It’s been raining an inordinate amount this summer and coupled with the fact that July and August are usually mosquito months in the capital, we thought it prudent to share some medical information on the dangers of this pesky bug, as well as advice on how to avoid them. The following information is shared by Oasis International Hospital.

While most of us may be familiar with the threat of dengue fever, malaria, and Zika, a more common mosquito-borne disease in China is actually Japanese encephalitis (JEV). There are approximately 33,900 cases of JEV every year, with most of the cases occurring in rural areas with irrigation farming. Here’s a small hurrah though – the World Health Organization (WHO) declared China malaria-free this year!

Are there are any vaccinations we should consider taking against any mosquito-borne diseases here?

Diseases that spread to people include Malaria, Zika virus, West Nile virus, Chikungunya virus, dengue, and Japanese encephalitis (JEV). Of these, only JEV and dengue have vaccines, but dengue vaccines can only be given to those with a previously confirmed dengue infection. In China, only JEV vaccine is commonly available.

Ways to prevent mosquito bites:

1. Reduce prolonged travel to rural areas from sunset to sunrise in May to September.
2. Cover up with long-sleeved tops, trousers, and socks when engaging in an outdoor activity such as hiking, camping, or cycling.
3. Install window screens over windows if sleeping indoors or sleeping under Permethrin-treated mosquito net if sleeping outdoors.
4. Avoid locations with standing water as this attracts mosquitos.
5. Apply a light cover of mosquito repellent on unbroken and exposed skin and face (except eyes). DEET has been in use for over 70 years as an insect repellent and covers for the longest duration of time. Products with 30 percent DEET are adequate for most conditions and should be re-applied every five hours or if swimming, washing, or in rainfall. Pregnant women shouldn’t take DEET in the first trimester and nor should children less than 2 months old. Sunscreen should be applied first before applying repellent.

Consult with Oasis’ Internal Medicine Dr. Liu Zhenqian if you may be traveling to rural areas in Asia or have children less than 15 years old to consider getting vaccinated against JEV. This is a single dose vaccine with a one-year booster and six-year booster (if necessary).

Traveling outside of China to high-risk malaria countries such as India may require prescription doxycycline one to two days before travel, taken daily, and 28 days after travel.

Proper mosquito bite care:

1. Try to leave the bite alone because if you scratch, it creates openings in your skin, thus allowing bacteria in and causing infections.
2. Apply External Over-The-Counter (OTC) mentholatum products, calamine lotion, or hydrocortisone cream to help relieve itchiness while avoiding the eyes and open cuts.
3. Take Oral OTC: Clarityne as prophylaxis for allergy sufferers or when necessary as anti-histamine.
4. Apply a cool compress or ice pack to help soothe the bite and reduce the itching.

If the bite causes fever, vomiting, or shortness of breath, call 120 or go to the nearest fever clinic to get treated immediately.

KEEP READING: Expat Kids Still Excluded as Beijing’s 12- to 14-Year-Olds Start Vaccinations

Images: Pexels

More bad news today as the Chinese vaccination scandal has deepened, with now 13 companies under investigation.

In the wake of it all, a lot of Beijing parents are asking themselves: What now? Should I proceed with my child’s vaccinations?

First of all, to frame the debate, we don’t intend to address the bigger issue of whether you should vaccinate at all. However you stand on that hot-button issue, we are presuming that those of you reading this support vaccinations as routine healthcare. Those that choose not to vaccinate as a practice we are assuming would not be interested in the details below of how to do so safely in Beijing.

What We Know So Far

First of all, news reports indicate that the scandal is limited to the improper handling of legitimate vaccines, and not a case of counterfeit or fake vaccines.

The issue at hand is that unlicensed middle men have become involved in the vaccine supply chain, acquiring vaccines from legitimate state-sanctioned medical supply companies and then selling them on to hospitals in China.

The crux of the issue is how these middle men have been handling the storage of vaccines during the logistics process.

Most vaccines require proper refrigeration "from the time they are manufactured until they are administered," according to the American Centers for Disease Control and Prevention (CDC).

I’ve Already Gotten a Vaccine, is My Child at Risk?

Poorly kept vaccines are unlikely to have turned virulent, "spoil" or otherwise cause disease in your child, according to both the World Health Organization and the CDC. However, the CDC states, improper handling of vaccines can decrease the potency and reduce the effectiveness of a vaccine.

That means that your child could then be susceptible to the very disease they were vaccinated against, should he or she be exposed to that disease into the future.

Those concerned about the effectiveness of specific vaccines received in the past can arrange to have their child tested for antibodies to the disease vaccinated against. If the vaccine was indeed effective, your child should have antibodies to that particular disease present in their system.

How Vaccines are Regulated in China

All vaccines in China must be ordered from vendors which are approved by the China Center for Disease Control. Any hospital that wishes to offer vaccination services must purchase from an approved vendor. However, each hospital is free to choose a supplier from within the spectrum of approved vendors.

That means every hospital could potentially be getting their vaccines from a different vendor; however if the regulatory system works the way it should, all will have come from government-approved and regulated channels.

Should I Go Ahead Then With Vaccines in Beijing?

The question then becomes: what is your next step as a parent if your child is due for a vaccination?

First of all, anything that we can offer here as a media outlet is only a suggestion, and we strongly suggest you consult directly with a trusted medical doctor or hospital and don’t take your advice solely from this blog.

Having stated that, we believe the wisest course of action is to take responsibility for informing yourself of the risks associated with getting vaccinations in China, and only work with trusted hospitals and doctors.

Here are some common-sense measures, which we would hope all parents would follow anyhow:

Ask your hospital about their vaccine sourcing. What we recommend is that you talk to your doctor or hospital and asked them specifically about the source of their vaccinations. Many hospitals manage their supply chain carefully and are very detailed about sourcing and on-site management of their vaccine supply. If they are unable to provide you with details of their supply chain, reconsider your choice.

Don’t accept a vaccine that comes from a source you can’t verify. Most international-standard hospitals in Beijing will offer the patient the opportunity to examine the packaging of the vaccination itself before it is opened in the examination room. Do not accept a vaccine that comes pre-drawn in a needle with the packaging discarded.

Consider a delay in your child’s immunization schedule if practical. Many vaccines can be postponed to a later time in a child’s life; a common-sense approach may be to wait to see how this news story develops.

At the very least a delay of a few months may make little difference to your child’s health and give regulators time to dig deeper and clear the system of likely ineffective vaccines.

Ultimately this scandal raises quite a few unanswered questions. First and foremost, anyone who has lived in Beijing through the 2008 Melamine scandal or SARS in 2004 can attest there’s plenty of examples of health crises that have ballooned despite regulations designed to prevent such occurrences.

And given that many industries are rife with counterfeit products in China, a parent would not be out of order to second-guess something like this.

It comes back down to a question of how much you trust government agencies such as the Chinese Center for Disease Control to truly prevent things like this from happening.

While well-managed hospitals can guarantee that they work only with trusted suppliers and that vaccines in their hands are handled according to strict protocols, there remains the possibility that even approved suppliers may not be giving the vaccines the proper handling they need to preserve their effectiveness.

Few hospitals we contacted for this story were willing to talk on the record regarding vaccines; however some have posted official statements on their websites. United Family Hospital has this statement on their website detailing how they source and handle vaccines and reassuring the community that there has "never been an untoward adverse clinical event associated with the administration of any vaccine at any UFH facility" throughout China.

 Image: gercekgundem.com

New owners of recently acquired puppies and kittens often bring the newest members of their families directly to the pet hospital for a checkup to ensure the pet is healthy. While this takes place daily in every country, a unique situation we see in China is that nearly all of the owners of purchased pets were told by the sellers or breeders that their pets are already fully vaccinated and won’t need additional shots. The pet vendors and sellers in China are largely unaware of the proper vaccination schedule for pets and so start vaccinations much too early, meaning the puppies and kittens are improperly vaccinated and inadequately protected against common infectious diseases such as canine or feline distemper virus and parvovirus and even the deadly rabies virus.

Our puppies and kittens need to be vaccinated to protect them against infectious diseases that they may be exposed to in their daily routines. Vaccination is particularly essential in China as the pet population is largely unvaccinated at this time. A low vaccination rate means that there is a higher rate of infectious disease within pets in our community. We recommend vaccinating all pets against rabies and distemper annually. The canine distemper combination vaccine protects against the distemper virus and several other infectious diseases such as hepatitis, parvovirus, parainfluenza, leptospirosis and coronavirus in dogs. For cats, the feline distemper virus protects against feline viral rhinotracheitis, calicivirus, and panleukopenia virus. Our recommendation for annual vaccinations extends to both indoor cats and dogs that rarely go outside as some of these viruses may be spread by fecal matter tracked into the house on soles of shoes.

Young or previously unvaccinated animals must be vaccinated several times in order for them to develop a sufficient level of antibodies for protection. Vaccination must be performed on a certain time schedule to develop immunity against a disease. We vaccinate starting at six-eight weeks of age to protect the animal should they have received insufficient protective antibodies from their mother.

If a young animal still has high maternal antibodies the initial vaccines will not stimulate the immune system, as the maternal antibodies will neutralize the vaccine. The age at which the maternal antibodies are low enough for the vaccine to stimulate the immune system is different for each animal. Based on the science of immunology, we vaccinate in a series of injections (called booster vaccinations) approximately every three-four weeks until an animal is 16 weeks of age. If we were to merely wait until an older age to start vaccination, the animal could be at risk of infection because the maternal antibodies may be too low.

So for a six-eight-week-old puppy or kitten, he or she would receive three injections of the distemper vaccine at three-four week intervals and then the rabies vaccination when they are at least three months (or 90 days) old.  The time period between each booster vaccination is also important. If given too closely together, vaccines can interfere with each other and insufficiently stimulate the immune system. Your veterinarian will make recommendations for your pet’s vaccination schedule based on your pet’s age, breed, health condition and medical history, before providing a tailored vaccination schedule for you to follow and take with you. Following these recommendations closely is crucial to protect your pet against infectious diseases.

To ensure the safety and quality of vaccines for your pets, please take your pets only to officially designated animal vaccination hospitals. These officially designated animal vaccination hospitals are issued a bronze plaque from the Agricultural Bureau that must be displayed prominently for all pet owners to see. The animal rabies, distemper and other vaccines used by officially designated animal hospitals may only be sold to them by the Agricultural Bureau that acts a vaccine distribution monopoly and controls all vaccine imports and sales to designated animal hospitals. Any other outlets cannot legally purchase rabies vaccines, and so their only recourse is to purchase vaccines from unsecured illegal channels where the vaccines may be counterfeit, expired or improperly stored and therefore, ineffective.

By vaccinating our pets against zoonotic diseases such as rabies, we are also safeguarding human public health. Click here for more information on rabies awareness and prevention.

You can follow ICVS on Weibo, Twitter and Facebook.

Mary Peng is the Co-Founder & CEO of International Center for Veterinary Services (ICVS).

This post first appeared on thebeijnger.com on July 30, 2014.

Photo: thebeijinger.com