Health Alerts
  • Australia: Imported measles spreads further

    The South Australian Health Department has advised of 2 measles cases, both of which are probable community contacts of an imported case in a traveller returning from Southeast Asia. The department’s website lists those places where others may also have been exposed to the virus during the height of the infectious period. Read more.

    Advice for travellers: Easily preventable through vaccination, measles is a highly contagious disease that can cause serious illness in people of all ages. Many cases reported in Australia are linked to overseas travel to both developing and developed countries. Travelvax Australia recommends travellers check their status for these and other routine childhood immunisations, such as diphtheria, tetanus and whooping cough (pertussis) 6 weeks before departure.

    Caribbean, Latin America: Zika & chikungunya updates

    Zika outbreak news
    A news source quotes St Kitts-Nevis Health Ministry in announcing ‘the Federation’s first confirmed cases of ZIKA in the local population.’ The 3 positive samples were taken at the end of August but confirmation has been delayed due to the high demand for laboratory services in the region.
    The US Virgin islands have recorded 19 additional Zika cases over the past week, taking the year’s total to 365 cases. Numbers have been rising for 2 months and authorities are hoping that the peak of the outbreak is approaching. The island of St Thomas is most affected (300 cases overall) followed by St Criox (52 cases). Read more 
    Government agencies in Costa Rica have released recent Zika infection numbers which identify as many as 18,000 locally acquired cases. Dengue and chikungunya rates also remain high. Read more (translate from Spanish) 
    Zika numbers are on the decline in the Dominican Republic, but dengue fever is maintaining a presence in the country: 5,879 suspected cases and 30 deaths so far this year. Read more (translate from Spanish) 
    Other Zika news
    The journal, Lancet Infectious Diseases, has documented a suspected case of sexual transmission of Zika virus from a vasectomised man to a woman in February this year. The infection was contracted by the man while on holidays in the Maldives. Read more 
    Chikungunya
    From information published in a Brazilian Ministry of Health bulletin covering chikungunya cases and chikungunya-related deaths, the states of Pernambaco, Rio Grande do Norte have fared the worst, followed by Paraiba, Ceará, Rio de Janeiro, Bay, Alagoas, Maranhao and Sao Paulo. Overall, suspected cases increased in the first 8 months of the year by 463 percent over last year’s figures for the same period. Read more (translate from Portuguese) 
    Researchers studying chikungunya cases in Haiti early last year observed a strain of another mosquito-borne virus, Mayaro, which has previously been limited to South America. Its symptoms include joint pains, malaise and fever, but unlike chikungunya & Zika, stomach problems are experienced. Read more.

    Advice for travellers: Epidemics of the Zika, chikungunya and dengue viruses continue undiminished in the Americas and Caribbean. Generally milder than dengue and chikungunya, Zika’s symptoms last 4-7 days and include a rash, pain in the joints, and the eye condition, conjunctivitis. With the apparent exception of pregnant women, long-term ill-effects are rare, although joint pain may linger for weeks – even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite aggressively by day and are found in urban setting, including leafy gardens and outdoor restaurants. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the mosquitoes’ main feeding time. 

    China: Further local dengue case in Hong Kong; Measles-free declaration

    A fourth case of dengue fever that was acquired in Hong Kong is being investigated by health authorities – the 59-year-old woman who lives in Wong Tai Sin and works in Kowloon City has been released from hospital and her contacts are being monitored. Read more
    THE World Health Organization (WHO) has announced that Hong Kong is now free of endemic measles, joining 6 countries of the Western Pacific region (Australia, Brunei, Cambodia, Japan, Macao and South Korea) in achieving the goal. The declaration of measles-free status is granted after at least 36 months of interrupted virus transmission. Read more.

    Democratic Republic of Congo: Gastro illness leaves 35 dead

    The governor of the eastern province of Maniema has declared an outbreak of diarrhoea in 6 health zones. To date, 335 people are known to be affected and 35 have died as a result. The cause is said to be related to the quality of drinking water and lack of hygiene. Read more (translate from French) 

    India: Mosquito-driven outbreaks prevail

    News reports of mosquito-borne diseases stream in from across the country: Haryana; Mumbai & Aurangabad in Maharashtra state; Uttar Pradesh; Dehra Dun, the holy city of Haridwar & the hill station of Nainita, Uttarakhand; Vijayawada, Andhra Pradesh; Bengaluru, Karnataka and Durg, Chhattisgarh. In Amritsar (Punjab), disease reports appear to be on the decline, but in Goa some medical facilities and doctors in the region of the port city of Vasco da Gama are advising of a rise in dengue cases, contrary to the government’s advice. Chikungunya cases in Delhi have risen by 150 percent over previous reports. Both Japanese encephalitis and malaria cases are on the increase in Jamshedpur (Jharkhand state). In an aside, Japanese encephalitis is now a notifiable disease in India, a move which it is hoped will lead to a reduction in cases. Read more.  
    In Chennai, doctors have had to debunk a social media posting promoting the use of coconut oil in deterring the mosquitoes that transmit dengue fever. The same posting claimed that the insect will only bite below the knee as it is unable to fly higher. Read more.

    Japan: Ongoing measles threat

    The measles outbreak that started at the end of August has now affected 115 people, many of whom work at Kansai International Airport in Osaka Prefecture. Other areas reporting associated cases are Hyogo and Chiba Prefectures and Tokyo. Read more.

    Malaysia: Marginal drop in dengue rates

    Health officials were able to report a general downturn in dengue fever cases and deaths so far this year compared to the same period last year; however the toll is still high - 78,077 cases (85,488 in 2015) and 176 deaths ( 234). Those states reporting recent high dengue activity are Johor, Sabah, Negri Sembilan, Perak, Perlis, Sarawak and Federal Territory Labuan. Read more.

    Pakistan: Diphtheria strikes village children

    Five children from the village of Kul (Punjab province) have died of diphtheria over the past 2 weeks and another 12 are seriously ill in a Lahore hospital. Read more.

    Philippines: Zika count rising

    Health authorities have announced that the country has recorded 9 locally acquired Zika cases this year; six of those are recent. Of the 9, seven are from loilo City in Western Visayas, 1 from Cebu City in Central Visayas and the last is from Laguna province in Calabarzon. The government is using the 4S strategy that was put in place in the past to tackle dengue fever: ‘Search & destroy mosquito breeding places, use Self-protection measures, Seek early consultation for fever lasting more than 2 days, and Say yes to fogging when there is an impending outbreak.’ Read more.

    Romania: Measles spike

    According to a news report, measles case numbers have rocketed this year, largely blamed on an anti-vaccination movement in the country. Last year there were 7 measles cases and no deaths recorded, but this year there have been 675 cases and at least 2 deaths from the highly infectious viral illness. Read more.

    Singapore: New Zika transmission area; Regional co-operation decision

    As the total of local Zika infections climbs to 383, the National Environment Agency has released details of the last 3 cases, none of which came from any of the previously identified clusters. The original cluster in the Aljunied/Sims Drive area has produced the most cases to date – 286. Read more. The agency has also advised that numbers of the dengue and Zika vector, the Aedes aegypti mosquito, are rising so the risk for both infections is still high. Despite this, there has been a slight downturn in dengue cases over the past 2 weeks. Read more 
    THE health ministers of ASEAN countries (Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, the Philippines, Singapore, Thailand & Vietnam) have issued a statement outlining their proposed efforts to tackle Zika virus infections in the region. Their plans are to strengthen disease surveillance, increase vector control measures, improve lab testing and the sharing of new research, knowledge and best practices. Read ASEAN statement

    South Africa: Regional flu report

    The latest WHO global influenza update confirms the flu season in southern Africa (Botswana, Lesotho, Namibia, South Africa & Swaziland) continues unabated, with ‘co-circulation of influenza A(H1N1)pdm09, A(H3N2) and B viruses’. The same report covers South America and identifies elevated flu levels in Chile and high reports of influenza-like illness and severe acute respiratory infections in Argentina. Read more.

    Advice for travellers: The 2016 flu season is underway in the southern hemisphere and Travelvax Australia recommends vaccination for all travellers over 6 months. 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. 

    Sudan: Blue Nile state cholera

    There have been calls to declare a cholera epidemic in the southern state of Blue Nile, bordering Ethiopia and South Sudan as official case numbers rise to 614. Other sources claim that more than 100 people have died from cholera in the area. 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.

    Taiwan: Dengue in wake of Malakas

    Five dengue fever cases that were not associated with travel outside the country have been identified in Taiwan since the beginning of summer. The most recent announced by the CDC on September 18th was a young man from Tainan City. In the wake of heavy rainfall that hit the country from typhoon Malakas, authorities are urging the public to remove potential mosquito breeding sites from their neighbourhoods and report dengue symptoms promptly. Read more.

    Turkey: Rabies in south

    Over 100 people are receiving rabies exposure treatments in Osmaniye state and the entire town of Ellek is in quarantine after a spate of attacks from rabid dogs. 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. Generally, the risk of rabies for most short-stay travellers is low. Vaccination recommendations are itinerary-specific but include those travellers planning to live in, or travel extensively through, rural areas. Read more on rabies

    United States of America: Zika news from Florida; CDC issues West Nile update

    Health authorities in Florida have advised of a further 4 Zika cases in Miami-Dade County, taking the total of locally-acquired infections to 89. A further 10 cases live outside Florida but were infected while visiting the state. Read more.The US Centers for Disease Control & Prevention (CDC) has eased its health advisory for people living in Wynwood, the area first affected by local transmission of Zika virus. Insecticide fogging and thorough investigation of cases has lowered the threat; however caution is still advised. Read more.
    WEST Nile virus (WNV) season continues during the warmer months – in the latest CDC update, 39 states and one district reporting 40+ cases are: Texas, South Dakota, California, Colorado, Nebraska and Arizona. Read more from the CDC

    Advice for travellers: Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites.

    Vietnam: HCM City’s dengue spike

    Ho Chi Minh City has recorded a 35 percent increase in dengue fever cases over the past month as the rainy season adds fuel to the rise in mosquito numbers. Hoc Mon, Binh Chanh, Thu Duc, Binh Thanh and Cu Chi Districts have all recorded outbreaks recently. Read more.

  • Afghanistan: Disease risk intensified during festival

    During this week’s religious festival of Eid-al-Adha, animals are slaughtered to feed the poor, but the risk of contracting Crimean-Congo Haemorrhagic fever (CCHF) is raised if those animals are infected. CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. Authorities have issued warnings fearing more cases - 71 cases have already been diagnosed this year, including at least 12 deaths. Read more. An article in the publication New Scientist gives details on the first locally acquired CCHF case in Spain – a 62-year-old man who had most likely contracted the infection through a tick bite while in the popular hiking region of Avila – he has since died. A healthcare worker in Madrid became infected with the virus while caring for the man. Read more about CCHF

    Australia: New strains of gastro virus strike; Flu vaccine a good match

    Hospitals have had to manage an increase in patients caused by the seasonal flu over the past few weeks, and now the highly infectious norovirus after it caused outbreaks of gastroenteritis in parts of NSW and the ACT.. Researchers at the University of NSW have identified 3 new strains of the virus that are behind the outbreaks. Read more
    FROM the most recent national influenza surveillance data, the flu season is yet to peak and highest rates have been seen in the over 85 and under 5 years age groups. Influenza A (H3N2) infections predominate and the seasonal flu vaccine offered to Australians this year is considered a good match for the circulating strains. 

    Advice for travellers: While it is extremely contagious, norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands after using the toilet and before eating, and practice good hygiene. Read more on norovirus.

    Austria: Second MERS case

    A Saudi Arabian tourist, a man aged in his late 60s, has been hospitalised with MERS infection in Salzburg. According to the WHO, one previous MERS case was diagnosed in Austria in 2014: a 29-year-old woman who had travelled from Affif in central Saudi Arabia. Read more (translate from German). The Saudi Ministry of Health has released details of their latest case: A man from Arrar, near the Saudi border with Iraq. He is believed to have contracted the virus through direct contact with camels. Read more.

    Caribbean, Latin America: Zika, dengue & chikungunya updates

    Outbreak news
    According to the Sept 8th Zika update issued by the World Health Organization (WHO) and the Pan American Health Organization (PAHO), rates of infection have dropped for the most part across the region, with the exception of Costa Rica and Guatemala (a slight increase). Language in the report is guarded when it comes to the progress of the outbreak: ‘it will be necessary to monitor whether the declining trend continues in these countries/territories’. Read the full report here
    Trinidad and Tobago’s health ministry announced their latest case numbers on Sept 9th: A total of 376 cases, eleven are in Tobago. Read more 
    Other Zika news
    Investigations are underway to determine the mode of transmission after the son of an elderly man who had a severe Zika infection with high viral loads contracted the virus. The older man, from Utah in the USA, had become infected with Zika on an overseas trip and was being cared for by the son. Read more from the US Centers for Disease Control and Prevention (CDC. 
    Dengue
    Dengvaxia, the first licensed dengue fever vaccine, will be provided through the private sector in Mexico from next Monday. While Mexico was the first country to approve the vaccine, it follows Brazil, Costa Rica, El Salvador, Guatemala, Paraguay, Peru and the Philippines in offering it to the public – 18 other countries are being approached by the manufacturer, Sanofi Pasteur. Dengvaxia is recommended for use from 9 to 45 years of age in countries which are endemic for dengue fever. Read more
    In Ecuador, the provinces of Manabi, Oro, Guayas and Esmeraldas have produced most of the 12,663 cases of dengue recorded this year. Galapagos, with 2 cases, had the lowest numbers. Read more (translate from Spanish) 
    Chikungunya
    Updated figures haven’t been provided to the PAHO by many countries in the region for weeks, but of those that did, Costa Rica had the highest numbers of new cases (223), followed by Colombia (138). Read more.

    Advice for travellers: Epidemics of the Zika, chikungunya and dengue viruses continue undiminished in the Americas and Caribbean. Generally milder than dengue and chikungunya, Zika’s symptoms last 4-7 days and include a rash, pain in the joints, and the eye condition, conjunctivitis. With the apparent exception of pregnant women, long-term ill-effects are rare, although joint pain may linger for weeks – even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite aggressively by day and are found in urban setting, including leafy gardens and outdoor restaurants. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the mosquitoes’ main feeding time.

    Democratic Republic of Congo: Threat not over

    Despite the widespread yellow fever vaccination campaign that has been carried out recently in the capital Kinshasa and outlying areas, the WHO stated this week that the danger is not over yet, with further (reactive) campaigns formulated for Feshi and Mushenge Health Zones in Kwango province. Better news for neighbouring Angola where the immediate threat of a full-scale outbreak has been averted - over 65% of the population has been immunised. 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

    Eritrea: South-west cholera spike

    A cholera outbreak that has hit the Upper Gash Region in the south-west of the country, bordering Sudan and Ethiopia, is spreading further south as authorities struggle to cope with what they describe as a ‘potential national epidemic’. 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. For further advice on whether you should consider vaccination for your trip, call Travelvax Australia’s travel health advisory service (1300 360 164). Read more about cholera.

    Haiti: Top in cholera stats

    The longstanding cholera crisis that has beset the country continues as an update of disease numbers in the Americas up to the end of August shows Haiti to have 96% of all cases for the region (26,799), with the Dominican Republic second (1,039). Read more.

    India: Monsoon season yields multiple disease threats

    A Times of India article documents the toll of dengue in the country, reporting the states hardest hit to be West Bengal (24 deaths from 5,600 cases), Kerala (9/5,286 cases), Uttar Pradesh (3/ 2,173 cases) and Telangana (Hyderabad is badly affected with 7 deaths from 135 cases until August). Read more.
    Of the major cities, Mumbai has been spared the worst of the outbreaks, but other parts of Maharashtra state - Kolhapur, Nashik and Thane – have reported over 2,200 dengue cases with 4 deaths. Delhi has recorded almost 400 dengue fever cases since the beginning of September but it’s chikungunya that is causing major disruptions in the city as many workers fall ill and take time off work.
    In Rajasthan, Jaipur has been hit by outbreaks of dengue, chikungunya, malaria and scrub typhus. 
    Doctors in Chennai (Tamil Naidu) have issued warnings to the public to be alert for symptoms of insect-borne diseases, but not to forget hepatitis A which can also strike during the monsoons.
    While reports of dengue fever and chikungunya predominate during the monsoons, the actual number of malaria cases across the country this year – over 471,000 – is much higher than the combined total of the other 2. Read more.

    Advice for travellers: Malaria is widespread in India and occurs year-round in both rural and urban areas, including major cities. Travellers visiting India should discuss their itinerary, insect bite avoidance measures and the possible need for anti-malaria medication during a pre-travel medical consultation. Read more about malaria

    Malaysia: Latest Zika case in KL

    The country’s sixth Zika fever case has been announced by health authorities – a woman from the suburb of Setapak in Kuala Lumpur. Her sister was the 5th recorded case. Read more. From a posting to the Avian Flu Diary website, the Minister of Health today announced that 2 strains of Zika virus are circulating in Malaysia at the moment, one from Singapore and the other a local strain. An earlier case, the 2nd acquired locally, was in Kota Kinabalu in the state of Sabah, Borneo. Read more.

    Nigeria: Lassa fever in 24 states

    The Chairman of the country’s Lassa Fever Control Committee said at a recent forum that at least 3 people are being diagnosed with Lassa fever every day and surveillance must be improved. Over 680 people are suspected to have had Lassa fever since the end of last year and 154 deaths have resulted from 24 states. 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.

    Pakistan: Dengue’s sudden spike

    A sharp increase in dengue fever cases over the past week in Rawalpindi has authorities concerned that an outbreak is looming in the city. Read more.

    Philippines: Iloilo Zika spread, dengue ‘a danger’

    There has been further spread of the Zika virus to 2 other household members of the original case in Jaro district of Iloilo City. As testing of nearby potential mosquito breeding sites produced positive results for the vector of Zika and dengue fever (Aedes aegypti species), more cases are likely. Dengue is still high on the list of health concerns: the Chief Epidemiologist warned that its heightened presence is a “clear and present danger in the region.” Read more. Cebu City and Mandaue City in the province of Central Visayas have borne the brunt of a dengue outbreak affecting the region, with over 12,000 cases and 106 deaths documented overall. Read more.

    Singapore: Dengue, Zika updates

    For the first time in 3 weeks, dengue fever case numbers dropped for the week – 242 were recorded, taking the annual total to 11,634. Read more. Seven clusters of Zika infections have produced 341 cases to date. The government has instituted subsidised testing, public education and mosquito control programs as it faces the challenges posed by the Zika virus outbreak. Future updates from the National Environment Agency will focus on Zika clusters and not actual cases. Read more.  

    Thailand: Push to lower Zika risk

    Mosquito vector control measures, including insecticide fogging, are being carried out in the nation’s capital as the total number of Zika virus infections recorded this year reached 29, with 22 of those in upmarket Sathon district. Read more. A health ministry official has announced that, on a national level, 20 new Zika cases have been diagnosed each week for the past 3 weeks, taking the annual figure to 200 across the country – one of the highest in the region. Read more.

    Uganda: Hep B surges in north

    A vaccination campaign targeting young children has been called for in response to the spread of hepatitis B in the north of the country. A contributing factor in the high rates is considered to be transmission of the virus from Hep B positive mothers to their babies at birth. Read more.

    United States of America: Florida’s Zika update; Rabid bats at safari park

    Florida’s locally-acquired Zika case count has now reached 71 – the most recent are residents of Wynwood, Miami Beach, Miami-Dade and Palm Beach Counties. Free Zika virus testing is available for pregnant women who live in the affected areas. Read more
    THREE rabies-infected bats have been found at a popular tourist park in San Diego over the past 4 months – all near an eatery at the San Diego Zoo Safari Park’s Nairobi Village exhibit. Anyone who had contact with the animal is asked to contact health authorities to ascertain their level of risk against the fatal infection. Read more.

    Zimbabwe: Call to control rabies

    In advance of World Rabies Day on September 28th, a national agency for animal welfare has called for the tightening of dog control laws in Harare. This comes after an upsurge in the numbers of unlicensed dog breeders who typically do not vaccinate their animals against rabies. Three people have died from rabies this year in the country – all in Harare. 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. Generally, the risk of rabies for most short-stay travellers is low. Vaccination recommendations are itinerary-specific, but include those travellers planning to live in, or travel extensively through, rural areas. Read more on rabies

  • Australia: Hope for RRV relief

    A drug which acts to repair cartilage and reduce inflammation in the joints of patients suffering from Ross River fever has passed phase one trials, according to an SBS article. Previously, doctors were only able to offer some symptomatic relief of the debilitating pain that the virus causes. The chikungunya virus, which is currently causing numerous outbreaks across the globe, is from the same family of viruses, Alphaviruses.  Read more on Ross River Virus.  

    Caribbean, Latin America: Zika, chikungunya and dengue updates

    The World Health Organization (WHO) has updated its advice for the prevention of sexual transmission of the Zika virus. Included in the advice for travellers returning from Zika-infected areas is: Both men and women should practice safer sex or abstinence for a period of 6 months. If planning pregnancy, to ensure Zika virus infection has cleared, wait 6 months before attempting to conceive. Practice safer sex or abstain for the entire pregnancy in the case of sexual partners of pregnant women on return from known Zika transmission areas. Read the WHO Interim guidance update
    A team of experts from the WHO have released their latest findings on the causal links between Zika virus infection and microcephaly (in pregnant women) and also Guillain-Barré syndrome (GBS). Their judgement is that, in view of current evidence, Zika virus infection during pregnancy is a cause of congenital brain abnormalities including microcephaly and that Zika virus infection is a trigger of GBS; however ‘the Zika virus alone may not be sufficient to cause either congenital brain abnormalities or GBS. It is not known whether these effects depend on as yet uncharacterized co-factors being present. Nor is it known whether dengue virus plays a part; dengue virus is carried by the same species of mosquito and has circulated in many countries during the same period.' Read the WHO Zika causality statement here
    Studies performed on mice have shown the presence of Zika virus in the eyes a week after infection. More research is needed to determine if this could also occur in humans and if the tears could be a further way to transmit the virus. Read more
    Chikungunya
    In the latest Pan American Health Organization report, the countries that updated their case numbers (Argentina, Colombia, Costa Rica, and El Salvador) identified a total of 290 suspected and confirmed cases. Read more Epidemiological Week 35 
    Dengue
    News of the dengue situation across Brazil from various Portuguese language news sources: In the state of Minas Gerais, the death toll now stands at 67 and high disease rates in Juiz de Fora, Uberaba, Araguari, Presidente Olegário and São Gonçalo do Abaeté. Pernambuco recorded over 550 cases in one week and there are reports of people co-infected with dengue and chikungunya. The total of cases in Mato Grosso has topped 25,000 to date. Pinhalzinho is one of 27 towns to report cases in Santa Catarina. Alagoas, Paraná and São Paulo are also reporting increased infection rates.

    Advice for travellers: Epidemics of the Zika, chikungunya and dengue viruses continue undiminished in the Americas and Caribbean. Generally milder than dengue and chikungunya, Zika’s symptoms last 4-7 days and include a rash, pain in the joints, and the eye condition, conjunctivitis. With the apparent exception of pregnant women, long-term ill-effects are rare, although joint pain may linger for weeks – even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite aggressively by day and are found in urban setting, including leafy gardens and outdoor restaurants. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the mosquitoes’ main feeding time. 

    China: Hong Kong dengue cases now at 3; Zika screening initiated

    Hong Kong health authorities have confirmed a 3rd locally transmitted dengue fever case – a 40 year old woman from Hong Kong Island with no history of travel. Mosquito control measures and testing of nearby residents have been instituted. Read more 
    AT least 74 people who were suffering generalised symptoms have had their health screened on arrival into China at Guangzhou Baiyun Airport because they had been in Zika-affected regions. The inspections have been in place since the beginning of August. Read more.  A Chinese news source announced that all nationals returning from countries reporting Zika infections should report themselves to authorities if they have ‘suspect’ symptoms. Read more.

    Democratic Republic of Congo: Mighty YF effort; Cholera in Kinshasa

    The WHO worked together with national health authorities and other international agencies to carry out a yellow fever vaccination campaign that has reached over 7.7 million people in the congested capital of Kinshasa over a 2-week period. It is hoped that the mass vaccinations will head off an escalation of the outbreak during the upcoming rainy season. No new yellow fever cases have been recorded in the DRC or neighbouring Angola in over a month. Read more.
    ANOTHER vaccination campaign, this time for cholera, will be held in the capital and surrounding areas in response to an outbreak that has so far this year affected 18,000 people and killed 517. 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: Monsoon, insect-borne diseases rage on

    Dengue alerts this week have come from Kolkata, West Bengal; Zirakpur and Amritsar in Punjab; Kurla in Mumbai, Maharashtra; Dehradun, Uttarakhand; Chennai in Tamil Nadu and Kota, Rajasthan. Southern areas of Delhi have been hit hard as cases reach 284 including at least 4 deaths. While in Meerut, Uttar Pradesh patients have had to share beds as hospitals are swamped with dengue cases. Chikungunya is also taking its toll across the country with Delhi recording 128 cases and an increase in cases in Bhopal, Madhya Pradesh. Meanwhile malaria has caused the death of a 30-year-old man in Delhi, the first in 5 years. Pimpri-Chinchwad in Maharashtra state is reporting malaria again after a 2-year respite and Ahmedabad, the largest city in Gujarat, has had 4,782 cases of malaria. Japanese encephalitis has caused the death of at least 224 children in Gorakhpur,Uttar Pradesh and 43 cases have been identified in the north-eastern state of Tripura.  

    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, the Torres Strait 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. Expatriates and travellers living for prolonged periods in agricultural areas where Japanese encephalitis is endemic or where seasonal epidemics occur are at greater risk and should consider vaccination.

    Japan: Measles burden grows

    Over 30 workers at Kansai International Airport, the gateway serving Osaka, have been diagnosed with measles believed to have been imported by a traveller. Most of those infected were aged in their 20s and 30s and they include 3 doctors who examined the ill employees. Read more. The Japanese Society for Infection Prevention and Control anticipates that more measles cases will be found, adding to the total of 41 up till September 6. 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.

    Kenya: Flu trends up

    In the latest World Health Organization (WHO) global influenza update, Kenya reported increased flu numbers (mainly H1N1 and H3N2 strains) while in the southern temperate regions of Africa numbers are also rising, with a shift in the predominating strain from B to A. Read more.

    Advice for travellers: The 2016 flu season is underway in the southern hemisphere and Travelvax Australia recommends vaccination for all travellers over 6 months. 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. 

    Malaysia: Further Zika case

    Authorities have advised of a second Zika case in the southern state of Johor – a 27-year-old pregnant woman. While the woman’s husband travels to Singapore frequently and is also suspected of having Zika infection, it is not known if she acquired it locally or from her husband. Read more.

    Myanmar: Some good malaria news

    Of the 6 nations in the Greater Mekong region, Myanmar has achieved the greatest reduction in malaria numbers, followed by Vietnam, Thailand and Cambodia. The other 2 countries, Laos and China (Yunnan province) reported increases in cases and deaths. The WHO is concerned, however, that parasite resistance to a first line treatment drug occurs in Cambodia, Laos, Myanmar, Thailand and Vietnam. Read more.

    Nepal: Kathmandu valley cholera

    Parts of the Kathmandu valley are affected by cholera – Lalitpur (110 cases), Kathmandu (19) and Bhaktapur (1) have reported cases, leading authorities to recommend stringent food and water precautions in the area. Read more.

    Nigeria: Third polio case in Borno; Lassa in 4 states

    A few weeks after 2 polio cases were confirmed in the northern state of Borno, the first in the region for 5 years, a third case has been diagnosed in a 2 year-old boy from Monguno in the state’s north-east. Read more 
    THE states of Plateau, Rivers, Bauchi and Gombe have a total of 5 confirmed cases of Lassa fever over the past 2 weeks, including one death. Further suspected cases are being tested. Read the ProMED post

    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

    Pakistan: Milk rabies risk for family; Karachi dengue numbers grow

    An extended family of 24 from Boshhara Gul Killay in the Federally Administered Tribal Areas has been admitted to hospital after drinking raw milk from a cow that had been bitten by a rabid animal, a theoretical risk factor for rabies transmission. Read more 
    DENGUE reports are increasing in Karachi with highest numbers from District East, followed by the District Central areas of Liaquatabad, North Nazimabad, Gulberg; New Karachi and District South. Men have the highest infection rates. Read more.

    Philippines: Zika in Iloilo City

    A woman from Iloilo City on the island of Panay who had no recent history of travel to affected countries is the first Zika virus case for 2016. Read more.

    Saudi Arabia: MERS case ahead of Hajj

    The Ministry of Health has announced a further MERS case – this time a 65 year-old man from Riyadh who had indirect contact with camels. The annual Hajj pilgrimage is imminent so the government is taking steps to avoid an outbreak while 2 million pilgrims are in the country. Read more. Advice on MERS from the WHO for Hajj pilgrims.

    Singapore: No quarantine for Zika; 2015 dengue cases exceeded

    The government has announced that it will not continue to quarantine those people confirmed to be infected with Zika virus. The heightened presence of the Aedes mosquito at this time of year does cause concern, but as most people do not display symptoms of infection, isolation is unlikely to halt the spread. Vector control programs are underway. Read more. The National Environment Agency updates Zika numbers and clusters locations – the latest (3pm, Sept 7) is 283 cases. Read more
    DENGUE cases reported over the past week have reached 311, taking the annual toll to over 11,440. This exceeds the annual total for 2015. Read more

    South America: Flu maintains presence in Chile and Peru

    In most parts of the continent, influenza activity decreased, with the exceptions of Peru and Chile. The circulating strains are A (H1N1 & H3N2) and B. Read more in WHO global flu update

    Thailand: More Zika reported

    This year, 8 Zika virus cases have been diagnosed in Bangkok, including 2 pregnant women. Read more. While in the rest of the country, over past week the provinces of Chiang Mai, Phetchabun, Bung Kan and Chanthaburi have reported a total of 20 new Zika virus cases. Read more.

    United States of America: Florida’s Zika update; Hep A toll in east now 85

    Seven new cases of locally acquired Zika infection were announced by the Florida Health Department on September 6th, taking the total to 56. Areas under investigation are Miami Beach and Miami-Dade County. Read more
    THE hepatitis A outbreak first reported in West Virginia has now led to 85 cases – all caused by consuming smoothies made from contaminated imported strawberries at a chain of stores in areas including Maryland, North Carolina, Virginia, and West Virginia. Read more.

    Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans by faecally contaminated food and water, or by handling everyday items. It is one of the most common infections in travellers and is a significant risk in most developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is 99%-plus effective and protects for 20-30 years. Travellers should also follow safe food and water guidelines

    Vietnam: Dengue spike in Central Highlands

    Dengue fever cases in the Central Highland province of Lam Dong have risen sharply this month – 1,286 since the beginning of the month – and one death. Bao Loc Town is badly affected as are the districts of Di Linh, Bao Lam, Duc Trong, and Lam Ha. Read more.