BSE risk

I am inquiring about my risk for infection of Madcow Disease (BSE or vCJ). I traveled to France in the summer of 2008 to the Aquitaine region. While I was there I ate at the same restaurant every night for a week, Spaghetti Bolognese (a meat sauce made from beef). What is my risk of aquiring Mad cow disease from this beef in 2008 in France? I have also eaten beef in 2009 in Spain, in 2009 in Fiji, in 2010 in Peru, and in 2010 in Ghana, Togo, and Benin. What is the risk in these countries? I am generally concerned.

BSE (in animals) are reported sporadically from North America, Japan and Europe. vCJD (in humans). In the end of the 1990es, 172 cases were seen in the UK. The outbreak was stopped by control, changing slaughter methods so that tisse from the central nervous system of the animals (where the organisms (prions) are found, were removed before the meat was sold to the consumer.
It was a concern at that time that vCJD could be transferred by blood transfusion, but only a single case have been found in the UK. 

The risk of infection in industrialized countries which has all taken measures to prevent transmission mean that the risk of vCJD here is exceeding low. The UK reported 3 cases in 2009 and 1 in 2008. In comparison you had 78 cases of sporadic CJD in the UK in 2009, so the risk of the "naturally" ocurring CJD is far greater than the variant CJD. 

2 cases in 1 per approximately 30 million inhabitants per year and in comparison the risk of being killed in road traffic is 1 per 10,000 inhabitants per year, so vCJD is not something that should be a concern in everyday life.

There are no data on BSE in cattle in Africa.

Rose
iglasias@gmail.com




Ecuador for 2 weeks and allergy

I will be traveling to Ecuador for 2 weeks and spending time in Quenca, 4 days in Guayaquil and a few days possibly in the Amazon.I have asthma, allergies and deathly allergic to peanuts. I am worried about the side effects of the various vaccinations and wonder if it safe to get the malaria and yellow fever vaccine.


We will definetely recommend malaria tablets if you visit the Amazonas. There is Yellow fever in Ecuador and especially in the Amazonas, so again it is strongly recommended.
The malaria tablets would for instance be Malarone containing atovaquone and proguanil, and if you have had no previous reactions to these two drugs, it is worth trying perhaps a few days beack home to ensure there is no problems.
The Yellow fever vaccinie is a live, attenuated vaccine grown on hens eggs and may contain small amount of egg yolk proteins. If you are allergic to eggs the vaccine should be administrered with great caution perhaps during admission.



Malaria in Cambodia

I am going with a mission group to Cambodia for 9 days.
We will mostly be in Phnom Penh area. But will be going up to angkor to see the temples. I am not sure what I should do about malaria. Some things I read says take pills, some say take it with you, some say just protect yourself.

The risk of malaria in Phnom Penh is low, but you need prophylaxis travelling outside the city. We would recommend Malarone from the day before leaving Phnom Penh to 7 days after returning.



Tick Bite Encephalitis

My little girl, 3year old, has been bitten by a tick on May 22nd in an endemic aream in Kitzingen, Bavaria.
21 days later, now, she started to have fever up to 39.7.
We live in south of France and the doctors do not know the TBE, can we ask for a serology ? and is there a way to detect it at this moment?

The incubation period seems a little long. Yes, you can have a serology done. The inceftion is called encephalitis because it cause an infection of the brain, which is seen from examining a spinal tap. If your daughter did not develop encephalitis, the diagnosis of TBE is unlikely.



Diarrhea and travels

I am often travelling to Turkey and Greece and has been once in Thailand. I almost always get running stomach the day I arrive and are sick for several days. I have tried diet, I take care of what I eat and where, but it does not help.
I got a shot for infectious hepatitis a few years ago but it did not make any difference.
What can I do?

Diarrhoea can be disabeling and some people are more prone to diarrhoea than others.
You should consider taking an antibiotic immediately the symptoms start, for instance a quinolone like ciprofloxacine or ofloxacine 250 mg twice a day for 3 days.

You are also welcome to ask your own questions.