Health Alerts
Australia: More measles cases surface in Sydney

A further spread of measles infections has been reported in Sydney – up to 10 people have been diagnosed with the highly infectious disease in the last week alone. This takes the case count for NSW this year to 19. Read more. Several states have reported measles cases imported from overseas recently. Read more.

Advice for travellers: Measles is a highly contagious virus and can cause serious illness in people of all ages. Most of the rising number of cases reported in Australia are linked to overseas travel - both developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure.

Brazil: Rio now in YF risk area, situation in 2 states improving

Information in the latest Pan American Health Organization (PAHO)/WHO yellow fever (YF) update on Apr 4 includes the news that the entire state of Rio de Janeiro, including urban areas of Rio city is now in the risk area for YF infection where vaccination is recommended. This comes as an Apr 3 PAHO report revealed that 5 of the 6 locally acquired cases in Rio de Janeiro state were residents of a city approx. 136 kms from Rio, Casimiro de Abreu (the 6th was further north, in São Fidélis). Data up to Mar 29 showed that, overall, case numbers are declining in the states of Minas Gerais and Espírito Santo but that 'there were 1987 cases of yellow fever reported (574 confirmed, 926 discarded, and 487 suspected under investigation), including 282 deaths (187 confirmed, 24 discarded, and 71 under investigation). The case fatality rate (CFR) is 33 percent among confirmed cases.’ Read more. Additionally, Para state is the latest to report YF – a Mar 31st release by the ECDC noted there had been 4 (fatal) cases in the state. 
Other countries in the region to be reporting YF cases are Colombia, Ecuador, Peru (9 cases), Bolivia, and Suriname. Read more.

Advice for travellers: Yellow fever virus is a mosquito-borne disease found in tropical and subtropical areas in South America and Africa. While it can be severe, yellow fever infection is a very rare in Australian travellers. However, under the International Health Regulations (IHR), proof of vaccination may be required of any traveller entering or leaving an area at risk of yellow fever transmission. Read more about yellow fever

China: ‘Mad honey’ risk; Bird flu update, WHO assessment

News this week that a Hong Kong man became ill after eating honey given to him by a friend who had sourced it from Nepal. The honey was found to contain grayanotoxin, which produces the symptoms of dizziness and shortness of breath. Nectar from a family of plants that includes rhododendrons (Nepal's national flower) contains the neurotoxin, which is then collected by bees to make honey – this can lead to what was first noted in the Black Sea area of Turkey as ‘Mad Honey Disease’. Read more.  
H7N9 avian influenza cases on the mainland have now hit a 4-year high, with a further 17 cases reported in the week to Mar 31st. Six of the cases were from the province of Hunan, followed by Jiangsu and Guangxi (3 each), Fujian and Guizhou (2 each) and 1 case from Zhejiang. Most had had direct contact with poultry. Read more. The WHO risk assessment of the current wave of infections recommends that: ‘travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.’ 

Europe: Flu season draws to a close

The flu season is winding down across the continent, with only Greece reporting medium level activity – all other country’s indicators are low. The predominant strain has switched from A(H3N2) to B, as is often the case at the end of the season. The WHO global flu update notes that influenza activity is dropping in North America but remains high in South Asia (mainly India, Maldives & Sri Lanka). A local news report in Taiwan indicates a rise in the incidence of flu recently, with a B strain becoming more prevalent. Read more.

Mozambique: Cholera outbreak slowing

There is hope that the cholera outbreak which killed 3 people and sickened a further 1,400 is almost over. A health official announced that this week there had been a reduction in the rate of infections - 200 new cases from the 360 reported last week. Read more.

Advice for travellers: Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera

New Caledonia: Dengue scourge - some improvement seen

For the first time since the dengue epidemic was declared in January, there has been no week-on-week rise in new cases. While it was noted that the numbers were slowing, the outbreak is not over as yet. Official figures show that for the month of April there have been 63 new cases, adding to the cumulative total since Sept 1, 2016 of 2,404. Read more.

Advice for travellers: Dengue is spread by two types of Aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid outdoors. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply an effective repellent containing an active ingredient, such as DEET, Picaridin, or PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites

New Zealand: Typhoid hits worshippers; Auckland mumps rises to 39

A church in Mt Roskill, a suburb of Auckland 7kms south of the CBD, is the epicentre of a typhoid outbreak that has so far sickened 16 people (plus 2 more suspected cases) and caused one fatality - a woman with pre-existing medical conditions. Parishioners of the Mt Roskill Samoan Assembly of God Church live in southern and central parts of the city and currently the Auckland Regional Public Health Service is tracking 60 contacts of the patients. A factsheet on typhoid has been released by the ARPHS. Read more.  
IN other news, the city’s health department is also having to deal with an ongoing outbreak of mumps which has produced 39 cases since January. The majority of cases have been in the 10 to 19 years age group; however of those affected there has been an infant of 5 months and an adult male of 51 years. Read more.

Advice for travellers: Typhoid occurs in some Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters. Read more about typhoid.

Nigeria: Men. Meningitis tally nears 3,000

Up to April 3 the outbreak of meningococcal meningitis, due for the most part to the C strain, had generated 2,997 cases with 336 deaths (under half were laboratory confirmed). The epidemic which is now being called the worst in 8 years first started in the state of Zamfara, but is now affecting Katsina, Sokoto, Kebbi and Niger, Kano, Cross River and the capital, Abuja. A massive vaccination campaign is underway. Read more

Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. Nigeria lies in North Africa’s ‘meningitis belt’, where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). If you plan to visit this region, call Travelvax Australia’s free travel health advisory service (1300 360 164 - toll-free for landlines) for further advice. Read more about Men. meningitis.

Portugal: Lisbon's Hep A spike

According to local health authorities, the hepatitis A outbreak that has spread across 13 European countries (reported on Mar 2, 2017) has produced 105 new cases since January, many of them in Greater Lisbon. As with the initial post, men who have sex with men have been most affected; vaccination against Hep A is highly recommended when travel, lifestyle or sexual practices increase the risk of this faecal-orally transmitted infection. Read more.

Advice for travellers: Hepatitis A (HAV) is one of the more common infections for overseas travellers. It is a significant risk in most developing countries, especially where sanitation and hygiene are lacking. The virus is transmitted by faecally contaminated food and water, or by handling everyday items, such as craft items, money, door-handles etc. A course of hepatitis A vaccine offers immunity that’s 99%-plus effective and long lasting (20-30 years). Travellers should also follow safe food and water guidelines.

Republic of the Congo: Viral disease hits north

Monkeypox infections continue to spread in the northern province of Likouala 2 weeks after first news of the outbreak. Up to March 28th, there had been 26 unconfirmed cases with 4 deaths. Read more.

Advice for travellers: Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox

Saudi Arabia: WHO update - more MERS cases

Healthcare transmission of the MERS virus at a Riyadh hospital has contributed to the 18 new cases reported in a WHO update this week. Meanwhile details of a new case in Doha, Qatar were released – the man, who has other medical problems, became ill in mid-March but has no history of travel outside the country or contact with camels. Read more.  

Singapore: Zika count increases by 2

The National Environment Agency has announced a further 2 Zika virus cases, taking the total for the first 13 weeks of the year to 8. No futher details were available. Read more.

Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).

South America: Slow release of chikungunya data

Once again very few countries provided information on new chikungunya cases for the weekly update. Among those and with the highest count was Bolivia with 297, followed by Guatemala (83), Paraguay (40) and Peru (33). Read more.

Advice for travellers: Like dengue fever and Zika virus, chikungunya virus is spread by the daytime-feeding Aedes aegypti and Aedes albopictus mosquitoes. The only way of preventing infection is to avoid mosquito bites. Read more about chikungunya

Sri Lanka: Dengue season hits hard in west

Of the 26,000 dengue fever cases and 53 related deaths this year, over half have been in the Western Province. As part of its response, the Dengue Control Body has declared alerts for the districts of Colombo, Gampaha, Kalutara, Galle, Matara, Hambantota, Batticaloa, Trincomalee, Jaffna, Ratnapura and Kegalle. Read more.

United States of America: Mumps updates from 3 states

News on the ongoing mumps outbreaks that have hit several states shows no contraction yet. Cases continue to be reported in Washington, Arkansas and Louisiana. Across the border in neighbouring Canada, Ontario has hit a 25-year high in cases. Read more

Advice for travellers: This ongoing outbreak of mumps highlights the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to any destination – be it a developed or developing country. Read more about mumps.

Zimbabwe: Dire sanitation conditions trigger disease

The latest news on the typhoid outbreak that has hit Harare and the provinces of Mashonaland West & Central dates from the second week of March. In it the Department of Health & Child Care announced that around 30 percent of cases were in children under 5 years of age. According to the department’s Facebook post, ‘cumulative typhoid figures nationally from 1 January to 16 March 2017 are 1 753 suspected cases, 43 confirmed cases and 5 deaths. However these are part of an ongoing outbreak in Harare City which started on 13 October 2016. To date there are 1 865 suspected typhoid cases, 96 confirmed and 10 deaths reported.’