07 November 2008

Pre-Trip: Vaccinations


In the midst of election fever, David, Hope and I went to Kaiser Hospital in South Sacramento for vaccinations. Because of David's employment, he did not need Hepatitis A & B, tetanus or the typhus vaccination. Hope, too, is current on her vaccinations, so she and David only had to have a yellow fever inoculation. I, on the other hand, earned the great honor of receiving four shots, two in each arm to grace my shoulders with a lovely spotted orange and purple pattern that made me look like a hairless pale leopard.

Imagery aside, the vaccination we each received on Tuesday was for yellow fever. Yellow fever is a virus which is transmitted through the bite of infected mosquitos in South America and sub-Saharan Africa. This map shows the region in South America for yellow fever transmission. Because we will be spending about 6 weeks in the "zone" and because there is no cure for yellow fever once it is acquired, we each received the vaccination.

Yellow fever is not common in the United States today. The Center for Disease Control and Prevention reports that "Between 1996 and 2002, five people from the United States and Europe who traveled to South America or Africa contracted yellow fever and died. They were all unvaccinated." Although it is now rare in the U.S., recent history offers several famous yellow fever outbreaks in the Americas, including Philadelphia in 1793, New Orleans in 1852 and 1905, Havana, Cuba in 1898, and Peru in 1995. A recent PBS program entitled The Great Fever features these historic events and can be found at http://www.pbs.org/wgbh/amex/fever/.

Globalization has also raised the ante for governments seeking to limit the transmission of yellow fever. The World Health Organization concludes in a 1998 report that "yellow fever is an important public health threat, which needs more attention" (WHO 15). The report presents the unique challenges of urbanization in the Amazon basin, and can be found at http://www.who.int/csr/resources/publications/surveillance/Yellow_fever.pdf.

Despite advances in understanding the origins of the disease, a yellow fever alert has been issued by the Brasilian Ministry of Health (MOH). According to the Center for Disease Control and Prevention "As of June 11, 2008, 45 confirmed cases of yellow fever have been reported [in Brasil], including 25 deaths. Among the most recent cases, two human yellow fever cases have been reported in the State of São Paulo ..." http://wwwn.cdc.gov/travel/contentYellowFeverBrazil.aspx. With a 2008 estimated population lurking at 190 million people, this handful of yellow fever cases in Brasil represents only a fraction of the number of people who live there. However, while I want this to be a trip of a lifetime, I am not interested in seeing it be the trip that ends my life. Therefore, although the MOH does not require yellow fever vaccinations, it does recommend them in light of these recent developments. Hence, the shots.

Science aside, the side effects I experienced from the vaccinations were interesting, if not annoying. Chiefly, I ached. In addition to general achiness and dizziness, I could not raise my arms above my shoulders. This posed some challenges to writing on the board while lecturing, which reduced me to explaining my condition to my classes. Being the great people that they are, the students were receptive and empathetic to my temporary disability. Between four shots and the emotions brought on by an historic presidential election, I was pretty much a wreck on Wednesday, November 5.

Another, more compelling, side effect has been the loss of control of my arms. They seem to have developed minds of their own and have taken to flailing, jiggering and generally being independent from my will at the most inopportune moments, such as when serving food, drinking tea or shaving the back of David's head. Yes, he really was putting his life in my stuttering hands this evening. It must be love. Sigh.

Muscle aches, known as myalgia, are an early symptom of yellow fever, and because the vaccination consists of injecting live antibodies of the disease into one's system, I suppose this is just a small taste of the real thing. In this case, I prefer the sample rather than the whole meal!

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