An investigation has begun into the private health market in the UK. Concerns have been raised that kickbacks paid to consultants are pushing costs up three times faster than inflation and causing unnecessary treatments to be performed.

The Competition Commission will look into the £5bn private medical market after discovering financial bribes were commonplace. These incentives, paid to consultants, are legal in the UK but banned in many other countries.

There is fierce competition for patients among private hospitals in the UK. The facility earns half the income from a patient while the medical practitioner receives the other half. In order to attract patients, hospitals offer incentives to consultants in the hope they refer their patients there. These incentive packages are paid for by the patients and their insurance companies.

The incentives offered to consultants could be administrative support to bonus payments upon a target of operation numbers being met. It is also believed that annual bonuses are also paid based on revenue generated or number of patients referred by a consultant.

Private healthcare much more expensive in UK

Medical insurers who pay for nearly 80% of private healthcare claim this situation pushes up costs for policyholders and leads to potential risks through unnecessary treatments. Private healthcare costs in Britain are twice as much as in Spain and 80% higher than Australia.

“Unfortunately, as far as private hospitals are concerned, the consultant is the customer, and all its energies are focused on winning his business, and keeping him loyal through a range of incentives. These have to be paid for, ultimately by the patient,” Natalie-Jane Macdonald, Bupa managing director, told the Daily Telegraph.

There is no information available for patients to help them see why one consultant charges more than another. It is also difficult to discover what another consultant may charge and if it is lower, why this may be.

The investigation could order hospital networks to be broken up, ban national charging regardless of local cost of living and make incentives for consultants illegal. It could also force consults to publish league tables so patients and insurers can readily compare consultants prices and outcomes.

Incentive payments are “morally wrong”

“Those running private hospitals wouldn’t be making these payments if they weren’t working. If it is working, then it is morally wrong, which is why they have been banned in the US,”
Fergus Craig, commercial director at Axa PPP told the Daily Telegraph.

SOURCE : reproduced by kind permission of : Expathealth.org

Retiring to the simple life in, say, Costa Rica, sounds absolutely fantastic. And there is certainly a lot of upside to disappearing from the rat race and spending your golden years in a tropical paradise. More and more, baby boomers are doing just that – as the globe has shrunk and international travel has become more common, expatriate retirees have become more common writes John Miller at the healthytravelblog.com

But before you get too carried away with visions of paradisiacal sunsets dancing in your head, here’s an important question a lot of folks don’t consider when retiring abroad: “What about healthcare benefits?”

Will your health insurance be accepted in your new home? Even if it is accepted, will you be able to afford it? And if not, what are your alternatives?

It’s important to know that those Medicare benefits you contributed to for so many years do not travel with you when you go abroad. That might not seem fair but that’s the way it is, at least for now. And as the Wall Street Journal points out, the sponsored plan from your old employer is very likely going to cost more than it did on the day you left the company. And will continue to rise in price.

In its 2012 Retirement Index, International Living identified the 19 best places for Americans to retire abroad; their study included a look at individual nations’ healthcare systems, which is obviously an important piece of the equation – it doesn’t matter how good your health insurance is if the hospitals are lousy.

What it boils down to is taking ownership of this important issue and doing a risk analysis. Before moving abroad, you need to consider numerous factors such as the healthcare system of your destination country, the financial health of your former employer, the stability of the country you’re moving to and, obviously, any preexisting conditions you may have. The best alternative may include purchasing an expat health insurance plan, ideally one that includes medical assistance services to help you navigate the healthcare realities of your new home.

SOURCE : HTH Worldwide healthtravelbolog.com

ALC Health’s international medical plans are available to anyone joining up to age 75 years and once you become a member there is no upper age restriction to continue your cover. Find our more from your specialist medical insurance advisor or visit ALC Health at www.alchealth.com

I know we’ve written about this before, but it bears repeating: One of the joys of international travel is sampling native cuisine, no matter where you are in the world writes John Miller at the healthytravelbog.com

For some with food allergies, trying new and native foods can be difficult, but not impossible. But for other folks, there really is no reason not to dive in and be a little adventurous when it comes to mealtime.

And Jason Sheehan at CNNGO wrote an article a couple days ago that tells you just how to find the best local food anywhere in the world. All it takes is a little sense of adventure.

Sheehan’s advice, in a nutshell, is to “just go.” Just walk out the front door of your hotel and explore. Follow your nose. Look for crowds. Ignore all those lists of the best restaurants in town and follow “hookers, cops and cabbies” – Sheehan swears that those are the local experts that know the best places to eat (certainly they know better than the concierge!).

It’s okay to be a little skittish about that slimy-looking thing sitting on your plate; sometimes it can be pretty intimidating. And maybe you have food restrictions, whether for medical reasons or self-imposed, that you intend to adhere to. Either way, there are ways to be adventurous without being completely knocked off your stride.

Eating the native cuisine is a great part of the experience of visiting a foreign land; you really haven’t visited and gotten to know what it’s like to be in a new place until you’ve eaten the food there – it gives you insight into how the people live their lives. And, if you believe in the lofty goals of “adventure chef” Sasha Martin, it can even help you gain understanding into a culture halfway around the world.

So go ahead – eat the octopus, the sweetbreads or the sheep’s eyes. Honestly, what’s the sense of traveling halfway around the world if you’re just going to eat a cheeseburger?

SOURCE : HTH Worldwide

Worldwide, nearly 35.6 million people live with dementia. This number is expected to double by 2030 (65.7 million) and more than triple by 2050 (115.4 million). Dementia affects people in all countries, with more than half (58%) living in low- and middle-income countries. By 2050, this is likely to rise to more than 70%.

Treating and caring for people with dementia currently costs the world more than US$ 604 billion per year. This includes the cost of providing health and social care as well the reduction or loss of income of people with dementia and their caregivers.

SOURCE : World Health Organisation

Hepatitis A is a viral liver disease that can cause mild to severe illness.

• It is spread by faecal-oral (or stool to mouth) transmission when a person ingests food or drink contaminated by an infected person’s stool.
• The disease is closely associated with poor sanitation and a lack of personal hygiene habits, such as hand-washing.
• An estimated 1.4 million cases of hepatitis A occur annually.
• Epidemics can be explosive in growth and cause significant economic losses:   300 000 were affected in one Shanghai outbreak in 1988.
• Improved sanitation and the Hepatitis A vaccine are the most effective ways to combat the disease.

Hepatitis A is a liver infection caused by the hepatitis A virus (HAV). The virus is spread when an uninfected (or unvaccinated) person eats or drinks something contaminated by the stool of  an HAV-infected person: this is called  faecal-oral transmission. The disease is closely associated with inadequate sanitation and poor personal hygiene. Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms.

The disease can wreak significant economic and social consequences in communities. It can take weeks or months for people recovering from the illness to return to work, school or daily life. The impact on food establishments identified with the virus, and local productivity in general, can be substantial.

Symptoms

The symptoms of hepatitis A range from mild to severe, and can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). Not everyone who is infected will have all of the symptoms. Adults have signs and symptoms of illness more often than children, and the severity of disease and mortality increases in older age groups. Infected children under six years of age do not usually experience noticeable symptoms, and only 10% develop jaundice. Among older children and adults, infection usually causes more severe symptoms, with jaundice occurring in more than 70% of cases. Most people recover in several weeks – or sometimes months – without complications.

Who is at risk?

Anyone who has not had been infected previously or been vaccinated can contract hepatitis A. People who live in places with poor sanitation are at higher risk. In areas where the virus is widespread, most HAV infections occur during early childhood. Other risk factors for the virus include injecting drugs, living in a household with an infected person, or being a sexual partner of someone with acute HAV infection.

Transmission

HAV is usually spread from person to person when an uninfected person ingests food or beverages that have been contaminated with the stool of a person with the virus. Bloodborne transmission of HAV occurs, but is much less common. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water. Casual contact among people does not spread the virus.

Treatment

There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and take several weeks or months. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.

Prevention

Improved sanitation and Hepatitis A immunization are the most effective ways to combat the disease.

Adequate supplies of safe-drinking water and proper disposal of sewage within communities, combined with personal hygiene practices, such as regular hand-washing, reduce the spread of HAV.

Several hepatitis A vaccines are available internationally. All are similar in terms of  how well they protect people from the virus and their side-effects. No vaccine is licensed for children younger than one year of age.

Nearly 100% of people will develop protective levels of antibodies to the virus within one month after a single dose of the vaccine. Even after virus exposure, one dose of the vaccine within two weeks of contact with the virus has protective effects.  Still, manufacturers recommend two vaccine doses to ensure longer-term protection of about 5 to 8 years after vaccination. Millions of people have been immunized with no serious adverse events. The vaccine can be given as part of regular childhood immunizations programmes and with vaccines commonly given for travel.

Where is the disease found?

Geographic areas can be characterized as having high, intermediate or low levels of HAV infection.

• High: In developing countries with very poor sanitary conditions and hygienic practices, the lifetime risk of infection is greater than 90%. Most infections occur in early childhood and those infected do not experience any noticeable symptoms. Epidemics are uncommon because older children and adults are generally immune. Disease rates in these areas are low and outbreaks are rare.
• Intermediate: In developing countries, countries with transitional economies and regions where sanitary conditions are variable, children escape infection in early childhood. Ironically, these improved economic and sanitary conditions may lead to higher disease rates, as infections occur in older age groups, and large outbreaks can occur.
• Low: In developed countries with good sanitary and hygienic conditions infection rates are low. Disease may occur among adolescents and adults in high-risk groups, such as injecting-drug users, homosexual men, persons travelling to high-risk areas, and in isolated populations, e.g. closed religious communities.

Immunization efforts

Planning for large-scale immunization programmes should involve careful economic evaluations and consider alternative or additional prevention methods, such as better sanitation and health education for improved hygiene.

Whether or not to include the vaccine in routine childhood immunizations depends on the local context, including the level of risk for children . Several countries, including Argentina, China, Israel and the United States have introduced the vaccine in routine childhood immunizations. Other countries recommend the vaccine for persons at increased risk of hepatitis A, including travellers to countries where the virus is endemic, men who have sex with men, or persons with chronic liver disease (because of their increased risk of serious complications if they acquire HAV infection).

Recommendations for hepatitis A vaccination in outbreaks should also be site-specific, including the feasibility of rapidly implementing a widespread immunization campaign. Vaccination to control community-wide outbreaks is most successful in small communities, when the campaign is started early and when high coverage of multiple age groups is achieved. Vaccination efforts should be supplemented by health education to improve sanitation and hygiene practices.

SOURCE : World Health Organisation

Cruise ships and all-inclusive resorts are where diets go to die – their famous buffets seem custom-made to pack on some pounds writes John Miller.

But it doesn’t have to be that way, and in fact, unleashing your inner glutton when you’re traveling can be counterproductive to experiencing your travel adventure to the fullest. As nutritionists will tell you, your body is a machine and food is the fuel, so you need to put good fuel into the engine. And that’s especially true of the first meal of the day, particularly when you’re traveling and your days and nights are filled with activity.

In short, you need to fuel up at the start of each day so that you have the energy to fully enjoy yourself. According to the Mayo Clinic, a healthy breakfast consists of complex carbs, fiber and protein. That means you should be eating:

• Whole grains, such as whole grain rolls or bagels, whole-grain cereals or bran muffins.
• Lean protein, such as eggs, lean meat (turkey sausage!) or peanut butter.
• Low-fat dairy, such as skim milk and low-fat yogurt.
• Fruit. Those all-you-can-eat buffets usually have piles and piles of fresh fruit. Feel free to dig in.

As our friends at Expat Health pointed out last week, you don’t want to consume “high glycemic” foods for breakfast – that is a recipe for crashing two or three hours later, right when you’re standing in line at Louvre. Specifically, you want to eat low glycemic foods – maybe a vegetable omelet with whole grain toast. That means avoiding the high glycemic foods that you think you might deserve because you’re on vacation – skip the waffles and crumpets, jams and marmalades, and sugary cereals.

Another helpful hint is to stock your hotel room with healthy alternatives such as bottled water, a jar of peanut butter, fresh fruit and other healthy snacks. You can make yourself a quick breakfast in the room before a day of sightseeing, and/or pack a healthy snack to help you keep your energy up.

You don’t need to be super-strict about your diet when you’re on holiday, and you obviously will want to sample the local fare. But when possible, start your day of healthily and you’ll have a much better chance of still being at your best for the 10 p.m. dinner reservation in Barcelona.

SOURCE : HTH Worldwide healthytravelbog.com

Crimean-Congo Hemorrhagic fever is a viral haemorrhagic fever transmitted by ticks. It can be responsible for severe outbreaks in humans but it is not pathogenic for ruminants, their amplifying host.

The disease was first described in the Crimea in 1944 and given the name Crimean haemorrhagic fever. In 1969 it was recognized that the pathogen causing Crimean haemorrhagic fever was the same as that responsible for an illness identified in 1956 in the Congo, and linkage of the two place names resulted in the current name for the disease and the virus.

CCHF spreads to humans either by tick-bites, or through contact with viraemic animal tissues during and immediately post-slaughter. CCHF outbreaks constitute a threat to public health services because of its epidemic potential, its high case fatality ratio (10-40%), its potential for nosocomial outbreaks and the difficulties in  treatment and prevention. CCHF is endemic in all of Africa, the Balkans, the Middle East and in Asia south of the 50° parallel north, the geographic limit of the genus Hyalomma, the principal tick vector.

ALC Health Source WHO

Once contracted, the virus incubates in the body for 3 to 6 days, followed by infection that can occur in one or two phases. The first, “acute”, phase usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve and their symptoms disappear after 3 to 4 days.

However, 15% of patients enter a second, more toxic phase within 24 hours of the initial remission. High fever returns and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates. Half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage.

Yellow fever is difficult to diagnose, especially during the early stages. It can be confused with severe malaria, dengue hemorrhagic fever, leptospirosis, viral hepatitis (especially the fulminating forms of hepatitis B and D), other hemorrhagic fevers (Bolivian, Argentine, Venezuelan hemorrhagic fevers and others flavivirus as West Nile, Zika virus etc) and other diseases, as well as poisoning. Blood tests can detect yellow fever antibodies produced in response to the infection. Several other techniques are used to identify the virus in blood specimens or liver tissue collected after death. These tests require highly trained laboratory staff and specialized equipment and materials.

• Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The “yellow” in the name refers to the jaundice that affects some patients.
• Up to 50% of severely affected persons without treatment will die from yellow fever.
• There are an estimated 200 000 cases of yellow fever, causing 30 000 deaths, worldwide each year.
• The virus is endemic in tropical areas of Africa and Latin America, with a combined population of over 900 million people.
• The number of yellow fever cases has increased over the past two decades due to declining population immunity to infection, deforestation, urbanization, population movements and climate change.
• There is no cure for yellow fever. Treatment is symptomatic, aimed at reducing the symptoms for the comfort of the patient.
• Vaccination is the most important preventive measure against yellow fever. The vaccine is safe, affordable and highly effective, and appears to provide protection for 30–35 years or more. The vaccine provides effective immunity within one week for 95% of persons vaccinated.

ALC Health Source : WHO

The Ministry of Health and Population of Egypt has notified WHO of a new case of human infection with avian influenza A (H5N1) virus.

The case is a 36 year-old female from Giza governorate. She developed symptoms on 1 April 2012 and was admitted to a hospital on 7 April 2012 and died on the same day.

The case was confirmed by the Central Public Health Laboratories; a National Influenza Center of the WHO Global Influenza Surveillance Network.

Epidemiological investigations into the source of infection indicate that the case had exposure to backyard poultry.

Of the 167 cases confirmed to date in Egypt, 60 have been fatal.

The Ministry of Health (MoH) of the Kingdom of Cambodia has announced a confirmed case of human infection with avian influenza A (H5N1) virus.

The 6 year-old female from Kampong Chhnang Province developed symptoms on 22 March 2012. After initial treatment at the village, she was later admitted to hospital in Phnom Penh on 28 March. She died on 30 March. Infection with avian influenza A (H5N1) virus was confirmed by Institut Pasteur du Cambodge on 30 March.

It was reported that the patient had contact with sick or dead poultry prior to onset of illness.

The National and local Rapid Response Teams (RRT) are conducting outbreak investigation and response following the national protocol. In addition, a public health education campaign is being conducted to inform families on how to protect themselves from contracting avian influenza.

To date, of the 20 cases reported in Cambodia since 2005, 18 have been fatal

Source : World Health Organisation

At the beginning of 2012, WHO was notified by the Federal Ministry of Health in Nigeria of an outbreak of Lassa fever. As of March 22, 2012, 623 suspected cases, including 70 deaths have been recorded from 19 of the 36 States since the beginning of the year. Laboratory analysis undertaken at the Irrua Specialist Teaching Hospital, Irrua Edo State has confirmed the presence of Lassa virus infection in 108 patients. Three doctors and four nurses were reported to be among the fatalities. This information is provisional and subject to change when laboratory results for Lassa fever in suspected cases become available.

The Federal and State governments are responding to the outbreak by enhancing the disease surveillance for early detection, reinforcing treatment of patients, and conducting awareness campaigns among the affected population.

Major challenges are the ongoing security risks in the country limiting access to some areas as well as the limited availability of resources to respond to the escalating outbreak.

WHO does not advise or recommend any restrictions on travel or trade with Nigeria. Travellers returning from affected areas who develop symptoms of fever, malaise, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, and abdominal pain should seek medical advice.

People usually become infected with Lassa virus from exposure to infected rodents belonging to Mastomys species. Person-to-person transmission occurs through direct contact with sick patients in both community and health care settings. Those at greatest risk are persons living in rural areas where Mastomys are found. Health care workers are at risk if adequate infection control practices are not maintained.

Voting for the 2012 Health Insurance Awards is now open and if you would like to recognise ALC Health at this year’s prestigious awards in the International Private Medical Insurance Provider categories, click here to cast your vote now

Andy Lindley, a member of ALC Health’s Head Office client services team will be cycling from Wembley Stadium Arch in  London (UK) to the Arc de Triumph in Paris (France) to raise funds for Help the Hospice between 14^th – 16^th June. Not content with that he will also be cycling from London to Brighton on 11^th May starting at midnight as a pre-runner warm up.

Andy will be plotting his progress and punishing training schedule at www.justgiving.com/andylindley where donations to this great challenge can be made.

Good luck Andy

It’s the time of year when the pollen starts to fall and eyes start to itch. If you have never suffered from hay fever before that may change when you move abroad. Various types of pollen are more prevalent in different areas and can affect people differently writes  Bill Cariker on expatheath.org

There are around 15 million hay fever sufferers in the UK – most are allergic to grass pollen but about 4 million are affected by tree pollen. Due to the mild winter in much of Europe, trees are pollinating early this year, meaning millions of sufferers are feeling the effects now.

In the South and Midwest USA pollen counts have reached record highs and sufferers are feeling the effects. Knoxville, Tennessee is seen by scientists to be the worst place affected by hay fever, based on pollen counts and sales of hay fever medication.

If you move region or country you can find your symptoms increase or become less noticeable. This is because different types of pollens affect different people. For instance, in the Tokyo area many people are allergic to the Japanese Cedar which pollinates from late February to early April. Moving to a new country could be a blessing, or a curse.

Hay fever symptoms

The symptoms of hay fever are commonly:

• Itchy, red or swollen eyes
• Sneezing
• Itchy, running or blocked nose
• Headaches
• Tightness in the chest/throat

Treatment for hay fever

Hay fever is generally treated in one of two ways. If just one particular area is affected, such as the eyes, treatment can be local. The use of eye-drops for itchy eyes or nasal sprays containing antihistamines for when the nose is affected is a quick way to treat mild symptoms.

For a range of symptoms that affect different areas an oral antihistamine is recommended. Antihistamines such as acrivastine, cetirizine, loratadine or chlorphenamine can be taken in a tablet or syrup.

Make sure if you’re travelling abroad you know the generic name of the antihistamine you usually take. This will make it easier to ask for in the pharmacy, if in doubt try to take a good supply of the drug that works best for you.

Hay fever abroad

France – The West Coast is better for hay fever sufferers as the pollen count is generally low. Inland areas, especially the south, have a lot of vegetation and pollen counts can be very high.

Spain – Andalucia and central regions have high olive pollen counts. Grass pollen decreases in mid July in Northern Spain and the Costa Brava. Usually coastal areas have lower pollen counts.

Italy – Avoid Naples during hay fever season as the pollen count is high in May and June. The best places for hay fever sufferers are the Northern Lakes and the West Coast.

Generally areas by the sea have lower pollen counts than those inland. With dry, arid countries, lacking in vegetation, the pollen count is very low and sufferers may see their symptoms disappear completely.

SOURCE : ExpatHealth.org

The number of people diagnosed with food allergies has exploded in recent years. There are now millions of people who have to be very careful about what they eat. Almost all of them are allergic to the same families of foods; eight foods – milk egg, peanut, tree nuts, fish, shellfish wheat and soy – are responsible for 90 percent of all food allergies.

The good news about that statistic is that people who suffer from food allergies have company. Which means that it’s very possible that someone else has blazed a trail for you if you suffer from food allergies. So if you’re smart about it, there’s no reason that “food allergy” should be synonymous with “house arrest” when it comes to traveling.

Here are some tips for traveling safely and comfortably with food allergies:

• Know what you’re talking about. You need to have at least a bit of an understanding of the native tongue so you don’t mistakenly order the wrong thing. An English-to-whatever dictionary is very helpful. So are allergy-specific food cards.

• Call the airline. If you are, for instance, allergic to nuts and worried about an international flight with peanuts as snacks, call the airline and let them know ahead of time. They may be able to offer you something else, or at least provide notice to the flight attendants so they can be aware of the allergy.

• BYOF – Bring your own food: You don’t need to bring enough food for a week’s worth of meals, but it’s smart to pack some baggies of snacks, such as cut vegetables, apples or maybe gluten-free pretzels. These will at least get you through the flight. Pack some non-perishable foods (canned goods are probably best) that you aren’t allergic to. And when you arrive at your destination, ask the concierge where the local supermarket is so that you can stock up on foods that are safe for you to eat.

• Check twice in restaurants. When eating out, it’s difficult to know all the ingredients that go into the dish you’re ordering. If you hand your food translation card to a waiter and they say “ok,” insist that they show it to the chef. The chef knows what goes into a dish better than the wait staff. Be very careful of hors d’oeuvres – avoid them unless it is a plain piece of fruit or cheese. And it’s best to avoid restaurants that specialize in a food you’re allergic to – don’t go to a seafood restaurant if you’re allergic to shellfish.

• Take Benadryl with you. The single-serve doses are easy to take along, and often sufficient for helping you or your child if one of you eats the wrong thing. And if you have an epi-pen, you obviously should bring it with you in your travels.

SOURCE : HTH healthytravelbog.com

Dr. Margaret Chan, the recently reappointed Director-General of the World Health Organization, delivered the keynote speech last week at the Conference on Combating Antimicrobial Resistance.  The Copenhagen meeting of European Union public health officials was held to discuss what could be done to solve the growing problem of microbial resistance to antibiotics in the EU and beyond writes Frank Gillingham, MD of HTH Worldwide.

In her address, Dr. Chan pointed to the fact that drug resistance was a global phenomenon, citing air travel, global trade in food, and medical tourism as major contributors.  She also mentioned the widespread use of antibiotics in healthy animals, adding that there are regions in the world where more antimicrobials are used in animals than in sick humans.

Dr. Chan lauded the efforts of the conference’s host country Denmark, pointing to officials who made the decision back in the late 1990s to ban the use of growth enhancing antibiotics in food producing animals.  In a follow-up study of the Danish decision conducted by the World Health Organization, the ban reduced human health risks without significantly harming animal health or farmers’ incomes.

While many countries have followed the Danish model by banning the use of antibiotics in healthy livestock, the problem of antibiotic resistant pathogens is still increasing worldwide.  First line antibiotics are losing their effectiveness, and are being replaced by drugs which are more expensive, toxic, and require longer treatment periods.

Dr. Chan cited as an example that over 650,000 of the 12 million cases of tuberculosis last year were “multi-drug resistant”.  Not only do these cases require treatment with costly medications in short supply, but only 50% will be cured.  With other emerging pathogens resistant to all known antibiotics, some experts believe that we are moving back to the pre-antibiotic era, where even a superficial skin infection or strept throat could be fatal.

The pipeline for new antibiotics is almost dry.  Pharmaceutical companies seem less interested in searching for new solutions than in the past because of the tremendous expense involved in research and development.  An additional deterrent is that irrational use of new antibiotics accelerates inevitable resistance.

Dr. Chan concluded her remarks by challenging her listeners “Prescribe antibiotics appropriately and only when needed. Follow treatment correctly. Restrict the use of antibiotics in food production to therapeutic purposes. And tackle the problem of substandard and counterfeit medicines.”   Otherwise, she added,”the threat, as you have noted, is indeed global, extremely serious, and growing.”

SOURCE : the healthytravelblog.com

Outbreaks have been detected as part of the enhanced surveillance in the African Meningitis Belt conducted in 14 countries² where a total of 6 685 suspected meningitis cases including 639 deaths have been reported.

The outbreaks are mainly caused by the W135 serogroup of Neisseria meningitidis (Nm) bacteria. In Chad, the predominant pathogen is Nm A, although NmW135 contributed to an outbreak in one district. Whereas NmA has always been the leading cause of epidemics in sub-Saharan Africa, outbreaks of NmW135 have already occurred in the region, since 2002.

The countries are responding to these outbreaks by enhancing surveillance, reinforcing treatment of patients and implementing mass vaccination campaigns. The International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control has approved the release of 117’500 doses of polysaccharide ACW vaccine to Côte d’Ivoire, 195’540 doses of polysaccharide ACYW vaccine to Ghana and 359’000 doses of conjugate Men A vaccine to Chad, along with injection materials and ceftriaxone (antibiotic) when necessary. The ICG constitutes of United Nations Children’s Fund (UNICEF), Médecins Sans Frontières (MSF), International Federation of Red Cross and Red Crescent Societies (IFRC) and WHO.

WHO continues to monitor the epidemiological situation closely, in collaboration with partners and Ministry of Health in the affected countries.

The supply of the appropriate vaccine to respond to W135 outbreaks is presently limited, and WHO and UNICEF are working closely with the vaccine manufacturers to ensure that this stock is maintained and adapted to the evolving outbreak situation.

Travelers are reminded of the importance of keeping their vaccination status up to date and to follow WHO travel advice.  WHO emphasizes  that individuals planning to travel to countries in the African Meningitis Belt obtain vaccine to protect against the four serogroups responsible for the epidemic disease (tetravalent vaccine ACYW135).

The Ministry of Health of Indonesia has notified WHO of a new case of human infection with avian influenza A(H5N1) virus.

The case is a 17 year-old male from Nusa Tenggara Barat Province. He developed fever on 28 February 2012 and sought treatment on 1 March 2012. His condition deteriorated and he was admitted to a referral hospital but he died on 9 March 2012.

Epidemiological investigation conducted by a team from the health office indicated that there were sudden poultry die-offs in his neighbourhood.

To date, of the 188 cases reported in Indonesia since 2005, 156 have been fatal.

The Ministry of Health and Population of Egypt has notified WHO of a new cases of human infection with avian influenza A (H5N1) virus.

The case is a 40 year-old female from Dakahlia Governorate. She developed symptoms on 6 March 2012, was hospitalised on 12 March 2012. She was in critical condition and received oseltamivir upon admission. She died on 15 March 2012.

The case was laboratory confirmed by the Central Public Health Laboratories(NIC).

Investigations into the source of infection indicate that the case had exposure to sick backyard poultry.

Of the 164 cases confirmed to date in Egypt, 58 have been fatal.

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The Ministry of Health, Viet Nam has reported a confirmed case of human infection with highly pathogenic avian influenza A(H5N1) virus in the country.

The case is a 31 year-old male from Dak Lak province. He developed symptoms on 29 February 2012 and sought health care on the same day. On 4 March 2012, he was admitted to a hospital and was diagnosed with viral pneumonia.  He was transferred to a referral hospital on 5 March 2012, where he is currently being treated.

Laboratory tests were confirmed by the Pasteur Institute Ho Chi Minh City, a WHO National influenza Centre.

Epidemiological investigation indicate that the man was involved in the slaughter and consumption of sick poultry. Pasteur Institute Ho Chi Minh City and the local health sector are conducting further investigation and providing appropriate response. No close contacts of the case have reported respiratory symptoms.

To date, of the 123 confirmed cases reported in Viet Nam, 61 have been fatal

ALC Health + WHO

The Ministry of Health of Indonesia has notified the world Health Organisation (WHO) of a new case of human infection with avian influenza A(H5N1) virus.

The case is a 24 year-old female from Bengkulu Province. She developed fever on 23 February 2012 and was hospitalized on the following day. She had breathing difficulty, her condition deteriorated and she died on 1 March 2012.

Epidemiological investigation conducted by a team of public health and animal health authorities indicated an exposure to a potentially contaminated environment where sudden deaths of poultry had recently occurred.

The case was confirmed by the National Institute of Health Research and Development, Ministry of Health.

To date, of the 187 cases reported in Indonesia since 2005, 155 have been fatal.

ALC Health + WHO

Expat workers may be at risk because of their employers’ lack of healthcare knowledge as they rely heavily on them providing adequate cover, according to a survey, writes Expatforum.com

The poll of 44 companies representing approximately 11,000 employees, found that only 5% of employers felt they fully understood international healthcare.

It means that employers do not always adequately understand international healthcare benefits, according to the research conducted by Jelf Employee Benefits.

Over two thirds, 69%, of organisations surveyed at Jelf Employee Benefits’ international healthcare seminar said they cannot keep up with the changing international healthcare rules in all the countries employees are based.

The research found that 98% said staff outside the UK rely on their employers to ensure they have adequate health cover and 38% are concerned the healthcare cover they have for some of their employers outside the UK is not adequate.

It also found that just 2% said their employees understood the rules for international healthcare completely in the country they are deployed while 29% said their employees may feel they do not have adequate cover for themselves, and 43% said they may feel they had inadequate cover for their dependents.

SOURCE : Expatforum.com

Moratorium underwriting offers you the chance of having some or all pre-existing medical conditions covered after a period of time. You won’t need  to fill out a medical questionnaire but instead will have a blanket exclusion against cover for any medical condition(s) for which you’ve sought or received advice, treatment or medication in the  five years before the start of your cover.

What is moratorium underwriting?

With this type of underwriting you will not be required to make any medical declarations and as a result, any new or unexpected medical conditions that occur after your policy has started with ALC Health will be covered subject to your choose policy terms and conditions.

The moratorium works on a rolling cycle, so a period of 2 uninterupted years on most pre-existing medical conditions (see below : excluded conditions) will need to pass where there has been no treatment sought for a condition, or any treatment directly related to it before any pre-existing medical condition will be eligible for treatment under your policy. This means that some pre-existing conditions will never be covered, as treatment will be needed on a recurring basis.

How does this affect pre-existing conditions?

With moratorium underwriting most (see below : excluded conditions) pre-existing medical condition will be covered if you have:

a. consulted a medical practitioner or specialist for medical treatment or advice; or
b. suffered symptoms; or
c. taken medication (including drugs, medicines, special diets or injections) for that condition for a continuous period of two years after the date of entry.
If your pre-existing condition is one of those shown below, we will also exclude treatment for the specified related conditions shown:

If for a period of two uninterupted years after the start date of the policy you continue to fulfill all the criteria above, then your condition may be covered again.

If you already have a medical insurance cover with another insurer

In some circumstances we may be able to transfer the medical underwriting terms from your previous international medical insurance policy for those medical conditions that existed prior to you joining that policy to ALC Health and so remove the need for you to start the moratorium period on your policy from the beginning.

Excluded medical conditions

None the less there are a few specified related conditions that will be excluded where the pre-existing condition is one of those shown below.

Why choose moratorium underwriting?

If you have no health issues you can take out cover quickly and even fill in all the forms online at https://www.alchealth.com/quote.htm.  If you have past health problems moratorium underwriting may be more beneficial as there many be conditions that ordinarily wouldn’t be covered with a full medical disclosure.

Are there any drawbacks to this type of underwriting?.

You will need a two year window in which you remain advice, treatment and symptom free in order to be covered for pre-existing conditions by your policy. If you break these rules you may have to start the two year waiting period again.

To find out more, call ALC Health and we’ll help you choose the right plan. www.alchealth.com

Sunday (March 11) is the one year anniversary of the tsunami/earthquake/nuclear disaster in Japan that held the world spellbound for weeks but now somehow seems like a distant memory.  Japan has done a remarkable job of getting back on its feet in just 12 months, and the bounce-back is now being felt in the tourism and travel industry. London’s Guardian reports on a new report from the World Travel and Tourism Council that states that, now, Japan’s inbound tourism is better than anyone could’ve predicted. The WTTC report says tourism to Japan dropped 28 percent in 2011, but is expected to rebound back to 2010 levels in the first half of this year writes John Miller at the Healthytravelblog.com

It seems everybody is talking about getting away to Cambodia this week. At the New York Times, Ondine Kahone marvels at a seaside village that was occupied by the murderous Khmer Rouge not so long ago, but now seems like the most peaceful place on Earth. While Kep hasn’t yet been hit by a wave of development, Song Saa on the Cambodian island of Koh Rong is more built up. C. James Dale writes about a more luxurious destination at CNNGO.

Part of the allure of international travel is sampling the local cuisine. But if you travel to China – specifically into the rural areas – finding the local cuisine is increasingly difficult. Rural Chinese used to have one of the healthiest diets in the world, but fast food is now more prevalent than the traditional healthy diet of local food and produce.

SOURCE : HTH Worldwide ALC Health

7 March 2012 -The Ministry of Health and Family Welfare, Bangladesh has confirmed two new cases of human infection with highly pathogenic avian influenza A(H5N1) virus in the country. These are the 5th and 6th cases reported in the country since 2008.‬‪

These two cases, 26 year-old and 18 year-old males,  presented with history of cough, and both have recovered. They were identified in the same live bird market surveillance site in Dhaka City as the fourth case recently reported, and were confirmed by the National Influenza Centre (NIC) of the WHO Global Influenza Surveillance and Response System (GISRS) in Bangladesh.‬‪

Epidemiological investigation and follow-up is being conducted by National Rapid Response teams of the Institute of Epidemiology, Disease Control and Research (IEDCR) and the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).‬‪

The Ministry of Health and Family Welfare, Bangladesh has confirmed the fourth case of  human infection with H5N1 avian influenza in the country. The case is a 40 year-old male from Dhaka City, who was identified as part of the live bird market surveillance system on 26 February 2012.

U.S. health officials have reported that after a full decade of decline, Europe and Africa reported an increase in the number of measles cases in 2010.  Because of concerted immunization efforts in those areas, total cases declined from more than 853,000 in 2000 to nearly 278,000 in 2008, and remained stable in 2009. However, the number increased in 2010 to almost 340,000 — a jump of over 21%.  Worldwide, measles remains a very serious problem, with over 20 million cases and 197,000 deaths each year.  Over half of the cases and deaths are in India and China writes Frank Gillingham MD.

The somewhat alarming rise in the number of cases is felt partly due to an increasing reluctance on the part of many parents to have their children immunized against measles. Indeed, in what most physicians feel is a gross misrepresentation of the dangers, claims of severe reactions, including autism, have been used by some parents as an excuse to forego the measles vaccination for their children. In truth, the incidence of serious side effects is very rare.  Most children experience only mild local discomfort, fever, and rash.

On the other hand, complications from measles such as ear infections (10%), pneumonia (5%) and brain damage from subacute sclerosing panencephalitis — an inflammation of the brain that can lead to convulsions, and leave the victim deaf or mentally retarded (0.1%) are much more common than unwelcome side effects of the vaccine.  Parents of unimmunized children reap the benefits of having the vast majority of the remaining pediatric population immunized, particularly in the United States.  This “free ride” has its limitations, especially for those traveling abroad. More >

SOURCE : HTH Worldwide

ALC Health News Blog

We love to travel, but travel is exhausting. The problem for many is that it’s just so difficult to sleep when they’re away from home. And that can make the thrill of visiting a new place a little less thrilling writes John Miller for Healthytravelblog.com

And, of course, when you’re crossing time zones, there’s the specter of jet lag.

The symptoms of being overtired on the road – body fatigue, headaches, inability to concentrate – are obvious. What might not be as obvious are strategies to get more rest while you’re traveling. Here are some ideas:

While on the plane:

• Block out light. Use a sleep mask to block out light.
• Reduce noise. Even if there isn’t a screaming baby sitting right behind you, there’s a lot of noise and conversation going on around you. Bring along earplugs or noise-cancelling headphones.
• Get comfortable. To do this, you’ll likely need some sleep aids such as a neck pillow and a blanket to remind you of home.

In your hotel:

• Ignore the time zone you’re visiting. Whenever possible, try to go to sleep at the same time that you would if you were at home – or at least as close to that time as possible.
• Get some exercise. Even a quick 20 minute workout during the day will make it easier for you to fall asleep at bedtime. It’s important that you get your exercise at least five hours before lights out; otherwise, you’ll be all amped up have a hard time finding Never-Never Land.
• Bring your own pillow. One of the best sleep aids is the pillow you’re must comfortable with. Bringing it with you is a signal to your brain that it’s allowed to relax.
• Create a good sleeping environment. Close the curtains, turn off dripping faucets, set the thermostat, turn off your phone and use a machine that creates white noise to help drown out unfamiliar noises in the night.
• Have a bedtime routine. A lot of travelers suggest a relaxing soak in the tub or even just listening to some soothing music.

SOURCE : HTH Worldwide Healthytravelblog.com

ALC Health News

Making sure you have the best value international health policy before moving abroad can take a lot of research writes Bryony Ashcroft of expathealth.org. But there are a few other questions you need to ask yourself before making the big move.

1. Is international health cover really what I need?
There are some countries that require expats to buy local insurance. Do your research and save yourself the time and hassle of setting up an international policy that could later be useless. Similarly, your new country may allow you to take out expat health insurance, but your chosen insurer may not be on its list of authorised providers.

2. Can I get my visa without health insurance?
While it’s common to sort out your health insurance needs after you move, it may actually be a requirement of your chosen country to have cover before you leave. It’s important to do your homework (we’re not going to list the requirements of every country in this article, sorry) to ensure you don’t run into trouble before you’ve even taken off.

3. Am I entitled to free healthcare?
Make sure you have done your research into the health infrastructure of your new country. You may think the government provides free healthcare – but there’s no such thing as a free lunch. For example, if you are an unemployed expat in France, you are no longer entitled to free health care. And while England offers free healthcare to all permanent residents, there are fees for certain things like eye-care, dentistry and certain long-term procedures. Also, you may find that free healthcare can incur a long waiting list, so private healthcare may be a better bet.

4. Am I eligible for an international health insurance policy?
People of a certain age may struggle to find expat health insurance. Retirees over 60, for example, can be refused a policy due to their age, or asked for a huge deposit of several thousand pounds. Similarly, those with pre-existing conditions may be turned away or charged extortionate amounts. Make enquiries with some different providers and get a few quotes for your own condition.

About ALC Health

For over 10 years ALC Health has been looking after and protecting the health of individuals, their families and international companies from across the world with a range of flexible, innovative medical insurance solutions that reflect the lifestyle of today’s expatriate international traveller and global citizen.

With many of our advisors having been expatriates themselves, we really do understand what it’s like to be living far away from home or in a country where healthcare treatment may not always be readily accessible.

We appreciate how important it is to have complete confidence in the medical treatment and support that you choose to put in place, should you need to call upon it in the future. We also realise that no two individuals or organisations are the same, which is why we take a more personal approach for each and every one of our clients.

ALC Health reflects the diversity and uniqueness of our clients, combining a wide range of language skills with an extensive knowledge of regional cultures and the protection our clients need and where our highly skilled claims team has handled cases in over 140 countries during the last decade.

Our aim is to ensure you experience a more dependable and accessible service that makes the most of our local knowledge and global support by . . . doing things differently.