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Vážení cestovatelia,

kvôli prebiehajúcej epidémii sa cesta do Číny neodporúča,

pripájame text v pôvodnom znení so súhnom všetkých cestovných obmedzení.

Travel Restrictions and Internal Disruptions

According to WHO, more than 70 countries have now implemented some form of travel restriction. Different types of travel restrictions are in effect:

Major International Airlines Still Serving China (mostly reduced frequency): Aeroflot, AirAsia, Air China, All Nippon Airways, Asiana Airlines, Cathay Pacific, China Eastern Airlines, China Southern Airlines, Emirates, Etihad Airways, Ethiopian Airlines, EVA Air, Hainan Airlines, Japan Airways, Korean Air, Malaysia Airlines, Pakistan International Airlines, SilkAir, Singapore Airlines, SriLankan Airlines, Thai Airways, Thai Lion Air

No Flights from Wuhan: Wuhan Airport is closed to all scheduled international and domestic flights.

No Flights from China: Indonesia, Israel, Italy, Kazakhstan, Northern Mariana Islands, Palau (no flights from China, Hong Kong, or Macau), Russia (except for Aeroflot flights), Vietnam

Land Borders with China Closed: Burma (Myanmar), Kyrgyzstan, Mongolia, North Korea, Russia (entire land border with China, except for the portion between Altai Republic and Nei Mongol Autonomous Region [Mongolia]); high speed rails, bus services, and ferry services are suspended, and all but 2 border crossings are closed in Hong Kong.

No Travelers from Hubei Province: Brunei (excluding its residents), Hong Kong, Japan (including visitors in the past 14 days), Macau, Malaysia (also applies to travelers who have been to Zhejiang and Jiangsu provinces), Philippines, South Korea (including visitors in the past 14 days)

No Travelers from China: Foreign nationals who have visited China within the past 14 days are banned from entry into Antigua and Barbuda, Australia, Fiji, Gabon, Grenada, India, Israel, Maldives, Mauritius, New Zealand, Saint Lucia, Singapore, U.S., and Vietnam. Exceptions may include immediate family of citizens and permanent residents who, along with citizens, may be subject to a 14-day mandatory quarantine (if coming from Hubei Province) or enhanced screening and self-quarantine (if coming from elsewhere in China). Foreign nationals who have visited China, Hong Kong, or Macau within the past 14 days are banned from entry into Taiwan. Foreign nationals who have visited China, Hong Kong, Macau, or Taiwan within the past 14 days are banned from entry into the Philippines. Additionally, Belize, Cook Islands, El Salvador, Guatemala, Jamaica, Indonesia, Iraq (passengers arriving at Basra International Airport), Micronesia, Saudi Arabia, and Trinidad and Tobago have banned all travelers coming from China in the past 14 days. Marshall Islands and Samoa have banned travelers coming from COVID-19–affected countries in the past 14 days.

No Entry without Medical Certificate – French Polynesia: Travelers arriving from Asia via Japan or New Zealand require a medical clearance attesting to the good health of the traveler for entry into French Polynesia. Samoa: Travelers originating from or transiting through China, Hong Kong, Japan, Macau, Singapore, or Thailand must spend at least 14 days in self-quarantine in a country that is free of COVID-19; this must be their final stop before traveling to Samoa. A medical/examination clearance must be issued within 3 days prior to arrival. All travelers originating from or transiting through the following locations require a medical examination/clearance issued within 3 days prior to arrival and the clearance certificate must be presented at airline check-in to receive the boarding pass: Australia, Canada, France, Germany, Malaysia, South Korea, Taiwan, United Arab Emirates, U.S. (California State), Vietnam. Tonga: Travelers originating from or transiting through China must spend at least 14 days in a country that is free of COVID-19. A medical clearance must be issued within 3 days prior to arrival. This does not apply to Tonga nationals, permanent residents, or their immediate families. Vanuatu: Travelers originating from mainland China, Hong Kong, Macau, or Taiwan must spend at least 14 days outside of the aforementioned countries. A medical clearance stating they are free of any respiratory illness is required for entry. Persons with respiratory illness must present a clearance stating they tested negative for SARS-CoV-2 at a WHO reference laboratory.

Internal Travel Restrictions in China: Restrictions on movement exist throughout the country, especially in Chongqing, Zhejiang, Anhui, and Heilongjiang provinces. Most public transportation has been suspended, and many intercity roads are closed. An estimated 54 million persons are quarantined inside this „cordon sanitaire.“ Interprovince shuttle buses in major areas have stopped. Much of the country has also closed bars, restaurants, shops, businesses, schools, and museums, as well as many major tourist attractions. China has stopped all inbound and outbound tour groups but not individual travel. Following the extended Lunar New Year holiday, workers in China (excluding Hubei Province) are now returning to workplaces in major cities; many workplaces remain closed, and others are allowing employees to work from home. Visitors from Hubei Province will be actively monitored for 14 days in Haikou, Hainan Province.

Internal Restrictions in Hong Kong: Schools will remain suspended until at least March 2. Hong Kong officials have recommended select businesses (including cinemas, karaoke rooms, education centers, and clubhouses) to close for 14 days as of February 11.

Internal Restrictions in Singapore: Singapore is currently under the Disease Outbreak Response System Condition (DORSCON) Orange, which introduces business continuity plans, daily health checks at the workplace, cancellations of or additional precautions for large-scale events, temperature screening at hospitals, suspended school activities, and limited visits to preschools and eldercare services. Singapore’s Ministry of Health (MOH) also requested all public hospital staff to limit their work to 1 hospital.

Zdroj Travax, 12. február 2020

Photo by Frank Vessia on Unsplash

 

 


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Aktuálna situácia

Včera zvýšilo CDC varovanie pre cestovateľov na 2. stupeň. Infekcia sa v Číne rozšírila do Pekingu, Šanghaja a Guangdong, ale aj za hranice Číny – do Thajska, Japonska, Južnej Kórei, a USA. Pravdepodobne bude počet nakazených v týchto krajinách ešte stúpať. Takisto sú obavy zo zvýšenia šírenia nákazy kvôli príchodu Nového lunárneho roku 25.1.2020.

Miera nákazlivosti sa odborníkom javí podobná ako pri SARS. Nakoľko v súčasnosti prebieha v Číne aj epidémia chrípky A, nie je možné vylúčiť ďalšiu mutáciu vírusu.

Mortalita ochorenia je približne 1 ku 50.  Doteraz bolo hlásených 470 nakazených pacientov a 9 úmrtí. Oficiálne informácie sa nemusia stotožňovať s aktuálnou situáciou, aj bez snahy skresľovať fakty.

 

Vírus

Nový Wuhan koronavírus patrí k typu B/ Sarbecovirus alebo betacoronavirus. geneticky je tento nový Wuhan vírus najbližšie SARS podobnému vírusu u netopierov (bat_SL_Cov in the plot), fylogeneticky majú spoločných predkov.

Rady pre cestovateľov

V ideálnom prípade je vhodné cestu do Číny, najmä do Wuhan odložiť, kým sa veci nevyjasnia.  Ak to možné nie je, je vhodné vyhýbať sa trhom, kde predávajú hydinu, používať na exponovaných miestach masku (letiská, železničné stanice, zdravotnícke zariadenia..) Často si umývať a dezinfikovať ruky.

Photo by Tore F on Unsplash

 


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V Pakistane prebieha epidémia multirezistenej formy brušného týfusu. Varovanie 1. stupňa je vydané, nakoľko XDR infekcia nie je liečiteľná takmer žiadnymi antibiotikami ako sú napr. ampicilín, chloramfenikol, cotrimoxazol, ciprofloxacin a ceftriaxon. V niektorých prípadoch môže byť brušný týfus smrteľný.

Po návšteve Pakistanu bolo táto rezistentná forma ochorenia diagnostikovaná u cestovateľov z USA, Kanady, Dánska a Austrálie. Ročne navštevuje Pakistan približne 1,75 milióna cestovateľov.

Pakistan je 6. najľudnatejšia krajina sveta, jej počet obyvateľov presahuje 210 miliónov ľudí. 

Epidémia XDR brušného týfusu začala v meste Hyderabad, v novembri 2016. 

Odporúčanie CDC je, aby cestovatelia do južnej Ázie, vrátane Pakistanu, boli očkovaní proti tomuto ochoreniu najneskôr 2 týždne pred odchodom.

Nakoľko účinnosť vakcíny nie je 100%, cestovatelia by mali dodržiavať aj bežné preventívne opatrenia pri stravovaní. 

Salmonela typhi sa šíri kontaminovanou vodou a potravou, človek je jediným zdrojom.

Inkubační doba je 6-30 dní. Najčastejšie príznaky sú horúčka, slabosť, bolesti brucha a hlavy, kašeľ, strata chuti do jedla. Niektorí pacienti môžu mať hnačku alebo zápchu. 

Ak sa u Vás objavia príznaky počas cesty, vyhľadajte lekársku pomoc čo najskôr. Ak ochoriete po návrate, informujte lekára o Vašej ceste. Nepripravujte jedlo pre postatných. 

 

Vo svete je približne 26 miliónov prípadov brušného týfusu ročne, a  215 000 úmrtí. 


Motto

Passion for travel medicine comes from passion to travel.

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