Annelies Wilder-Smith

..Until the availability of a licensed vaccine, disease surveillance and vector population control remain the mainstay of dengue prevention...

..Risk factors for acquiring dengue include duration of stay, season of travel and epidemic activity at the destination. Any pre-travel advice on the risks of developing dengue infections should consider these factors...

..We hypothesize that hypobaric hypoxic conditions associated with air travel may contribute to immune impairment...

..Alert thresholds at which to trigger outbreak investigations, and standardised guidelines with regard to their control are outlined, based on the Sphere Project...

..In spite of multiple circulating types, the rate of dengue haemorrhagic fever is low in Singapore...

..Of all exposed HCWs, 7.5% had asymptomatic SARS-positive cases. Asymptomatic SARS was associated with lower SARS antibody titers and higher use of masks when compared to pneumonic SARS...

..If SARS reoccurs, the subsequent outbreak will be smaller and more easily contained if the lessons learnt from the recent epidemic are applied. Lessons learnt during the outbreak in relation to international travel will be discussed...

..We have a duty to protect our health care workers...

..It will then be possible after this information is obtained to assess whether screening is feasible and to identify approaches that are most cost-effective on the basis of characteristics of local populations and seasonality of dengue...

..No association between dengue activity and haze was found. Our findings do not lend support to the hypothesis that haze is associated with reduced dengue activity in Singapore...

..Protection after childhood vaccination is minimal after 10 years without boosting. The need for adult booster depends on the national epidemiology...

..We therefore set out to determine whether W135 meningococcal disease would become endemic in Singapore after its introduction in 2000. Cases occurred until 2003, but no further cases have been reported since 2004...

..Conjugate meningococcal vaccines have significant advantages over polysaccharide vaccines, and should be the preferred option for travelers...

..Acellular pertussis vaccines have been evaluated in adults and confer safe and effective protection and now exist as combination vaccine together with tetanus and diphtheria...

..New vaccines to prevent meningococcal disease have been licensed in recent years. It is therefore timely to discuss current vaccine strategies pertinent to international travelers in relation to the changing epidemiology...

..Epidemics of dengue, their seasonality, and oscillations over time are reflected by the epidemiology of dengue in travelers. Sentinel surveillance of travelers could augment existing national public health surveillance systems...

..In view of the production cessation of the inactivated mouse brain-derived Japanese encephalitis vaccine, it is timely to provide an update on new Japanese encephalitis vaccines and revised vaccine recommendations...

..Licensing dengue as a travelers' vaccine poses unique challenges beyond the development of a vaccine for the endemic population...

..Current vaccine recommendations are to vaccinate all Hajj pilgrims, all travellers to areas with current outbreaks, travellers to the SubSaharan meningitis belt, and individuals with certain medical conditions...

..Misdiagnosis may have serious public health consequences. We aimed to determine simple laboratory features to differentiate SARS from dengue...

..The epidemiology of carriage may be changing or may have been controlled by vaccination and a policy of administering antibiotics to pilgrims from countries with a high incidence of meningococcal disease...

..If we continue to fail to deliver high quality essential obstetric services for all, the Safe Motherhood Initiative of the 1980s will remain an orphan...

..Public health policies to protect household contacts of Hajj pilgrims need to be implemented...

..If proven to be true, insecticide-treated school uniforms would be a cost-effective and scalable community based strategy to reduce the burden of dengue in children...

..These findings would support a policy of eradication of pharyngeal carriage in returning pilgrims to prevent introduction and dissemination of meningococci...

..Of the 40 pilgrims who had no pre-Hajj immunity to pertussis, 3 (7.5%) acquired pertussis. Administration of acellular pertussis vaccine to pilgrims before the Hajj should be considered to address this problem...

..The odds ratio of dengue seroprevalence increased by 4.13 (95% CI: 2.88-5.93) for every 10 year increase in age. Dengue infections remain a major problem in Singapore...

..We conducted a prospective study to assess the risk of M. tuberculosis infection among Hajj pilgrims...

..The incidence was estimated to be 1 out of 156 passengers. The risk of in-flight transmission of SARS appears to be far lower than that reported for influenza, but may be increased with superspreaders on board...

..Transmission to 8% of their unvaccinated household contacts occurred within the first few weeks, but no late transmission took place. Public health interventions are needed to protect household contacts...

..In view of increasing worldwide reports of Y and W135 meningococcal disease, there should be a switch in recommendation from the bivalent (against A& C) to the quadrivalent vaccine for all travellers...

..Public health measures to reduce the potential introduction of N. meningitidis W-135 into the countries of origin of returning pilgrims need to be prioritized for the hajj pilgrimage...

..The current recommendation is to vaccinate all Hajj pilgrims, travelers to areas with current outbreaks, travelers to the sub-Saharan meningitis belt, and high-risk individuals (i.e., those with immunodeficiencies)...

..Screening at entry points is costly, has a low yield and is not sufficient in itself, but may be justified in light of the major economic, social and international impact which even a single imported SARS case may have...

..CONCLUSION: There is an urgent need for increased awareness about travel-related infectious diseases among Asian travelers, and greater uptake of pretravel health advice, vaccinations and malaria prophylactic measures...

..Travel patterns and behaviours need to be taken into account when developing evidence-based travel medicine in Asia...

..Singapore is a transition country in Southeast Asia that is both vulnerable and receptive to the introduction and re-introduction of imported communicable diseases...

..Crossover vaccination of quadrivalent meningococcal vaccine after recent vaccination with bivalent vaccine does not increase the prevalence of adverse reactions and is therefore safe...

..Individual strategies in pandemic preparedness plans may not reduce the impact of an influenza pandemic...

..We aimed to assess the efficacy of such an intervention...

..893). CONCLUSION: Stavudine ER does not appear to cause less peripheral lipoatrophy...

..Here, we report a case of a New Zealander traveler who acquired the infection on a business trip...

..Dengue fever is a frequent cause of admission to hospital in South East Asia, however many of the clinical characteristics and abnormalities on laboratory investigations at presentation are found in other common infections...

..Expatriates are a distinct population at unique risk for health problems related to their travel exposure...

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..It also discusses the role Singapore can continue to play in addressing global inequities in access to public health education and in strengthening public health capacity in the region and beyond...

..The objective of this study was to analyze infections associated with oral ingestion of pathogens in international travelers in relation to place of exposure...

..A greater proportion of immigrant VFRs presented with serious, potentially preventable travel-related illnesses than did tourist travelers...

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..Also, dengue cases detected at atypical times in sentinel travelers may inform the international community of the onset of epidemic activity in specific areas...

..Tropical and parasitic diseases were rare. Pre-travel consultation for China travelers should be individualized according to these findings...

..This new method allows production in a cell culture system and potentially reduces the risk of adventitious viruses and selection of a subpopulation during replication, thereby increasing safety...