Health Alerts
  • American Samoa: Zika under-reporting feared

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

    Australia: Measles import adds to SA toll

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

    Advice for travellers: Measles is a highly contagious virus and can cause serious illness in people of all ages. Most of cases reported in Australia are linked to overseas travel - both developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure. 

    Burkina Faso: Dengue outbreak deepens

    The dengue fever outbreak reported last week has now led to approximately 2,000 cases and 20 deaths, with all areas of the capital Ouagadougou affected as well as regions of the country’s north (Sahel Region) and west (Hauts-Bassins). Read more.

    Advice for travellers: Dengue is spread by two types of Aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid outdoors. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Cambodia: 6 years between confirmed Zika infections

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

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).

    Caribbean, Latin America: Zika, dengue, chikungunya summary

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

    China: Bird flu in Hunan; Water quality upgrade planned

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

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

    India: West Bengal, Assam dengue woes continue

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

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

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

    Niger: No relief from fever in Tahoua

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

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

    Pakistan: Child deaths from diphtheria, polio

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

    Peru: Drought’s dengue legacy

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

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

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

    Advice for travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals – especially dogs, the main source of infection. If bitten, urgent post-exposure treatment is required. Discuss your itinerary and whether rabies vaccination is recommended during your pre-travel consultation. Read more on rabies.

    Qatar: Vax campaign to check measles

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

    Russia: Low herd immunity stirs epidemic fears

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

    Saudi Arabia: More MERS cases likely

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

    Singapore: Welcome dip in dengue, Zika

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

    South Sudan: Juba, River Nile bear brunt of cholera

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

    Advice for travellers: Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera

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

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

    Vietnam: Zika’s reach extends in HCMC

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

    Zimbabwe: Spike in water-borne diseases feared for Masvingo

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

    Advice for travellers: Typhoid fever is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid

  • Caribbean, Latin America: Zika & chikungunya updates for region

    As advised in the latest World Health Organization (WHO) Zika virus situation report (Nov 10th), 2 new territories have recorded local, sporadic transmission of Zika infection: Montserrat, a British Overseas Territory in the Caribbean, and Palau, a republic in Micronesia (see separate report). Read the full WHO report here
    Turks and Caicos Islands and British Virgin Islands are now considered to have widespread virus transmission. Read more.  Authorities in the US Virgin Islands have released newly confirmed infection figures: 833 cases, with the highest case numbers coming from St. Thomas (556), St. Croix (139) and St. John (52). Read more
    The California Department of Health has updated its Zika virus travel advisory for residents of the state travelling to Mexico, stating that: ‘Individuals have been infected in popular tourist destinations including Cancun, Acapulco, Cabo San Lucas, Puerto Vallarta, Ixtapa, and Mazatlan.’ The advisory also warned visitors to Baja California that while no Zika virus infections have been recorded there, the presence of the Zika vector means that mosquito bite avoidance measures should be used. 
    Other Zika news
    In a report published recently in the Morbidity and Mortality Weekly Report (MMWR) by the US Centers for Disease Control and Prevention (CDC), findings from Puerto Rico's Zika outbreak demonstrate that more women (61%) were infected than men in the 20+ years’ age group. While this could be explained by the higher rates of sexual transmission from men to women, it might also be the case that women are more likely than men to seek medical advice for symptomatic infection. Further study is needed to determine how to prevent the spread of Zika virus disease and which age groups to target. Read more
    Chikungunya
    Brazil updated some of its weekly statistics to the Pan American Health Organization (PAHO) last week by announcing 136,708 new cases – these don’t include data for the past 8 weeks however. Guatemala has also had a recent spike in cases as 496 new cases were reported to the PAHO. 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). 

    Burkina Faso: Capital’s dengue surge

    A dengue fever outbreak in the capital Ouagadougou that has led to the deaths of at least 7 people is behind a recent travel advisory issued by the Turkish government as it encourages its travellers to avoid mosquito bites when in the area. Read more.

    Advice for travellers: Don’t get bitten and you won’t get dengue. To avoid biting insects, apply repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus to all exposed skin when outdoors. 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 also cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. 

    China: Human bird flu cases in 2 provinces

    Authorities have announced 2 new H7N9 avian influenza cases: a woman aged 77 who had bought poultry at a wet market in Huzhou, Zhejiang and an 89-year old man from Suzhou in Jiangsu province. Both are in a serious condition in hospital. 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. 

    Ghana: Cholera persists in Central region

    The Cape Coast cholera outbreak is not yet under control as numbers rose from last week’s 157 to over 260 today. No deaths have been recorded but authorities are on the alert, anxious to avoid a repeat of the 2014 epidemic that produced more than 17,000 cases and 150 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. 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 on cholera. 

    India: Malaria count grows in east; Delhi’s disease threats taper; Encephalitis burden grows

    Reports of malaria in the eastern state of Jharkand have increased with several districts advising of cases. Nearly 60,000 malaria infections were recorded to September; almost half of those were due to the more serious falciparum strain. Read more
    COOLER temperatures are finally giving Delhi the edge over the mosquito-borne illnesses that have caused record numbers of infections this year. In the week to Nov 12th, chikungunya cases had dropped to 332 and dengue, 135. Read more
    THE states of Odisha and Uttar Pradesh continue to report cases of Japanese encephalitis; Odisha’s Malkangiri district recorded a further climb in the death toll to 115 over the past 69 days. 

    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.

    Malaysia: Five states avoid dip in dengue

    While dengue fever case numbers are now on the decline across most parts of the country, the states of Pahang, Johor, Pulau Pinang, Perlis and Kedah bucked the trend by delivering higher figures over the previous 1-week reporting period. Read more.

    Micronesia: Palau now reporting Zika

    The US CDC has issued an advisory for travel to Palau in response to the confirmation of local Zika virus infection. Level 2 ‘enhanced precautions’ are recommended, which includes the use of effective insect repellents and safe sex practices (or abstinence). Read more.

    Philippines: Zika count rises

    A further 10 cases of Zika virus infection were confirmed by the health department this week taking the total to 33. According to a news source, 12 cases have now been recorded in Iloilo province while the remainder occurred in areas of the National Capital Region. Read more.

    Romania: Measles rates still climbing

    The message for US travellers visiting Romania is to ensure vaccinations are current and practice strict personal hygiene as the CDC responds to the spike in measles infections this year – 935 cases including 6 deaths, according to one news source. Read more

    Advice for travellers: Measles is a highly contagious virus that can cause serious illness in people of all ages and it occurs in developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other routine vaccinations such as tetanus, diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure.

    Saudi Arabia: MERS update - 2 new cases

    The Saudi Ministry of Health has advised of 2 new MERS coronavirus cases diagnosed over the 6 days: both are aged in their 50s - a woman from Afeef who is known to have had high-risk exposures and a man from Tabuk who had recent direct contact with camels. The man is reported to be in a critical condition. Read more.

    Singapore: Dengue, Zika cases on decline

    Only 86 dengue fever cases were reported in the past week which is the 3rd week in a row with numbers sub-100. Of the 10 active clusters, only one is classified as high risk. Read more. New Zika infections were confirmed on only 2 of the last 7 days as the total now sits at 451 with 3 active clusters. Read more on the National Environment Agency Zika website

    Thailand: Zika spread confirmed

    Confirmation of another 33 Zika virus cases, and spread to 2 more provinces, has been announced by the health ministry this week. This takes the year’s total number of cases to 680. There is concern however for the potential for further spread as large numbers of people travel to the capital to pay their respects following the death of King Bhumibol Adulyadej in mid-October. Read more

    Uganda: High Hep B prevalence

    Vaccination campaigns are planned in response to the high rates of hepatitis B in the Central region (Sembabule district) after recent testing in the community showed this to be as high as 21 percent. Read more.

    Advice for travellers: Vaccination is the mainstay of prevention and the full course of 3 doses (at least 2 prior to travel) provides highly protective antibody levels lasting at least 20 years – life-long for most. At least 2 shots are needed for travel. (Intending travellers can get effective protection in as little as 3 weeks through a shortened hepatitis B immunisation schedule.) A combined Hep A-B vaccine is also available. Read more about hepatitis B, the vaccine, and schedules. 

    United States of America: Zika persists in 2 Florida locations

    Zika virus infections continue to rise in Florida, with an increase of 11 over last week’s figures. Little River in Miami-Dade County and Miami Beach are the focal points of investigations into the sources of infection as authorities persist with measures aimed at eradicating the mosquito vector in these areas. Read more.

    Vietnam: More HCMC districts reporting Zika

    Thirteen of Ho Chi Minh City’s 24 districts have now reported Zika virus infections according to the update issued by the city’s deputy director of the Department of Health. The total now stands at 38. Read more.

    Yemen: Cholera outbreaks concern WHO

    The escalating cholera outbreak is now affecting 11 of the country’s 15 governorates as the WHO announced this week that suspected cases have spiralled to 4,000 – a 2-fold increase over the previous 12 days. The greatest concern is for the south-west region that takes in the provinces of Ta'izz and Aden. Read more.

  • Australia: Measles spike for SA

    South Australia has recorded 12 measles cases this year and the state health department is warning that the infection is spreading in Gawler with 6 recent cases. The department’s website gives details of where the latest cases had visited while infectious and advises all those in the area to be aware of symptoms and ensure their MMR (measles, mumps, rubella) vaccinations are current. 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. 

    Brazil: Monkey deaths signal fever risk

    The Epidemiological Surveillance Group of São Paulo’s Secretariat of Health has issued a warning to travellers to the São José do Rio Preto region in the state’s north, in response to the confirmation of increased circulation of the yellow fever virus in monkeys. New World monkey species are the virus’ primary reservoir in Brazil and the virus can be passed on to humans if a mosquito bites an infected monkey and then a human. The health department is ensuring that susceptible people in the local population have been vaccinated and is advising visitors to be vaccinated also. 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

    Caribbean, Latin America: Zika, chikungunya updates

    Public Health England publishes a list of countries with current or past Zika virus activity and has categorised them into high, moderate, low and very low risk for the benefit of travellers planning their itineraries . 
    Chikungunya
    Mexico, Costa Rica, El Salvador, Bolivia, and Colombia have contributed the most new confirmed or suspected cases over the past week, producing the majority of the 440 cases as advised in the Pan American Health Organization’s Nov 4th update. Read more  
    In a Nov 2nd update report from the WHO/PAHO, the latest data shows that chikungunya case numbers this year are higher than for the same period last year and there has been spread of the virus to new regions. 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). 

    Ghana: Cholera spreading in Cape Coast

    Six of the 26 districts of the Central region have now reported cholera in a broadening of the outbreak reported last week. To Nov 6th, there had been 172 cases recorded and no fatalities with Cape Coast Metropolitan and nearby surrounding areas most affected. 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

    Haiti: Vax campaign for SW

    Organisations including the WHO, PAHO, UNICEF and GAVI Alliance will vaccinate 800,000 people against cholera in the areas of Sud and Grand’Anse, hardest hit by the recent hurricane. Nearly 3,500 suspected cholera cases have been reported in the areas during October. Read more.

    India: Cooler temps bring relief to some

    A drop in temperature has not offered the expected relief from dengue fever in Rudrapur (Uttarakhand), which makes up part of the Terai region that stretches into Nepal. Local doctors remain vigilant for more cases during a season when they would not normally be seen. Read more. Uttarakhand’s capital, Dehadrun, has recorded the state’s highest dengue fever rates – a 3-year high of 1,386 cases. Read more. In Telangana, Hyderabad council’s chief entomologist believes that the city’s current dengue fever and chikungunya spike will settle from the beginning of next month. Read more. After a horror year for dengue and chikungunya infections, the state of Maharashtra is finally getting a reprieve from mosquito-borne illnesses. Fewer than 400 dengue cases were reported in Mumbai the in the first 7 days of November, compared with 4,000 in the previous month. Read more. Delhi has also seen a decline in chikungunya cases in the week to Nov 7th – 342 cases were recorded taking the annual figure to 11,193, a 10-year high. Read more.

    Micronesia: Emergency declared on dengue, Zika

    Since the first Zika case was identified in Kosrae in mid-March this year, 157 people with typical symptoms of Zika virus have been tested and 22 infections have been confirmed. Read more. The routine testing of pregnant women for Zika virus has revealed most of Kosrae’s 6 confirmed cases of dengue fever – 58 other cases are still being investigated. The governor has declared a public health emergency in response to the mosquito-borne diseases affecting the state. Read more

    Myanmar: Two regions hit hard by dengue

    Children under 15 and people living in Mandalay and Yangon have made up the highest number of dengue infections this year, as the country recorded nearly 8,000 cases and 43 deaths until October. Read more.

    Nepal: Dengue threat not over yet

    Doctors are encouraging residents and visitors in Chitwan to maintain mosquito bite avoidance measures despite a slight drop in the incidence of dengue since the beginning of November. Ratnanagar Municipality has been hardest hit, with 519 infections diagnosed since mid-August. Read more. Meanwhile in Damak in the south-eastern district of Jhapa, a local doctor has revealed that 8-10 new dengue patients are arriving at hospital each day as the infection spreads ‘in epidemic proportion.’ Read more.

    Nigeria: Malaria spikes in NW

    Parts of Sokoto state in the country’s northwest are reporting high numbers of malaria cases – around 2,000 people have received treatment in the past 8 days. Many of the cases were classified as severe. Read more. Just across the border in Niger, Madaoua health district saw a doubling of malaria cases over the same 1-week period of October compared to 2015 (6,695 c/w 3,901). Read more.

    Advice for travellers: For most travellers, Africa presents 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.

    Pakistan: Children bear brunt of vax-preventable diseases

    News reports from Bannu, in southern Khyber Pakhtunkhwa, have announced the deaths of 27 children from diphtheria over the past few weeks. Hospitals have been unable to source supplies of the necessary vaccines for children arriving in the area from nearby war-torn regions. Read more
    ALSO in Khyber Pakhtunkhwa, an infant girl has become the 9th polio case for the year. 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. Temporary recommendations to limit the spread of polio have been instituted by the WHO. More on polio

    Singapore: Dengue, Zika review

    This week’s dengue case count is slightly higher than last week, as a further 86 new infections were diagnosed bringing the annual total to 12,574. Of the active clusters, 2 that are located in the Yishun residential district in the island’s north are classified as high risk. Read more. There has been an increase of 5 in the total of Zika cases over the past week, taking the figure to 449. Active clusters as advised on the National Environment Agency website are located in the island's south-east. Read more.

    Solomon Islands: Aid to beat dengue

    Humanitarian aid is under way in the island group to tackle the growing dengue fever outbreak that started 4 weeks ago and has now affected Honiara city, Guadalcanal, Malaita, Isabel and Choiseul provinces. There has been 1 death from dengue-related causes and over 1,700 people have been infected. Read more.

    South Sudan: Cholera strikes central state

    Two payams (districts) of Unity state’s Payinjiar county have been struck with cholera outbreaks that have so far led to 2 deaths and at least 30 admissions to treatment centres. Local doctors are calling for humanitarian relief as medical supplies are in short supply. Read more.

    United States of America: Arkansas mumps spreads further; Florida Zika cases rise

    Of the 1,140 confirmed or suspected mumps cases in NW Arkansas to date, the 5 to 17 years age group has been hardest hit (762 cases), according to the Nov 8th health department update.
    IN order to adhere to the US Centers for Disease Control & Prevention’s (CDC) updated case definition for Zika virus infection, there has been a marked increase in the case count as reported in the Florida Dept of Health Zika website. Added to this, a further 7 locally-acquired cases have brought the total to 217 as of today. This week cases were reported in residents of Little River (8kms north of Downtown Miami) and Miami-Dade County. A further case does not reside in Florida; investigations are under way to determine where each person contracted the virus. Read more.