Cholera outbreaks in the Democratic Republic of Congo (DRC) and the Republic of Congo

Travel Health Advisory: The Public Health Agency of Canada increased the alert to a level 2: practise special precautions on August 19th, 2010.

The World Health Organization (WHO) has reported cholera outbreaks along the Congo River, affecting the Democratic Republic of Congo (DRC) and the Republic of Congo. Several thousand cases have been reported, many of which have resulted in death.

In DRC, the outbreak began in March 2011 and has recently intensified, affecting four provinces (Bandundu, Equateur, Kinshasa and P Orientale).

In the Republic of Congo, cases have been reported from four provinces (Brazzaville, Cuvette, Likouala and Plateaux).

The risk of further spread along the Congo River is high. The outbreak has been reported to have spread to new locations, particularly in Kinshasa, where there are many people without an adequate supply of safe water.

The Public Health Agency of Canada (PHAC) recommends practising safe food and water precautions when travelling the DRC and the Republic of Congo and advises speaking with a health care provider about cholera vaccine prior to travel.

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. People usually become infected by drinking or eating contaminated water or food. It is associated with watery diarrhea and rapid dehydration, which may be life-threatening.

Cholera occurs most commonly in regions of the world where there is inadequate sanitation, poor hygiene, overcrowding and a lack of safe water and food.

Recommendations
Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.

1.Practise safe food and water precautions.

2.Consider getting vaccinated.
Most travellers are at low risk. Travellers at high risk for cholera (humanitarian relief workers, travellers visiting areas of high risk with limited access to clean water and food) may benefit from vaccination and should consult with a health care provider to discuss this option.

3.If you develop severe diarrhea and/or vomiting while travelling or after you return to Canada:

a.Seek medical attention immediately.

b.Drink fluids and use oral rehydration salts to prevent dehydration.

Infants, young children, the elderly and those with underlying health conditions are at greatest risk of dehydration.
 
Source: PHAC, WHO

Cholera in Dominican Republic-Travel Health Advisory

The Public Health Agency of Canada raised the alert for cholera in the Dominican Republic to level 2 (practise special precautions) on July 13, 2011.

Cases of cholera continue to be reported in many of the provinces in Dominican Republic.

The government of Dominican Republic continues to investigate and their response includes epidemiologic investigation, enhancing surveillance, water and sanitation services and public education on cholera. They are also focussing on prompt and appropriate care for those who become infected.

The Public Health Agency of Canada (PHAC) recommends practising safe food and water precautions while in the Dominican Republic and advises speaking with a health care provider about cholera vaccine prior to travel.

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. People usually become infected from drinking or eating contaminated water or food. It is associated with watery diarrhea and rapid dehydration, which may be life-threatening.

Recommendations
Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.

1.Practise safe food and water precautions

2.Consider getting vaccinated

a.Most travellers are at low risk. Travellers at high risk for cholera (travellers visiting areas of high risk with limited access to clean water and food) may benefit from vaccination and should consult with a health care provider to discuss this option.

3.If you develop severe diarrhea and/or vomiting when you return to Canada

a.Infants, young children and the elderly and those with underlying health conditions are at greatest risk of dehydration.

b.Seek medical attention immediately.

c.Drink fluids and use oral rehydration salts to prevent dehydration.

4.Review the Public Health Agency of Canada’s recommendations for travel to the Dominican Republic
 

Source: Public Health Agency of Canada

Virtual Colonoscopy Now Available at ViaMedica

Virtual Colonoscopy

Virtual colonoscopy is a quicker and less invasive technique than a conventional colonoscopy. A CT scan of the abdomen and pelvis, along with 3-D reconstructed images are used to view the inside of the colon. The entire exam takes only 10 minutes.

Virtual colonoscopy is used to screen for polyps or cancer in the large intestine. It is a highly advanced and accurate screening method.

Polyps are growths that arise from the inner lining of the intestine. Some polyps may grow and turn into cancer. The goal is to find these growths in their early stages, so that they can be removed before cancer has had a chance to develop.

Risk factors for the disease include a history of polyps, a family history of colon cancer, or the presence of blood in the stool.

What are the benefits vs. risks?

Benefits:

• Minimally invasive - can depict many polyps and other lesions as clearly as when they are directly seen by conventional colonoscopy.

• Markedly lower risk of perforating the colon than conventional colonoscopy.

• Virtual colonoscopy is an excellent alternative for patients who have clinical factors that increase the risk of complications from colonoscopy, such as treatment with anticoagulants (blood thinners) or a severe breathing problem.

• Elderly patients, especially those who are frail or ill, may tolerate Virtual colonoscopy better than conventional colonoscopy.

• Virtual colonoscopy can be helpful when colonoscopy cannot be completed because the bowel is narrowed or obstructed for any reason, such as by a large tumor.

• If conventional colonoscopy cannot reach the full length of the colon-which occurs up to 10 percent of the time. Virtual colonoscopy can view the entire colon.

• No sedation or pain-relievers are required; therefore there is no recovery period.

• Able to go to work right after the procedure.

Risks:

• There is a very small risk that inflating the colon with air could injure or perforate the bowel. This has been estimated to happen in fewer than one in 10,000 patients.

• There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

• CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the baby.

Disadvantages:

• No biopsies are taken with this method; if something is seen and requires biopsy a conventional colonoscopy will be required.

• Does not visualize Irritable Bowel Syndrome.

To book an appointment call us at: 514-626-5888.