Health Alerts
American Samoa: Mozzie diseases circulating

Twin outbreaks of the mosquito-borne diseases, dengue fever and Chikungunya are occurring. On the main island of Tutuila, 343 cases of Chikungunya fever have been recorded in the past 5 weeks, with 6 people hospitalised. Read more. Meanwhile around 100 dengue cases have also been diagnosed to July 22. Read more.

Advice for travellers: Advice for travellers: The symptoms of Chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. Acute joint pain with a rash is typical of Chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication: Using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about Chikungunya.

Australia: Measles alerts in Sydney, Perth; Uptick in flu

Measles alerts were issued in Sydney and Perth last week following cases of the highly contagious disease. In the Western Australian capital, authorities warned passengers on a flight from Singapore to watch for symptoms after a fellow passenger was infected in the Philippines city of Davao. WA has recorded a 10-year high of 33 cases this year, with half aged 20-49 and 9 admitted to hospital.
THE influenza season may belatedly be underway with more influenza-like illnesses reported and the number of influenza detections increasing, according to a WHO flu update. Influenza A(H1N1)pdm09 has been the most commonly detected virus.

Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis), mumps, and polio 6 weeks before departure.

Burundi: Cholera flares in south

In the southwest, 86 cases of cholera, including 1 death, have been reported in the past fortnight in the township of Rumonge (Bururi Province). 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.

Cameroon: Cholera epidemic rages on

An 8-week long cholera epidemic in the north has killed at least 65 people and infected around 1300 in Northern Province, near the turbulent Nigerian border. The outbreak is centred on the districts of Mogode, Hina, and Bourha, with health experts concerned mortality rates have more than doubled to 4.8% in recent months. Read more.

Caribbean: Chikungunya tops 500,000 cases

The number of Chikungunya cases has topped half a million. This week’s tally of 513,393 cases, including 32 deaths, reflects an increase of 37,870 cases, or 8.0%. Of these, 508,122 are suspected cases acquired locally. The Dominican Republic accounted for 26,012 of the new cases last week and more than half of all cases, with an overall total of 307,933, according to official figures. Neighbouring Haiti had only 50 new suspected cases, taking its total to 64,709, while Guadeloupe’s total jumped by 6740, to 71,068. All 6 new deaths were in Martinique, where the toll is now 19 from 54,075 cases – 3620 more than the previous week. In Central America, El Salvador reported 376 new cases for a total of 2353. Venezuela reported 86 cases (30 local, 56 imported), according to the latest Pan American Health Organization update.
DENGUE is also plaguing the Dominican Republic, with 3882 cases and 42 deaths recorded to July 12. Read more.

China: Cholera found at HK market; Flu activity rises in south

In Hong Kong, cholera was detected during routine tests on water in a fish tank at a market stall in Chai Wan. Read more.
INFLUENZA activity has increased slightly in southern mainland regions, due mainly to influenza A(H3N2) viruses. Read more.

Cuba: Dengue reported in Camaguey, La Habana

Unofficial sources report a significant outbreak of dengue in Camaguey province involving more than 1000 cases, and a smaller outbreak in La Habana. Read more.

Democratic Republic of Congo: Cholera persists in South Kivu

A 6-month long cholera epidemic in South Kivu province has sickened more than 1000 people and left 6 dead. Health officials investigating the source of the persistent outbreak say latrines emptying into Lake Tanganyika may be one source of infection. Read more.

Egypt: 100 Brits felled by Shigellosis

Poor hygiene has been blamed for an outbreak of shigellosis involving around 100 British tourists at the 4-star Coral Sea Waterworld resort in Sharm el Sheikh, located in eastern governate of South Sinai. Angry holidaymakers blamed the virulent bug on dirty buffet food containers, utensils and tables, and poor hygiene among staff. Read more.

Advice for travellers: Shigellosis is an acute infection of the intestine caused by one of four species of bacteria in the genus Shigella. Transmission occurs via the faecal-oral route, through direct person-to-person contact, or indirectly through contaminated food, water, or fomites. As few as 10 organisms can cause infection, one reason why 80–165 million cases of disease and 600,000 deaths occur worldwide each year. The best defence against shigellosis is effective hand washing and food and water safety precautions. Read more about Shigella (CDC). 

El Salvador: Dengue exceeds 8,000 mark

The national dengue tally has reached 8033, including 1 confirmed and 2 suspected deaths. Read more.

Ghana: Accra's cholera stretches resources

Hospitals are under strain from an ongoing outbreak of cholera centred on the capital, Accra. More than 850 cases have resulted in 15 fatalities with the municipality of La among the worst affected areas. Read more.

Guinea, Liberia, Nigeria, Sierra Leone: Ebola spreads across north

To August 1, 163 new Ebola virus disease (EVD) infections and another 61 deaths were reported from four West African nations – Guinea, Liberia, Sierra Leone, and Nigeria. Nigeria reported 2 probable cases and a suspected infection, while cases and fatalities in Liberia (77 new cases, 28 deaths), Sierra Leone (72, 21) and Guinea (13, 12) took the overall totals to 1603 cases and 887 deaths. Read more (WHO).
In other EVD news…
EMIRATES has halted flights to Guinea – the first major airline to do so. “The safety of our passengers and crew is of the highest priority and will not be compromised,” an airline spokesperson said in a statement.
AMERICA’S Centers for Disease Control and Prevention (CDC) issued a Level 3 travel advisory recommending that all non-essential travel to Guinea, Liberia and Sierra Leone be avoided, as well as a Level 2 advisory (Practice enhanced precautions) for Nigeria.
IN new guidelines for US doctors evaluating travellers who’ve returned from West Africa with illness, the CDC advised they also be tested for malaria. The mosquito-borne infection is a common cause of fever among travellers visiting the region.
ELSEWHERE in Africa, suspected Ebola death of a traveller in Morocco proved to be heart failure, while in Nigeria a doctor who treated its case in an arriving passenger is ill with the disease.

Honduras: Dengue count rising in Choluteca

Three strains of dengue fever – types 1, 2, and 3 – are circulating as case numbers soar nationwide. 1017 new cases in the third week of July took the national total to 10,574, including 2 deaths. Read more. More than 280 dengue cases have been reported in Choluteca (Choluteca department) in the country’s extreme south. Read more.

India: Three states hit by dengue

Dengue outbreaks are occurring in Maharashtra’s Nashik district (54 cases, 2 deaths), Odisha State (55, 1), and Madhya Pradesh’s Bhopal City (43, 2).

Malaysia: Selangor under siege as dengue rate soars; Brunei reports 108 cases

With 29,972 cases – 4 times 2013 levels – Selangor continues to be the country’s main dengue hotspot. Nationwide, the tally for the disease has reached 60,000 reported infections, including 101 deaths. Read more.
MEANWHILE, on Borneo, Brunei’s dengue tally has reached 108. Read more.

Mexico: Chikungunya settles in; Dengue in Baja California Sur, Tamaulipas

There have now been 2 local cases of Chikungunya fever, along with 380 cases imported from the Caribbean – 98 in the past week. Read more.
IN Baja California Sur State, the capital’s La Paz municipality (173 cases) and Los Cabos (84), on its southern tip, are among the municipalities most affected by current dengue outbreaks. Read more. Dengue activity is also increasing in Tamaulipas State, where more than 1800 confirmed and suspected cases have been reported. Read more.

Myanmar: Concern over recurring flu

Doctors in Rangoon are concerned about unexplained bouts of recurrent influenza being seen in the city during the current rainy season. It is not known which flu virus is circulating or if another respiratory virus is actually responsible for the upsurge of infections. Read more.

New Zealand: Flu fatality; Fresh measles outbreaks

An unvaccinated 47-year-old Christchurch woman has died from influenza despite specialist hospital treatment. Read more. After a late start, the number of flu cases is increasing in New Zealand and Australia, with A(H1N1)pdm09 the most common strain, according to the latest WHO update.
MEASLES was confirmed in an unimmunised child in Northland last week, while a new case was reported in Gisborne. To date this year, 265 confirmed measles cases have been reported from the Auckland region, Waikato, Bay of Plenty, Lakes, Hawkes Bay, Taranaki, and Wellington, with over 100 cases during a recent outbreak among high school students in Hamilton.

Nigeria: Cholera hits crowded camp

In Borno State, cholera has erupted in one of two camps providing shelter for more than 10,000 displaced persons, with 27 deaths among the 375 cases so far. Borno is in the extreme northeast bordering northern Cameroon where cholera is also occurring among displaced refugees. In Kaduna State, an outbreak of cholera has resulted in 7 deaths in 3 villages in the Kudan district. 

Pakistan: Two new polio cases

Infants aged 12 and 8 months are the latest cases of polio in the provinces of Khyber-Pakhtunkhwa and the Federally Administered Tribal Area (FATA). They take the country’s tally for 2014 to 104 – almost half of them occurring in North Waziristan. Read more.

Panama: Metro's dengue count tops 1,000

In Panama metropolitan area (Panama Province) the number of dengue cases has reached 1075. Read more.

Paraguay: Dengue toll mounting

Nationwide, more than 8800 confirmed or suspected cases of dengue have been recorded, including 5 deaths. Read more.

Philippines: Dengue, measles sweep through northern Mindanao

With 4150 cases and 15 deaths in northern Mindanao Island, dengue activity is increasing in all provinces except Bukidnon, which has registered 532 cases. Most affected is Misamis Oriental (606), as well as the cities of Cagayan de Oro (1229 cases) and Ozamiz (281). With the wet season extending into September, more cases are expected. Read more.
ALSO on Mindanao, measles has been widespread in Davao city and surrounding regions this year, with 1810 cases and 9 confirmed or suspected deaths. Outbreaks have been recorded in Compostela Valley (294 cases, 0 deaths), Davao del Norte (213, 2), Davao del Sur (147, 1), and Davao Oriental (70, 0). With more than 2.26 million people, Metro Davao is the country’s third most populous metro area. Read more.

Russia: Measles returns to Nizhnevartovsk

After an 11-year absence, measles has surfaced in the city of Nizhnevartovsk in Khanty-Mansi Autonomous Okrug. Read more (ProMed: Measles Update 31)

Saudi Arabia: Ebola fears spark Hajj, Umrah bans

Fears over Ebola has seen Muslims from Sierra Leone, Guinea, and Liberia banned from attending this year’s Hajj or Umrah. The Saudi Ministry of Health announced it will not issue visas because of concerns about the spread of the Ebola virus in the three neighbouring West African countries. Read more.

South Sudan: Cholera moves east as epidemic wanes

In the southeast, a cholera epidemic centred on Juba is waning after 5459 registered cases and 118 deaths. Most new cases are being reported east of Juba in Torit (Eastern Equatoria State), near the border with Uganda. Read more.

Taiwan: Mosquito virus on the move

Authorities warn dengue is spreading to the island’s north. This year’s 412 cases, including 1-in-4 locally acquired infections, is almost double the 2013 figure for the first 7 months. Read more.

United States of America: Plague season in New Mexico; Chagas a concern in southern states; RMSF increasing in Tennessee; New local Chikungunya cases; Vibrio death in Florida

THE year’s second case of bubonic plague in New Mexico has been confirmed in a woman Rio Arriba County. Most cases occur in summer when pets bring home infected fleas from rabbits, squirrels, pack rats and other rodents killed by the bacterial disease. Read more.
CHAGAS disease is on the rise in Texas and Virginia with the influx of infected migrants from Mexico and Latin America, where the triatomid bugs that spread the parasites originate. Read more.
MEANWHILE, in line with a nationwide trend, health authorities in Tennessee have warned of an increase in the tick-borne bacterial disease, Rocky Mountain spotted fever (RMSF), with 328 cases to the end of July. North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri account for over 60% of US cases. Read more.
IN Florida’s Palm Beach County, 2 cases of Chikungunya fever in patients with no travel history bring to 4 the number of locally acquired cases in the southern state and nationwide. The CDC has recorded 398 travel-linked cases in the US and territories and 203 locally acquired cases, the latter mainly in Puerto Rico.
ALSO in Florida, a naturally occurring bacterium found in warm saltwater has killed a man in Sarasota – the latest among 10 deaths and 32 cases this year. Vibrio vulnificus, a cousin of the bacterium that causes cholera, also occurs in the ocean waters of Alabama, Louisiana, Texas, and Mississippi. Read more.

Advice for travellers: According to ProMED, most of the life-threatening illnesses occur in individuals with underlying medical illnesses, including immunocompromised states, chronic liver disease, and diabetes. In others, gastroenteritis is the most common symptom. Infection can occur from swimming or wading in warm seawater or eating raw or undercooked seafood. Read more on Vibrio illness.

Venezuela: Zulia tops dengue list

The national dengue tally has reached 32,168 cases. Numerous areas continue to battle dengue outbreaks, including the states of western Zulia (4491 cases), north central Aragua (2830), western Merida (2183), south-western Tachira (2151), north central Carabobo (1540), northern Nueva Esparta (1493), and southern Amazonas 1107 cases. Read more.

Vietnam: Japanese encephalitis kills 10 in north

Japanese encephalitis has killed 10 children during July in the northern province of Son La, among 84 youngsters treated for the mosquito-borne disease, according to a media report.

Zimbabwe: Rabies death prompts warning

The death from rabies of a young boy from Chegutu, in Mashonaland West Province, has prompted a warning from veterinarians concerned over the increasing number of rabies cases countrywide. Read more.