Health Alerts
  • Canada: Uni students hit in mumps hike

    Adults in the 17 to 29 years age group – many of them students of universities in Winnipeg and Manitoba - make up the majority of the 61 mumps cases reported in the central province of Manitoba from early Sept to Dec 8th. Read more.

    Advice for travellers: This and other ongoing outbreaks of mumps (see USA posting) 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.

    China: Bird flu season warning, Macau’s first H7N9 case

    Warnings over the increased incidence of bird flu during winter months has accompanied the latest news of 5 more avian influenza A(H7N9) cases in humans on the Chinese mainland. All cases are in men: 4 from the province of Jiangsu (2 residents of Kunshan and 1 each from Nantong and Suzhou) and 1 from Fuzhou, Fujian province. Most had been exposed to poultry in markets. Read more. A poultry stall holder at a market in Macau has become the territory’s first case of H7N9 avian influenza, according to a posting by Avian Flu Diary. The World Health Organization (WHO) Director-General, Dr Margaret Chan, has warned that the ability of the H7N9 virus to cause severe disease in humans while not producing symptoms in birds is cause for concern – in other avian influenza strains, sickness in birds does give some warning of an outbreak or potential for transmission. Read more.

    Advice for travellers: There are several strains of bird flu and while the virus can be fatal, infection generally poses a low risk for travellers – even for those heading to a region where the disease is present or an outbreak is occurring. Travellers should avoid contact with birds or poultry in marketplaces, wash hands thoroughly before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.

    Democratic Republic of Congo: Yellow fever rekindles

    Seven confirmed cases of yellow fever have been detected in Sandoa (6) and Kasaji (1) in the southern province of Lualaba, bordering Angola to the south. Vaccination campaigns were carried out in the province 3 months ago as part of a drive to end the large outbreak that had affected both the DRC and Angola, but it is feared that people living in remote areas may not have been vaccinated. Read more.

    Advice for travellers: Yellow fever virus is a mosquito-borne disease found in tropical and subtropical areas in parts of South/Central 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.

    Egypt: Travel alert for high tourist season

    The Department of Foreign Affairs and Trade has posted an alert on the smartraveller website advising travellers to reconsider travel to Egypt, and to avoid completely areas such as the north Sinai, due to the high possibility of imminent terrorist attacks in areas popular with tourists. 

    Europe: Flu situation update

    The latest World Health Organization update on global influenza (taking in data up to Nov 27th) specifies northern parts of Europe as experiencing an uptick in cases, but only slight rises for East Asia, North America, Iran and Sri Lanka in South Asia, Vietnam in SE Asia and Morocco & Ghana in Africa. In a separate Spanish language news report, a statement has been issued by a Puerto Rican health department official declaring a flu epidemic on the island. Read more (translate from Spanish).

    Kenya: Cholera in Tana River County

    A national strike by health workers is worsening an already serious situation in Tana River County, north of Mombasa. Cholera infections have hit people in parts of Garsen Town and there are no doctors and nurses at local hospitals to care for them. To date there have been 2 deaths and many more are critically ill. 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. 

    South America, Latin America: Dengue, chikungunya, malaria data updated

    Sporadic reporting of dengue fever cases indicates that published data from the Pan American Health Organization (PAHO) is not current for many countries in the region. New figures for the 2-week period from Nov 23rd to Dec 12th show increases in dengue cases for Ecuador (609 new confirmed cases), Colombia (538) and Venezuela (257). Read more.
    As with the PAHO dengue updates, many countries have not provided new data for chikungunya infections, but of those nations that did, Guatemala had the highest count (133), followed by Bolivia (31). Read more (EW 49) 
    The WHO released the World Malaria Report 2016 this week, summarising the global disease burden and advances made in reducing malaria incidence; however Latin America figures indicate that the situation has worsened in Venezuela and, to a lesser extent, in Peru and Nicaragua. Read more

    Advice for travellers: Dengue and chikungunya are spread by daytime-feeding Aedes mosquitoes and travellers should avoid bites by applying an insect repellent containing an effective active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, when the mosquitoes are most active.

    Malaysia: More malaria for Gerik, Perak

    The case count for the Plasmodium vivax malaria outbreak in Gerik (Perak state) posted on Nov 24th has risen to 129, with 16 people requiring hospitalisation. Read more.

    Philippines: Dengue spike leads to alert

    A dengue alert is now in place in the southern Mindanao province of South Cotabato as officials deal with a near 100 percent increase in infections over last year’s figures. The death toll from dengue-related illnesses has also increased to 24 – mostly from the municipalities of Koronadal, Tupi, Polomolok, Surallah, Banga town, Tantangan, Norala and Lake Sebu. Read more.

    Saudi Arabia: WHO releases new MERS review, local case count update

    The WHO has updated its MERS Co-V risk assessment (the last one was in mid-2015): Many of the cases identified since the last assessment were acquired in a healthcare setting, with the non-specific nature of the initial symptoms often to blame for missed early diagnosis and isolation. Other infections have been through direct or indirect contact with dromedary camels, a known risk factor. Additional information includes: Approx. 80 percent of cases have been in Saudi Arabia; males aged 60 and over with underlying medical conditions have a higher risk of infection, severe disease and death; the highest risk of infection occurs in people who have regular contact with dromedary camels (farmers, abattoir workers & shepherds) and health workers caring for MERS-CoV patients. Read the WHO MERS-CoV Global Summary and risk assessment here. The Ministry of Health has released details of the latest MERS case, a 72- year old man from Taif in Mecca province who had direct contact with camels. He brings the country’s total to 1,508 cases with 625 deaths. Read more.

    Singapore: Further Zika case, new ‘red’ dengue cluster

    The cumulative total of Zika virus cases in the island-state now stands at 457, with one more case added this week by the National Environment Agency. Read more.  Dengue case numbers continue to decline but 12 transmission clusters remain active, one is classified as red meaning it has produced >10 cases. 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).

    Somalia: Children bear brunt of measles outbreak

    Children under 5 have been hardest hit in an outbreak of measles that has been running in the port city of Kismayo since September. To date, 419 cases have been recorded. Read more.

    Thailand: Malaria alert issued for 9 provinces

    Travellers to the provinces of Kanchanaburi, Tak, Songkhla, Narathiwat, Ubon Ratchathani, Mae Hong Son, Si Sa Ket, Chiang Rai and Pattani are cautioned to be aware of the malaria risk in those areas. The Department of Disease Control issued the alert while announcing that 16,651 cases of malaria were detected in the country this year, over 5,000 of those were tourists. Read more.

    United States of America: Zika in Texas, Florida; Mumps numbers swell

    Investigations are underway into a further 4 locally-acquired cases of Zika virus infection in people who lived near to the first identified case in Brownsville, Texas. Read more. The US Centers of Disease Control & Prevention (CDC) has issued a list of precautions advised for residents and visitors to Brownsville in view of the Zika notifications.  And in Florida, 2 more cases of locally-acquired Zika virus infection have been reported from Miami-Dade County this week, but health authorities have not revoked the closure of the final active virus transmission zone in the county. Precautions are still advised for residents and visitors. Read more
    A BROADENING of the mumps outbreak in the NW state of Washington has seen new cases found in neighbouring cities and counties. While only 12 cases are confirmed there are dozens more suspected in both King and Pierce Counties. Seattle, the capital of Washington state, lies in King County. The CDC has announced that this year’s mumps figures are the highest since 2006. Read more

    Vanuatu: Dengue numbers climbing

    A health official has warned that dengue fever cases will continue to occur, adding to the current 34 confirmed and 119 suspected cases. The capital Port Vila has seen the majority of the cases to date. Read more.

    Vietnam: Zika cases rise again

    A French language news report puts the Zika virus case count in Ho Chi Minh City to be 128 from 23 of the city’s districts. The districts most affected to date are: Binh Thanh, district 2, district 12 and Tan Phu. Only district 8 has been without cases. Read more.

  • 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.