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I love new beginnings seasons, dried figs, maternity belly and old cabinets. I man, who fools the technology, I prefer postcards as SMS messages and a hundred times rather go to the movies or the theater as watching TV. but I also have a weakness: my computer, namely, that it is my love. the first Mac I had an unscheduled and is really not enough razveselia, because I think that you do not need. our love has grown slowly and at the end when he broke down before parimi months ago, I was really miserable. today I got a new one: of course I sacrificed a few hours of learning and with it better to know (yeah, I decided that this time the woman) and together we have selected some popular supplements, without which it is not easy.
(hmm, I always wanted to be a writer sometime in 1910, and typing on a typewriter)

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Sometimes Fate is like a That keeps small sandstorm Changing directions. You change direction But the sandstorm chases you. You turn again, But the storm adjusts. Over and over you play this out, like catfish ominous Dance With Death Just Before Dawn. Why? Because this Is not Something That storm blew and from far away, Something That has nothing to do With You. This storm is you. Something inside of you. So all you can do is Give in to it, step right inside the storm, closing your eyes and plugging up your ears so the sand doesn't get in, and walk through it, step by step. There's no sun there, no moon, no direction, no sense of time. Just fine white sand swirling up into the sky like pulverized bones. That's the kind of sandstorm you need to imagine.

An you really will have to make it through that violent, metaphysical, symbolic storm. No matter how metaphysical or symbolic it might be, make no mistake about it: it will cut through flesh like a thousand razor blades. People will bleed there, and you will bleed too. Hot, red blood. You'll catch that blood in your hands, your own blood and the blood of others.

And once the storm is over you won't remember how you made it through, how you managed to survive. You won't even be sure, in fact, whether the storm is really over. But one thing is certain. When you come out of the storm you won't be the same person who walked in. That's what this storm's all about.
— Haruki Murakami

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Hepatitis A: Immigrants are more naturally immune? The

Prevalence of antibodies against hepatitis A
Source: Centers for Disease Control and Prevention. The Yellow Book, 2010 Edition
http://wwwnc.cdc.gov/travel/content/yellowbook/home-2010.aspx

Vaccination against hepatitis A is recommended ; for travelers going to countries where the disease is endemic. In areas of high transmission of the virus circulation is very frequent, it is a microorganism that can easily contaminate food and water. In developing countries the infection usually occurs in childhood, a time when it is often asymptomatic.

Until a few years ago it was believed that people who were born and have lived a long time in an endemic area were naturally immune, having contracted the infection - in subclinical or clinically manifest - a ' an early stage of their lives.

have recently produced evidence related to a reduction in the circulation of hepatitis A in many countries in developing as a result of improved sanitation situation occurred in recent years. As a result, the infection tends to occur at a later age and the proportion of naturally immune subjects among young people is lower than in the past.

A study of the Pasteur Institute in Paris (1) reports the results of seroprevalence of antibodies against hepatitis A virus in immigrants who were born and have lived for at least a year in a developing country . These are people that in the period September 2008 - February 2010 have turned to the center because they intended to make the vaccine from the Pasteur Institute in the country of origin. All subjects were given the research of antibody to hepatitis A. During the period of observation, the test was conducted on 646 people.

The overall seroprevalence was 82, 4%. significant differences were found in seroprevalence by region of origin, that I summarized in the chart below.

Another important variable is represented by age. Multivariate analysis showed a statistically significant difference between the proportion of immune in age groups younger than most elderly, with a proportional increase in age.

Finally, another variable is represented by length of stay in an endemic area. The average duration was 22.6 years (range 1-64 years). As you might guess, a long stay was associated with a higher rate of seropositivity.

Conclusions The study shows that the seroprevalence of hepatitis A has undergone changes in the immigrant population, such as to suggest an adaptation prevention strategies in this category of passengers. The authors suggest to perform the pre-vaccination serological test if the migrant intends to travel in the country of origin or in other areas at risk, or if there is enough time because of an imminent departure, directly to practice vaccination.

What this study tells us
When we are dealing with a young immigrant (child, teenager or young adult), especially if it comes from Eastern Europe, Central and South America , or the Far East, we must not give for granted that it is immune against hepatitis A. What is the best strategy to be implemented, ie whether it is preferable to serology or vaccination per se, can be discussed. Certainly we can not ignore the changes in the epidemiology of hepatitis A occurred in countries that have recently improved their socio-economic conditions - including health - and are entering the international arena as a new industrial powers. It would also be interesting to know the seroprevalence in immigrants in Italy, which does not necessarily have the same characteristics of the subjects included in the French study. Recently in our country has been published only study of its kind: the study population, however, was restricted to immigrants from sub-Saharan Africa, which showed positive for hepatitis A IgG 99.5% (2).

Bibliography

1. Anna E. Gergely, Stephane Bechet, Angèle Simons de Fanti et al. Hepatitis A Seroprevalence in a Population of Immigrants at a Frenchman Vaccination Center. J Travel Med, 18:126-129, March / April 2011

DOI: 10.1111/j.1708-8305.2010.00495.x

http://onlinelibrary.wiley.com/doi/10.1111/j.17088305.2010.00495.x/abstract  

2. Majori S, Baldo V, Tommasi I, et al. Hepatitis A, B, and C infection in a community of sub-Saharan immigrants living in Verona (Italy). J Travel Med 2008;15:323-7

DOI: 10.1111/j.1708-8305.2008.00230.x

http://onlinelibrary.wiley.com/doi/10.1111/j.17088305.2008.00230.x/abstract