Health Alerts
Australia: Mozzie threat over holiday time; Water carries disease threats in Melbourne, Darwin

NSW’s Health Minister has issued a warning for people planning on spending time outdoors over the Easter break to avoid mosquito bites. The flooding in the north of the state, as well as recent rains in the south, have increased the risk of transmission of diseases such as Ross River fever and Barmah Forest virus. Read more.
IN Melbourne, 5 people are recovering in hospital after receiving treatment for Legionnaire’s disease; it is believed they contracted the bacteria while in a limited area of the CBD. Decontamination of water systems and cooling towers is currently being carried out. The state health department website at health.vic is advising medical follow-up for anyone with ‘influenza-like symptoms, particularly those with severe pneumonia, who have been around the Melbourne CBD or Southbank areas since the end of March 2017.’ Read more
NEW building works underway in Darwin are believed to be part of the reason for an uptick in melioidosis cases in the Territory. While the causative bacterium is present in the soil in many areas of the Top End, it takes heavy rains for it to become easier to infect people. So far this year, Darwin has seen 39 cases and 9 deaths. Read more. More on melioidosis.

Advice for travellers: Cases of Ross River occur throughout Australia, including more temperate southern states. Travellers visiting areas of Australia affected by recent flooding or continuing rain should take measures to prevent mosquito bites. Use a personal effective insect effective ingredient such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors and wear long, loose-fitting, light coloured clothing – especially at dawn and dusk, the times of day when RRV-carrying insects are most active.

Bhutan: Continued hope for measles elimination

The target for eliminating measles is the end of 2018, but it’s hoped that results of tests carried out on 16 cases reported in Samtse, Phuentsholing and Thimphu this year will show that they weren’t indigenous cases, but were caused by imported strains of the virus. Both Samtse and Phuentsholing lie in the country’s west, near the border with the Indian state of West Bengal. 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. 

Botswana: Malaria rise to persist till May

The malaria surge first announced in February this year is likely to continue to the end of the current wet season in May. The north-western district of Okavango has been severely hit. Read more.

Advice for travellers: Malaria is endemic in many areas of southern Africa. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164.

Brazil: Yellow fever update

An area taking in the five states of Espírito Santo, Minas Gerais, Pará, Rio de Janeiro, and São Paulo is the epicentre of the current yellow fever outbreak.. According to the Pan American Health Organization (PAHO) April 6th update, there have been ‘2,210 cases of yellow fever reported (604 confirmed, 1,054 discarded, and 552 suspected under investigation), including 302 deaths (202 confirmed, 52 discarded, and 48 under investigation).’ Over the last week or so, southern parts of Espírito Santo and the state of Rio de Janeiro have been seeing a rise in cases, and 4 confirmed infections were reported from Pará (towns of Alenquer & Monte Alegre). The report goes on to say that the urban-dwelling Aedes aegypti mosquito (also the vector of dengue, Zika & chikungunya) does not seemed to have played a part in the spread of the diseas thus far. The PAHO warns that there continues to be a risk of the outbreak widening to include other countries in the region following the reporting of outbreaks in primates in states adjacent to national borders. Read more  More on yellow fever from the World Health Organization (WHO). 

Canada: Mumps in Manitoba

There’s been no relief from the reports of mumps cases occurring in many regions of North America. This week it has been announced that Manitoba has recorded almost 100 cases over the past month, bringing the total for the past 7 months to a 20–year high of 290. Read more.

Advice for travellers: The outbreaks of mumps occurring across several regions of North America highlight 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.

China: Human bird flu first for Tibet, more mainland cases

A Chinese national, who was known to work with live poultry has been diagnosed with H7N9 avian influenza – he is currently being treated at a hospital in Lhasa. Read more. Chinese authorities announced a further 14 cases for the mainland (in addition to the Tibet case) this week: Beijing (3 cases), Hunan & Jiangsu (2 cases each) and one case each from Chongqing, Fujian, Gansu, Guizhou, Henan, Shandong and Zhejiang. Read more.

Czech Republic: Measles hike in Northern Moravia

Measles cases in the NW Moravian-Silesian Region have spiked recently, with as many as 38 cases diagnosed. The capital of the region, Ostrava has reported most cases to date. This follows reports of a sharp rise in cases across many countries in Europe, notably Romania and Italy. Read more.

Ethiopia: Gastro illness strikes near southern border

An outbreak of ‘acute watery diarrhoea’ (AWD) has struck a southern region near the border with Somalia. A news report gives varying details of the actual case count and death tolls but does note that medical teams have been sent to the area to provide treatment. Read more. And in Somaliland, an outbreak of cholera/AWD has sickened over 400 people and caused the deaths of 28 over the past 12 days. 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

India: Uptick in chickenpox

Cases of chickenpox have topped the 1,000 mark in Mumbai during February and March, double the 4-month total for the beginning of 2016 – most cases have been in children. Read more.

Advice for travellers: Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.

Kenya: Malaria spike in central west

Continuing rains falling in Uasin Gishu County, part of the former Rift Valley province, have led to a spike in malaria cases. Around 100 cases have been recorded over the last 4 weeks and more are expected right up to the start of the dry season in July. Read more.

Marshall Islands: New outbreak for Majuro

The hepatitis A outbreak that hit the islands in January has been controlled with an extensive vaccination program, but now mumps is circulating among schools in teh capital, Majuro. Authorities have announced that there have been more than 250 cases in total. Read more.

Nepal: Leishmaniasis outbreak hits the unwary

Leishmaniasis, or kala azar (a parasitic disease transmitted by some species of phlebotomine sand flies), has caused at least 2 deaths and sickened many other villagers from the Sarlahi district in southern central Nepal. Calls have been made for more awareness of the disease and its prevention among local people to prevent more cases occurring. Read more.

Advice for travellers: Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention. 

New Caledonia: Dengue persists into April

Three dengue virus serotypes are circulating in the current epidemic declared in early January. The case count for April (till the 12th) increased to 215 from last week’s 63. Read more.

New Zealand: More news on typhoid outbreak

The number of infections in the outbreak stemming from the Mt Roskill Samoan Assembly of God Church now sits at 20, with a further case under investigation. Testing of contacts revealed the 2 most recent confirmed cases; however they were not showing symptoms. Read moreSamoan health authorities have requested that any nationals who have recently travelled to Auckland (and in particular to areas around Mt Roskill) be tested for typhoid. Read more.

Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary specific, but is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid

Nigeria: Men. Meningitis toll nears 500

While there are a total of 19 states reporting meningococcal meningitis cases, it’s the states of Zamfara, Katsina, Kebbi, Sokoto and Niger that have borne the brunt of the outbreaks. The most recent report issued by the Nigeria Centre for Disease Control (NCDC) on April 6th gave the case count as 3,959 infected with 438 deaths (updated to 4,637 cases & 489 deaths on Apr 11). As mentioned in previous reports, the bacteria's ‘C’ strain is largely responsible and the hardest hit age group is the 5 to 14 years cohort. 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.

Pakistan: Chickenpox outbreak hits major city

It’s not just children who are falling ill in a chickenpox epidemic that has struck the city of Faisalabad, adults and the elderly have also been affected. The death toll in the outbreak now sits at 12 as local authorities attempt to source adequate supplies of vaccines for this central region of Punjab province. Read more.

Peru: Rains add to dengue woes

At least 3 people have died of dengue fever in the current season, with rains prolonging the threat. In the north-west, Piura's dengue case count is 707, a figure that is 20 percent of the national total. Read more (translate from Spanish).

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 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.

Singapore: Zika, dengue updates

The area of the first Zika virus cluster of the year remains under surveillance and has produced no further cases; however 4 new cases were identified this week from the Hougang/Serangoon area in the city-state’s east. Read more. Three locations in the north, east and south have produced the most recent dengue fever cases as the year’s case count reached 781 this week. 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). 

United Arab Emirates: MERS revisits

The first case of MERS Co-V to occur in the Emirates in 10 months has been announced this week. The man has been hospitalised in Abu Dhabi; however no further details were provided. The Ministry of Health and Prevention is advising people to employ strict personal hygiene measures: ‘wash hands often with soap and water, use hand sanitiser if the former is not readily accessible, cover the nose and mouth with a tissue when coughing or sneezing and throw the tissue into a rubbish receptacle.’ Read more. More on MERS.

United States of America: Parasitic infection in Hawaii, Maui

Several confirmed and suspected cases of the parasitic ratworm lung disease, or Angiostrongylus infection, have been reported on Hawaii’s Big Island and Maui recently, leading health authorities to advise locals to ensure fruit and vegetables are washed thoroughly before consumption. Read more

Zimbabwe: Floods bring disease menace

The provinces of Matabeleland North, South and Midlands continue to suffer the after-effects of flooding, with a total of 192 deaths among the nearly 135,000 malaria cases reported since January. Read more.