Health Alerts
  • Angola: YF cases top 3000

    Local transmission of yellow fever is underway in 11 provinces, with Luanda and Huambo the worst affected, according to the WHO’s weekly situation report. Meanwhile, vaccination programs have shifted to border areas as overall suspected cases reached 3137 – 847 confirmed. The agency is still ‘highly concerned’ over ongoing urban transmission in Angola and Democratic Republic of Congo (DRC), and the risk of the virus spreading globally. The DRC has reported the first locally transmitted cases in Kisenso district in Kinshasa province (see separate post). Elsewhere, investigations are underway in Ethiopia, where one case has been confirmed, the Republic of Congo, and Ghana. 

    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

    Australia: Whooping cough spike in Queensland

    Whooping cough cases have been rising in Queensland this year, prompting a warning to pregnant women to get vaccinated. The 1141 cases to date compare with 552 by the same time last year, and 784 in 2014. Nationwide there have been 8893 cases to date, compared with 7400 during the same period last year. Read more

    Advice for travellers: Travelvax recommends Australians travelling overseas check their immunisation status for childhood diseases such as whooping cough, diphtheria, measles, mumps, and polio 6 weeks before departure. Read more about whooping cough

    China: Bird flu surfaces in north; Dengue and ‘silent’ Zika in Guangdong; HFMD on the rise

    China has reported a human H7N9 avian flu infection in Liaoning. Officially, it is the first H7N9 case from the north-eastern province and China’s fifth for June, typically a quiet month for the virus. The new cases lift China's overall H7N9 total to 798. Read moree.
    GUANGDONG’S capital, Guangzhou has reported 2 local cases of dengue fever, with authorities advising the public to take preventive measures. Read more (translate to English) 
    GUANGDONG has also identified 6 ‘silent carriers’ of the Zika virus, prompting a warning to nearby Hong Kong to tighten its border controls. Read more
    MEANWHILE, both Guangdong and Hong Kong’s Kowloon Tong district are reporting substantial outbreaks of hand, foot and mouth disease among local children. The virus is also circulating in other Asian countries, notably Malaysia and Singapore, with a handful of deaths reported. 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. 

    Caribbean, Latin America: Updates on Zika, dengue and chikungunya

    ZIKA
    Brazil recorded 138,108 probable Zika virus infections in the first 4 months of 2016, including 49,821 confirmed cases. The highest incidence was in the Midwest region (140.9 cases/100,000 inhabitants), while Mato Grosso (558.1), Bahia (265.9), and Rio de Janeiro (230.8) reported the highest rates. Read more
    IN its latest bulletin, Brazil’s Ministry of Health has confirmed 1581 cases of microcephaly and other neurological changes suggestive of congenital infection, recorded in 562 municipalities of 25 states and the Federal District. The ministry believes that the majority of mothers who had babies diagnosed with microcephaly had been infected with Zika. Read more
    EL Salvador has confirmed its first case of microcephaly in a newborn whose mother had Zika. Since November, El Salvador has recorded 10,476 Zika infections. Read more
    IMPORTED cases of Zika are on the rise in Cuba. The latest of 21 cases involved 4 Cubans infected during a 7-day stay in Guyana. Read more
    OF Costa Rica’s 107 confirmed Zika cases, 67 were from the Central Pacific canton of Garabito, where the popular beach destination of Jacó is located. As of last week, authorities also had recorded 7711 confirmed cases of dengue and 1483 of chikungunya. Read more
    PERU’S confirmed Zika tally has risen to 91. Affected areas include the cities of Jaén (Cajamarca region), Yurimaguas (Loreto), Zarumilla (Tumbes), Tocache (San Martín) and Pucallpa (Ucayali). Of the total, 34 are pregnant women. Read more (translate to English) 
    TWO new cases of Zika virus have been reported in the US Virgin Islands, taking the number 26 – 16 on St Croix Island, 9 on St Thomas, and 1 on St John. Read more
    In other Zika news…
    The spread of Zika virus through the Americas is likely to affect tens of thousands of children with a wide range of neurological and psychiatric problems in the next year, requiring a new approach to their care, according to a leading US disease expert. Read more
    THE WHO has just $US4 million of the $122 million it needs to roll out an updated strategy to fight the Zika virus over the next 18 months, according to a statement.  
    AMERICA’S Food and Drug Administration has approved the first clinical trial for an experimental Zika vaccine. The initial trials will determine if the vaccine is safe to administer to people and the effective dosage. GLS-5700 is a US-South Korean collaboration. Read more

    DENGUE FEVER
    Brazil – states and localities reporting dengue transmission in multiple Portuguese-language sites include: Minas Gerais – 500,000 cases, 133 deaths, with Uberlândia, Uberaba, Araguari, Patrocínio, São Gonçalo do Abaeté worst effected; Paraná – epidemics in 89 cities; Paraíba - 30 deaths; Tocantins – municipalities of Palmas, Araguaína, Miracema do Tocantins, Porto Nacional, Tocantinópolis and Dianópolis; Piauí - virus is present in 147 municípalities, including Teresina, Parnaíba, Barras, Altos and José de Freitas, but waning; São Paulo - mainly Pereira Barreto, São José do Rio Preto, Ribeirão Preto; Santa Catarina - epidemic levels in Pinhalzinho, Serra Alta, Bom Jesus, Coronel Freitas, Descanso, Modelo, Chapecó and União do Oeste; Rondônia – Guajará.
    Peru – Ica District residents are being warning of a significant increase in dengue fever cases, mainly in the districts of Pachucútec (58 cases), Tate (19), Pueblo Nuevo, Subtanjalla, and Parcona. Read more (translate to English). 

    CHIKUNGUNYA
    More than 90% of the 21,200 official chikungunya infections reported from across the region last week were from Bolivia. The 19,329 cases take its 2016 total to 83,678, while Honduras added 844 cases for a total 10,333. The cases take the region’s total for the year to date to 148,453. The Pan American Health Organization (PAHO) reported a new chikungunya-related death from Brazil, raising the toll to 17 for the year. Read more
    In other chikungunya news…
    A new study in Nicaragua has found higher chikungunya antibody levels in older people compared with younger people. Age, water availability, household size, and socioeconomic status were all linked with chikungunya seropositivity, the research revealed. Read more

    Advice for travellers: Zika continues to spreading in the Americas, and is also circulating in the Pacific and Southeast Asia. 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: Yellow fever epidemic declared

    With 1000 suspected yellow fever cases, health officials have officially declared an epidemic of the mosquito-borne disease in 3 provinces – Kinshasa, Kongo Central, and Kwango. Kinshasa is of particular concern as it is home to 12 million living in crowded conditions with poor health infrastructure, Reuters reports. 
    MEANWHILE, the heavily depleted global stockpile of yellow fever vaccines now stands at 6 million doses after 18 million have been administered in Angola and elsewhere in Africa. To stretch the supply, the WHO last week approved fractional vaccine dosing. Read more

    Ghana: Rains raise spectre of cholera in capital

    As the rainy season looms and sporadic cases emerge, authorities have warned of the high risk of another cholera epidemic in the greater Accra Region this year. They are testing diarrhoea patients aged over 5 as part of nationwide surveillance effort which aims to identify cholera cases early in the hope of containing any outbreaks. Read more.

    Advice for travellers: While the risk of infection with cholera is low for most short-stay travellers, Australians travelling to regions where an outbreak is occurring should adhere to strict personal hygiene and choose food and beverages with care. For further general advice on whether you should consider vaccination for your trip, call Travelvax Australia’s travel health advisory service (1300 360 164). 

    India: JE spreading in Assam; Rains bring mozzie, water diseases

    IN Assam State, an outbreak of Japanese encephalitis is spreading across villages in the Lahorighat and Bhurbandha blocks in the Morigaon district, with 200 cases and 6 deaths – 4 in just 48 hours. Read more
    THREE dozen people have been sickened by cholera in the village of Mustapur Wadi (Humnabad taluk, Karnataka state). Doctors suspect drinking water has been contaminated by open defecation. Read more
    AS monsoon rains set in, dengue, chikungunya and other viral fevers are on the rise in Karnataka’s Chikkamagaluru district. More 130 patients have been treated at the district hospital, including 50 last Wednesday alone. Read more
    JUNE has seen a spike in dengue cases across villages in the Dakshina Kannada district (Mangaluru), with hundreds of people seeking help from government and private hospitals hampered by a lack of resources and staff shortages. Read more
    KERALA state health authorities are concerned over an alarming number of acute diarrhoea cases in Kozhikode district this year. To June 18, 21,350 cases of severe diarrhoea, including 2 fatal shigella infections, had been reported. Read more

    Indonesia: Rabies rates rise in Sulawesi; Dengue deaths in Ambon; Art lovers have brush with tainted food

    In North Sulawesi province, the deaths of 9 people from rabies have prompted a warning over the spread of the disease. Almost 1000 people reported bites of rabies-infected cats, dogs or monkeys, according to North Sulawesi Health Agency figures. Most of the attacks occurred in Minahasa regency (243 possible exposures), followed by South Minahasa (195), and North Minahasa (114). Read more
    IN Maluku Province, dengue has claimed 7 lives among 139 cases in the eastern city of Ambon, with five districts – Kayu Putih, Passo, Kebun, Cengkeh, Batu Merah and Benteng Karang – among the areas worst affected. Dengue is reportedly at endemic levels in North Sumatra, Banten, East Java, and West Nusa Tenggara. Read more
    HEALTH inspectors have reportedly found traces of formalin in fish satay and borax in krupuk crackers during raids on food stalls at Bali’s annual Arts Festival in Denpasar last week. Read more

    Malaysia: National HFMD rates soar; Dengue hits Malacca City

    Malaysia is on high alert over widespread outbreaks of hand, foot and mouth disease (HFMD). A third of the cases have been reported from Selangor (4441), followed by Johor (1393), Kuala Lumpur (1317), Sabah (1299), and Sarawak (1108). In Negri Sembilan, health authorities closed 12 nurseries and preschools so buildings could be disinfected. Read more
    THE southern state of Malacca recorded 1002 dengue cases to the end of May. Hotspots included the capital, Malacca City and the surrounding Melaka Tengah district (679 cases), Jasin (167), and Alor Gajah (156). In 2015, 2420 cases were recorded state-wide. Read more.

    Nepal: Diseases surface as rains fall

    As monsoon rains fall, local doctors are warning poor quality drinking water and inadequate sanitation in Kathmandu and other earthquake-hit areas could see a further rise in hepatitis, typhoid, diarrhoea and other water-borne diseases. Read more

    New Zealand: New Plymouth on alert for measles

    In the Taranaki region (North Island), New Plymouth residents are being warned about a potential measles outbreak after two infected people visited the region. They are among 60 confirmed cases of measles currently in New Zealand, most linked to a Hamilton outbreak sparked by a resident infected overseas. Read more

    Pakistan: Dengue cases mount in Karachi

    At least 30 new dengue fever cases in Sindh province last week have taken the year’s official total to 722. The majority were recorded in Karachi (668), along with Hyderabad, Sukkur, Tando Muhammad Khan, with isolated outbreaks in a dozen other cities and towns across the province. Read more

    Peru: ‘Jungle’ yellow fever outbreak expands; Deadly flu hits southern cities

    An outbreak of jungle (sylvatic) yellow fever continues to grow in the Selva Central area, including the districts of Junín, Pasco, Ucayali, Loreto, Huancavelica and Cusco. There have been at least 9 deaths and more than 50 cases. Read more (translate to English). 
    SOUTHERN Peru is on alert over an outbreak of influenza A (H1N1) following 3 deaths in Juliaca, the capital of San Roman Province in the southern region of Puno, and another 3 in Arequipa City, capital of the neighbouring region of Arequipa. Ten suspected cases await lab confirmation. Read more

    Philippines: Dengue spike in Western Visayas; Rabies death

    Dengue cases have risen from 1446 cases in the first half of 2015 to 3653 in the same period this year, including 8 deaths. Iloilo province posted the highest increase with 1035 cases and 3 deaths. Chikungunya is also on the rise: 35 cases in 2016 compared with 14 during the same period in 2015, while Zika was diagnosed in 2 Korean travellers visiting Boracay Island. Read more
    IN Negros Occidental province, a 53-year-old man has died of rabies 3 months after being bitten on the finger in Sagay City by a dog thought to have been vaccinated. Each year 200-300 Filipinos die from rabies, mainly children. Read more

    Saudi Arabia: MERS linked to Riyadh hospital

    At least 8 cases of MERS-CoV have been linked to a growing healthcare outbreak in the national capital, Riyadh. They are among 12 new cases reported in the past week. Since June 15, Saudi Arabia has reported 25 cases in Riyadh. Most involve healthcare workers or patients at King Khalid University Hospital, including several with no symptoms. The latest cases take the kingdom’s MERS total to 1416 cases, 594 of them fatal. Read more.

    Singapore: New dengue surge; Trial for new dengue vaccine

    After recent falls, dengue cases are again on the rise, based on figures from the National Environment Agency’s (NEA) dengue website. A total of 193 cases were reported in the week ending Jun 18, up from 159 in the previous the week. Read more
    MEANWHILE, Japanese pharmaceutical giant, Tadeka is recruiting 400 Singapore residents for Phase 2 safety and efficacy trials of its dengue vaccine candidate. Read more

    South Africa: Jackals pose rabies risk

    In Gauteng Province, 2 people have been treated for rabies following bites from infected jackals in the popular tourist destination of Muldersdrift and surrounding areas. Tests confirmed the deadly disease in 4 jackals and an unvaccinated domestic dog. Jackal rabies is well documented in South Africa, with cases reported from North West and KwaZulu-Natal provinces this year. Rabies-infected jackals can appear unusually tame‚ prompting warnings not to approach the animals. Read more

    Advice for travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals – especially dogs, the main source of infection. If bitten, urgent post-exposure treatment is required. Generally, the risk of rabies for most short-stay travellers is low. Vaccination is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas. Read more on rabies

    Taiwan: First JE case of 2016

    Taiwan’s annual Japanese encephalitis (JE) virus transmission season is underway, with a 64-year-old Tainan farmer confirmed as the first indigenous case last week. The man worked near two pig farms and a large rice field, ideal breeding grounds for the JE-carrying Culex mosquitoes and home to the wading birds and pigs that serve as animal hosts of the virus. The JE season runs from May to October, peaking in June and July. Read more

    Advice for travellers: On average, 24 JE cases are recorded each year in Taiwan. Cases typically occur in rural, rice-growing areas where people live near the host animals, pigs and wading birds. While infection is a low risk for most travellers staying in urban areas, expats and travellers spending extended periods in agricultural areas of Asia should consider vaccination. Read more about JE

    Tanzania: Mystery illness kills 10

    At least 10 people have died and 21 others hospitalised after a family consumed the meat of a slaughtered cow in their village in the central region of Dodoma. Doctors are investigating the outbreak, but an initial diagnosis has ruled out anthrax as the cause of the mystery illness. Read more

    Thailand: Sterile mozzies enlisted to fight dengue

    Maehongsorn, the remote mountain province bordering Myanmar, has the country highest rates of dengue illness, surpassing Bangkok, Rayong, Trad and Phuket. Dengue is present in all 77 provinces and more than 19,000 cases and 16 deaths have been reported this year. Read more
    IN an attempt to reduce mosquito populations and dengue rates, Mahidol University researchers last week released sterilised Aedes aegypti mosquitoes in Chachoengsao province, east of Bangkok, in what is thought to be the world’s first open-environment trial of the control method. Read more

    Uganda: Malaria deaths soar

    Kitgum Hospital has been overwhelmed by a malaria outbreak that is causing 1000 cases and up to 6 deaths a week. Read more

    United States of America: Rare diseases make appearance; STIs on rise in California county

    A TEENAGE boy from Rio Arriba County (New Mexico) is the USA’s first human case of plague this year. Plague can also be passed to humans through contact with infected animals, including household pets. A handful of plague cases occur each year, mainly in the south east. Read more
    MEANWHILE, an urban gardener in Colorado's Front Range has been diagnosed with tularaemia. Rabbits and rodents are the most common animal carriers of tularaemia, but the bacteria can also live in water or soil contaminated with an infected animal's urine or faeces. Read more
    A CASS county child is Michigan’s first confirmed a case of tick-borne Rocky Mountain spotted fever (RMSF) in 7 years. Read more
    IN California, the beachside community of Santa Barbara is the latest to raise concerns about a sharp increase in sexually transmitted infections. Reported cases of gonorrhoea almost tripled between 2013 and 2015, chlamydia increased 22.6% and syphilis cases more than doubled in the same three years. Authorities say there has been a ‘staggering’ increase in STIs across all age groups. Read more

    Vanuatu: Dengue returns to Port Vila

    Vanuatu's health ministry has belatedly reported a local case of dengue fever in the capital, Port Vila last month – the first since 2014. More than 300 people were infected during the 2014 outbreak. Read more

    Vietnam: Big spike in dengue rates

    The first 4 months of 2016 saw 25,441 cases of dengue including 10 deaths across two-thirds of the country. The figures reflect a 179% increase on the same period last year. Read more

  • Angola: Yellow fever outbreak slowing

    Despite new clusters in new districts, Angola’s yellow fever epidemic is ‘slowly decreasing’, according to a World Health Organization (WHO) statement released yesterday (June 14). The provinces of Luanda (1778 cases) and Huambo (508) have seen most of the nation’s 3137 suspected or confirmed cases and 345 deaths, followed by Benguela (291 cases), Huila (135), Cuanza Sul (99), and Uige (54). The WHO published an outbreak timeline, a video explaining the global vaccine stockpile system, and a document intended to guide the international response.

    Advice for travellers: Vaccine-preventable Yellow fever (YF) is spread by the same Aedes aegypti mosquitoes that transmit the more common dengue, chikungunya and Zika, for which there are no vaccines. However, unlike 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 the tropics 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

    Cambodia: Dengue count set to rise; Measles persisting

    With the 5-month long rainy season underway, Cambodia’s tally of 1915 reported dengue cases is double the figure for the same period in 2015. The virus has killed 4 children this year to date. Read more
    MEANWHILE, Cambodia’s measles-free status is under threat after the WHO confirmed a third case in May. It follows 2 in January. Read more

    Caribbean, Latin America: Zika, dengue and chikungunya updates

    ZIKA
    In its latest statement, the WHO’s Emergency Committee on Zika has concluded that there is a ‘very low risk’ of further international spread of Zika virus as a result of the Olympic and Paralympic Games. It says Brazil will be hosting the Games during its winter when local transmission of diseases like Zika and dengue is typically low, and vector-control measures at Games venues should further reduce any risk. The statement includes the latest advice to travellers, including pregnant women. 
    JAMAICA has announced it will require all pregnant women to be tested for the Zika virus (ZIKV) to help monitor the spread of the disease in the island nation. Read more
    IN Mexico, the list of states reporting Zika infections is headed by Chiapas (143 cases) and Oaxaca (130). Of the 345 lab-confirmed cases to June 7, 105 were pregnant women. Read more
    THE US Centers for Disease Control and Prevention (CDC) has released a draft of its 57-page Zika response plan, which is based on Aedes mosquito activity and illness levels in a given mainland state. Pockets of local transmission are likely to occur in areas that have reported dengue or chikungunya — two diseases also spread by local Aedes aegypti mosquitoes. 

    DENGUE
    Dengue outbreaks reported by Spanish and Portuguese-language media include:
    Mexico has reported 57 dengue deaths, with Tabasco, Tamaulipas, Morelos, Quintana Roo, Sonora, Jalisco, Oaxaca, and Veracruz among the states with current outbreaks.
    Among the Central American countries reporting sporadic or ongoing transmission are Belize, Costa Rica (multiple municipalities), El Salvador , Guatemala, Honduras (20,000 cases, 7 deaths), and Panama (1000 cases nationwide). In Peru, dengue-effected regions include La Libertad (Ascope, Virú, Trujillo), Lambayeque (Motupe, Olmos, Tumán and Patapo), Ayacucho, Tumbes, and Ica.
    In Brazil, transmission of the dengue fever virus is occurring in Santa Catarina; Sergipe; Paraná (1000 new cases a week, 57 deaths); São Paulo; Minas Gerais (widespread outbreaks in Juiz de Fora, Belo Horizonte, Itaúna, Uberaba, and Divinópolis, 200 deaths); Espíritu Santo (50,000 cases, 35 suspected deaths); Rio Grande do Sul (new outbreak in Porto Alegre); and Ceará (53,000 cases, 4 deaths – notable in Fortaleza City).
    Argentina’s Misiones Province has been hardest hit by dengue with 14,000 infections and case numbers continuing to rise despite falling temperatures.

    CHIKUNGUNYA
    The chikungunya epidemic that began in December 20123 has now topped 2 million cases across the Caribbean and Latin America. The 9424 new chikungunya cases reported last week bring the 2016 total across the region to 127,253, according to the Pan American Health Organization’s latest figures. Most were from Bolivia (15,721 cases in 2016), while Colombia added 278 cases (15,903 in 2016) and El Salvador’s 101 new cases for a 2016 total to 4949. However, many countries have not reported data for months. 

    Advice for travellers: Zika continues to spreading in the Americas, and is also circulating in the Pacific and Southeast Asia. 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: Tianjin reports H7N9

    Two human H7N9 cases have been confirmed in northern Hebei Province’s Tianjin Municipality. Both have been hospitalised with severe pneumonia after contact with poultry found to have been carrying the virus. Read more

    Advice for travellers: Human H7N9 cases continue to be reported sporadically in China, possibly linked to the sale of poultry. However, there has been no sustained person-to-person transmission. 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

    Democratic Republic of Congo: Malaria ‘out of control’ – MSF

    Malaria is ‘out of control’ in the country’s east, with many parents forced to let their sick children die at home because they cannot afford treatment, according to Médecins Sans Frontières (MSF). Of the 45,000 malaria patients MSF has treated in the north-eastern province of Haut-Uele, 80% are children under 13. The government asked MSF to step in after recording more than 93,000 malaria cases in 4 health zones in the province in the first 16 weeks of 2016 - almost 4 times the figure for 2015. Read more

    Europe: Summer brings the chance of Zika

    Parts of southern Europe may experience Zika virus outbreaks between June and August if infected travellers introduce the virus into areas with established Aedes mosquito populations, according to a Swedish study. Warmer temperatures this summer could increase the rate in which the female Aedes mosquitoes bite, as well as virus reproduction rates. Read more

    India: Delhi struggles to rein in pollution; JE season underway; Rains bring dengue; Malaria flares in Kerala, Odisha

    One of the world’s most polluted cities, Delhi – like Beijing, Mexico City, London and Los Angeles – is struggling to reduce pollution, even as its population swells. Late last year, air quality levels prompted the Delhi High Court to declare the city a ‘gas chamber’. Read more
    THE Japanese encephalitis virus season is well underway in Assam with 24 confirmed cases in the past 2 weeks. There have been 7 deaths to date this year in the northern state. The start of the annual rains has raised the perennial spectre of dual outbreaks of the mosquito-borne virus and the more mysterious acute encephalitis syndrome. People living in rice-growing areas are most vulnerable: The rice paddies are home to the wading birds and pigs that serve as JE’s reservoir and amplifying hosts respectively, and to the Culex mosquitoes that transmit the virus to humans. Read more
    EVEN before the monsoon begins in earnest, dengue fever has been spreading across Karnataka. In the past month, the state has seen 380 confirmed cases. Read more
    HEALTH officers collected scores of blood samples after sealing off part of the Elathur coast in Kerala State's Kozhikode District for 2 days last week following an outbreak of potentially severe P. falciparum malaria. In Odisha state, malaria has also been reported in the tribal villages of Andrahal and Mudulipada. 

    Advice for travellers: Kerala is usually regarded as a low risk area for malaria. However, like other vector-borne diseases, malaria is thought to be hugely underreported in India and occurs in both urban and rural areas across much of the country.

    Indonesia: Manuku’s dengue toll mounts

    Classic dengue fever and more severe dengue haemorrhagic fever infections have risen sharply in Manuku province (Manuku Islands) in the past month. Outbreaks are occurring in 5 areas in the capital, Ambon – Kayu Putih, Passo, Kebun Cengkeh and Batu Merah, and Benteng Karang – with 7 deaths reported. Of the province’s 10 cities, Mataram city and surrounding district had the highest incidence (643 cases, 7 deaths), marginally more than Lombok Timur (575, 7). Dengue fever is currently at endemic levels in North Sumatra, Banten, East Java, and West Nusa Tenggara, according to this media report quoting local health officials. 

    Ireland: Travel-linked measles tally reaches 40

    A third of the 40 confirmed or suspected measles cases in Ireland recently have required hospital treatment. The outbreak began with a traveller infected in Europe. Of the 29 cases either confirmed or under investigation in the south-west, none had been vaccinated. The patient’s ages range from under 12 months – too young to be vaccinated –to mid-30s. Read more

    Kenya: Cholera, chikungunya cases mount

    Mandera county’s chikungunya tally has risen to 580 cases, including around half of its health workers. Read more. Meanwhile, Mandera’s cholera count has reached 1213, including 18 deaths, since mid-April 12. Read more.

    Malaysia: Dengue rates falling; Japanese encephalitis suspected

    Although dengue rates are falling in Penang, lab-confirmed cases are still running at 11 cases a day. With 1765 cases this year, Penang ranks fifth countrywide after Selangor (27,166 cases), Johor (6,857), Kuala Lumpur and Putrajaya (3,712), and Perak (1,945). Read more
    A 6-YEAR-OLD boy from Kuala Pilah, a rice-growing district in Negeri Sembilan state, has been hospitalised with suspected Japanese encephalitis. The third unconfirmed case of 2016, it follows one in Kuala Pilah and another in neighbouring Jelebu. Read more

    Advice for travellers: South East Asia is endemic for Japanese encephalitis and cases occur sporadically in Malaysia – 16 cases (including 4 deaths) were recorded in 2014, according to government figures. Herons are the main reservoir hosts of the JE virus, which is transmitted by several species of Culex mosquitoes, while pigs can serve as amplifying hosts. Read more about JE

    Mayotte (French): Leptospirosis at record levels

    A record 147 leptospirosis cases have been recorded this year on the island of Mayotte, a small French territory in the Indian Ocean off the coast of East Africa. Read more

    Advice for travellers: Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers.

    Myanmar: Spike in diphtheria cases

    Six children have died from diphtheria in Yangon and the Ayeyarwady region this year. Most of the victims are unvaccinated children from ethnic communities living in disputed or remote areas. While Myanmar usually records 20-60 diphtheria cases each year, the number jumped to 80 last year, including 10 deaths. Read more

    New Zealand: Measles on the move

    Health officials fear Waikato’s measles outbreak, now involving 26 cases, will spread to Hawke’s Bay after an infected child visited a number of public venues last week, including the National Aquarium in Napier. Cases have also been reported in Horowhenua, Northland and Nelson. Read more

    Advice for travellers: Measles is a highly contagious virus and can cause serious illness in people of all ages. Like Australia, most of the measles cases reported in New Zealand 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. 

    Pakistan: Floods behind malaria’s expansion

    Balochistan is ground zero for malaria in Pakistan, with a million cases in the province each year and more than 1-in-10 residents with current or past infection. Pakistan’s frequent floods leave millions of displaced people living in makeshift shelters close to water, which are ideal breeding sites for malaria-carrying Anopheles mosquitoes. The disease is also on the rise in Punjab and Sindh provinces. Read more.

    Philippines: Dengue cases up 33%: Deadly gastro, diarrhoea takes heavy toll

    While the national dengue vaccination campaign falls behind target, first quarter case numbers were up by a third on 2015 figures. Around 33,748 suspected cases of dengue, including 126 deaths, were recorded to the end of March, compared with 24,927 in the same period in 2015. To date 263,000 children have been vaccinated with Dengvaxia, well short of the government’s declared June target of 1 million. Read more
    IN Zamboanga City (Mindanao Island), health officials say they expect the cases of acute gastroenteritis (AGE) and diarrhoeal disease to rise with the coming rainy season. The city has already reported some 3,000 diarrhoeal diseases due to rotavirus and norovirus since late March, including 22 fatalities. Read more.
    THE toll from a severe diarrhoea outbreak effecting 3 cities in Eastern Visayas’ Samar province has risen sharply to 44 following 11 deaths over the weekend. Poor sanitation and contaminated water have been blamed for nearly 3500 infections in the region. Cases have been reported throughout the province, including Northern and Eastern Samar, as well as areas of Leyte Island. Hilongos has recorded more than 300 cases and Tacloban city 3 dozen cases, including 1 death. Read more

    Saudi Arabia: MERS returns; Qatar reports third case

    After an 18-day break in MERS-CoV cases, 2 cases have been reported from different parts of the country. Both involved contact with camels, a known risk factor. MERS-CoV has now infected 1386 people in Saudi Arabia, including 593 deaths. Read more. Meanwhile, Qatar's health ministry reported the country’s third MERS infection of 2016 over the weekend. The cause of the infection remains unknown: the patient is a 23-year-old with no known contact with other confirmed cases or with camels. Read more.

    Singapore: Kid’s disease at record levels; Dip in dengue cases

    Singapore could be facing one of its worst years for hand, foot and mouth disease (HFMD), with infections nudging record high levels. The first 5 months of 2016 saw 21,102 cases reported compared with an annual average of 8193 for the same period. More than 200 children have been hospitalised in Singapore’s main children’s hospital to date this year. Read more
    THERE has been good news on dengue fever: last week’s 161 cases is the lowest weekly total of 2016. There are now 44 active dengue clusters in Singapore, including six classified as high-risk – most notably around Geylang and Guillemard Road. Five people have died of the disease this year. 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. 

    Sri Lanka: Colombo tops dengue list

    Colombo has reported the lion’s share of the country’s 18,613 suspected dengue cases this year. Almost half were reported from the Western Province, including the capital, Colombo, and the Gampaha and Kalutara districts. Read more

    Sudan: Deadly measles stalks Aweil North

    A deadly measles outbreak claiming young lives is sweeping through Aweil North County in the proposed Lol State. The outbreak has prompted a massive vaccination drive involving the WHO and international aid agencies to save already vulnerable malnourished children. Read more

    Taiwan: Scrub typhus season ramps up

    Two weeks into Taiwan’s peak season for scrub typhus, 117 infections have now been confirmed this year – the majority in the counties of Taitung (27 cases), Hualien (24) and Penghu (20). Scrub typhus cases occur year-round in Taiwan, usually increasing in May and peaking in June-July, and again in September-October. 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 the mites or ‘chiggers’ latch onto travellers when they camp, hike, or go river rafting in rural areas of 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 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 scrub typhus and other rickettsial diseases.

    Uganda: Rift Valley virus returns to Kabale

    The Western Region district of Kabale has had a new case of Rift Valley fever, 2 months after an earlier outbreak of the haemorrhagic virus. Rift Valley fever virus is endemic in Uganda, but cases are sporadic. The virus affects people and animals, typically buffaloes, camels, cattle, goats, and sheep. Humans are infected through direct contact with blood or body fluids during slaughter, by eating contaminated meat, or from the bite of infected Aedes mosquitoes. Read more

    United States of America: Puerto Rico’s Zika tally tops 1500; Measles in Florida, Arizona; West Nile in Colorado

    Almost 150 new cases of Zika have taken the island’s total to 1501, with 14 pregnant women among them. Read more
    A MEASLES outbreak has been confirmed in Florida’s Collier County, while Arizona’s ongoing outbreak has grown to 14 cases in Pinal and Maricopa counties.  
    COLORADO has confirmed the state’s first human case of West Nile virus (WNV) in Larimer County. Read more.

  • Angola: Yellow fever spreads to new provinces

    A total of 2893 suspected yellow fever cases with 325 deaths have been reported in Angola, while some 8 million people have now been vaccinated against the mosquito-borne virus. The first local cases have been reported from Cunene and Malanje provinces. Three countries have reported cases yellow fever exported from Angola – Democratic Republic of Congo (44 cases), Kenya (2) and China (11), according to the latest WHO situation report (June 2). The WHO notes that the outbreak remains of ‘high concern’ due to its spread into new districts and provinces of Angola, and the ongoing ‘high risk’ of it spreading into neighbouring countries.

    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 in tropical regions of the world. However, unlike the 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 are (thankfully) 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: Flurry of Zika in North Queensland

    Queensland Health has dismissed any link between two possible Zika cases in the Whitsundays and a confirmed case involving a Mackay man who visited Mexico. Two women, from Bowen and Cannonvale, had been travelling in Bali with another person from Gordonvale, who is confirmed to have the virus. Read more.

    Canada: Mumps hits 30-somethings

    A mumps outbreak is escalating rapidly, with 26 new cases in the past fortnight taking the total to 41 in the snowfields of Whistler, as well as in Squamish, Vancouver, and North Vancouver. The average age of patients is 33, a group likely to have had only one dose of mumps vaccine rather than the now-standard 2. Read more

    Advice for travellers: Easily preventable through vaccination, mumps is a highly contagious disease that can cause serious illness in people of all ages. Travelvax Australia recommends travellers check their status for routine childhood immunisations such as mumps, measles, diphtheria, whooping cough (pertussis), and polio 6 weeks before departure.

    Caribbean, Latin America: Zika, dengue and chikungunya updates

    ZIKA
    In outbreak news…
    Sixty countries and territories report ongoing mosquito-borne Zika outbreaks, No new country reported mosquito-borne or person-to-person transmission, according to the WHO’s latest Zika situation report (June 2). 
    FOUR months after Jamaica’s first case of Zika, the government has confirmed 16 cases – including 2 pregnant women – and 1287 suspected cases. Most notifications have been reported in Kingston and St Andrew (465), and St Catherine (405). Read more
    HONDURAS has reported 22,700 Zika infections, along with a similar number of combined dengue and chikungunya cases this year. (Read more – Translate to English) 
    In other Zika news…
    The WHO has asked its emergency committee to weigh in on whether the Brazil Games should proceed on schedule, given the potential threat to athletes and visitors. The request came as scientists found more evidence of Zika virus's ability to infect neural progenitor cells, allowing it to evade detection and replicate for weeks. Read more.  
    SCIENTISTS say it is likely that Zika virus can be transmitted during oral sex — perhaps even by kissing — citing a case in France. Sexual transmission is now considered to be an important driver of the epidemic in the Americas, with cases reported in 10 countries where no mosquitoes carry the virus, including France, Germany, Italy, Portugal, and New Zealand. Read more
    ZIKA patterns in Dominica show twice as many infections in women (230) than men (107) – similar to findings reported recently from Brazil. Dominican women with Zika outnumbered men by two to three times in all age groups, except for those 61 years and older. Read more

    DENGUE
    Central American countries reporting dengue cases to mid-May included Belize (12 cases, DENV 3 strain), Costa Rica (6640, DENV 1,2,3), El Salvador (4931, DENV 2), Guatemala (2431, DENV 1,2,3,4), Honduras (11,652, unknown), Nicaragua (19,473, DENV2), Panama (1009, DENV 1,2,3). Mexico has recorded 26,971 cases, with all 4 serotypes in circulation. Fatalities have been recorded in Guererro state (8), Tabasco 4, Quintana Roo 2, Sonora 2, Tamaulipas 2, Jalisco 1, Oaxaca 1, and Veracruz 1. Read more (PAHO update) 
    IN the Caribbean, all four dengue types are circulating in Puerto Rico (7840 cases). The Dominican Republic has recorded 4270 cases of unknown type, while other to report case numbers include Martinique (399 DENV 1,2,3), St Kitts & Nevis (18 cases, unknown), Suriname (2, DENV 1), Trinidad & Tobago (193, DENV 3). Read more (PAHO update) 
    IN South America, Paraguay topped the year-to-date count with 120,275 cases (16 deaths) of strains 1,2 and 4, ahead of Argentina (70,311 cases, DENV 1, 4), Colombia (56,221, unknown), Venezuela (23,594, DENV 1,2,3,4), Peru (20,774, DENV 1,2,3), Ecuador (7612, unknown), and Uruguay (1337, DENV 1). Read more (PAHO update). In Peru’s La Libertad region, the provinces of Ascope, Virú, Trujillo have been have been hardest hit by an outbreak of dengue fever exceeding 3200 cases. Other regions to report outbreaks include Lambayeque (868 confirmed or suspected cases), Ayacucho (1430), Tumbres (579), and Ica (79). In Peru’s La Libertad region, the provinces of Ascope, Virú, Trujillo have been have been hardest hit by an outbreak of dengue fever exceeding 3200 cases. Other regions to report outbreaks include Lambayeque (868 confirmed or suspected cases), Ayacucho (1430), Tumbres (579), and Ica (79). Read more. (ProMED)  
    THERE will be relatively few dengue cases among the 400,000 foreigners expected to visit Brazil for the Olympics, according to a mathematical model used successfully to gauge the risk during the FIFA World Cup in Brazil in 2014. Read more

    CHIKUNGUNYA
    Almost 2500 new chikungunya cases reported last week have taken the 2016 total in the Americas to 117,829 cases, according to the Pan American Health Organization’s (PAHO) latest update (June 3). Honduras’ 1174 new cases took its total for the year to 9489, while 824 new cases in Colombia took the 2016 total to 15,625. However, the disease remains hugely underreported: Many countries have not reported data for months. Nicaragua reported a chikungunya-related death to take the regional death toll to 16, with the rest all in Brazil. Since the outbreak began in December 2013, the PAHO has reported 1,997,796 suspected or confirmed cases, including 284 deaths.

    Advice for travellers: Zika continues to spreading in the Americas, and is also circulating in the Pacific and Southeast Asia. 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 settings, 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: Beijing catches slow bird flu wave

    Beijing’s first human case of A(H7N9) avian influenza for 2016 has taken the number of people infected in the current ‘fourth wave’ of the disease to 791. It was not revealed how the 49-year-old man from the Tongzhou district, in Beijing’s south east, was infected. The latest H7N9 wave began in early October last year and the 106 reported cases reported to date are fewer than in earlier waves. Read more

    Advice for travellers: Human H7N9 cases continue to be reported sporadically in China, possibly linked to the sale of poultry. However, there has been no sustained person-to-person transmission. 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

    Ecuador: Cholera surfaces in El Oro

    A rare cholera infection involving a 57-year-old resident of Machala City (El Oro province) is the first locally acquired case of the water-borne disease in Ecuador in 12 years, authorities say. 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

    Fiji: Mozzie disease trio circulating

    As well as 332 dengue fever cases recorded to mid-May, Fiji has had at least 19 confirmed Zika and 24 chikungunya cases this year, mainly from the Western and Central divisions. Ministry of Health permanent secretary Dr Maciusela Tuicakau expects the 'Fight the Bite - Clean up Fiji' campaign will help reduce transmission. Read more.

    Finland: Norovirus strikes sour note on cruise

    Five passengers and 3 crew of the Silja Symphony are the latest of around 200 people sickened by norovirus on recent cruises. Read more

    Advice for travellers: Norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea. However, these symptoms can lead to more serious complications among the sick, young children, and the elderly, which makes outbreaks on cruise ships, in aged care facilities and hospitals of particular concern. To minimise the risk, wash your hands after using the toilet and before eating, and practice good general hygiene. Read more on norovirus

    Haiti: Cholera rages on

    Haiti and neighbouring Dominican Republic continue to battle epidemics of cholera. To date in 2016, Haiti has reported more than 16 000 cases, resulting in nearly 13 000 hospital admissions and 175 deaths. Since October 2010, the cumulative totals exceed 780,000 cases and 9300 deaths, making it the most explosive cholera epidemic of modern times. Read more. In the neighbouring Dominican Republic, 714 suspected cholera cases and 16 deaths were reported to May. 

    India: HIV via blood transfusion; Malaria deaths; CCHF strikes in Gujarat: Dengue outbreaks

    At least 2234 Indians have contracted HIV while receiving blood transfusions in hospitals in the past 17 months, according to an official report. India has more than two million people living with HIV/AIDS. Read more
    TRIPURA’S malaria toll has risen by 7 after the latest deaths in remote tribal villages in the Dhalai district over 2 days last week. Hospitals in Gandacherra, Chhawmanu and Chhailengta are reportedly full of malaria patients. Read more
    IN Jharkhand state, around 650 villagers have tested positive for malaria this year, prompting authorities to launch a concerted effort against the vector-borne disease. Last year, the district recorded 3 child deaths among 1700 malaria cases. Read more
    GUJARAT state has recorded its fourth case of Crimean-Congo heamorrhagic fever (CCHF) of the year, involving a 30-year-old woman from Mudhan village near Lakhpat. The cause of the infection is not known. CCHF virus transmission may occur from contact with blood and tissues of CCHF virus-infected animals and ticks, but also with blood and secretions of infected people, usually in a hospital setting. Read more
    IN Kerala State, the Pathanamthitta municipality has recorded 90 confirmed cases of dengue fever in the past 3 weeks, mainly from Ranni-Angady, Vallana, Thannithode, Malayalappuzha, Elanthoor, Omalloor, Kadammanitta, and Konni. Up to 19 cases of leptospirosis and 15 hepatitis B infections were also reported from the district. Read more
    DENGUE fever has broken out in the village of Puthupady, in the Kozhikode district of Kerala state. Read more
    THE city of Pune (Maharashtra state) has recorded the highest number of dengue and chikungunya cases in the state over the past 4 months. Health authorities have made it mandatory for the city’s private GPs and laboratories to report dengue cases. Read more

    Malaysia: Fears for record dengue year

    Malaysia has recorded almost 50,000 dengue cases this year, raising concerns that 2016 may be another record year. Malaysia reported a record 120,000 lab-confirmed cases in 2015. Half of 2016’s total has been recorded in Selangor State (26,704 cases), with Johor recording 6800 and Kuala Lumpur 3400. To mid-May, there have been 109 dengue-related fatalities. Read more
    THE state of Sarawak has reported 1105 dengue cases and 4 deaths in 2016, a slight rise on 2015 figures. Three-quarters of the cases occurred in urban areas, with the highest rates in the Sibu, Meradong and Song districts. Read more

    Nepal: Concern over leishmaniasis’ spread

    The incidence of visceral leishmaniasis is increasing in far western Nepal, with low-level outbreaks of recent years ramping up in 2015-16. A senior doctor described kala-azar as a ‘major public health problem’ in Nepal. Outbreaks have occurred in 12 Indian border districts of the eastern and central Terai region since 1982, however in recent years the parasitic disease has been reported from new areas – including Hilly region and the Kathmandu Valley. It is estimated that 8.5 million Nepalese are at risk of infection. Read more

    Advice for travellers: Leishmaniasis is a parasitic disease spread by infected sand flies and is found in the tropics and subtropics, as well as in southern Europe. There are two main forms – cutaneous and visceral. The former causes skin ulcers, the latter a severe systemic disease that is usually fatal without treatment. Read more on the disease, where it’s found and how prevent it

    Peru: Gold rush prompts mercury emergency; Oropouche surfaces in Cusco

    A gold-mining boom in south-eastern Amazon is driving widespread mercury contamination. High levels of mercury have been found in people, fish and sediments in 25 villages in the Madre de Dios region. An estimated 48,000 people across 85,301 square kilometres are affected. Read more
    OROPOUCHE fever, a midge-borne disease which often goes undetected because its symptoms are similar to Zika, chikungunya, and dengue, has been diagnosed in the Cusco region of the Amazon basin. Most of the 57 cases occurred in the first quarter of the year from the rainforest region, which had not previously reported cases. Given the wide geographical distribution of midges across the Americas, the WHO said it is likely that neighbouring countries will report cases. Read more

    Advice for travellers: The cause of large outbreaks in the Brazilian Amazon region, Oropouche virus is transmitted to humans by the Culicoides paraensis midge. It usually causes only mild, self-limiting disease with a fever. Along with the La Crosse and Jamestown Canyon viruses, Oropouche is a member of the Orthobunyavirus genus, which has been known to cause encephalitis in North America.

    Saudi Arabia: New case ends MERS ‘drought’

    After 18 days with no new cases, the Ministry of Health (MOH) last Friday reported a MERS infection in an 85-year-old Saudi woman from Riyadh, who is in stable condition. The case lifts Saudi Arabia's MERS total since 2012 to 1384 cases, 592 of them fatal, the MOH said in a June 3 statement

    Singapore: New surge in dengue cases

    A spike of 220 dengue cases in the first week of June has taken the city-state’s official 2016 tally to 8373, including 5 deaths. The 37 active dengue clusters include 6 high-risk areas, most notably Geylang and Guillemard roads. Meanwhile, there have been no further cases of Zika following Singapore’s first last month – a man infected in São Paulo, Brazil. Read more

    Slovakia: Raw milk linked to tick disease

    An outbreak of tick-borne encephalitis (TBE) in the city of Košice has seen 27 of 32 patients admitted to hospitals for treatment. Košice is the biggest city in eastern Slovakia, located near the border with Hungary. People can get TBE by consuming unpasteurised milk or dairy products made from the milk of infected animals. It’s thought raw sheep's milk caused the outbreak. Read more.

    Advice for travellers: Central and Eastern Europe countries are endemic for the European subtype of tick-borne encephalitis (TBE) virus and cases occur annually. There is a vaccine for TBE available in Australia under the Special Access Scheme of the Therapeutic Goods Administration. Vaccination is recommended for people who live or work in at-risk areas or those at risk of tick bites. Read more about TBE

    South Sudan: Malaria season ramps up

    As the May-December peak malaria seasons ramps up, the first 5 months of the year have seen more than 500,000 cases, including over 200 deaths. An unprecedented malaria outbreak in 2015 infected more than 2.1 million people. Read more

    Thailand: As rains begin, Bangkok braces for more dengue

    The annual rains are underway and health officials have warned of more dengue in the capital. Bangkok’s 3630 cases represent a 20% increase on the same period in 2015 and a fifth of national total of 18,044, including 15 deaths. Children aged 10-14 years account for the majority of cases. The 5 provinces most impacted by dengue also include Rayong, Maehongsorn, Phuket and Trad. Read more

    United States of America: Microcephaly birth in New Jersey; Flu deaths; West Nile alert; Measles in Arizona; Local dengue, chikungunya cases; Angler hooks flesh-eating disease; More campus mumps

    A woman who travelled from Honduras for treatment of Zika-like symptoms has gave birth to a baby with microcephaly in New Jersey. It is the second such case on the US mainland: In January, a baby infected with Zika was born with microcephaly in Hawaii. Read more.
    DESPITE low levels of the virus nationwide, flu killed 2 children in the last week of May, the CDC announced in its weekly update.  
    WEST Nile virus has surfaced in Washington State, with health officials concerned at the presence of large mosquito populations. Read more
    AN outbreak of measles in Arizona has now infected 13 people in a federal detention centre for immigrants, including 4 staff. Read more.
    TEXAS has reported its first locally acquired case of chikungunya, while a US holiday-maker visiting Florida’s Key West has become that state's first local case of dengue for 2016. Both diseases are transmitted by the bite of Aedes mosquitoes. 
    MEANWHILE, a woman beach fishing on the Gulf coast in Louisiana has contracted the flesh-eating organism, Vibrio vulnificus, which entered through a wound in her foot caused by stepping into the mouth of a fish. Read more
    IN Nebraska, 10 cases of mumps at Midland University in Fremont have sparked another 11 in 6 nearby counties. Nationwide, there has been a rise in mumps cases in 2016, most notably on university campuses. Read more.

    Venezuela: Malaria range expands; Shortages see crime rates soar

    The number of states reporting malaria outbreaks has increased to 12, with Vargas, Trujillo, Anzoátegui and Barinas joining the list. More than 73,000 cases have been registered nationwide this year. Read more (translate to English). 
    SHORTAGES of electricity, food and other essentials due to falling oil prices have resulted in a soaring crime rate. Venezuela's quaintly named Observatory of Violence reported almost 28,000 violent deaths - or 90 murders for every 100,000 people – this year, making it one of the most violent in the region. Read more

    Zimbabwe: Border areas hit hardest by malaria

    Zimbabwe continues to be plagued by malaria. The annual average is more than 400,000 cases – 3% of the population. Transmission is generally seasonal from November through May, peaking throughout March and May. Northern and eastern regions bordering Mozambique and Zambia are considered high-risk areas. Read more.