Health Alerts
Australia: Imported measles risk to WA students

Measles vaccinations have been offered to unimmunised students at a school in Perth, after one pupil returned from a holiday in Europe infected with the highly contagious virus. According to a news article, around half of the 200 enrolled students are unvaccinated, leading to fears of a widespread outbreak in that and associated communities. The European Centre for Disease Control (ECDC) update on the ongoing measles outbreak reveals that in the first 7 months of this year, Romania reported 6,378 cases (& 34 deaths since Jan 2016), while Italy had 4,001 cases and the UK, 962. 

Advice for travellers: Measles is a highly contagious virus and can cause serious illness in people of all ages. Most of the 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.

Cape Verde: Concerning rise in malaria

The capital of Praia recorded nearly 50 cases of malaria in July, more than for all of 2016. Of some concern, the area is categorised as low risk for malaria transmission and the wet season when cases are more likely hasn’t commenced yet. The World Health Organization (WHO) regional office is assisting in investigations and support. Read more.

Advice for travellers: Travellers can discuss their itinerary and the need for anti-malaria medication with a trained travel health professional at their nearest Travelvax clinic. For details call 1300 360 164. Read more about malaria

Cote D'ivoire: Dengue fever hits capital

The rainy season is in full swing, mosquito breeding sites are abundant and the local population lacks awareness of the dangers of dengue fever. A World Health Organization (WHO) risk assessment of the dengue outbreak that began in late April is moderate on a national level. Most cases have been in the capital, Abidjan. Read more from the WHO. 

French Polynesia: First dengue death of 2017

A 7 year-old boy who contracted dengue fever while visiting the island of Moorea has died of associated complications, the first such death this year. He is one of the 25+ dengue cases the territory reported in late July – mainly among children. A French language news report identifies the locations of confirmed cases as Bora Bora, Moorea, Raiatea, Rimatara and Tahiti. 

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.

Guatemala: Typhoid strikes north

No source has been identified as yet in an outbreak of typhoid in the town of Dolores in northern Petén Province. Two deaths from 60 cases have now been confirmed, as testing of the water supply and other potential sources of infection continues. Dolores lies approx. 120kms to the south of the ancient Mayan site of Tikal. Read more (translate from Spanish). 

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 fever.

India: Monsoon-related diseases climb

Authorities in the city of Tiruppur in western Tamil Nadu are cracking down on residents who fail to eradicate dengue mosquito breeding grounds around their homes by cutting off their water supply. As many as 65,000 households were deemed to be risk areas and subject to the ruling which aims at reducing dengue fever rates. Read more. The state of Karnataka and the city of Delhi are reporting dengue spikes, while cases of Japanese encephalitis in Assam have exceeded 420, with 58 deaths. Water-borne infections are also on the rise: cholera in Kerala and typhoid fever in northern Andhra Pradesh.

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

Japan: Ticks on the move

Western parts of the country have reported higher rates than usual of tick-borne infections, with Mie Prefecture recording 35 of the nation’s 118 cases of Japanese spotted fever. Spread of the infecting ticks from the central and western regions to the east has also been noted. The more serious severe fever with thrombocytopenia syndrome (SFTS) had sickened 51 people by late July and killed 5, one through a bite from an infected cat. Many of the tick bites apparently went unnoticed until the onset of symptoms. Other tick-borne infections that have been reported in Japan include Lyme disease and tick-borne encephalitis. Read more.

Advice for travellers: SFTS causes symptoms including high fever, vomiting, diarrhoea, thrombocytopenia, leukopenia, and multiple organ failure. The virus has a 6%–30% case-fatality rate and there is no effective virus. The vector ticks are found in 23 prefectures, ranging from Hokkaido in the north to the island of Kyushu in the south. 

Laos: Dengue in central, southern provinces

Dengue fever is ramping up across the country, although the capital Vientiane has been most affected. As many as 5,000 cases & 7 deaths have been reported so far this year, 2,000 of those cases since early July. Read more.

Malaysia: Diphtheria kills one; A sixth rabies victim

A young boy who had not completed age-appropriate vaccinations died of diphtheria in late July and two close contacts are being treated after showing mild symptoms of the infection. Local health authorities in Sandakan are currently vaccinating the rest of the household of 18. This news comes in the same week as a report from Singapore outlining another death from diphtheria, this time a Bangladeshi worker who had not been out of the city-state during the incubation period. Two contacts who have shown symptoms of the infection have been isolated in hospital and other contacts are being treated with antibiotics. Read more. More on diphtheria.
THE sixth rabies case in the current outbreak, a boy aged 7, is in a critical condition in hospital - he was bitten by a dog in mid-July and his condition deteriorated 2 weeks later. His village in Serian, Sarawak is now on the list of 23 rabies-affected areas. Read more.

Advice for travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals – especially dogs, the main source of infection. If bitten, urgent post-exposure treatment is required. Vaccination is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.

Nigeria: No let-up in Lassa; Measles alert in east

Two people died of Lassa fever this week in Lagos and cases continue to be reported from 5 states: (Bauchi, Edo, Ogun, Ondo, and Plateau. A WHO assessment of the situation points out the ‘reports of increasing frequency of Lassa fever cases outside the usual season and from non-endemic areas’ as requiring concerted effort on the part of the government and international agencies, together with rodent control measures from the local population. Read more.
TARABA state, which borders Cameroon, has reported a measles outbreak in 10 districts affecting 140 - for the most part unvaccinated children under 5. Read more.

Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

Saudi Arabia: Hajj health requirements, MERS precautions

Smartraveller has issued a bulletin on travel to the Hajj, with many Australians expected to take part in the pilgrimage that draws around 3 million visitors to the kingdom. The advice includes a link to the Ministry of Health website which provides all vaccination requirements, including the mandatory ACWY meningococcal meningitis vaccine. As cases of MERS Co-V continue to be reported, Smartraveller advice also takes in the need to follow strict hygiene measures, avoid contact with sick people and any camels/camel products and lastly, seek medical advice immediately if unwell. 

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. In North Africa’s ‘meningitis belt’, 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.

Thailand: Flu activity high; Rabies risk in Hua Hin

Thailand, the Philippines, southern China, Hong Kong and Myanmar are named in the latest WHO influenza update as reporting high flu activity, with all virus subtypes present. In southern hemisphere temperate regions, flu levels across Australia and New Zealand are ‘following seasonal patterns’ or ‘just above the seasonal threshold’, with influenza A(H3N2) & B (Yamagata lineage) predominating.
A RABID dog has bitten at least 15 people, both residents and foreign tourists, in the beach town of Hua Hin. The local response has been to set us a month-long monitoring zone in the area, stretching 3km south from Klai Kangwon Palace. Rabies post-exposure treatment has been provided to those who were bitten. Read more.

Uganda: Kampala, Wakiso measles cases

Children under one year of age are bearing the brunt of a measles outbreak hitting Kamapala and nearby Wakiso district, with 67 suspected cases to date. Health authorities have instituted public education sessions and vaccination campaigns in response. Read more.

United States of America: Island mumps outbreak tops 200

The mumps outbreak remains on the Hawaii health department’s radar, with the case count now sitting at 209 on 3 islands – Oahu (191), Kauai (15) & Hawaii (3). The department’s advice: Ensure your family is fully vaccinated with the MMR vaccine. Read more.

Advice for travellers: This 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.