Health Alerts
  • Bangladesh: Dhaka’s 10-year dengue surge

    This year’s dengue season in the capital Dhaka has been the worst for 10 years – in 2006 only 2,200 cases were recorded, while 2016’s figure until Nov 30th was nearly 3 times higher at almost 6,000. Data for the rest of the country is not available. 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 repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Caribbean, Latin America: Zika, chikungunya situation update

    According to the latest Pan American Health Organization (PAHO) Zika update (Dec 1st), no new countries or territories are reporting local transmission of the virus. While most regions are reporting a gradual lessening in the numbers of Zika virus infections, in the Caribbean, the islands of Saint Martin and Saint Barthélemy continue to report cases, as does Iquitos, a tourist hub in the Peruvian Amazon. Read more
    The reporting of chikungunya case numbers to the PAHO has been sporadic this year with some countries weeks behind, however in the latest update issued by the regional health authority Colombia added a further 106 cases to bring its yearly total to 19,384. Of the other nations that did provide figures, between 50 & 62 cases were reported by Mexico, Costa Rica and El Salvador. Brazil, which has the majority of cases for the region, hasn’t updated its data since mid-September. 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). 

    Colombia: Leishmaniasis hits hard in Tolima

    Leishmaniasis cases have risen sharply this year with the central/western department of Tolima most affected. To date over 2,500 cases have been recorded across the country. Read more (translate from Spanish).

    Advice for travellers: Leishmaniasis is generally a low risk for travellers. The parasitic disease is 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. The former causes skin ulcers and the latter a severe systemic disease that is usually fatal without treatment. Along with India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil, Nepal account for 90% of visceral leishmaniasis. A similar percentage of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia, and Argentina. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention.

    Dominican Republic: Rains bring diseases

    The risk of leptospirosis rises annually during the rainy season, this year causing over 500 deaths, mostly among men. Authorities have urged the population to avoid contact with dirty water and to practise good personal hygiene when eating. Read more (translate from Spanish).

    Advice for travellers: Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis

    India: Tick-borne disease persists; Delhi’s chikungunya easing

    Central/western regions of the state of Madhya Pradesh have reported increased numbers of suspected scrub typhus cases recently. The districts of Bhopal, Raisen, Rajgarh, Vidisha and Sehore have been most affected to date. Read more
    AS the warmer, mosquito-friendly weather draws to a close, chikungunya cases in Delhi dropped last week to 153, 44 fewer than the week before; 105 new dengue fever infections were also recorded in the city. Read more.

    Advice for travellers: Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases.

    Kyrgyzstan: Flu spike hits kids

    Influenza and Acute Respiratory Viral Infection cases have spiked early this year in the capital Bishkek which has reported a 15 percent increase over the same period last year; two-thirds of cases are in children under 14 years of age, leading authorities to close schools for a quarantine period. Read more.

    Madagascar: Suspected plague outbreak in SW

    An outbreak of what is suspected to be bubonic plague has broken out in remote, rural areas of the island’s southern district of Befotaka Atsimo. Authorities have confirmed 31 deaths so far but have not released details of ongoing investigations carried out by medical teams sent to the area. Plague is a bacterial disease of rodents and is generally transmitted to humans through the bites of infected fleas, but can also be transmitted by direct contact with infected animals, including rodents, wildlife and pets. October is regarded as the start of the plague season, and this year bushfires have caused rodents, the carriers of the flea vectors, into human habitations. Read more.

    Malaysia: 8 states buck dengue trend

    Fewer dengue infections were reported across the country this year compared to 2015 but the figure is still high - 94,337 up till Nov 26th, and some states have fared worse than others: Pahang, Selangor, Negeri Sembilan, Perak, Melaka, Sarawak, Kedah and Sabah. Read more.

    Mexico: Border state reports dengue rise

    In the northern state of Coahuila, dengue fever case numbers have stayed high with the towns and cities of Muzquiz, Torreón, Matamoros, Francisco I. Madero and San Pedro adding most of the 416 cases to date. Read more (translate from Spanish).

    Myanmar: Severe dengue warning

    Over 8,000 dengue fever infections have been recorded from all areas of the country this year and the fear is that there will be another spike in the cycle of severe dengue cases (dengue haemorrhagic fever) next year. The risk of severe dengue increases with some medical conditions as well as previous dengue infection with another of the 4 dengue types. Read more.

    Nicaragua: Dengue, Zika situation

    Dengue fever cases have risen this year, going from 3,366 in 2015 to 6,293 to date. By comparison, the number of Zika virus infections for the year sits at 2,052. Read more.

    Philippines: Zika numbers climb again

    The nation’s Zika virus infection toll has reached 39, with 4 more cases confirmed this week. The recent infections are in residents of Mandaluyong City (one of the component cities of Metro Manila), Binan (south of Manila, in Laguna Province) and Iloilo City on the island of Panay. Read more.

    Rwanda: Campaign to reduce malaria

    A sharp rise in the incidence of malaria – up from 800,000 cases in 2012 to 3.9 million in 2015/16 – has led the government to offer free treatment for local people infected with malaria who lack the financial resources to pay for it. Read more.

    Saudi Arabia: MERS toll still rising

    The Ministry of Health released further figures on the number of confirmed MERS-CoV cases, advising of another 7 cases since Dec 2nd and bringing the cumulative total to 1,501 including 621 deaths. The 3 most recent cases were from Afeef in the Riyadh region, Riyadh, and Hufoof in the eastern Ash Sharqīyah region. Read more.

    Singapore: Zika campaign aids dengue action

    The concerted campaign to tackle Zika has also led to fewer dengue fever cases than forecast this year, with increased awareness and extensive insecticide fogging carried out; since our last posting, a further 60 dengue fever cases have been reported from 13 active clusters. Read more.

    Sri Lanka: Concerns over possible outbreak

    Up to 10 districts, including Colombo, Gampaha, Hambantota and Kalutara, risk dengue outbreaks as authorities announce the data for this year – 46,000 cases for the first 11 months of the year and 2,500 in November alone. Additionally 76 dengue-related deaths were recorded. Read more.

    Taiwan: Late HFMD spike

    Warmer temperatures have led to a late increase in the number of enterovirus infections this year. Over 18,000 cases were reported in the past week, the 7th in a row with epidemic levels. Younger children are most likely to display the typical symptoms of the infection which causes hand, foot and mouth disease (HFMD). Read more.

    Advice for travellers: Seasonal epidemics of HFMD occur sporadically throughout Asia, mainly affecting young children. Asian countries with recent large increases in reported cases include China, Hong Kong (China), Japan, South Korea, Malaysia, Thailand, Taiwan, and Vietnam. Symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection.

    Tanzania: Cholera warning issued

    Morogoro, Dodoma, Mara, Kigoma, Arusha and Dar es Salaam remain on alert for cholera cases as the government this week warned of the potential for further spread. The 6 affected regions have so far produced over 450 suspected cases and 6 deaths. 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

    United States of America: Local Zika threat lessening; Mumps spreads further

    Another active Zika cluster zone has been closed in the Miami area – this time it’s Little River, about 8kms north of downtown Miami – leaving Miami Beach as the only ‘red’ transmission zone. Read more. Five more locally-acquired Zika cases from Miami-Dade County takes the state figures to 249 (& 15 with undetermined location of transmission). According to the Dept. of Health, Florida Zika update webpage, the 5 recent cases were earlier infections that have been reclassified. 
    MUMPS outbreaks persist in many areas: Auburn (Seattle, Washington state), NW Arkansas, Columbia (Missouri) and Johnson County (Texas).

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

    Vietnam: Zika in 19 of HCM City’s districts

    In an update to the ongoing spread of Zika virus in Ho Chi Minh City, authorities this week added 4 more cases to the total, taking it to 94 (country total of 103) from 19 of the 24 municipal districts. Read more.

  • Brazil: Mosquito alert remains

    A Ministry of Health report on the prevalence of the mosquito that can transmit the dengue, chikungunya and Zika viruses, revealed that over 1/3 of cities that took part in the Rapid Assessment for Aedes aegypti (LIRAa) survey were at risk of disease outbreaks and maintained an alert status. Read more (translate from Portuguese).

    Bolivia: Trio of mozzie diseases in east

    Satellite townships and localities within Santa Cruz, the capital of Santa Cruz department in the lowlands east of the Andes mountains, are to undergo intensive insecticide fogging and destruction of mosquito breeding sites ahead of the approaching rainy season. The area has recorded confirmed chikungunya cases (802), dengue fever (695) and Zika virus infections (132) this year. Read more (translate from Spanish).

    Advice for travellers: Travellers should avoid mosquito bites when the insects are most active: cover up with long-sleeved tops, long pants, shoes and socks and apply repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. For most travellers, the lowlands also present a significant malaria risk. 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.

    Czech Republic: Return of Hep A

    Hepatitis A cases have spiked in Southern Moravia, with the bulk of cases in the regional capital, Brno. Doctors, who blame the sudden increase (400 cases over the past weeks) on drug use and lack of personal hygiene, believe the current outbreak is the largest since 1990. Read more (translate from Russian).

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

    India: Pockets of mosquito-borne diseases remain

    In the western state of Gujarat, the former capital city of Ahmedabad continues to battle mosquito-borne diseases. Last week further cases of dengue fever (190), chikungunya (29) and falciparum malaria (69) were recorded amid hopes that the dropping temperatures will reduce mosquito numbers and hence the disease incidence. Read more. While Delhi’s disease rates have dropped, the risk of infection remains: last week 135 people with dengue fever and 197 with chikungunya infections sought medical advice. Read more. News reports from Malkangiri district in Odisha maintain that Japanese encephalitis (JE) infections are still causing child deaths in the region, with the toll now standing at 123; however a government team disputes the diagnosis in many of those and is searching for other causes. Read more.

    Advice for travellers: A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it can occur in or near cities. The risk to short-stay travellers and those who confine their travel to urban centres is very low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Japan: Flu’s early arrival

    Influenza season has officially started in Tokyo after a threshold was reached in the number of flu cases reported by local hospitals. Read more.

    Advice for travellers: Seasonal flu is the most common vaccine-preventable travel-related illness, posing a risk aboard aircraft, in crowded airport terminals, and at your destination. Travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol wipes are a convenient alternative if soap and water is not available. Read more on influenza.

    Kenya: Chickenpox spike hits kids

    Holidays, overcrowding and the dry season are being blamed for the high chickenpox rates being reported in the counties of Mombasa and Nairobi. No figures were provided for Nairobi, but up to September, this year’s case count had hit 1,200 in Mombasa County - young children are most affected. 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.

    Mexico: Zika under-reported in Yucatan state

    Cases of Zika virus infection are believed to be as much as 50 percent higher than the stated 331 in the state of Quintana Roo, location of the popular tourist destinations of Cancun, Playa del Carmen and the Mayan ruins of Chichen Itza. Many people displaying typical signs of Zika virus infection are not tested to differentiate between it and other viral diseases with similar symptoms such as dengue fever and chikungunya. Read more (translate from Spanish).

    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).

    Nepal: More dengue for Terai

    Over 100 people in the Terai district of Rupandehi have contracted dengue fever over the past 2 months. The area lies to the west of Chitwan National Park. Read more.

    Niger: Fever spreads, WHO investigating

    In a statement, the World Health Organization (WHO) has voiced concern that the outbreak of Rift Valley Fever (RVF) that started in August during the annual gathering of nomadic herders and their animals in the Tahoua region has spread, but is still to determine the reasons for negative results of lab tests performed on many of the reported ill individuals, including women and children. Probable RVF animal cases have been discovered in Bani Bangou in the south-western Tillabéri Region and human and animal RVF cases were confirmed in the neighbouring region of Menaka in Mali. Read more.

    Advice for travellers: Rift Valley fever (RVF) is an acute viral disease that typically infects domesticated herd animals. It is generally found in eastern and southern Africa where sheep and cattle are raised, as well as in West Africa, Madagascar, and more recently Saudi Arabia and Yemen. People are infected after exposure to blood, body fluids, or the tissue of RVF-infected animals, or from the bite of an infected mosquito. The virus presents a low risk to travellers, but is another reason to use personal insect repellent and take other steps to minimise insect bites in places where it occurs. Read more about RVF.

    Paraguay: Dengue surge in Central

    Adults in the 20 to 39 years age group have been hardest hit by dengue fever infections in Paraguay this year. Over 72,000 suspected and confirmed cases have been reported in the country with most cases in Central department, adjacent to the capital district of Asunción. Read more (translate from Spanish).

    Saudi Arabia: New MERS cases, hope for a vaccine

    Data on new MERS cases for the month of November shows there were 20 confirmed cases including 4 deaths, but some good news is on the horizon with an article published today on how US scientists have made significant inroads in the development of an effective vaccine against MERS. Read more

    Singapore: Better news on Zika but dengue persists

    Another incremental rise in dengue fever cases this week – 75 in total – brings the annual figure to 12,810 with 9 associated deaths. Read more. No new Zika cases have been uncovered in the past 7 days and only one area is classified as active - part of the residential town of Bedok in the island’s east - according to the National Environment Agency Zika website

    Solomon Islands: Dengue in 8 provinces

    In an update to the dengue fever outbreak provided by ReliefWeb (a UN service providing humanitarian-based information) that takes in data from mid-August until November 19th, nearly 4,000 suspected cases have been reported from the capital Honiara and the provinces of Guadalcanal, Malaita, Isabel, Choiseul, Makira, Temotu, Western and Central (the last 2 reported cases for the first time during this episode). Read more.

    Taiwan: Local dengue cluster identified

    Health inspectors are monitoring Taipei’s eastern Neihu District following the detection of a cluster of locally-acquired dengue fever cases. Read more.

    Thailand: South’s dengue surge

    Reports of the 3rd dengue fever death this year in the southern province of Yala as authorities confirm case numbers tipping 544 till mid-November. Muang Yala, a northern district bordering the provinces of Songkhla and Pattani has been hardest hit. Read more.

    United Kingdom: Disease uptick in Western Isles

    The tick season might be over in the Outer Hebrides of Scotland, but authorities are ready to raise community and visitor knowledge of the dangers of Lyme disease ahead of next spring. The islands of North Uist, South Uist and Benbecula have between them reported 165 cases of Lyme disease since 2012. During the warmer months, the islands are popular tourist areas offering many outdoor activities. Read more.

    Advice for travellers: Lyme disease (Lyme borreliosis) is the most common human tick-borne infectious disease in the northern hemisphere, occurring mainly in temperate regions of North America, Europe and Asia. Ticks can attach to any part of the body but are often found in hard-to-see areas such as the groin, armpits, and scalp. Infected ticks must be attached for 36-48 hours or more before transmission of the Lyme bacteria can occur, so it’s important travellers conduct a thorough full-body check each day after outdoor activities. The CDC’s Lyme disease fact sheet offers more prevention advice.

    United States of America: Zika in Florida, now Texas

    While the local Zika outbreak lingers in Florida - this week producing 8 further cases from Miami-Dade County (7) and Broward County (1) with investigations underway to determine where infection took place - the US city of Brownsville on the Texas/Mexico border has recorded its first likely case of Zika. The US Centers for Disease Control & Prevention (CDC) is assisting local health authorities in investigating and limiting any further spread. Read more.

    Venezuela: Disease spreads to capital

    The Society of Public Health and the National Epidemiological Defence Network have confirmed that the diphtheria outbreak in the states of Monagas, Sucre, Anzoátegui, Apure, Bolívar, and Miranda has now spread to the capital, Caracas. Official confirmation of numbers isn’t available, however the country-wide total is believed to be between 200 and 300 cases. Immunisation rates are low: the state of Amazonas has the worst, with only 24 percent of children vaccinated against diphtheria and other childhood diseases. Read more (translate from Spanish).

    Vietnam: More on dengue, Zika

    Binh Dinh province has recorded its 2nd death from dengue fever, a 5-year-old boy from the town of An Nhon (roughly half way between Nha Trang and Hoi An). Dengue cases this year have increased in the province, with 4,250 recorded for the year - 700 of those over the past 2 months alone. Many districts have been affected: Quy Nhon city, An Nhon, Phu My, Tay Son and Phu Cat amongst the worst. Read more
    INSECTICIDE fogging will be carried out for the next month in the 17 Ho Chi Minh City districts producing Zika virus infections in an attempt to control the ongoing outbreak. Highest case numbers stem from the districts of (in descending order): Binh Thanh, District 2, Tan Phu, District 12 and District 9. Read more. A health official has announced that 93 Zika cases in all have been confirmed in Vietnam, mostly from the southern provinces. Read more.

  • American Samoa: Zika under-reporting feared

    There are concerns over the impact Zika virus could have on the nation’s 55,000 inhabitants due to the lack of health facilities and extended delays in getting results from testing of suspected cases. While only 54 cases have been confirmed to date, infection is mostly asymptomatic, leading the territorial epidemiologist to speculate that that the number of infections could be as high as 1,000. Funds have been put towards raising public awareness of Zika virus and promoting the use of insect repelllents and condoms. Read more.

    Australia: Measles import adds to SA toll

    South Australia has recorded its 11th measles case this year - a 1-year-old boy who contracted the highly contagious infection in Bali. He was diagnosed on return to the state after arriving through Adelaide airport on Nov 13th. Read more.

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

    Burkina Faso: Dengue outbreak deepens

    The dengue fever outbreak reported last week has now led to approximately 2,000 cases and 20 deaths, with all areas of the capital Ouagadougou affected as well as regions of the country’s north (Sahel Region) and west (Hauts-Bassins). 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 repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Cambodia: 6 years between confirmed Zika infections

    The government confirmed last week the country’s first Zika virus infection in 6 years. The 44-year-old man, who became ill in mid-October, lives in a district adjacent to Kampong Cham City, capital of the eastern province of Kampong Cham. 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).

    Caribbean, Latin America: Zika, dengue, chikungunya summary

    On Nov 18th the Emergency Committee of the World Health Organization (WHO) convened for discussions on the global Zika situation and to review the need for the ongoing Public Health Emergency of International Concern (PHEIC) that had been established in February this year to address the reports of Zika virus-related microcephaly and Guillain-Barré syndrome. The decision was made to revoke the PHEIC and, while maintaining that a public health challenge still existed, the focus would now be on ‘a sustained programme of work with dedicated resources to address the long-term nature of the disease and its associated consequences.’ In addition, the Temporary Recommendations decided in earlier meetings were reissued, namely
    ‘- Pregnant women should be advised not to travel to areas of ongoing Zika virus outbreaks; pregnant women whose sexual partners live in or travel to areas with Zika virus outbreaks should ensure safe sexual practices or abstain from sex for the duration of their pregnancy,
    - Travellers to areas with Zika virus outbreaks should be provided with up to date advice on potential risks and appropriate measures to reduce the possibility of exposure through mosquito bites and sexual transmission and, upon return, should take appropriate measures, including practicing safer sex, to reduce the risk of onward transmission,
    - The World Health Organization should regularly update its guidance on travel with evolving information on the nature and duration of risks associated with Zika virus infection.’ Read more 
    Dengue
    Warmer temperatures and summer rainfall herald the upcoming dengue season in Brazil. Various local news sources indicate high risk areas of concern: many areas of Recife (Pernambuco state), Limeira (São Paulo), Belo Horizonte, Governador Valadares and Juiz de Fora (Minas Gerais), Goiânia (Goiás), Cachoeiro and others (Espírito Santo), Brasília and environs (Distrito Federal), Campos Gerais (Paraná) and eastern areas of Pará state.
    Sanofi Pasteur, the makers of the dengue vaccine Dengvaxia, announced that the vaccine will become available in Guatemala within a few weeks. Read more 
    Chikungunya
    Most countries in the region did not update their disease data to the Pan American Health Organization (PAHO) this past week. Of those that did, highest numbers were from Guatemala (209 cases) and Costa Rica (87). Read more.

    China: Bird flu in Hunan; Water quality upgrade planned

    The avian influenza A(H5N6) strain was announced as the cause of death this week of a woman farmer from Hunan province. She died 2 days after admission to hospital and was known to have had contact with dead poultry. Read more
    A RECENT focus of the government has been to tackle air pollution, and now water quality is being targeted following the release of Ministry of Environmental Protection reports that show only a slight improvement over the year since testing identified that ‘nearly two thirds of underground water and a third of surface water was unsuitable for human contact, with much of it contaminated by fertilizer run-offs, heavy metals and untreated sewage.’ Read more.

    Advice for travellers: While bird flu is often fatal in humans, there has been no sustained person-to-person transmission. Infection occurs after contact with infected birds, which makes the disease a low risk for travellers. Australians travelling to a region where the disease is present or an outbreak is occurring should avoid contact with birds or poultry in marketplaces, wash their hands before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.

    India: West Bengal, Assam dengue woes continue

    A more intense dengue season this year might be behind the persistence in dengue fever cases still being seen in West Bengal's capital, Kolkata, according to local doctors. They are hoping the prevailing temperatures will drop soon to levels that inhibit the survival of the mosquito vector. Read more. Stronger measures are needed to combat the dengue fever problem impacting Guwahati, the largest city in the north-eastern state of Assam. Residents believe the insecticide fogging that is being carried out is insufficient to check the spread. Read more.

    Malaysia: Malaria strikes in Perak; Lubuan’s dengue hike

    At least 40 Plasmoduim vivax malaria cases have been identified in settlements of mainly Temiar people in the north-east of Perak state. The Temiar are one of the 6 Semoi tribes: the indigenous peoples, or Orang Asli, of Peninsula Malaysia. Over 330 individuals have been tested and insecticide fogging is being carried out. Read more
    DENGUE fever cases in the financial and tourist hub of Labuan, a territory off the Sabah coast, have increased from 3 last year to 13 this year, causing concern to local authorities. Read more.

    Niger: No relief from fever in Tahoua

    The outbreak of Rift Valley Fever (RVF) stalking the western Tahoua region has now claimed as many as 32 lives among 230 cases. Read more.

    Advice for travellers: Rift Valley fever (RVF) is an acute viral disease that typically infects domesticated herd animals. It is generally found in eastern and southern Africa where sheep and cattle are raised, as well as in West Africa, Madagascar, and more recently Saudi Arabia and Yemen. People are infected after exposure to blood, body fluids, or the tissue of RVF-infected animals, or from the bite of an infected mosquito. The virus presents a low risk to travellers, but is another reason to use personal insect repellent and take other steps to minimise insect bites in places where it occurs. Read more about RVF.

    Pakistan: Child deaths from diphtheria, polio

    Up to 30 children have died of diphtheria among the hundreds of infections that have struck South and North Waziristan and adjoining districts. The bacterial infection is believed to have spread from unvaccinated individuals living in camps for internally displaced persons. Local doctors fear the severe lack of vaccines and treatments could lead to an epidemic. Read more
    ANOTHER polio infection, the province of Sindh’s 7th and the country’s 18th was reported this week. A 3-day vaccination campaign is planned for this week in the Federal Administered Tribal Areas (FATA). Read more

    Peru: Drought’s dengue legacy

    A drought in the north-western city of Piura, about 100kms from the border with Ecuador, has led to many people storing water in containers around their dwellings – the perfect breeding grounds for the mosquitoes that transmit dengue fever. The local health department has released dengue fever data for the area: over 8,000 suspected cases and 17 deaths with more to come likely. Read more (translate from Spanish). 

    Philippines: Dengue persists in Cebu; End of rabies in sight?

    The province of Cebu continues to record high numbers of dengue fever cases: from mid-October to November, a further 2,500 cases took the yearly total to nearly 9,000. Those municipalities most affected are Toledo City, Carcar City and Talisay City. Read more
    IT is hoped that the free laboratory testing of suspected rabid animals that will continue for the next 4+ years will assist in the eradication of rabies in the country. Each year around 200 Filipinos lose their lives to rabies infection. 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. Discuss your itinerary and whether rabies vaccination is recommended during your pre-travel consultation. Read more on rabies.

    Qatar: Vax campaign to check measles

    A measles vaccination campaign that was rolled out in October has been extended till the end of November in an effort to halt a spike in cases. Early this year, 22 cases were confirmed, a rise in the peninsula from the 18 reported last year; 6 have been recorded over the past 3 months. All the most recent cases were in unvaccinated children. Read more.

    Russia: Low herd immunity stirs epidemic fears

    Measles infections have spiked in the city of Yekaterinburg, the administrative centre of the Ural Federal District. This year there have been 24 cases, but authorities are concerned that the large numbers of unvaccinated children under 18 years of age in the city could mean a large outbreak is imminent. Read more.

    Saudi Arabia: More MERS cases likely

    More MERS cases are expected in the coming weeks, according to a health official. The camel breeding season is nearing and contact with camels is deemed a risk factor in contracting the coronavirus. A further 4 cases have been confirmed over the past week and 2 previous infections have cleared, with the patients recovering. Read more.

    Singapore: Welcome dip in dengue, Zika

    The expected decline in dengue fever cases has finally started with the last of the high-risk active disease areas closed, leaving 8 ‘yellow’ clusters (those with fewer than 10 cases). Read more. Three Zika cases have been reported over the last 7 days from one active infection cluster, as detailed on the National Environment Agency’s Zika webpage

    South Sudan: Juba, River Nile bear brunt of cholera

    The impact of a cholera outbreak that started back in June has been felt the hardest in Juba and areas along the Nile in central Terekeka state, while other states have also been affected (Imatong, Eastern Lakes, Jubek, Terekeka, Jonglei, Western Bieh, Northern & Southern Leich, and Eastern Nile). Over 3,000 cases and 44 deaths have been recorded: Juba reported most cases while the case fatality rate is highest in Terakeka. The UN and other international health agencies are providing assistance to local authorities. 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

    United States of America: Florida’s Zika zones cut; Mumps on the move

    One of the 3 Zika cluster areas in Florida has been removed from the active transmission zone list - a 11.5 sq km area of North Miami Beach has been without infections for over 45 days and the level of caution advised for the area is the same as for rest of Miami-Dade County. South Miami Beach and Little River continue to report cases – 8 more since our last post bringing the total of locally-acquired cases to 236. Read more.
    SEVERAL mumps outbreaks are occurring across the country, 3 of them in tertiary education institutions. Universities in New York, Missouri and Boston (Harvard) have been affected. The provisional case count of the NW Arkansas outbreak reported previously stood at 1,558 in the latest health department update (Nov 22nd). Read more.

    Vietnam: Zika’s reach extends in HCMC

    Sixteen of Ho Chi Minh City’s 24 districts have now recorded Zika virus infections, with 5 cases this week taking the municipality’s total to 62 to date. The 2 districts with the most confirmed cases are Binh Thanh and, on the opposite bank of the Saigon River, District 2. Read more.

    Zimbabwe: Spike in water-borne diseases feared for Masvingo

    Inadequate treatment of water and low dam levels are thought to be behind an outbreak of typhoid in the south-eastern city of Masvingo. Four confirmed cases were recorded last week and authorities are concerned more water-borne diseases could emerge. Read more.

    Advice for travellers: Typhoid fever is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination 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