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New Four-Strain Influenza Vaccine, VaxigripTetra™, Regulatory Dossier from Sanofi Pasteur Now Approved in Europe
New VaxigripTetra™ vaccine:
• A 4-strain influenza vaccine for people 36 months of age and older,
• Helps protect children, adults and seniors against both influenza B strains (B/Victoria and B/Yamagata),
• Newest addition to the Vaxigrip® family of influenza vaccines.
Sanofi Pasteur, the vaccines division of Sanofi, announced today that its quadrivalent influenza vaccine VaxigripTetra™ obtained a positive end of procedure from the German Reference Member State Paul Ehrlich Institute, as a conclusion of the European Decentralized Procedure. Marketing Authorizations can now be issued in the Reference Member State (Germany) and each of the Concerned Member States involved in this procedure. VaxigripTetra™ is a four-strain influenza vaccine, containing two A strains (A/H1N1 and A/H3N2) and two B strains (B/Victoria and B/Yamagata), for use in individuals aged 36 months or older. VaxigripTetra™ is the newest addition to the Vaxigrip® family of influenza vaccines.
Currently, the majority of seasonal influenza vaccines are trivalent meaning that they protect against three strains: two A strains and a single B strain (B/Victoria or B/Yamagata). However, two distinct influenza B strains (B/Victoria and B/Yamagata) now co-circulate worldwide in varying and unpredictable proportions[1]. In recent years, influenza B viruses represented around 23% of the circulating strains around the world. These proportions can be as high as 90% during some seasons and are therefore an important cause of influenza disease[2]. Given this current virological situation with the co-circulation of the two B strains, influenza vaccines need to be adapted and to fit with the current virological situation to ensure broader level of protection. Because trivalent influenza vaccines only contain one B strain, this co-circulation makes the selection of the right strains to be included in the seasonal vaccine very difficult to predict. As an example in Europe in 2015 92%[3] of the documented B influenza cases were caused by the B/Victoria strain not included in the vaccine. Adding the second B strain to VaxigripTetra™ will address the unpredictability issue.
“For over 60 years the expertise of Sanofi Pasteur has been committed to providing new immunization solutions for the prevention of influenza to better protect lives and help healthcare providers meet the specific immunization needs of all types of their patients. This new quadrivalent influenza vaccine, which includes both co-circulating B strains, completes our long line of Vaxigrip® family vaccines dedicated to fighting influenza infections and its complications. Once launched in Europe VaxigripTetra™ will offer broader protection for people from 36 months and older and support our public health ambition to constantly innovate to save lives worldwide” said David Loew, Executive Vice President Sanofi Pasteur.
The World Health Organization includes quadrivalent influenza vaccines in its recommendations, stating “Quadrivalent influenza vaccines that could potentially provide wider protection against influenza B viruses are becoming available and recommendations should not be limited to trivalent vaccine.” [4]
From a public health perspective, using quadrivalent rather than trivalent influenza vaccines could have resulted in a further reduction of up to 1.6 million influenza cases, 37,300 influenza-related hospitalizations and 14,800 influenza-related deaths in the EU over a decade[5].
Sanofi Pasteur supports influenza immunization policies and is committed to developing vaccine solutions that fit with the influenza epidemiology. VaxigripTetra™ is the newest formulation designed by Sanofi Pasteur, offering a quadrivalent influenza vaccine. VaxigripTetra™ includes two A strains and two B strains to help provide broader protection for all age groups as of 36 months. Sanofi Pasteur intends to progressively switch all its trivalent influenza vaccines to quadrivalent influenza vaccines worldwide.
About the evolution of influenza vaccines
Influenza viruses mutate often and the antigenic and ecological evolution results in the need to adapt the vaccine composition annually to ensure it remains effective[6]. Each winter the strains for the seasonal influenza vaccines are selected from the influenza strains anticipated to circulate in the Northern Hemisphere during the approaching influenza season by WHO. Until 1978, seasonal influenza vaccines contained only two strains (one strain of type A influenza and one strain of type B influenza), when the decision was made to incorporate a second type A influenza strain to help provide protection against both A strains that were co-circulating[7]. Since then, influenza vaccines have been trivalent to help protect against three strains of influenza virus: a type A(H1N1), a type A(H3N2) and one type B.
However, since the 2001-2002 season, influenza B viruses have diverged into two antigenically distinct lineages (the Victoria and Yamagata lineages). Both B lineages have co-circulated with varying prevalence by season and region, supporting the need for extended protection with quadrivalent influenza vaccines[8].
About influenza and vaccination
Influenza is a serious respiratory illness[9]. Each year, 3 million to 5 million cases of severe illness are reported worldwide. Depending on virus virulence during the influenza season, influenza associated-deaths can range from 250,000 to 500,000 people[10]  worldwide.
In Europe, in the absence of vaccination, the annual burden related to influenza was estimated at 22 million cases, 3.5 million flu-associated hospitalizations and 171,000 flu-associated deaths[11]. Currently seasonal influenza vaccination prevents on average between 1.6 million and 2.1 million cases of influenza, 45,300 to 65,600 hospitalizations, and 25,200 to 37,200 deaths every year[12]. The World Health Organization recommends vaccination to help prevent influenza for everyone six months of age and older.
About Sanofi
Sanofi, a global healthcare leader, discovers, develops and distributes therapeutic solutions focused on patients’ needs. Sanofi has core strengths in diabetes solutions, human vaccines, innovative drugs, consumer healthcare, emerging markets, animal health and Genzyme. Sanofi is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY).
Sanofi Pasteur, the vaccines division of Sanofi, provides more than 1 billion doses of vaccine each year, making it possible to immunize more than 500 million people across the globe. A world leader in the vaccine industry, Sanofi Pasteur produces a portfolio of high quality vaccines that matches its areas of expertise and meets public-health demand. The company’s heritage, to create vaccines that protect life, dates back more than a century. Sanofi Pasteur is the largest company entirely dedicated to vaccines. Every day, the company invests more than EUR 1 million in research and development. For more information, please visit: http://www.sanofipasteur.com or http://www.sanofipasteur.us
Forward Looking Statements
This press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, as amended. Forward-looking statements are statements that are not historical facts. These statements include projections and estimates and their underlying assumptions, statements regarding plans, objectives, intentions and expectations with respect to future financial results, events, operations, services, product development and potential, and statements regarding future performance. Forward-looking statements are generally identified by the words “expects”, “anticipates”, “believes”, “intends”, “estimates”, “plans” and similar expressions. Although Sanofi’s management believes that the expectations reflected in such forward-looking statements are reasonable, investors are cautioned that forward-looking information and statements are subject to various risks and uncertainties, many of which are difficult to predict and generally beyond the control of Sanofi, that could cause actual results and developments to differ materially from those expressed in, or implied or projected by, the forward-looking information and statements. These risks and uncertainties include among other things, the uncertainties inherent in research and development, future clinical data and analysis, including post marketing, decisions by regulatory authorities, such as the FDA or the EMA, regarding whether and when to approve any drug, device or biological application that may be filed for any such product candidates as well as their decisions regarding labelling and other matters that could affect the availability or commercial potential of such product candidates, the absence of guarantee that the product candidates if approved will be commercially successful, the future approval and commercial success of therapeutic alternatives, the Group’s ability to benefit from external growth opportunities, trends in exchange rates and prevailing interest rates, the impact of cost containment initiatives and subsequent changes thereto, the average number of shares outstanding as well as those discussed or identified in the public filings with the SEC and the AMF made by Sanofi, including those listed under “Risk Factors” and “Cautionary Statement Regarding Forward-Looking Statements” in Sanofi’s annual report on Form 20-F for the year ended December 31, 2015. Other than as required by applicable law, Sanofi does not undertake any obligation to update or revise any forward-looking information or statements.

Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions.

Coronary artery disease pathogenesis and treatment urgently requires a paradigm shift.

Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong.

A landmark systematic review and meta-analysis of observational studies showed no association between saturated fat consumption and
all-cause mortality, coronary heart disease (CHD),
CHD mortality, ischaemic stroke or type 2 diabetes in healthy adults. Similarly in the secondary prevention of CHD there is no benefit from reduced fat, including saturated fat, on myocardial infarction, cardiovascular or all-cause mortality.

It is instructive to note that in an angiographic study of postmenopausal women with CHD, greater intake of saturated fat was associated with less progression of atherosclerosis whereas carbohydrate and polyunsaturated fat intake were associated with greater progression.

Preventing the development of atherosclerosis is important but it is atherothrombosis that is the real killer.

The inflammatory processes that contribute to cholesterol deposition within the artery wall and subsequent plaque formation (atherosclerosis), more closely resembles a ‘pimple’ (figure 1). Most cardiac events occur at sites with <70% coronary artery obstruction and these do not generate ischaemia on stress testing.4 When plaques rupture (analogous to a pimple bursting), coronary thrombosis and myocardial infarction can occur within minutes.

The limitation of the current plumbing approach (‘unclogging a pipe’) to the management of coronary disease is revealed by a series of randomised controlled trials (RCTs) which prove that stenting significantly obstructive stable lesions fail to prevent myocardial infarction or to reduce mortality.

Figure 1
Lifestyle interventions for the prevention and treatment of coronary disease.
Dietary RCTs with outcome benefit in primary and secondary prevention.
In comparison with advice to follow a ‘low fat’ diet (37% fat), an energy-unrestricted Mediterranean diet (41% fat) supplemented with at least four tablespoons of extra virgin olive oil or a handful of nuts (PREDIMED) achieved a significant 30% (number needed to treat (NNT)=61) reduction in cardiovascular events in over 7500 high-risk patients.

Furthermore, the Lyon Heart study showed that adopting a Mediterranean diet in secondary prevention improved hard outcomes for both recurrent myocardial infarction (NNT=18) and all-cause mortality (NNT=30), despite there being no significant difference in plasma low-density lipoprotein (LDL) cholesterol between the two groups.

Thank It is the alpha linoleic acid, polyphenols and omega-3 fatty acids present in nuts, extra virgin olive oil, vegetables and oily fish that rapidly attenuate inflammation and coronary thrombosis.

Both control diets in these studies were relatively healthy, which make it highly likely that even larger benefits would be observed if the Mediterranean diets discussed above were compared with a typical western diet.

LDL cholesterol risk has been exaggerated
Decades of emphasis on the primacy of lowering plasma cholesterol, as if this was an end in itself and driving a market of ‘proven to lower cholesterol’ and ‘low-fat’ foods and medications, has been misguided. Selective reporting may partly explain this misconception.

Reanalysis of unpublished data from the Sydney Diet Heart Study and the Minnesota coronary experiment reveal replacing saturated fat with linoleic acid containing vegetable oils increased mortality risk despite significant reductions in LDL and total cholesterol (TC).

A high TC to high-density lipoprotein (HDL) ratio is the best predictor of cardiovascular risk (hence this calculation, not LDL, is used in recognised cardiovascular risk calculators such as that from Framingham).

A high TC to HDL ratio is also a surrogate marker for insulin resistance (ie, chronically elevated serum insulin at the root of heart disease, type 2 diabetes and obesity). And in those over 60 years, a recent systematic review concluded that LDL cholesterol is not associated with cardiovascular disease and is inversely associated with all-cause mortality.

A high TC to HDL ratio drops rapidly with dietary changes such as replacing refined carbohydrates with healthy high fat foods.

A simple way to combat insulin resistance (chronically high levels of serum insulin) and inflammation.

Compared with physically inactive individuals, those who walk briskly at or above 150 min/week can increase life expectancy by 3.4–4.5 years independent of body weight.

Regular brisk walking may also be more effective than running in preventing coronary disease. And just 30 min of moderate activity a day more than three times/week significantly improves insulin sensitivity and helps reverse insulin resistance (ie, lowers the chronically elevated levels of insulin that are associated with obesity) within months in sedentary middle-aged adults.

This occurs independent of weight loss and suggests even a little activity goes a long way.
Another risk factor for CHD is environmental stress. Childhood trauma can lead to an average decrease in life expectancy of 20 years.

Chronic stress increases glucocorticoid receptor resistance, which results in failure to down regulate the inflammatory response.

Combining a complete lifestyle approach of a healthful diet, regular movement and stress reduction will improve quality of life, reduce cardiovascular and all-cause mortality.

It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat. Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 min a day and eating real food.

There is no business model or market to help spread this simple yet powerful intervention.

1. SUPERCHARGE YOUR DOPAMINE LEVELS TO NEVER FEEL SAD, STRESSED OR DEPRESSED AGAIN

Our cerebrum discharges a neurotransmitter called dopamine. It is vital for the correct working of different organs in our body.
▪ It is powerful in our body in the accompanying ways:
▪ It controls the discharge of prolactin.
▪ It helps in directing body development.
▪ It helps in enhancing your intellectual capacities (i.e. consideration, information, assessment, memory, basic leadership and critical thinking abilities)
▪ It controls the focal point of delight and reward in your cerebrum.
At the point when the dopamine level in our body is decreased it could prompt to:
▪ Misery
▪ Despondency
▪ Antagonism
▪ State of mind swings

To keep away from these medical problems, you should raise your dopamine level and you can do this in these 10 viable ways.

1 DETOXIFY REGULARLY
A development of microscopic organisms and poisons in the body can debilitate your invulnerable framework and lower the dopamine generation in the body. You ought to consistently detoxify your body and free it of these unsafe poisons.

2 NORMAL EXERCISE
When you practice, you raise your endorphin, serotonin and dopamine levels. You will feel fit, sound, upbeat and peaceful.

3 REMAIN OFF ILLICIT DRUGS AND OTHER ADDICTIONS
You ought to abstain from being dependent on;
▪ Betting
▪ Liquor
▪ Drugs
▪ Sex

These addictions just give a brief settle to our anxiety and sorrow. Addictions change our way of life and suit it to our wellspring of enslavement. You ought to have a go at taking part in side interests and work that makes you upbeat.

4 HAVE AN INCREASED TYROSINE
Tyrosine is an amino corrosive which is only one out of 22 fundamental amino acids that are useful in the generation of proteins. It is likewise a key substance for dopamine generation.

You can raise your tyrosine levels when you devour avocados, dull chocolate, green tea and watermelons.

When you tune in to music your dopamine levels increment for a brief span, so you ought to tune in to music every now and again to calm anxiety and misery.

6 TAKE PART IN CREATIVE ACTIVITIES
Your dopamine level increments when you take part as a main priority entrusting and aptitude required exercises, for example, painting, designing, cooking, auto repair, sewing, composing, moving and singing.

7 GET YOURSELF ORGANIZED
When you are sorted out you have a sentiment fulfillment and this is on the grounds that your dopamine levels will be raised. You can record your everyday errands and execute them one by one.

8 CONSISTENCY HELPS
When you do things constantly and you aren’t fruitful in these assignments your dopamine level will ascend as you have a feeling of achievement.

9 PARTICIPATE IN MEDITATION
This type of practice is awesome for raising your dopamine level and it enhances your state of mind and helps you to unwind.

10 TAKE SUPPLEMENTS
When you take certain supplements your dopamine level will increment.
These supplements include:
▪ Ginkgo Biloba
▪ Curcumin which is a dynamic segment in turmeric can raise your dopamine level.
▪ L-theanine is known to bring a few neurotransmitters up in the cerebrum and dopamine is one of such neurotransmitters. You can get this compound from green tea.
▪ Acetyl-l-tyrosine underpins the generation of dopamine

A new bionic eye lens currently in development would give humans 3x 20/20 vision, at any age.
The lens, named the Ocumetics Bionic Lens, was developed by Dr. Garth Webb, an optometrist in British Columbia who was looking for a way to optimize eyesight regardless of a person’s health or age. With this remarkable lens, patients would have perfect vision, ending the need for driving glasses, progressive lenses, and contacts, all of which are set to become a dim memory as the eye-care industry is transformed, CBC reports. Even better is the fact that people who get the lens surgically inserted will never get cataracts, because the lens replaces that of their natural eye, which inevitably decays over time. Webb says that anyone over the age of 25 is the best candidate, because that is when the eye is fully developed.
“This is vision enhancement that the world has never seen before,” he says, “If you can just barely see the clock at 10 feet, when you get the Bionic Lens you can see the clock at 30 feet away.“

The lens, which would be custom-made, is folded like a taco in a saline-filled syringe and placed in the eye, where it unravels itself within 10 seconds.

Dr. Garth Webb says the bionic lens would allow people to see to infinity and replace the need for eyeglasses and contact lenses. Webb says that the surgery can be done within 8 minutes and immediately corrects a patient’s vision. The project has been in the works for the last eight years, Webb told CBC, costing about $3 million in research and development fees, along with the acquisition of international patents and the securing of a biomedical manufacturing facility in Delta, B.C.
His mission is fueled by the “obsession” he’s had to free himself and others from corrective lenses since he was in Grade 2, when he was saddled with glasses.
“My heroes were cowboys, and cowboys just did not wear glasses,” Webb says.
Webb’s efforts were recently recognized after he presented the lens to 14 top ophthalmologists in San Diego during a gathering of the American Society of Cataract and Refractive Surgery.
Surgeons from all around the world were intrigued by his “clever” design, Webb says.
“I think this device is going to bring us closer to the holy grail of excellent vision at all ranges — distant, intermediate and near,” said Dr. Vincent DeLuise, an ophthalmologist who teaches at both Yale University and Weill Cornell Medical College in New York.

Pending clinical trials on animals and then blind human eyes, the Bionic Lens could be available in Canada and elsewhere in about two years, depending on regulatory processes in various countries, Webb says. Webb is hopeful that his lens will do away with the need for laser eye surgery, a procedure that still isn’t as efficient as it could be.
“Perfect eyesight should be a human right,” he says.

When suffering from diabetes, choosing what to eat every day can be a real challenge. Although there are many delicious foods, many of them are not suitable for your condition. If you choose the right foods, you can control your blood sugar level and thus prevent diabetes complications.

You fight and control your diabetes simply with the food you consume.
These 11 foods will help you fight diabetes and prevent its complications.

1. Kale
Kale is one of the healthiest and the most nutritious green in existence. It is rich in lutein, an important carotenoid which is extremely good for the eyes.
This property is especially important for people who suffer from diabetes because they may experience eye problems as complications of the disease. Kale is also high in fiber, iron, B vitamins, vitamin C, and calcium.

2. Nuts
Nuts are celebrated for their countless benefits, and they offer lots of nutrition for your body. They can improve the blood sugar control, especially in type 2 diabetes. They make the artery walls more flexible thus preventing blood clots.

3. Chocolate
Dark chocolate improves insulin sensitivity and helps in the prevention and treatment of type 2 diabetes. Also, dark chocolate significantly lowers blood pressure, reduces bad cholesterol and improves the blood vessel function. However, make sure you do not overdo it because it abounds in calories and fats.

4. Beans
These nutritional powerhouses are the perfect ingredient for salads, soups, and many other dishes. They offer lots of nutrition and reduce the risk of heart disease and diabetes. They are packed with fiber, which slows down the release of glucose into your bloodstream. This would prevent the blood sugar spikes and the feeling of hunger.

5. Blueberries
These sweet and nutritious berries abound in a high level of fiber which reduces the risk of cognitive decline and diabetes. They are rich in anthocyanins, specific antioxidants which according to recent research lower the risk of type 2 diabetes.

6. Barley
Barley is one of the healthiest cereal grain that is found in bread, beverages and some dishes. It can balance your blood sugar level and keep you satiated for longer. Also, barley contains a modest amount of calcium.

7. Salmon
Salmon is an important source of vitamin D, omega-3 fatty acids, and healthy fats that lower the risk of heart diseases, reduce inflammation, shape your waistline and improve insulin resistance.

8. Dairy
Dairy products abound in vitamin D and calcium, an important combination for treatment of diabetes.

9. Oats.
Nothing will give you strength and energy as a bowl of oatmeal. Oats are rich in fiber which can lower bad cholesterol and improve insulin resistance.

10. Oranges
According to many studies, people who suffer from diabetes have a low level of vitamin C in their bodies. So, make sure you eat more oranges and get the most vitamin C of them.

11. Soy Bean
Soy is loaded with high-quality protein that contains a low level of cholesterol and saturated fat.

6 Causes Of Foot Pain And How To Heal Them

1. Fractures

Diagnosis is made with an x-ray, and if you do have a fracture your foot will need to be immobilized with a cast or a boot. Vitamin D, Vitamin C and calcium are integral for bone repair and may help your bones to heal faster.

Proper hormone levels are also necessary for bone health; if you are a woman, get your estrogen levels checked, if you are a man, make sure your testosterone levels are normal.

2. Tendonitis

You have 31 tendons in a foot, and if one of them becomes inflamed it can cause a lot of pain. Like anywhere in the body, inflammation is designed to repair damaged structures, but inappropriate or unbridled inflammation can cause more harm than good.

If you have tendonitis in your feet, you want to rest them as much as possible and get a new pair of supportive shoes. Avoid foods that can cause inflammation, such as saturated and trans fats and increase healthy fats such as Omega 3 fish oils. Turmeric is a potent anti-inflammatory as well.

3. Plantar Fasciitis and Heel Spurs

Steroid injections are often used to manage the severe pain from plantar fasciitis, but while steroid injections significantly decrease pain, they actually weaken tissues and need to be readministered for long-term management. Platelet Rich Plasma (PRP) “is as effective as Steroid injection at achieving symptom relief at 3 and 6 months after injection. . . but unlike Steroid, its effect does not wear off with time.

At 12 months, PRP is significantly more effective than steroid” Joint mobilization of the foot and ankle, and stretching exercises (especially of the calf muscles) improved plantar fasciitis symptoms for up to a year.

You can also add in anti-inflammatories like EPA/DHA and Turmeric for natural management of inflammation. [see references above]. Change your shoes, sorry, no high heels, and acupuncture treatments may also be helpful in this case.

4. Morton’s Neuroma

Feeling like there is a pebble in your shoe between your third and fourth toes is from a thickening of tissue around one of the nerves leading to your toes. This is called Morton’s neuroma and can cause a sharp, burning pain in the ball of your foot.

This condition is often treated with surgery, but manual or physical therapy may eliminate the need for it. Steroid injections are also helpful to manage pain in the conventional setting, and we can, therefore, extrapolate that anti-inflammatory supplements may help to manage pain from Morton’s neuroma as well.

5. Gout

Gout is a painful arthritis caused by the deposition of uric acid in your synovial joints. Uric acid is a byproduct of a rich diet high in protein and fat; royalty used to be the only people afflicted with this disease of excess, but our standard western diets are high in fat and protein and we now see it throughout the population.

Decreasing meat and alcohol intake, while increasing the number of fruits and vegetables in your diet can help with gout pain. Cherries are especially effective in reducing gout attacks.

6. Neuropathy

Many diabetics experience foot pain from neuropathy. Managing blood sugar through diet may decrease neuropathic pain: avoid simple sugars, eat low glycemic, plant based, and unprocessed foods. B12 injections may also help with neuropathic pain.

Remember, it is important to have your foot pain diagnosed correctly so you may make the best treatment choices. In general, wearing supportive, well-fitting footwear and decreasing inflammation are effective first steps to decrease foot pain.

Sneakers and flats aren’t as sexy as stilettos, but they are much healthier in the long run because high heels put unnatural pressures on the foot in places it was not designed to withstand them. PRP and stem cell therapies are also incredibly effective to help tissues heal in the foot, and elsewhere.

CDC

2/2/2017

Yellow Fever in Brazil

Warning – Level 3, Avoid Nonessential Travel
Alert – Level 2, Practice Enhanced Precautions
Watch – Level 1, Practice Usual Precautions

What is the current situation?

The Brazilian Ministry of Health has reported an ongoing outbreak of yellow fever starting in December 2016. The first cases were reported in the state of Minas Gerais, but cases have since been reported in the neighboring states of Espirito Santo and Sao Paulo. Cases have occurred mainly in rural areas, with most cases being reported from Minas Gerais state. Some cases have resulted in death. Health authorities in the affected states, with assistance from the Brazilian Ministry of Health, are conducting mass vaccination campaigns among unvaccinated residents of affected areas.

In response to this outbreak, health authorities have recently expanded the list of areas in which yellow fever vaccination is recommended for travelers. For a list of these municipalities and a map showing the existing and new yellow fever risk areas in Brazil, see the World Health Organization’s most recent update (scroll down on linked page for the list).

The Brazilian Ministry of Health maintains a list of all other municipalities in Brazil for which yellow fever vaccination continues to be recommended (not including recently added municipalities). It is located at http://portalsaude.saude.gov.br/images/pdf/2015/novembro/19/Lista-de-Municipios-ACRV-Febre-Amarela-Set-2015.pdf.

Anyone 9 months or older who travels to these areas should be vaccinated against yellow fever. People who have never been vaccinated against yellow fever should not travel to areas with ongoing outbreaks. CDC no longer recommends booster doses of yellow fever vaccine for most travelers. However, a booster dose may be given to travelers who received their last dose of yellow fever vaccine at least 10 years ago and who will be in a higher-risk setting, including areas with ongoing outbreaks. Because of the ongoing outbreak, travelers to the Brazilian states of Minas Gerais, Espirito Santo, and parts of Bahia, Sao Paulo, and Rio de Janeiro states may consider getting a booster if their last yellow fever vaccination was more than 10 years ago. Travelers should consult with a yellow fever vaccine provider to determine if they should be vaccinated. For more information on booster shots, see “Clinician Information,” below.

Because of a shortage of yellow fever vaccine, travelers may need to contact a yellow fever vaccine provider well in advance of travel.

What is yellow fever?

Yellow fever is a disease caused by a virus spread by mosquito bites. Symptoms take 3–6 days to develop and include fever, chills, headache, backache, and muscle aches. About 15% of people who get yellow fever develop serious illness that can lead to bleeding, shock, organ failure, and sometimes death.

How can travelers protect themselves?

Get yellow fever vaccine:

Visit a yellow fever vaccination (travel) clinic and ask for a yellow fever vaccine.
You should receive this vaccine at least 10 days before your trip.
After receiving the vaccine, you will receive a signed and stamped International Certificate of Vaccination or Prophylaxis (ICVP, sometimes called the “yellow card”), which you must bring with you on your trip.
For most travelers, one dose of the vaccine lasts for a lifetime. Consult a travel medicine provider to see if additional doses of vaccine may be recommended for you based on specific risk factors.
In rare cases, the yellow fever vaccine can have serious and sometimes fatal side effects. People older than 60 years and people with weakened immune systems might be at higher risk of developing these side effects. Also, there are special concerns for pregnant and nursing women. Talk to your doctor about whether you should get the vaccine.
Prevent mosquito bites:

Cover exposed skin by wearing long-sleeved shirts and pants.
Use an EPA-registered insect repellent containing DEET, picaridin, oil of lemon eucalyptus (OLE), IR3535, or 2-undecanone (methyl nonyl ketone). Always use as directed.
If you are also using sunscreen, apply sunscreen first and insect repellent second.
Pregnant and breastfeeding women can use all EPA-registered insect repellents, including DEET, according to the product label.
Most repellents, including DEET, can be used on children older than 2 months.
Follow package directions when applying repellent on children. Avoid applying repellent to children’s hands, eyes, or mouth.
Use permethrin-treated (clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself:
Treated clothing remains protective after multiple washings. See the product information to find out how long the protection will last.
If treating items yourself, follow the product instructions carefully.
Do not use permethrin directly on skin.
Stay and sleep in screened or air conditioned rooms.
Use a bed net if the area where you are sleeping is exposed to the outdoors.

Clinician Information: Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015
Yellow Fever in CDC Health Information for International Travel -“Yellow Book” Clinical and Laboratory Guidance
Diagnostic Testing
Testing for Vaccine Adverse Events

Alkaline Foods To Clean, Repair, And Regenerate New Cells

Due to various reasons like stress, pollution, and illnesses, your body goes through a lot of changes on a daily basis. This being the case, you need to take extra measures to rejuvenate the body on a cellular level to live a healthy life. Here are 10 alkaline foods that will clean, repair, and produce new cells in your body, strengthening your immune system:

1. Achiote

Achiote is a rich source of norbixin, which is a powerful antioxidant. The anti-mutagenic effect of norbixin on healthy cells helps them to stay healthy and disease-free.

2. Burro Bananas. Rich in iron and copper, burro bananas help in increasing the blood count in your body. They also help in the production of red blood cells.

3. Cantaloupes

Loaded with beta-carotene and phytochemicals, cantaloupes help your body fight toxins. They also help in the production of white blood cells and boost your immunity against toxic substances.

4. Oregano contains important organic compounds that can defend your body from various diseases in the gut. It can stimulate the production of white blood cells, helping you recover faster from illnesses.

5. Plums. The high content of antioxidants in plums makes them one of the best foods for strengthening your immune system. They are also known to slow down the chances of formation of tumor cells in your body.2

6. Sea Salt help in the excretion of excess acids through urination. They help in keeping the body in an alkaline state by balancing the pH of your blood.

7. Soursop fruit positively impacts your overall health by keeping your cells clean. Consumed through refreshing beverages or desserts, soursop is rich in antioxidants that stimulate the production of white blood cells. It also helps to get rid of toxins from the cells.

8. Teff contains substantial amount of nutrients that are important for cell growth and development. These nutrients help in creating new cells, repairing old ones, and encouraging the growth of healthy cells in the body.

9. Wakame. An important compound called fucoxanthin is found in wakame, which inhibits the growth of fat in the cells. It also helps in stimulating fat oxidation. This compound is rarely found in other vegetables.

10. Wild Rice is known to encourage the production of white blood cells. White blood cells are the first-line defense of your body. White rice also contains important components that help in producing collagen, which is needed to repair the cells of organs, tissues, and blood vessels.

Heart attack, heart failure, and cardiac arrest all fall under the umbrella of heart disease.

610,000 people die from heart disease annually—that’s one in every four deaths.

The term “heart attack” is often mistakenly used in place of “heart disease.” “Scientifically, the term means damage or death of the heart muscle.”

Also known as a myocardial infarction, a heart attack happens when blood flow to the heart is blocked, starving the muscle tissue of oxygen and causing damage. It’s often caused by a build-up of plaque in the arteries (called atherosclerosis).

Symptoms can be sudden, or they can build for days or weeks in advance, like chest pain, followed by nausea and vomiting. (Note: heart attack symptoms are often different in women than in men.)
Heart attacks are usually treated by opening the clogged artery, often with a stent or wire mesh that props the artery open. If a heart attack is treated quickly, damage to the heart muscle, which results from lack of oxygen, may be minimal. If treatment is delayed, the damage is more widespread or results in death. Sometimes death occurs quickly, even with treatment.

While heart attacks are caused by blood-flow problems, cardiac arrest results from a problem with the heart’s electrical circuitry. The electrical problem leads to an irregular heartbeat (arrhythmia), which in turn causes the heart to stop beating completely and usually without any warning.

With the heart completely shut down, “there’s not enough blood circulation, the blood pressure goes down, there’s no blood to the brain and the person faints.”

If the heart isn’t restarted within minutes, the person will die.

While heart attacks and cardiac arrest have different causes, both can result in serious harm, even death. In some cases, a heart attack can cause cardiac arrest, although it is not the only cause.

“Cardiac arrest doesn’t have to be from a heart attack, It could be anything—from drugs, if you drink 18 cans of Red Bull, from arrhythmia.” Other forms of heart disease can also cause cardiac arrest.

Heart attacks can also cause heart failure.

Most cases of heart failure are chronic and progressive, meaning they develop over years and get worse over time.

Heart failure does not mean the heart has failed or stopped working altogether; it means the heart can no longer pump blood efficiently. The condition has no cure, but it can be treated.

Chronic heart failure stems from many of the same problems behind heart attacks and cardiac arrest, such as coronary artery disease (which causes artery blockages), hypertension, and diabetes.

There is also acute heart failure, which can be a byproduct of chronic heart failure or of a heart attack. A recent study in the Journal of the American Heart Association speculates that this could be due to holiday stress, changed eating habits, or not getting medical care right away.

If you start early with Vitamin D supplements, you’d lower your risk for type 1 diabetes by 90% and type A influenza by 40%.
You’d also be half as likely to get a heart attack as those with a D deficiency. Vit. D boosts your bone and muscle mass and strength by helping in calcium absorption and can reduce the risk of falls by 19%. It can also protect against colon, prostate, and breast cancer. Make sure you get at least 600 IU of it daily.
Vitamins for good health – now that has been dinned into us right from childhood. There is no question that all vitamins are important, but vitamin D deserves a special mention. It is the wonder vitamin that helps your nerves to carry messages between your brain and other body parts and which enables your immune system to fight off diseases.
What Can Vitamin D Do For You?
1. Fortify Your Bones And Muscles
Vitamin D plays an important role in the absorption of calcium, and a lack of it can spell trouble for your bones and muscles. A vitamin D deficiency can cause rickets in children and osteomalacia in adults – diseases which are characterized by bone pain, muscle weakness, and soft or weak bones which do not have sufficient calcium in them.
Various studies have found that vitamin D supplementation can help prevent fractures too.
And that is not all. Vitamin D can also bolster muscle strength. Poor muscle strength is particularly risky for the elderly, leading to falls which can have serious consequences. Research among seniors shows that taking vitamin D supplements (700–1,000 IU per day) can reduce the risk of falls by as much as 19%.
2. Prevent Type 1 Diabetes
Type 1 diabetes, where the body’s immune cells erroneously attack insulin-producing cells, is usually seen in children and young adults.
But what if you could prevent it from developing in your child? A long-term study that looked at 10,821 Finnish children for 30 years from birth onward found that those who consistently took vitamin D supplements when they were infants had about 90% lower chance of developing type 1 diabetes than those who didn’t.
3. Protect Your Heart
There is evidence that a vitamin D deficiency can leave your heart weaker. A large study which followed 50,000 men for a decade found that those who had a vitamin D deficiency were twice as likely to have a heart attack than those who did not.
Low levels of vitamin D have also been linked to a higher risk of cardiovascular disease, heart failure, and stroke.
The sunshine vitamin could be protecting your heart by controlling blood pressure and stopping your arteries from getting damaged.
4. Lower Your Risk Of Cancer
Some research suggests that vitamin D could protect against certain cancers like colon cancer, prostate cancer, and breast cancer. A study even found that improving vitamin D and calcium levels substantially lowered the risk of most common cancers in post-menopausal women.
5. Increase Testosterone Levels
Low levels of testosterone can wreak havoc in a man’s life, affecting everything from his sex drive, fat distribution, bone mass, and muscle strength and mass to the production of sperm and red blood cells.14If you are dealing with this, upping your vitamin D intake might be an easy way to tackle it. A study compared the effects of vitamin D supplementation with a placebo among 165 men and found that vitamin D significantly increased testosterone levels.
6. Stave Off The Flu
Do you worry when flu season comes around? Well, worry no more – vitamin D might be able to protect you. A Japanese study involving 340 school children found that the group which received vitamin D supplements had 40% lower rates of type A influenza than the group that did not. This might be because vitamin D can mitigate the inflammatory reaction of white blood cells as well as enhance the production of microbe-fighting proteins in immune cells.

Are You Getting Enough Vitamin D? The Food and Nutrition Board recommends that you get about 600 IU of vitamin D daily if you are a healthy adult. Elderly people might need a little more (about 800 IU if you are 71 or older).
Our bodies can make this important vitamin when our skin is directly exposed to sunlight. We also get it through food – fatty fish like tuna and salmon are good sources. Also, milk is usually fortified with vitamin D in the US though milk products like cheese and ice cream may not be.

Some groups of people may be vulnerable when it comes to getting enough vitamin D and this can impact poorly on their health:

Human milk does not contain enough vitamin D and babies who are being breast-fed might end up being deficient. In fact, the American Academy of Pediatrics recommends that infants be given vitamin D supplements (400 IU/day) till they start consuming at least 1,000 mL of whole milk or formula fortified with vitamin D per day.
Those who do not get enough sun exposure or have dark skin might not be able to produce enough vitamin D from sunlight.
Elderly people might also be at risk because as we age our skin loses the ability to efficiently synthesize vitamin D.
Being obese may also cause you to end up with low levels of vitamin D.
Do take care to check in with your doctor before you get supplements, though. Excess amounts of vitamin D can be toxic and have effects ranging from nausea to constipation. It can also damage your heart and kidneys. The upper limit of vitamin D that can consumed safely is 4000 IU/day for adults.
You do not have to worry about overdosing on vitamin D by getting too much sun, though, as the body automatically regulates the amount it produces – so the danger almost always comes from taking unnecessary supplements. However do keep in mind that too much sun can up your risk for skin cancer, so do not ditch your sunscreen!