Health Alerts
  • Angola: YF outbreak improving slowly

    The latest yellow fever situation report released by the World Health Organization on July 29th revealed of a slowing of new cases in Angola (66 for the previous week). Meanwhile, the Democratic Republic of Congo reported 109 new cases in the same period as authorities try to bring the outbreak under control amid fears it could take hold in the highly populous urban areas of Kinshasa. Read more 

    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

    Australia: Salmonella-tainted melon alert; Measles in Brisbane transit

    A spike in Salmonella cases – at least 80 to date – across the country have been attributed to rockmelons from a supplier in the Northern Territory. The advice from health authorities is to discard any melons already purchased – washing the fruit will not make them safe – and be alert for gastrointestinal symptoms. Read more 
    A HEALTH alert is in place in Brisbane after a man who was infectious with measles transited through the international airport on his way from Bali to Wellington in New Zealand’s north island. He arrived in Brisbane on July 24. As measles is highly infectious, fellow travellers and visitors to the airport are advised to monitor their health for symptoms which could include fever, tiredness, runny nose, conjunctivitis and aches and pains. 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), mumps, and polio 6 weeks before departure.

    Caribbean, Latin America: Zika, dengue & chikungunya updates

    Outbreak news
    Pan American Health Organization (PAHO) figures released on July 29th indicate rising numbers of Zika cases over the past month in Costa Rica, Ecuador, Guatemala, Jamaica, Mexico, Nicaragua, Puerto Rico, Saint Barthelemy, Saint Martin, the U.S. Virgin Islands, and Venezuela. Case numbers peaked in Brazil in mid-February, whereas Guatemala experienced a peak in early February with a further rise starting towards the end of June. In Mexico, Zika activity increased from the second week of June and started to fall again early in July. Read more 
    Puerto Rico has experienced a spike in Zika cases recently, with 1,714 for the last recorded week and a total for the year of 7,296. The weekly total includes 116 pregnant women and 2 cases of Guillain-Barré syndrome. Read more 
    Colombia’s latest tally takes in some delayed reports as well as the most recent week, amounting to 745 new suspected cases. Over half of the cases were in the departments of Valle del Cauca, Norte Santander, Santander, Tolima, and Huila. The gradual decline in numbers continues. Read more 
    Despite the start of the rainy season in June in Trinidad and Tobago, measures to reduce mosquito numbers are apparently working, with only 60 confirmed Zika cases so far – all but one were in Trinidad. Read more 
    Cuba reports a further imported case of Zika (from Haiti), taking that number to 30 and only one locally acquired case. Read more (translate from Spanish) 
    Other Zika news
    A team of researchers in the US, funded by the National Institutes of Health, has used extensive modelling to highlight the discrepancies of Zika reporting in the region. They believe that the largely asymptomatic nature of the illness, together with the view that many people with symptoms don’t seek medical help, means that actual disease numbers may be many times higher than reported. Read more 

    Chikungunya
    In the PAHO update issued on July 29th, activity over the previous week was highest in Honduras (617 new cases) and Bolivia (570). Across the region, the updated yearly total for new suspected cases is 214,547. 

    Dengue
    Brazil’s Paraná state has recorded a further 358 dengue cases over the past week and 90 urban areas have ongoing epidemics. Those most affected are Paranagua, Foz do Iguaçu and Londrina. Read more (translate from Portuguese) 

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

    China: Summer heat affects kids

    A second day of temperatures around the 40°C mark have caused a stream of young patients for one of Shanghai’s major hospitals, with daily attendances exceeding over 7,000. Many required rehydration, according to a Chinese language media source.

    Europe: West Nile season begins

    The mosquito vectors of West Nile Virus (WNV) become more active during the warmer months of the European summer and reports of outbreaks are starting to emerge. Russia, Israel, Italy and Romania have all recorded cases; however the majority of infections produce no symptoms. The European Centre for Disease Prevention and Control has been monitoring WNV in the region for the past 5 years. Read more Three people from the regions of Southern Banat and Macva in Serbia are suspected of being infected with West Nile Virus (WNV), one of them subsequently died. Read more

    India: Assam’s JE flood woes; Dengue numbers on the rise

    In the eastern state of Assam, the rains have brought floods but also a surge in Japanese encephalitis cases. To date 295 cases have been confirmed with 66 deaths. Read more 
    ILLNESSES caused by insects and contaminated water are affecting Mumbai in rising numbers. Increaseses in cases of gastroenteritis, malaria, hepatitis (A & E) and leptospirosis have hit the city. Dengue fever cases are also higher than for the same period last year. Read more 
    States and territories reporting dengue outbreaks include Delhi, Uttarakhand, Andhra Pradesh, OdishaKarnataka, Haryana and Telangana
    IN West Bengal, the dengue spike continues, with nearly 1,000 cases since the beginning of the year and 7 deaths attributed to the virus since the end of June. Read more

    Advice for travellers: India’s monsoon extends from June to September and the rains bring an upsurge in diseases, including vaccine-preventable hepatitis A, typhoid, and cholera. All travellers to India should follow safe food and water guidelines, and personal hygiene practices.

    Indonesia: West Java dengue spike

    The regency of Lebak, in the western Javanese province of Banten has been hit hard by dengue fever. To date at least 590 people have been infected and four have died. Read more

    Malaysia: Aedes clusters in 7 states

    Seven states have localities with high numbers of dengue-carrying mosquitoes, according to national health authorities: Selangor is most affected, followed by Johor, Putrajaya/Kuala Lumpur, Perak, Malacca, Kelantan and Sabah. Overall, dengue numbers are lower this year compared with the same period last year: 865,618 dengue cases, 147 deaths against 70,680 cases and 190 deaths in 2015. Read more 

    New Caledonia: Dengue lingers in the cooler season

    Authorities admit that the milder cool season temperatures and the cessation of insecticide fogging have contributed to the continued spread of the dengue virus in the territory: in the first 3 weeks of July, 70 cases were diagnosed within the territory, mostly from the capital Noumea. Read more (translate from French) 

    Pakistan: Tick-borne menace in Punjab

    IN Bahawalpur (Punjab Province), two people have died of the tick-borne viral disease, Crimean-Congo haemorrhagic fever (CCHF). The treating doctor of the initial case was the second fatality. 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, making infection a low risk to travellers. Read more about the virus. 

    Philippines: 20 percent rise in dengue

    Dengue cases in the country are rising, with most coming from Calabarzon, Central Visayas, Northern Mindanao, Central Luzon, Soccsksargen, Davao Region and Western Visayas. Overall the year’s tally is over 20 percent higher than for the same period last year - 66,299 until mid-July. Read more

    Poland: WYD pilgrim death

    A 19-year-old Italian woman has died of meningococcal meningitis in Vienna while on her return home from attending the World Youth Day proceedings in Krakow. Prophylactic antibiotics have been given to fellow travellers and other visitors to the Casa Italia centre in Krakow; they have also told to be aware of symptoms of the bacterial infection: high fever, headache, stiff neck, vomiting and sensitivity to light. Read more

    Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person by coughing and sneezing. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. Australian children are vaccinated against the ‘C’ strain in the National Immunisation Program but a more recent vaccine to protect against type ‘B’ is available privately. Read more about Men. meningitis

    Russia: Nomads infected with anthrax

    The count of anthrax cases in northern Siberia has been confirmed as 21, including the death of a 12-year-old boy. The Russian health minister is quoted as saying that the outbreak is localised within the region of Yamalo-Nenets and has been contained. To date, there have been 72 suspected cases of anthrax, 41 of them are children. Read more 

    Advice for travellers: The anthrax bacterium is transmitted in the form of spores when contaminated meat is eaten, through inhalation or via contact with the wool, hair or hide of infected animals. It can affect the skin, gastrointestinal tract or respiratory system. 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

    Saudi Arabia: MERS cases increase by 3

    In the week ending August 1st, a further 3 new MERS infections have been identified. One, a man in his late 40s, had indirect contact with camels. The other two are women, one a healthcare worker, from Jubail in the country’s east and the other from Jeddah. All are reported to be in a stable condition. Read more

    Singapore: Dengue count now over 10,200

    The 2015 dengue total was 11,286 cases, however this season is proving to be worse as numbers reported on the National Environment Agency website now exceed 10,200 since January 3rd. Of the 90 high risk areas, Telok Kurau in the island’s south-west recorded the most cases – a further 13 in the past week. Read more 

    Taiwan: Suspected dengue cases climb; Airport measles likely

    Despite a weekly increase in suspected dengue fever cases over the past 2 weeks across the southern part of the country - 190 and 198, there have been no confirmed cases during this period. The peak dengue season runs during the warm, wet weather from April to October. Read more 
    THE primary source for 2 cases of measles likely contracted at the domestic terminal of Taipei airport on July 15th is being sought. Two people who had been in the terminal at the same time have since been diagnosed with the highly contagious illness, one a traveller, the other a ground staff worker. Read more 

    Thailand: HFMD hits Bangkok kids; Dengue widespread

    Bangkok has recorded over 6,000 cases of hand, foot and mouth disease (HFMD) for the first 6 months of this year, mostly in small children under 4 years of age. Read more 
    DENGUE fever is being reported in all 77 provinces of the kingdom as case counts exceed 25,000 with 20 deaths. 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.

    United States of America: NY state mumps; Zika in Florida mosquitoes; Rabies’ summer peak; Hep A on Hawaii persists

    There's an outbreak of mumps underway in Nassau County of New York State, with at least 18 cases diagnosed to date and more likely to emerge. Read more 
    A LOCAL outbreak of Zika infections in southern Florida has now led to 15 people becoming infected. Initial cases were from an area north of Miami’s CBD, however on Aug 2nd, a further case was diagnosed further north, in Broward County. All cases had not travelled out of the area so transmission is presumed to be through local mosquitoes infected witht the virus. Read more  UK health authorities have issued a notice to pregnant women planning travel to Florida to reconsider in view of the current Zika outbreak. Read more
    THE summer months are also the peak rabies season in the US and reports of human exposure to the deadly virus through contact with infected animals have this week come from Virginia, Georgia, New York and South Carolina. Read more 
    HAWAII’S hepatitis A outbreak shows no sign of slowing as case numbers reached 135 on August 3rd, 42 more than the last update. While food workers are numbered amongst those with confirmed Hep A, they are not thought to be the original source of infection and authorities say that no patrons of the businesses where they work have been found to be infected at this time. The Hawaiin Department of Health website lists those businesses. 

    Vietnam: Mozzie scourge with rains; Zika case in central province

    The central and southern regions of the country have been hardest hit by dengue fever as the rainy season aids the spread of the mosquito that carries the virus. In July around 5,500 dengue cases were recorded and 2 deaths, taking the country-wide toll to 44,900 cases with 14 deaths. Read more 
    AUTHORITIES are monitoring the health of people living in the neighbourhood of a 27-year-old man from Phu Yen province after he was diagnosed with Zika virus. No evidence of further spread of the virus has been found so far. Read more 

  • Canada: Drugs to treat STI in short supply

    Extra supplies of antibiotics used to treat syphilis are being sourced from countries including Australia as Canadian health authorities struggle to combat a 30-year spike in the incidence of the sexually transmitted infection – bi-sexual and gay men have been most affected in the outbreak. Read more

    Caribbean, Latin America: Zika, chikungunya & dengue updates

    Outbreak news
    Nicaragua has seen a 53 percent increase in new Zika cases over the past 4 weeks, after a further 334 new infections were reported. Most affected are the departments of Masaya, Managua, Carazo, Granada, Nueva Segovia and Jinotega. Read more (translate from Spanish) 
    The peak of Zika notifications (~100,000 cases overall) has passed according to government authorities in Colombia but they now anticipate the endemic phase when the virus remains in the population, infecting at lower levels. However, a US researcher has warned that this could just be an “inter-epidemic period”. Colombia had the 2nd highest case count overall, with only Brazil recording more. Read more 
    Other Zika news
    As reported last week, a US woman was found to have transmitted the Zika virus to a male sexual partner while she was infectious. In view of this, the US Centers for Disease Control & Prevention (CDC) this week updated its recommendations for the prevention of sexual transmission of the Zika virus. All details of the new CDC recommendations can be found here. One of the strongest warnings applies to pregnant women whose partner (male or female) has been in a Zika-affected area: Abstinence or the strict use of barrier methods should be employed for the term of the pregnancy. Other changes include the need for safe sex or abstinence for partners of those people who have been diagnosed with Zika infection or presumed infection for 6 months in the case of men and 8 weeks for women. Read more 
    Experts from the Yale School of Public Health in the US have downplayed the risk of travellers to Rio de Janeiro for the Olympic Games becoming a large source of Zika infections on their return home. They outlined their reasoning in an article published online in the Annals of Internal Medicine. Read more 

    Chikungunya
    For the 2 weeks ending July 22, Brazil posted the highest tally for the PAHO region with 15,046 suspected or confirmed cases. Bolivia is also reporting high numbers – nearly 1200 for the week to July 22 and 19,588 since the beginning of the year. This year’s total for the region is now 212, 839. Read more 

    Dengue
    In Brazil, dengue cases for the past week have risen by 380 in the state of Paraná – the coastal city of Paranaguá and the Iguacu Falls area have recorded the highest numbers. Read more (translate from Portuguese). Pernambuco has also seen a spike in deaths due to dengue with 21 recorded until July 23. Read more (translate from Portuguese).

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

    China: RVF imported from Angola

    A man from Henan province who suffered symptoms of Rift Valley Fever while visiting Angola is in a critical condition in a Beijing hospital following confirmation of the diagnosis. 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.

    Egypt: Latest bird flu patients recover

    The World Health Organization has released details of 3 new H5N1 (bird flu) infections in humans. Two of the cases were children (non-related) from Cairo Governate and the third, a 30-year-old woman from Menia Governate, south of Cairo. All had a recent history of some contact with poultry and have now recovered following treatment. The 2016 total of confirmed cases for Egypt as notified by the WHO are 8 cases with 1 death. 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.

    Haiti: High cholera rates

    Over 95 percent of all cholera cases reported in the Americas this year up to July 8 were in Haiti (21, 661 suspected & 200 deaths) followed by the Dominican Republic (894, 17). Read more.

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

    India: JE, malaria in East; Rabies vax shortage; Dengue season’s arrival

    More Japanese encephalitis cases are likely as authorities conduct further testing of symptomatic people in the state of Manipur. Nine people have already been diagnosed with the mosquito-borne virus leading health officials to plan a vaccination campaign and insecticide fogging of the areas of residence of those affected. Read more
    Malaria has struck villagers in Bolangir district in the state of Odisha – five people have already perished, including 2 children. Read more
    MOST of the 20-30 people who are bitten by dogs each day in the district of Aurangabad city (Maharashtra state) have been told that supplies of anti-rabies vaccine have been unavailable outside of private clinics for the past two months, according to a news report. Public hospitals provide free-of-charge vaccines to people who are at risk of rabies infection following an animal bite whereas private hospitals charge for the service. 
    HOSPITALS in Delhi are starting to see an increase in people presenting with dengue symptoms as the annual season gets underway, reaching its peak in October. Across the country, dengue case numbers are also rising, with Kerala recording the highest - 2753 with 5 deaths from a national total of 8,307 dengue cases and 10 deaths (up to July 28). Read more

    Japan: First dengue death in 11 years

    A 30-year-old woman who had suffered symptoms of dengue fever while on holidays in the Philippines has died from complications of the illness. As she was not bitten by mosquitoes on her return to Japan, local transmission of the virus is not anticipated. Read more

    Malaysia: 3 states report diphtheria

    Five deaths among 24 diphtheria cases have now been reported from the states of Negeri Sembilan, Penang and Kedah. The ages of those affected are eight to 50 years and include the children of a woman who was infected. Read more.

    Mexico: Gut parasite infects UK tourists

    Since June, a number of British holidaymakers to Mexico have contracted the intestinal parasite, Cyclospora, according to the UK’s National Travel Health Network and Centre. Many had stayed in the Riviera Maya, a popular tourist area on the Yucatán peninsula that takes in the town of Playa del Carmen and the Mayan ruins of Tulum. Read more.

    Advice for travellers: A single-celled coccidian parasite, Cyclospora cayetanensis may be a risk for travellers to tropical or subtropical regions where it is found. The microscopic parasite causes watery diarrhoea, nausea, anorexia, abdominal cramps, weight loss and, occasionally, fever that can last for several days – and reoccur - if not treated effectively with antibiotics. Most cases result from consuming food or water containing the parasite, or swallowing contaminated water while swimming. Fruits and vegetables such as raspberries, basil and lettuce washed with contaminated water are common culprits, especially those imported from developing nations. Read more about Cyclospora.

    Myanmar: 100 sickened by cholera

    Cholera has struck Pegu and Magwe divisions of Bago region, north-west of Yangon. Around half of the 100 people admitted to hospital for treatment are in a severe condition. Read more.

    Nepal: Cholera hits Kathmandu valley, viral fever in Chitwan

    C ontaminated drinking water is believed to be behind a cholera outbreak in Kathmandu valley that has so far sickened 21 people. Lalitpur and Kathmandu districts have been most affected. Read more
    Monsoon conditions in Chitwan, in the western Terai, have caused an increase in cases of ‘viral fever’. Local news reports don’t specify the nature of the virus, but have outlined that it is due to ‘lack of safety measures taken in … daily food, sanitation, and personal hygiene during monsoon’. Read more.

    Pakistan: Punjab, Sindh dengue’s early start

    Unlike previous years when the dengue season started in August, cases in Punjab are already rising, with 53 reported to date. Monsoon rains will only add to the concerns as conditions favour mosquito breeding. Read more.  Nineteen dengue cases were reported in the past week in Karachi taking the yearly toll for the province to 821. Read more.

    Peru: Jungle yellow fever spike

    In the July 26 Pan American Health Organization yellow fever Situation Summary for the Americas, Peru was noted to have had more cases this year than all of the previous 9 together – a total of 78 confirmed or suspected cases. Peru, along with Brazil and Colombia were the only countries to report jungle yellow fever cases. 

    Philippines: Insect & waterborne diseases rise with rains

    Deaths due to dengue have risen almost four-fold this year in the region of Central Visayas as the state battles an outbreak that has so far sickened 6,810 people since the beginning of the year. Cebu City (978 cases), Mandaue City (312) and Toledo City (268) report the highest numbers in urban areas. Read more. On the southernmost island of Mindanao, the municipality of Tupi has experienced a 48% rise in dengue cases over this time last year. Read more.  Health officials in Manila have warned the capital’s citizens to be aware that dengue is not the only disease to increase in incidence during the rainy season; influenza and leptospirosis infections also become more prevalent. Read more.

    Saudi Arabia: Two MERS deaths, risk factors revealed

    As the Ministry of Health confirmed another 2 deaths from MERS this week (one in the central north of the country, the other in the south-west), the WHO has given some information on 9 of the latest MERS cases which were diagnosed in early July: 4 had had some degree of contact with camels (a known risk factor and includes consuming raw camel’s milk) and most (8 of the 9) had pre-existing medical conditions. Read more.

    Singapore: Dengue total near 10,000

    According to the National Environment Agency's (NEA) dengue website, the total of dengue cases reported in the city-state since January 3, 2016, is now almost 10,000. Maps on the NEA site also identify high-risk clusters of the active dengue zones (9 of 43). Read more.

    South Africa: Second rabies death of 2016

    A six-year-old girl from the central province of Free State has died of rabies infection one day after being admitted to hospital with symptoms. It is not known how she became infected with the virus; no bites or at-risk exposures were recognised. The last rabies death in the country was in KwaZulu-Natal province at the beginning of the year. Read more.

    South America: Flu levels up in temperate zones

    Chile, Paraguay and Uruguay have reported increased activity of influenza-like illness (ILI) while the peak of infections appears to have passed in Argentina. Read all details in the World Health Organization Influenza update of July 25. 

    South Sudan: Measles toll increasing; Conflict worsens cholera outbreak

    In the northern state of Warrap, 280 people have been diagnosed with measles and at least 5 have died from the infection. A vaccination campaign has been planned for the affected region. Read more
    AN outbreak of cholera is centred on the capital Juba and the states of Terekeka & Jonglei. Scores of people have been affected and the situation is unlikely to improve as conflict continues in the region. Read more.

    Sri Lanka: Campaign to control dengue

    With the nation’s dengue numbers now at 26,690 including 48 deaths, authorities have instigated an ‘intensive dengue control programme’ centred in the west of the country. The capital Colombo has reported the highest disease count (8,665) followed by Gampaha district (2,383). Read more.

    Taiwan: Local dengue in south

    Seasonal rains have brought about an increase in locally transmitted dengue fever cases. Areas reporting cases include Pingtung County, Kaohsiung City and Tainan City in the south/south-west of the country. Read more

    Tunisia: Typhoid strikes coast

    An outbreak of typhoid fever has been reported in the town of Ghannouch, on the coast of the Gulf of Gabès and 350kms south of Tunis. At least 24 people – both adults and children – have been sickened in the outbreak. Read more.

    United States of America: Hep A count now 93; LA meningococcal vaccine advice

    No source of the ongoing hepatitis A outbreak on the island of Oahu has been identified yet, while cases have now climbed to 93 (by July 26), an increase of 19 since the last update. Only adults have been affected, with 29 admitted to hospital for treatment. Read more
    PUBLIC health authorities in Los Angeles have extended advice for all gay and bi-sexual men to receive meningococcal vaccination in what is now being described as an outbreak. Nine cases have been recorded in the area since May 1st. Read more.

    Yemen: Shabwa dengue increasing

    Damaged infrastructure in the southern province of Shabwa has led to a devastating outbreak of dengue fever that has so far affected around 3,000 people and killed 27. Read more.

  • Australia: Flu activity low

    The latest WHO global influenza update notes that influenza-like illness rates are low for this stage of the flu season in both Australia and New Zealand. 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.

    Caribbean, Latin America: Zika, dengue, chikungunya updates

    Outbreak news
    The Pan American Health Organization published its latest Zika update on July 14th which included advice that no new locally (insect) transmitted infections had occurred in those countries already reporting Zika cases. Of note was the steady increase in cases in the past month in Costa Rica, Ecuador, Guadeloupe, Guatemala, Jamaica, Mexico, Nicaragua, Puerto Rico, Saint Barthelemy, Saint Martin, and Venezuela. 
    In St Ann, Jamaica’s largest parish, suspected Zika cases have risen to 107. Read more 

    Other Zika news
    Until now, all known cases of sexual transmission of Zika virus have been from a male to his partner, however a report from the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly has documented a case where a woman who returned infected from a Zika area transmitted the virus to her male partner. The man became ill 7 days after sexual contact with the woman and had not travelled outside the US. 
    A team from London’s School of Public Health has used data from the Zika and other mosquito-borne virus outbreaks to explain their reasoning as to why they consider that the current Zika outbreak will be over within 2-3 years. The report, published in the journal Science last week, recommended that work on an effective vaccine continues; herd immunity from those already infected will help to protect at-risk populations in the short to medium term. Read more 
    Several companies, including small biotech firms, are now in the race to develop a vaccine for the Zika virus, Reuters reports. They join major vaccine producer Sanofi which, as reported last week, is gearing up towards human trials of its candidate vaccine later this year. 

    Dengue
    Ecuador has recorded 10, 212 dengue cases this year, mostly from low-lying areas of the coastal provinces of Manabi (3,338 cases), Gold (1,314) and Guayas (1,287). Read more 
    Those areas of Piracicaba city (state of São Paulo, Brazil) where genetically modified Aedes aegypti mosquitoes have been used to reduce insect numbers have shown a 91% reduction in dengue cases in a one-year period. This compares with a 52% reduction where conventional methods were used. Read more 

    Chikungunya
    In the latest update posted by the PAHO, no new cases were advised by Brazil, whereas Colombia confirmed 179 new cases and 9 deaths. Further north, the report noted the highest rates in Honduras (451 new cases) and Guatemala (247). Read more in report (EW28) 
    Of Ecuador’s 24 provinces, 21 have reported the majority of the 274,000 chikungunya cases - Manabi, Gold, Guayas, Esmeraldas and Santo Domingo de los Colorados are worst affected. Read more 

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

    China: First JE case of season; Mozzie alert declared

    A 22 year-old woman from Kowloon peninsula in Hong Kong is the first case of Japanese encephalitis diagnosed in the territory this year. It is not known if she was infected in Hong Kong or during recent travel to Thailand and Myanmar. Read more
    EIGHT districts of Hong Kong have produced alarmingly high levels of Aedes albopictus mosquitoes, a species capable of transmitting several viruses including dengue fever and Zika. While only 8 areas have provoked an alert, mosquito numbers for the city are higher and warmer temperatures plus forecast rainfall are expected to exacerbate the situation. Read more 

    Democratic Republic of Congo: Yellow fever numbers rise

    Due to technical issues at the country’s main laboratory, it wasn’t possible to accurately diagnose blood samples from suspected yellow fever cases over the past 3 weeks. The most current data from the latest WHO situation report of July 15 identifies cases in five of the country’s 26 provinces (1798 suspected cases, 68 confirmed and 85 deaths) – a 38% increase on previous numbers. The next round of yellow fever vaccinations will take place this week in Kinshasa and Kwango provinces.  In the region, concern has been raised for those densely populated areas of Angola where vaccination campaigns have already been carried out and new cases, new areas of spread continue to appear.

    Advice for travellers: Vaccine-preventable 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

    India: Rains trigger mozzie diseases, cholera; Scrub typhus strikes north

    The districts of Kannur (Kerala state) and Gaya (Bihar state) have each reported a case of Japanese encephalitis.
    Two more people have died from complications of dengue fever in the state of Odisha (Barbil & Cuttack) – the recent total is now 6. Read more. Meanwhile in New Delhi, dengue cases are higher and have been reported earlier in the season than usual, with 50 confirmed to date. Read more. Hospitals in Bengaluru are straining under the pressure of rising dengue fever admissions. Read more
    An unconfirmed number of people have been diagnosed with cholera in the districts of Malappuram, Thrissur, Kozhikode and Palakkad (Kerala state). With fears that more cases will appear due to the monsoon conditions, authorities are advising careful selection of food and drink, plus strict personal hygiene practices. Read more
    IN the northern state of Himachal Pradesh, mites infected with scrub typhus have sickened at least 19 people however there are a further 200 suspected cases. 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 is endemic throughout the Asia-Pacific region and more than a million cases occur annually. There is no vaccine or prevention medication: the best way to avoid Scrub typhus is to avoid being bitten by mites. Protective measures include the use of an effective personal insect repellent, wearing protective long clothing, and a thorough end-of-day self-examination after visits to rural areas. Due to the disease’s 5- to 14-day incubation period, travellers may only experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Treatment involves taking antibiotics and should begin as quickly as possible. Always see a doctor as soon as possible if you develop a fever after the trip and remember to discuss any recent overseas travel. Read more about rickettsial diseases.

    Indonesia: Rabies kills in west Bali

    A 36-year-old mother of two from the western Bali regency of Jembrana has died of rabies 3 months after being bitten on the leg by a neighbourhood pet dog. While she did seek medical assistance locally, she was not given rabies treatment, instead told to monitor the health of the offending dog and report if it died. The woman only returned to the doctor when already suffering rabies symptoms. Read more

    Advice for travellers: Bali’s health authorities are winning the battle to rid the island of rabies, however it’s clear that eradication will take some time. Australian travellers to Bali should continue to avoid contact with all animals, including pets, and seek immediate treatment if bitten or scratched. Rabies vaccination is generally not recommended for short stays.

    Ireland: Measles, 33 and counting

    The outbreak of measles that started in early May has now lead to 33 cases, the most recent had visited busy Dublin airport or County Kerry in the south-west. 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 numbers 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), mumps, and polio 6 weeks before departure. 

    Malaysia: Sibu, Selangor dengue cases rise

    Dengue fever cases in Sarawak are 22% higher than for the same period last year, with over 1500 cases reported up till July 9, mostly from urban areas. Sibu, a central division of the state, has recorded the highest rates of infection – 848 cases. Authorities believe dengue rates will rise further as school holidays, religious gatherings and the upcoming Malaysia Games cause large numbers of people to move around the state, and from urban to rural areas. Read more. Favourable weather conditions for Aedes mosquitoes to breed in Petaling Jaya have led to a sudden increase in dengue fever cases - 3,138 confirmed cases and 3 deaths have been recorded for the year until July 9th. Read more

    Netherlands: Zika count at 60

    A public health institute has estimated the number of Dutch nationals who have contracted Zika virus this year to be at least 60 - many infections produce no symptoms so this number could be higher. All had travelled overseas before falling ill. Read more.  

    Pakistan: FATA leishmaniasis outbreak

    In Mohmand Agency, within the Federally Administered Tribal Areas, cases of cutaneous leishmaniasis have risen to 193; this despite the use of mosquito nets and insect fogging in the battle to eradicate the sand fly vectors of the Leishmania parasite. Read more

    Advice for travellers: Leishmaniasis is generally a low risk for travellers. It is endemic in 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. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil 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.

    Philippines: JE strikes Davao City; Dengue doubles in Aklan

    A 52-year-old man from Davao City on the island of Mindanao is the latest person to have been diagnosed with Japanese encephalitis (JE). Local health authorities warn that JE is not the only circulating mosquito-borne disease so all measures should be taken to avoid mosquito bites. Read more.  
    DENGUE fever cases in Aklan, Western Visayas province have risen over 100% from last year’s total for the same period. Highest numbers by age group were recorded by children and young adults 11 to 20 years and the capital Kalibo recorded 106 cases, highest of all municipalities in the region. Read more

    Saudi Arabia: Jeddah dengue spike; 3 new MERS cases

    Warmer, humid weather conditions in Jeddah are behind a total of nearly 3,000 dengue fever cases recorded since the beginning of the year. Read more
    IN the past week 3 men have been treated for MERS infections, two of them died. The 2 deceased were from Jeddah and Taif in the west of the country. The third, an 86-year-old from Aflaj who was infected after contact with a camel, is recovering in hospital. Read more

    Singapore: 6th dengue death, record numbers forecast

    A 72-year-old woman has become the 6th person to die from dengue this year. Insect fogging to remove mosquito breeding sites has been carried out in the area where the woman lived. Read more. The cumulative total of dengue cases for the year is now 9,641 and health authorities are forecasting a record of 30,000 cases. The previous highest was 22,170 in 2013. Read more

    South Africa: Regional flu cases rise

    Temperate areas of Southern Africa (which includes Botswana, Lesotho, Namibia and Swaziland) are recording rising numbers of influenza B cases. Read more in the July 11 WHO Influenza Update

    South America: Flu levels up, and down

    While flu levels appear to have peaked in Brazil and Ecuador, activity continues to rise in Colombia and Bolivia. The primary virus detected is 2009 H1N1 virus, according to the WHO’s latest global flu update

    Uganda: Cholera hits Namayingo

    Drinking contaminated water is believed to be the cause of death of 3 people in the eastern district of Namayingo. Tests confirmed the diagnosis of cholera and local residents have been urged to consume boiled water and maintain strict personal hygiene before eating. Since the outbreak began in April, 12 people have succumbed to cholera. Read more

    United States of America: Second food worker positive for Hep A

    THE source of the hepatitis A outbreak on Oahu is still unknown but isn’t believed to be one of the latest people diagnosed with the illness, another food worker who was based at a fast food chain branch in Waipio. Of the 52 people who have now be diagnosed with Hep A, 16 have been treated in hospital. Read more

    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, with an estimated 1.4 million cases occurring worldwide each year. 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.

    Vietnam: Diphtheria strikes south; Mosquito-borne risk in north

    Seven people in a remote region of Binh Phuoc province have contracted diphtheria and 3 of them have died. They were in the 12 to 24 years age group. Information received since suggests that others in the same district may also be incubating diphtheria – a serious bacterial illness that Vietnamese children are immunised against from 1 month of age. Read more
    ACCORDING to a news report, northern districts have reported a rise in Japanese encephalitis cases, including 2 deaths. Areas affected are Hanoi (9 cases till end 6/2016), northern Bac Giang, Dien Bien, Son La, Thai Binh, Lao Cai provinces, northern Hai Phong city and central Thanh Hoa province. Read more