Swiss adventurer, athlete, w88 online casino betting writer and photographer Ella Maillart said “You do not w88 online casino betting if you are afraid of the unknown, you w88 online casino betting for the unknown.” When it comes to international w88 online casino betting, excitement and the unknown are both on the itinerary.
w88 online casino betting offers many health benefits including increased mental well-being and happiness from new experiences, creating fun, new memories, breaking routine, meeting new people and taking in the endless sights the world has to offer. However, fear of being attacked by a wild animal generally isn’t a blip on the radar of those inevitable w88 online casino betting emotions - even when considering the possibilities of the unknown.
In parts of Africa and Asia, wild animal attacks are a very real threat, though they are rare enough that pre-travel vaccination against w88 online casino betting is not on the short list of preparedness to-do’s.
A northern w88 online casino betting woman knows all of this all too well.
The importance of international w88 online casino betting preparedness
You never know when you might face the unexpected, especially while traveling and venturing into the unknown. Being prepared is a w88 online casino betting truism, but even the best-laid plans can go awry.
Reno residents Dr. Lisa w88 online casino betting and her husband had planned their upcoming vacation in South Africa by the book. A long-time patient of Dr. Steven w88 online casino betting, AAHIVS / CTH, Professor of Internal w88 online casino betting at the University of Nevada, Reno, School of w88 online casino betting (UNR Med) and w88 online casino betting medicine expert, Leiden thoroughly consulted with Zell before her departure.
Zell says that w88 online casino betting medicine is so much more than looking up where a patient will be traveling to and administering the required or recommended vaccinations. He says it’s a lot like being a w88 online casino betting agent. “You look at past medical history, what recreational activities are on the agenda and risks. Especially as people age and are on multiple medications, an expert in internal medicine can best advise the client on possible drug interactions that might make them prone to specific tropical diseases.”
Primed for a successful South African vacation, methodical medications and first aid kits carefully packed inside their luggage, the couple excitedly arrived in Cape Town, a port city on South Africa&w88 online casino betting;s southwest coast with sweeping ocean views from majestic mountains, exotic wildlife and all around natural splendor.
Their international w88 online casino betting excitement soon turned to disappointment as they learned their meticulously prepared luggage had been stolen almost as soon as they arrived at their destination.
Making the best w88 online casino betting situation, however, the couple set out for a tour of Victoria Falls, one w88 online casino betting greatest attractions in Africa and one w88 online casino betting most spectacular waterfalls in the world.
Monkey see. Monkey w88 online casino betting.
Cute, anthropomorphic and mischievous, monkeys of various types and sizes are a common encounter in South Africa with the macaque being one of the most common. Making their way through the main entrance of the falls, Leiden and her husband enjoyed capturing the macaque&w88 online casino betting;s adorable antics and carefree frolicking on camera.
It didn’t take long before a small group of monkeys, seemingly innocently, started following Leiden. The formerly serene scene turned into trouble as one macaque w88 online casino betting bolted from the group, bounding onto Leiden’s shoe. Unprovoked, the w88 online casino betting latched onto her leg, sinking four teeth through her jeans and into her flesh, drawing blood.
According to Zell, animal bites that cause puncture wounds are more likely to become infected, and animals who attack without provocation are more likely to be infected with a virus that can cause w88 online casino betting. While w88 online casino betting in humans is rare, it is most often deadly if contracted.
The couple reported the monkey w88 online casino betting at the park entrance. Although they were told it was not a risk, Leiden located an antiseptic wash in the park’s first aid kit. Returning to the hotel with just the clothes she was wearing, no luggage and no familiar first aid supplies from home, the concierge assured Leiden 100 percent that she would never have a problem from the monkey w88 online casino betting.
Viruses know no boundaries, nor does good medical care.
Unconvinced, Leiden reached out to Zell, now half a world away from her. “Like most UNR Med faculty members, I live on email, so it was very easy for Lisa to get ahold of me,” said Zell. Immediately, he knew rabies exposure was looming, as did his resident, Dr. Khazi Nayeemuddin. Nayeemuddin is a native of India and has seen rabies there. “Without capturing the w88 online casino betting, you don’t know if it is ill,” Nayeemuddin said.
“This was my first time coordinating medical care for a wild monkey w88 online casino betting,” said Zell. “I networked with Dr. Robert Dedmon in Wisconsin, a retired global expert in rabies. He called me back immediately and told me in addition to rabies, there is a Simian Herpes Type B virus that can be transmitted from a macaque monkey.”
Leiden’s monkey w88 online casino betting incident was classified as a category III rabies exposure which includes transdermal bites, such as puncture wounds, lacerations and avulsions, or scratches and abrasions with spontaneous bleeding.
Assuming the unprovoked wild w88 online casino betting could be rabid, Zell’s first recommendations were basic first-aid measures: (1) scrubbing the wound or bitten area with soap under a running tap water for at least 15 minutes; (2) removing foreign material from the site; (3) rinsing with plain water; and (4) irrigating with a virucidal agent, such as alcohol or povidone iodine.
The dedicated UNR Med doctor immediately made contact with a colleague at the International Society of w88 online casino betting Medicine (ISTM) to arrange care in Africa. While international communication between Zell and Leiden, and between Zell and his ISTM contacts remained constant, progress for Zell’s next step unexpectedly ceased. The dedicated physician learned that the country of Zambia had zero readily-available w88 online casino betting immune globulin (RIG) for his patient.
Getting both RIG and administration of w88 online casino betting vaccine simultaneously is preferred. w88 online casino betting can take weeks to establish infection, allowing a window timeframe of up to a week to get proper treatment. Leiden’s treatment was delayed for three days while Zell worked from across the globe to coordinate the international medicine delivery that Leiden needed.
The cost of survival
The rabies vaccine is given for prevention to people who are at higher risk of coming in contact with rabies, such as veterinarians, wildlife workers, lab workers doing rabies research, etc. It’s also given to people after an animal w88 online casino betting if the animal could have rabies. For those not receiving vaccine prior to travel, RIG must be given at the site of a w88 online casino betting with the first dose of rabies vaccine at a distant second site.
Though painful upon injection, the rabies vaccine is well-tolerated with minimal side-effects. But it’s the cost of the vaccine that is even more painful and prohibitive. A serious rabies w88 online casino betting is capable of taking a serious w88 online casino betting out of the bank account.
According to the CDC, although the cost varies across locations, a course of w88 online casino betting immune globulin and four doses of vaccine given over a two-week period typically exceeds ,000. The medical cost of saving a human life from w88 online casino betting ranges from approximately ,000 to 0 million, depending on the nature of the exposure and the probability of w88 online casino betting in a region.
“It was an act of urgency, and I was able to arrange for her an appointment with some of my friends with the ISTM at a district global clinic that has expertise in w88 online casino betting medicine,” said Zell.
“We had to get money by going to the head of the hotel and giving him our debit card. He sent a driver across the border to Zambia to get money out w88 online casino betting a Zambian ATM machine. We then took a cab to the pharmacy in this very small town,” said Leiden.
In spite of the cost, being vaccinated against w88 online casino betting may be one of the best investments of Leiden’s life.
“A lot of people have a laissez-faire attitude on safety and preparedness, when it comes to travel. If Lisa would have taken the advice from the park and her hotel, she may have become very ill and may have died. Wild animal bites, especially w88 online casino betting bites, are all serious. You don’t want to take ‘you’ll be fine’ for an answer. Lisa didn’t and she is better for it,” said Zell.
Leiden and her husband flew to Johannesburg, South Africa’s biggest city, to continue treatment which included injecting seven milliliters of rabies-immune globulin around her leg w88 online casino betting. She also received four doses of the rabies vaccine, Rabavert, in her arm – one dose right away, and additional doses on the 3rd, 7th, and 14th days after exposure.
World w88 online casino betting Day: September 28
September 28 marks the anniversary of the death of Louis Pasteur, the French chemist and microbiologist, who developed the first w88 online casino betting vaccine. It’s no wonder the same date was chosen to celebrate World w88 online casino betting Day, an annual global health observance to raise awareness about w88 online casino betting, prevention and control efforts.
Although w88 online casino betting cannot be cured, it can be prevented. One of the best ways to do so is to avoid being bitten by a rabid animal.
For Leiden, the unprovoked monkey w88 online casino betting was unavoidable, and she never dreamed of being attacked on her well-planned African vacation. Luckily, Zell was able to coordinate her medical care, ironically enough, during the month of World Rabies Day.
International w88 online casino betting preparedness tips
Vaccinations are an important part of international w88 online casino betting preparedness. Planning for a safe and successful vacation involves more than getting all of the required and recommended immunizations and medications.
Zell recommends five health/safety steps to take when planning international w88 online casino betting.
1. Make a phone call to the consulate of the country you&w88 online casino betting;re planning to visit. Make certain there are no vaccines required at customs. There are two designated by the World w88 online casino betting Organization (WHO): Yellow Fever and, in certain areas of sub-Saharan Africa and Saudi Arabia, proof of meningitis vaccine may be required for entry.
2. Make an appointment to see a good w88 online casino betting clinician. This is especially important if you are older and are on medicines for dual diagnosis conditions such as heart disease plus diabetes. A w88 online casino betting clinician will do an analysis of your itinerary, risk assessment and recommend/administer vaccines for preventable diseases, such as travelers’ diarrhea or malaria.
3. Get vaccinations from your w88 online casino betting clinician at least six weeks before departing. Some vaccines take time to kick in.
4. Prepare an adequate first aid kit. Zell equips his w88 online casino betting medicine patients with a 40-page handout on various levels of first aid kids, depending on location. Information included entails nonprescription drugs, medicines to have on hand, such as acetaminophen, anti-diarrheal, creams, steroids, sunblock, and mosquito repellent, as many viruses are carried by mosquitos, wound care supplies for abrasions, cuts, deep puncture wounds, antiseptics to clean wounds, rubber gloves to prevent contamination and a mask.
5. Pre-identify a source you can go to for help in a third world country. Ensure the source can speak your native language and offer expert medical advice should you need during your travels abroad. The ISTM global directory lists experts in foreign countries who specialize in w88 online casino betting medicine.
w88 online casino betting is not only an international concern
The w88 online casino betting problem is as old as mankind, dating back in written records to the Romans, Greeks and Egyptians. The term “w88 online casino betting,” came from the Sanskrit word rabhas, which means “to do violence.”
While w88 online casino betting is a 100 percent preventable disease, Centers for Disease Control and Prevention (CDC) estimates that w88 online casino betting kills more than 59,000 people worldwide, every year. To help prevent and control w88 online casino betting, vaccinate pets and learn how to stay safe from the animals that commonly spread w88 online casino betting in the U.S., including raccoons, bats, skunks, and foxes.
And they traveled happily ever after
Lisa Leiden’s health and even life were saved from potentially deadly misinformation, thanks to Zell’s expertise and Certification in w88 online casino betting Health (CTH), which allows him to connect patients to medical providers anywhere in the world.
“UNR Med and Dr. Zell are at the forefront of delivering comprehensive w88 online casino betting health services, enabling people to w88 online casino betting and return home safely,” said w88 online casino betting. Thomas L. Schwenk, dean of the University of Nevada, Reno School of Medicine. “We are extremely proud our UNR Med faculty like Dr. w88 online casino betting and his team, whose health care services address real-world needs and improve the quality of life for the people of Nevada, the nation and the world.”
Zell’s w88 online casino betting services are available to the general public. Those interested do not have to be an established patient of UNR Med to be seen for a pre-w88 online casino betting consultation. To make a w88 online casino betting consultation appointment, call (775) 982-5000.
