Health Alerts
  • Australia: Flu season takes off; Bacterial infection spreads in VIC

    Hospitals in Perth are feeling the squeeze following a rise in influenza cases not seen since 2012. Up to 100 people a day are presenting at local hospitals, with the elderly most affected by the predominating flu strain in circulation this year. Read more. On a national level, all states are reporting an increase in influenza-like illnesses - influenza A(H3N2) is the leading strain and in recent weeks, influenza B notifications have also risen. Read the Australian Influenza Surveillance Report
    CASES of Bairnsdale (Buruli) ulcer have doubled in Victoria over the past 3 years, spreading from the endemic areas of the Bellarine and Mornington peninsulas into Melbourne’s southeast. Australia is one of 33 countries that report the ulcerating infection that is caused by a mycobacterium (from the same family of bacteria that cause tuberculosis and leprosy). Besides Victoria, cases are also found in tropical north Queensland. While the exact mode of transmission is not known, it is suspected that insects play a part. Some animals can also be infected (horses, dogs, possums & koalas). Read more.  More on Buruli ulcers

    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.

    Caribbean, Latin America: Zika & dengue update

    Outbreak news
    The US Centers for Disease Control & Prevention (CDC) has added the British Virgin Islands to the list of those countries reporting local transmission of the Zika virus and their advice when travelling to affected areas is to use insect bite avoidance measures and practice safe sex (or abstinence). Read more 
    In the most recent update issued by Colombia, Zika infections are starting to fall in number, with 170 for the past week bringing the total number recorded to 8,826 confirmed and 93,515 suspected cases. Over half of all cases were in the departments of Valle del Cauca, Norte Santander, Santander, Tolima and Huila. Read more 
    Health authorities in the Cayman Islands have identified 2 further cases of local transmission in the capital George Town, taking the total to 5. Read more 
    Read the full World Health Organization (WHO) situation report of August 25 here
    Other Zika news
    A review of a Zika case in the US state of Maryland suggests that the virus can be transmitted sexually from a man to a woman, even when no symptoms are present i.e. with asymptomatic infection. Read more 
    Puerto Rico, which has been hit hard by Zika virus this past summer, is to be the site of a Zika vaccine trial. Read more

    Dengue
    Of the countries that updated their data to the Pan American Health Organization dengue webpage, since the August 5 posting: in Central America, Mexico noted an increase of nearly 1,200 confirmed cases and Nicaragua, 960. In South America, increases were recorded by Brazil (19,555 cases), Peru (765) and Ecuador (622). Read more – PAHO EW 33.

    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: YF situation: serious but not emergency

    The emergency committee of World Health Organization (WHO) will not be declaring a Public Health Emergency of International Concern over the yellow fever outbreak that has affected Angola and the DR of Congo since 2015; however it is a ‘a serious public health event which warrants continued national action and international support. Furthermore, the imminent onset of the rainy season will intensify vector activity, thus raising subregional risks of yellow fever transmission’. The progress of the outbreak has slowed and vaccination campaigns are ongoing – Angola’s last cases were reported on June 23rd, the DR of Congo on July 12th. Read the WHO statement

    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

    Europe: West Nile update

    The European Centre for Disease Control and Prevention provides surveillance of West Nile virus fever (WNV) cases in EU member states and neighbouring countries. In its August 26th update, new areas of WNV spread include: the first case in Cyprus (Larcana district) and further spread in already affected countries (Hungary, Italy, Romania, Russia and Serbia). Read more.

    Advice for travellers: West Nile virus is endemic and epidemic in Eastern Europe and the Mediterranean basin, with epidemics regularly reported in summer and autumn since the 1950s. 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. Europe’s outbreaks are not as severe or widespread as in other regions where the virus occurs, notably North America.

    India: Officials meet to tackle insect-borne diseases; JE burden grows

    Government officials will be meeting this week to discuss the country’s escalating dengue and chikungunya case numbers: 24,892 cases of dengue from 35 states and 11,510 cases of chikungunya from 26 endemic states up to August 21st. According to an article in The Asian Age, those states most affected by dengue are (in order of severity): Kerala, Orissa, West Bengal, Karnataka, Maharashtra, Tamil Nadu, Gujarat, Andhra Pradesh and Assam. Fifty-three deaths have been recorded as being caused by dengue infection. Of the chikungunya rates, Karnataka, Andhra Pradesh, Telangana, West Bengal, Maharashtra, Gujarat and Goa have the highest tallies. Read more 
    IN Kheri, a district of Uttar Pradesh that borders Nepal, 8 cases of Japanese encephalitis (JE) have been reported with one death resulting. Read more. The JE virus is extending its reach in India and returning to some areas after a period of respite. Read more.

    Japan: Measles not music to the ears

    A young man who attended a music concert near Tokyo in mid-August while suffering symptoms of measles, was confirmed to have the infection 5 days later. In the interim he had also visited Tokyo and Kanagawa prefecture. Health authorities have now issued a warning to the nearly 25,000 people present at the concert, as well as other possible contacts, to be alert for symptoms of the highly infectious disease. According to a news report, the man had contracted measles earlier this month while in Indonesia. Read more.

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

    Nepal: Scrub typhus lingers in Chitwan

    A further 17 cases of scrub typhus have been diagnosed in Chitwan over the past week, taking the 4-month total to 162 including 5 deaths. Read more.

    Advice for travellers: Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rats 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.

    Pakistan: Tick-borne fever toll now 19; Leishmaniasis cases climb

    Two cases of Crimean-Congo haemorrhagic fever (CCHF), a tick-borne infection, have been diagnosed in Quetta & Loralai. The death toll from CCHF this year has risen to 19 – 12 from Quetta, 5 in Karachi and 2 Bahawalpur. Read more
    KARAK district, in the northern province of Khyber Pakhtunkhwa has seen a rise in the incidence of sand fly-borne leishmaniasis cases over the past 3 years. This year, there have been nearly 1,000 cases – 82 this month. Read more.

    Advice for travellers: 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. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about the virus. 

    Philippines: Dual mozzie threat

    Health authorities in Cagayan de Oro, the capital of Misamis Oriental province, are warning of dual outbreaks of mosquito-borne infections. Dengue fever and chikungunya cases have been identified in the city recently and the weather is expected to exacerbate the situation with the rainy season to come. Read more.  And in Iloilo City on the island of Panay, dengue numbers have more than doubled this year leading the local mayor to issue free larvacide to residents and encourage the emptying of all small water receptacles that could be used as mosquito breeding sites. Read more.

    Singapore: Dengue, and now Zika

    To add to the dengue woes already inflicting the city-state, local transmission of Zika has been proven as 115 people have tested positive for the virus to date. Of the early cases, some worked in the south-east of the island (Aljunied Crescent/Sims Drive/ Kallang Way/ Payar Lebar) and lived elsewhere in Singapore, suggesting the virus could potentially be carried into other districts. Now, a second area of concern, some 7kms from the first is under investigation. The National Environment Agency is conducting extensive mosquito control programs in an effort to stem the number of infections. Read more. In response to the Zika cases in Singapore, and even as Malaysia increases its monitoring of arrivals through the causeways that link the 2 countries in the southern state of Johor, a resident who visited Singapore has been diagnosed with Zika. Read more. DFAT has updated its advice for Australians travelling to Singapore through the smartraveller website – the advice includes “Adopt additional measures advised by the Department of Health, including deferring non-essential travel if pregnant, avoiding pregnancy for two months following your return and other advice for both males and females. 

    South Korea: Summer heat brings diseases

    Unseasonably high temperatures over the summer months have caused an increase in some infectious diseases this year. A few days after cholera was diagnosed in a man from South Gyeongsang, a further case was identified who similarly contracted the illness after eating contaminated raw seafood. Hepatitis A infections have also climbed: over 3,300 cases to date and the incidence of insect-borne illnesses such as malaria and scrub typhus has risen too. Read more.

    Sri Lanka: Dengue numbers climbing

    Colombo district has recorded 11,952 of the nation’s over 37,500 dengue cases this year, with Gampaha district next highest (4,737 cases to date) and Kandy (2968). The resulting death toll from the infections is now 59. Read more.

    Taiwan: Strict hygiene measures advised

    This month, 5 cholera cases have been reported causing authorities to issue a warning to residents to practice heightened food and water precautions during the hot weather. 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

    Thailand: Zika cases increase; MERS imported from Kuwait

    Zika infections have risen this year – as many as 96 people have tested positive to the virus. Recent infections were recorded in the provinces of Chiang Mai, Chanthaburi, Phetchabun and Beung Kan. Read more. Thailand, Indonesia, Vietnam and the Philippines are categorised by the WHO as being countries in SE Asia ‘with possible endemic transmission or evidence of local mosquito-borne Zika infections in 2016’. 
    THE WHO has released a report on young man hospitalised with MERS Co-V infection after arriving in Thailand from Kuwait in July. He has since recovered and contacts have been tested but not shown evidence of infection. Read more.

    Turkey: Water wells contamination

    Norovirus-contaminated wells that provide water for most of the province of Kahramanmaraş in Turkey’s south have caused gastro-intestinal symptoms in 32,000 people from Elbistan district over the past 3 days. Read more.

    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.

    United States of America: Tourists offered insect protection; Smoothies still causing Hep A cases; Ticks and mosquitoes summer peak

    According to a news report, visitors to some Florida theme parks will be provided with insect repellent, hotel rooms will have knock-down sprays and there will be advice to cover up to avoid mozzie bites – this comes as the area is experiencing a downturn in visitor numbers following the confirmation of local Zika virus transmission. Still on Zika in Florida, the state’s health department will be issuing daily updates (weekdays) on the ongoing local virus transmission: today a further case has been identified in Palm Beach, taking the total to 47. 
    THE hepatitis A outbreak in Virginia reported in last week’s alerts has now claimed 44 victims in that state and further 11 in total from Maryland, West Virginia, North Carolina, Oregon and Wisconsin. The culprit, Egyptian frozen strawberries used in smoothies, has since been withdrawn from supply. Read more
    A MARKED increase in tick-borne diseases such as anaplasmosis and babesiosis is alarming authorities in the state of Maine. The increase is being seen in the south of the state but is expected to continue north as the season progresses. Read more. More on tick-borne diseases of the US from the CDC
    WEST Nile fever case numbers (confirmed and probable) reported by each state to the CDC show the highest rates for the year to be in Texas (68), South Dakota (64), Colorado (32) & Arizona (27). Read more
    The toll of the mumps outbreak that struck Long Island, NY earlier this month is now at 36 cases. Read more.

    Vietnam: Dengue peak still to come

    The central highlands and parts of the Mekong Delta region are facing a dengue spike this year – numbers are 3 times higher than for this time last year. Across the country there have been 49,049 cases and 17 deaths. Dengue numbers are also increasing in Ho Chi Minh City with the peak not expected to pass for another 2 months. Read more.

  • Bangladesh: Concern over anthrax spike

    Over 100 cutaneous anthrax cases have been recorded since May in the central sub-district of Shahjadpur. Read more 

    Advice for travellers: The anthrax bacterium is transmitted to people in the form of spores which are can produce disease through consuming contaminated meat, through inhalation or via contact with the wool, hair or hide of infected animals. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about anthrax

    Caribbean, Latin America: Zika, dengue & chikungunya updates

    Outbreak news
    The US Centers for Disease Control & Prevention (CDC) has added The Bahamas to its Travel Notices following the notification of local transmission Of Zika virus on the island of New Providence, location of the capital Nassau. The level 2 notices recommend enhanced precautions which include avoiding mosquito bites and further measures for pregnant women or those planning pregnancy. 
    It has been estimated that around 25 percent of Puerto Rico’s population may have been infected with Zika virus by the end of the northern hemisphere summer season. Already the case count is at 12,800, not including undiagnosed, asymptomatic infections. Local authorities are trying to encourage measures to reduce mosquito numbers but must deal with apathy on the part of many of the inhabitants who are only too familiar with mosquito-borne diseases such as dengue and chikungunya. Read more 
    A Spanish language news source in Nicaragua quotes the Ministry of Health’s figures for this year as: 1,366 Zika virus cases, 4,329 dengue and 630 chikungunya. 
    Most of Mexico’s 1,619 cases have been reported in the states of Chiapas, Guerrero, Oaxaca and Veracruz; the situation is expected to worsen with the start of the rainy season. Read more 
    Cases in Honduras have reached the 30,000 mark, including 600 women, and there has been a corresponding increase in cases of Guillain-Barré syndrome this year. Read more (translate from Spanish) 
    Other Zika news
    A news source in Florida has put together a timeline of the spread of Zika since it was first identified in Uganda in 1947. 

    Dengue
    Paraguay has approved the use of the dengue vaccine, Dengvaxia. It joins Mexico, Brazil, El Salvador and Costa Rica in the region, plus the Philippines, in providing the vaccine as a control measure against the growing incidence of dengue fever. Read more 
    Municipalities in Costa Rica’s south-west have been hard hit by dengue. The cantons of Atenas, Quepos, Parrita, Osa, Nandayure and Buenos Aires have the highest burden from a national tally of nearly 13,000 cases this year. Read more (translate from Spanish) 

    Chikungunya
    Even before the start of the rainy season in October, Bolivia’s chikungunya cases have risen to 7,577 and dengue 3,531 this year. Read more (translate from Spanish) 
    An article published in the British Medical Journal outlines the incidence of chikungunya in Brazil, noting the tally for the first 6 months of this year at 170,000 cases, making up 94 percent of all cases in the Americas. Read more 
    Caribbean islands which updated their chikungunya numbers this past week include Aruba (704 cases), Trinidad and Tobago (590), Dominica (271) and Jamaica (205). Read more  Plus details on cases reported across the Americas from August 19th, as compiled by Flutrackers

    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: YF review planned

    A review of the ongoing yellow fever outbreaks in Angola and the DRC will take place on August 31 when the emergency committee of the World Health Organisation convenes. Read more

    Haiti: Cholera on the rise again

    Over 1,300 people have contracted cholera over the first 3 weeks of this month, leading authorities to issue a red alert for the 14 communes that have confirmed infections and deaths. Read more

    India: Insect-borne diseases spread

    As the monsoon season continues, reporting of insect-borne diseases is ramping up across the sub-continent. Accounts of dengue fever cases have come in from Kanpur and Lucknow in Uttar Pradesh; Chandigarh, Punjab & Haryana; Dehradun and Haridwar in Uttarakhand; Patna in Bihar; Delhi; Pune, Maharashtra; Mandya, Karnataka and West Bengal. In Aizawl, capital of the state of Mozoram, passengers arriving at the domestic aiport are being screened for dengue. Read more
    Chikungunya reports are also climbing: favourable weather conditions for the infecting mosquitoes are believed to be behind a rise in cases in Delhi and Uttar Pradesh. Read more. Hyderabad has had its first reports of chikungunya for the season - also at least 20 diphtheria cases. Read more  
    The north-eastern state of Assam reports 360 confirmed cases of Japanese encephalitis including 78 deaths so far this year. The comes on top of 480 cases of dengue fever, many of those in the district of Kamrup. Read more. Encephalitis has been the cause of death of 175 people in Uttar Pradesh. Read more

    Advice for travellers: Dengue occurs throughout India – both in urban and rural areas. The virus is spread by two types of Aedes mosquitoes. Both breed in shady places close to dwellings and bite mainly during the daylight hours, making them difficult to avoid when 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.

    Malaysia: Dengue numbers climb again; Diphtheria strikes 3- year- old

    Selangor, Kelantan, Negri Sembilan, Johor and Malacca have all recorded rises in dengue numbers recently. Kelantan also recorded four deaths last week taking the national toll for the year to 153. Read more 
    THE Health Director-General has advised this week that a 3 year-old child from Selangor has contracted diphtheria – the child became ill in mid-August and required hospitalisation involving intensive care admission. Diphtheria-tetanus-whooping cough vaccine is given to Malaysian children as part of the immunisation schedule but, according to the news report, the child was not immunised as the family chose homeopathy over vaccination. Read more.

    Myanmar: JE vaccination campaign planned

    Three people have died and another 14 have been infected with Japanese encephalitis in 4 townships of Kayin State, an area bordering Thailand. Further north, near the border with China, 13 cases were confirmed last month. Read more. A vaccination campaign is planned for the states of Rakhine and northern Shan states over the coming months. 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, 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. 

    Nepal: Water, hygiene to blame for cholera, typhoid

    At least 10 cholera cases are being reported each week of the ongoing monsoon season from areas of Kathmandu and Lalitpur. A total of 68 cases have been confirmed however many more diarrhoeal illnesses are being seen at local hospitals, blamed for the most part on contaminated water and unsafe hygiene. Read more. In Ramechhap, south-east of Kathmandu, typhoid fever has broken out among the local population, with up to 10 cases a day presenting. Read more.

    New Zealand: Measles alert, contacts traced

    Health authorities have tracked at least 150 people who had contact with a person infected with measles in Auckland over the period August 8-13. While there have been no further reports of measles cases, contacts are being monitored. The source case is believed to have contracted the illness while in South-East Asia. Read more.

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

    Nigeria: Lassa in Anambra

    Authorities in the south-eastern state of Anambra have reported 4 deaths – one a doctor - from Lassa fever, but no details on other cases. People in the affected state have been advised to refrain from eating raw cassava and ensure rats are kept away from food. Read more.

    Advice for travellers: Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings and it’s then passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. While Lassa fever is mild or has no observable symptoms in about 80% of people infected with the virus, the remaining 20% have a severe multisystem disease. Read more on Lassa fever.

    Pakistan: Dengue tally grows

    Those areas reporting dengue fever this week are Rawalpindi, Punjab and Makaland district in Khyber Pakhtunkhwa.

    Saudi Arabia: After the lull, 2 more MERS cases

    The Ministry of Health has updated MERS case numbers after 2 men: one from Al Kharj, south of Riyadh, and the other a secondary contact of an earlier case from Huraymala were diagnosed with the illness. Read more.

    Singapore: Dengue season persists

    As forecast by environment agency officials, dengue fever cases have climbed again this past week, with the total since January 3rd this year now over 10,800 and 7 deaths resulting. Read more.

    South Korea: Cholera after 15 years

    A man from from the city of Gwangju with no history of travel outside the country is the first case of cholera to be diagnosed in the country for 15 years. Read more.

    Switzerland: Tick bites boost

    The incidence of tick bites and tick-borne diseases has climbed this year – 8,400 cases of Lyme disease (over 3,000 more than the 2015 total) and 119 cases of tick-borne encephalitis. Overall, the numbers of tick bites treated by doctors are at their highest since reporting began in 2008. Read more.

    Advice for travellers: A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia. However, vaccination can be obtained from medical practitioners through a Special Access Scheme.

    United States of America: Hep A smoothie risk; Zika in Florida spreads

    Smoothies made from Egyptian strawberries have been found to be the source of a hepatitis A (HAV) outbreak in Virginia that has infected 12 people. Investigations are underway to determine if the same supplier was used by other food outlets. Read more. Meanwhile the probe into the large HAV outbreak in Hawaii is not yet finalised as a further 22 cases have been detected in the last week bringing the total to 228 cases, 58 of whom required treatment in hospital. As a precaution, the Hawaiin Health Department webpage devoted to the outbreak notes the business names and dates of attendance for the food service workers who have been infected. 
    A SECOND zone of locally acquired Zika infections in South Florida was detected in Miami Beach late last week and now a further case has been identified in Pinellas county, some 450 kms from the first reports in Wynwood county. This case, plus a further 4 from Wynwood and 2 from Palm Beach counties, takes the total to 43 across the state. Read more.

    Vietnam: Whooping cough strikes north

    A vaccination campaign against pertussis (whooping cough) is planned for young children in the northern province of Cao Bang after a spike in infections was detected. At least 49 infections have been confirmed in the area. Read more.

  • Australia: NSW flu season intensifies

    Across NSW, 1950 influenza cases were confirmed last week and the death toll among the elderly rose to 45, causing health authorities to advise those suffering flu symptoms to stay away from aged care facilities. 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. 

    Burundi: Cholera in SW

    Contaminated drinking water is thought to be behind a cholera outbreak that has struck the country’s southwest – 95 cases have been reported over the past 3 weeks mainly from Bujumbura Rural province and Ruziba in the capital. Read more

    Caribbean, Latin America: Zika, chikungunya updates

    Outbreak news
    A public health emergency has been declared in Puerto Rico in response to the dangers posed to pregnant women by the Zika virus. Over 10,500 cases have been confirmed since the outbreak began. Read more 
    An Aug 10th update from the Brazilian Ministry of Health quoting figures from early July states that there had been 8,071 new suspected Zika cases of an annual total of 173,000. Bahia is most affected (48,010 cases), then Rio de Janeiro (46,022). Read more
    Other Zika news
    In reviews on 2 cases of Zika virus infection diagnosed in men who had travelled to Haiti, European researchers were still able to detect the virus in semen 181- 188 days after symptoms were first reported, and in saliva 47 – 91 days after symptom onset. Read more 
    In order to counter the misinformation that exists about Zika among the general public in the USA, the Anneberg Public Policy Center at the University of Pennsylvania has produced a guide for media outlets, “A Guide to Effective Zika Coverage”. Read more
    An article published recently in The New Yorker charts the road to finding a Zika vaccine. Read more

    Chikungunya
    The state of Pernambuco in Brazil’s northeast is reporting high numbers of chikungunya cases - 20,677 so far this year, with the capital Recife most affected. Read more.  Across the region, a further 32,492 more cases were recorded – Brazil updated its figures for a one month period (nearly 30,500 new cases) but increases were also noted by Costa Rica, El Salvador, Guatemala, the Dominican Republic and Colombia. 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. 

    Central African Republic: Cholera spread in region

    A cholera outbreak that started in Djoujou has spread to Damara and the capital Bangui over the past week. Sixty cases have been identified and at least 13 people have died during the outbreak. Read more

    China: Mainland bird flu; Dengue in Guangdong

    More H7N9 avian influenza cases have been reported on the mainland - Fujian (2 cases), Beijing (1) and Hebei (2). Read more. The WHO is investigating several of the recent H7N9 cases with no apparent direct contact with poultry to determine if transmission could have been human-to-human. Read more 
    GUANGZHOU, capital of Guangdong province, has reported 41 dengue cases so far this year, followed by Shenzen and Foshan with 16 cases each - the peak season is yet to start. 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: Growing concern over spread of yellow fever

    Latest reports identify a spread of the virus into new areas of the 3 affected provinces - Kinshasa, Kongo Central and Kwango.
    In Angola, the situation has improved - from the second week of June, yellow fever cases have been declining – the provinces of Luanda and Huambo have been most affected in the outbreak which has produced 3867 suspected cases (879 confirmed) since early December 2015. Vaccination campaigns continue to be carried out, including 4 districts bordering Namibia. Read more from World Health Organization (WHO) situation report of August 12. Also Republic of Congo report. 

    Advice for travellers: Yellow fever (YF) is spread by the same Aedes aegypti mosquitoes that spread more common viruses, such as dengue, chikungunya and Zika, for which there are no vaccines. However, this trio of urban viruses, YF is more commonly found in rural areas of tropical and subtropical regions of endemic African and South American countries – one reason cases continue to be rare among Australian travellers. Travellers visiting tropical regions should apply a personal insect repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about yellow fever

    Fiji: Disease update issued

    The Minister of Health has given a briefing on the year’s communicable disease statistics, which included Zika, 34 cases; dengue fever, 623; chikungunya 41; typhoid fever 225 and leptospirosis 430 cases. Read more

    India: Monsoon season diseases escalate

    A medical facility in New Delhi is recording high numbers of chikungunya cases this year – 241 against 61 for 2015. Read more.  Dengue is also making its presence felt as 109 cases were identified in the city for the first 2 weeks of August. Read more
    Dengue reports over the past week have come from from Nashik and Mumbai in the state of Maharashtra state; Udupi in Karnataka; Cuttack and Berhampur, Odisha; Ranga Reddy & Hyderabad district, Telangana; Kanpur in Uttar Pradesh and Kamrup in the northeastern state of Assam. The twin cities of Kolkata and Howrah in West Bengal are being affected by both dengue and malaria

    Ireland: STI rates up

    Syphilis notifications in Cork and Kerry counties have increased markedly over the past 18 months – 21 cases have been identified for the first 6 months of this year, mostly homosexual men. Read more

    Japan: Hokkaido reports tick-borne disease

    A man from the northern island of Hokkaido is the first person in Japan to die of tick-borne encephalitis and only the second case to be reported in the country. He was bitten by the tick in mid-July and died on August 13th. Read more

    Advice for travellers: A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. VACCINE: While safe and effective vaccines are available in Europe, none are licensed in Australia. However, vaccination can be obtained by doctors through a Special Access Scheme.

    Malaysia: HFMD increase recorded

    Nearly 2,000 cases of hand, foot and mouth disease (HFMD) were reported in the first week of August – this is an average of 100 more cases per week since the beginning of the year over the same period last year. Selangor, Sarawak, Johor, Kuala Lumpur and Sabah have been most affected. Read more 

    Advice for travellers: Parents of young children should be aware of that seasonal epidemics of HFMD occur throughout Asia. The virus mainly affects young children and 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. Read more about HFMD.

    Mexico: Oaxaca's kissing bugs

    Two districts of Oaxaca state (Valles Centrales and Costa) have reported over half of the states’s 53 cases of Chagas disease this year. Read more (translate from Spanish) 

    Advice for travellers: Chagas disease (American trypanosomiasis) is widespread in Mexico, Central America, and South America. However, it presents a low risk to Australians travelling to the region who stay in air-conditioned or screened accommodation. Infected triatomine bugs infest poor-quality dwellings and take a blood meal from victims at night. However, as has become more common, the disease can also be transmitted through freshly pressed juice contaminated with the insects attracted to the ripening fruit. Read more on Chagas disease.

    Nepal: Spread of insect -borne diseases in Terai

    Two deaths among 11 cases of scrub typhus have been reported in the districts of Sankhuwasabha, Dhankuta, Bhojpur, Morang and Ilam in the country’s east, according to an article in the Kathmandu Post. From the same post, Chitwan and nearby regions in the Terai are also recording cases – 50 over the past 4 months. 
    In other areas of Terai, visceral leishmaniasis has been diagnosed in 6 people from Palpa. There has been a gradual increase in incidence over the past 2 years. Read more. Kailali in the far west has reported 15 malaria cases over the past month. Read more

    New Zealand: Men. meningitis spike in south; Gastro illness hits Hawke’s Bay

    The south island’s Southern health district is reporting increased numbers of meningococcal meningitis cases, with 14 cases identified this year, double the average for most years. No one strain or type is predominating and authorities are recommending awareness of meningococcal symptoms in the community. Read more 
    BACTERIA-contaminated water has caused an outbreak of gastrointestinal illness in over 3,000 residents of Havelock North, in the country’s Hawke’s Bay district. Tests this week confirmed the presence of Campylobacter, a common cause of bacterial diarrhoea. Read more. More on campylobacter from the US Centers for Disease Control & Prevention. 

    Nigeria: Polio returns

    In October 2015, Nigeria was removed from the list of polio endemic countries after a year without any positive cases. Last week however, it was confirmed that 2 young children from the northeastern state of Borno have been infected with poliovirus. Vaccination campaigns are planned in the area and in neighbouring Chad, Cameroon, Niger and the Central African Republic. Read more 

    Advice for travellers: Polio is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low. Vaccination is recommended for travel to affected regions. If at risk, adults should have a booster to the childhood series every 10 years. More on polio.

    Philippines: Dengue rates, deaths increase

    Dengue rates across the country are over 15 percent higher this year than last, according to the Department of Health. Calabarzon, Central Visayas, Northern Mindanao, Western Visayas and Soccsksargen and Central Luzon are most affected. The annual total to date is 84,085 suspected cases with 372 deaths. Read more

    Republic of the Congo: Border checks for yellow fever

    Amid fears of a suspected outbreak of yellow fever in the Congo, the World Health Organisation (WHO) is considering whether to declare a public health emergency of international concern which would allow for control measures to be instituted. Border checks are in place between Kinshasa and the capital of the Congo, Brazzaville and a mass vaccination campaign is planned for the region ahead of the wet season which begins in October. Read more

    Singapore: Slight dip in dengue numbers

    Fewer than 200 dengue cases were reported in the past week but infecting Aedes mosquito numbers are high in the community so the risk of transmission remains during this annual dengue season. Total case numbers for the year are now 10,623 with 7 deaths. Read more

    United States of America: Likely Hawaii Hep A source identified; Zika spread continues in Miami & beyond

    Imported frozen scallops from the Philippines that were served raw at a chain of sushi restaurants are believed to be behind an outbreak of hepatitis A on Hawaii’s Oahu and Kauai islands which has so far sickened 206 people. The affected restaurants have been closed until further notice. Read more 
    A FURTHER 3 cases of local transmission of the Zika virus were confirmed today in Florida, taking the total to 33. A business traveller who visited Miami from Taiwan earlier this month was diagnosed with Zika infection on her return to Taiwan and has since recovered. A one square mile area within the county of Wynwood is still believed to be the origin of the infected mosquitoes; insecticide spraying and capture/testing of mosquitoes is underway. Read more.

    Vietnam: Dengue toll exceeds 30,000

    With the peak of the dengue season still to come, southern provinces are struggling with rising numbers of infections and a 76 percent increase on last year’s rates. Ho Chi Minh City, Binh Phuoc, Binh Duong, Ben Tre and Lam Dong have been hardest hit as news reports quote the region’s total as 31,000 cases and 13 deaths. Read more