons for travel (get-away, work, study)

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Vaccines Required Yellow fever Routine Updating missed measurements and supporters Recommended Variable as indicated by the outing and past therapeutic history (Hepatitis A, Typhoid fever, MMR, Rabies and Hepatitis B)

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Other pre-travel suggestions Protection against vector-borne illnesses Repellents Risk from sustenance and water (drinking and recreational exercises) How to eat and drink securely Boiling, concoction cleansing, channels Possible contaminations identified with swimming or swimming.

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Southeast Largest provincial populace (72,412,411)* Most industrialized São Paulo state is pioneer in wellbeing, social and instructive improvement Contrasts between various states and areas * 2000 registration

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Yellow fever shot . Why? High dreariness and mortality Recent changes in the study of disease transmission Epizootic transmission outside endemic range Both Ara çatuba and Jequitinhonha inside move zone of transmission Allow for the likelihood of extra, impromptu travel

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Yellow Fever Epidemiological status in Brazil, 2001 Endemic zone 12 states Population: 29,327,171 Transition territory 7 states Population: 17,892,237 YF-Free zone 8 states Population: 117,896,554 Source: FUNASA; adjusted from Vasconcelos and cols., 2001

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Human Yellow Fever zones Minas Gerais 2001/2002/2003 Primate event - 2002 Serro Sabinópolis Santa Vitória Alvorada de Minas Pitangui Leandro-Ferreira Municipalities with instances of FA 2001/2003 Municipalities with instances of FA 2001/2003 and epizootic transmission Municipalities with instances of FA 2001/2003 Itaúna Municipalities with instances of FA 2001/2003 and epizootic transmission Divinópolis Municipalities with instances of FA 2001/2003 Source: FUNASA Area of epizootic transmission and yellow fever

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Municipality of Jequitinhonha

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Yellow fever - Brazil, 1990 - 2007* Endemic zone Transition zone Safe region Potencial hazard zone * Initial information Source: SVS/MS

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Araçatuba district

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Yellow Fever – epizootic transmission and human Cases, Brazil 1999 - 2006 Source: SVS/MS

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Leishmaniasis Transmitted by bugs Cutaneous and instinctive sicknesses Most cases reported in the North Predominantly country transmission Urban cases in the Southeast and Northeast

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Cases of cutaneous leishmaniasis 2003 - 2004 Source: SVS/DESP

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Cutaneous leishmaniasis in Minas Gerais, 2006

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Cutaneous leishmaniasis in Minas Gerais, 2002 to 2006

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Wild repository rattus Nectomys squamipes Bolomys lasiurus

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Visceral leishmaniasis in Minas Gerais, 2001 to 2006

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Visceral Leishmaniasis Deadliness of instinctive leishmaniasis in Brazil, 1994 to 2004 Source: SVS/MS

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Schistosomiasis Aquired through contact with crisp water Still common in Minas Gerais, Bahia and other NE states Cause of intense and unending ailment and inconveniences like entrance hypertension disorder

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Endemic Areas of Schistosomiasis in Minas Gerais Concentrated Areas of Schistosomiasis in Minas Gerais Source: SVS/DVE/SES/MG

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Deaths brought about by Schistosomiasis in Minas Gerais, 1996 to 2004 Source: DATASUS/MS

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Hospital permissions because of Schistosomiasis, 1994 to 2005 Source: DATASUS/MS

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Fresh water presentation Women in Jequitinhonha stream

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Chagas ailment Vector-borne illness High commonness in Bahia, Minas Gerais, São Paulo, Goiás Presently, low occurrence among youngsters and youthful grown-ups Changes in the study of disease transmission (nourishment borne transmission)

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Year # Municipalities Sample Size Positive Samples % Prevalence Chagas ailment sero-pervasiveness among understudies in Minas Gerais Source: CCZ/DVE/SE/SES-MG

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State Municipality Cases Deaths Death rate Transmission Transmitted by Acute Chagas ailment, sustenance obtained, 2007

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Snakes, bugs, and so on. Mischances are uncommon among voyagers Most cases are accounted for in ranch land Pay consideration while strolling in the nation

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# mishaps % Snake chomps, by sort

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Coefficient of yearly occurance of snake episodes per 100,000 occupants, by locale of Minas Gerais State, 2001 to 2005 Source: CCZ/DVE/SE/SES-MG

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Per 100,000 tenants * Partial information subject to change Coefficient of yearly occurance of noxious creature occurrences per 100,000 occupants, Minas Gerais state, 1986 to 2004* Source: CCZ/DVE/SE/SES-MG

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Incidence of snake nibbles in São Paulo state Source: CVE

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Natural foci of maladie

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Human disease in Brazil, 1980 to 2005 Source: CDTV/CGDT/DEVEP/SVS/MS

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