World travel health alerts for 19th of December 2018.
Stinger alert north of Cairns
Several beaches near Cairns have been closed after Irukandji jellyfish were found inside stinger nets at Yorkeys Knob beach. One news source states that the affected beaches include ‘Palm Cove, Clifton Beach, Kewarra Beach, Trinity Beach, and Yorkeys Knob’. November to May each year is considered peak stinger season. Read more.
More about marine stingers here.
Regional Ebola precautions, latest report
Ebola virus disease vaccinations for frontline healthcare workers has already started in Uganda and they are planned for Rwanda and South Sudan as, according to the WHO, they are “at very high risk” of importation of Ebola from the DRC’s north-east. According to the Ebola dashboard, the number of confirmed or probable Ebola cases in North Kivu and Ituri provinces has risen to 542, there have been 319 deaths and 96 people are currently under observation. Read the Dec 18 WHO Situation Report here. Read more
Advice for travellers
Ebola Virus disease is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola virus disease.
Improved sanitation to help control typhoid
In a measure aimed at limiting the spread of typhoid, the government is to ensure each house in typhoid-affected villages of Naitasiri District will have its own toilet after it was found that some residents used shared facilities. As of Dec 15, there had been 31 confirmed typhoid infections and a further 14 were suspected in the district which is located in SE Viti Levu, near Suva. Read more
Advice for travellers
Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination against typhoid fever is itinerary specific, but is usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices.
Measles toll now 34
ECDC measles data has recently been updated: ‘In 2018 and as of 10 December 2018, most of the cases in the EU were reported from Romania (5,316), France (2,727), Italy (2,368), and Greece (2 290). Thirty-four deaths have been reported in 2018 from Romania (22), Italy (7), France (3) and Greece (2). Outside EU/EFTA countries, Ukraine has experienced the continuation of the largest outbreak with over 44,000 cases reported in 2018, including 15 deaths. An ongoing outbreak has also been reported in Serbia with over 5 000 cases and 15 deaths, as well as outbreaks in the Americas, Israel, Mauritius, the Philippines and Russia’. In-depth information is provided in the ECDC Communicable Disease Threats Report 9-15 December 2018.
Advice for travellers
Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure. Read more about measles.
CDC Zika warning; JE in Maharashtra; SW’s tick-borne infection returns
From a Dec 13 US CDC Travel Notice (level 2, practice enhanced precautions), issued for American travellers in response to the Zika virus outbreak: in ‘Rajasthan and surrounding states. Zika continues to be a risk throughout India… Pregnant women should NOT travel to areas with risk of Zika. This is because Zika infection during pregnancy can cause serious birth defects. All travelers to areas with risk of Zika should (1) prevent mosquito bites and (2) use condoms or not have sex to protect against Zika during travel. They should continue to take these precautions after their trip to stop the spread of Zika to others back home’.
A review of Japanese encephalitis cases in the state of Maharashtra this year brings to light news from authorities that cases had more than trebled from 2016 and 2017 and were found in new areas. Only six of the 108 confirmed cases required treatment, the remainder were asymptomatic and were only diagnosed during surveillance activities.
THE FIRST two cases of tick-borne Kyasanur Forest Disease this (dry) season have been reported in Karnataka’s Sagar taluk (Western Ghats). A vaccination campaign for people living in nearby districts has been initiated and authorities are monitoring monkeys in the area as they are common hosts for the infection following bites from infected ticks.
Advice for travellers
Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).
Hike in dengue infections
Dengue fever infections have risen from 177 last year to at least 570 in 2018. Government sources say most cases have been mild, however as many as 70 patients were suspected to have severe dengue. Read more
Advice for travellers
Dengue is spread by two types of Aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply repellent containing an active ingredient, such as DEET, Picaridin, or PMD when outdoors to all exposed skin. Read more about dengue fever.
Vax campaign targeting men
Over 16 million men aged between 39 and 56 years who are confirmed to have low immunity to German measles will be offered the rubella vaccine, starting during the Japanese springtime and continuing for three years. This response is to counter the large outbreak which has affected many areas including metropolitan Tokyo, producing nearly 2,500 cases. A US CDC travel notice remains in place for US travellers to Japan. Read more
Advice for travellers
Rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine, one of the routine immunisations which should be current for prior to overseas travel. Travellers should also check their immunisation status for tetanus, diphtheria, and whooping cough. Read more about rubella.
10,000+ measles cases from 20 regions
On Dec 12, authorities announced the total number of measles cases from 20 regions had exceeded 10,000, with children aged under 15 years making up over three-quarters of all cases. One hospital in Antananarivo reports a 7-fold increase in parents presenting their infants for vaccination since the outbreak began. A WHO report on the situation expresses concern ‘that this outbreak may evolve exponentially’. Read more
Advice for travellers
A highly contagious virus, measles occurs in developing and developed countries. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure.
Edo’s YF troubles WHO
The yellow fever outbreak in the central-south persists amid concerns over low vaccination coverage in the area (~ 60 percent) which is near to Edo’s state capital, Benin City. A WHO update notes that ‘Between 22 September and 10 December 2018, a total of 97 suspected yellow fever cases, including 23 deaths were reported across 15 (out of 18) local government areas in Edo State. More than half of these cases occurred in the last two weeks.’
Advice for travellers
Yellow fever virus is a mosquito-borne disease found in tropical and subtropical areas in Central/South America and Africa. While it can be severe, yellow fever infection is a very rare in Australian travellers. However, under the International Health Regulations (IHR), proof of vaccination may be required of any traveller entering or leaving an area at risk of yellow fever transmission. Read more about yellow fever.
Local dengue a first in Seeb
For the first time locally acquired dengue fever has been found near the capital Muscat, one of three autochthonous cases in Oman this year. The case was identified in Seeb, adjacent to Oman’s international airport, and subsequent surveillance in the city revealed the presence of the dengue vector, the Aedes aegypti mosquito. Read more
Advice for travellers
Dengue is spread by two types of Aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply repellent containing an active ingredient, such as DEET, Picaridin, or PMD when outdoors to all exposed skin. Read more about dengue fever.
New dengue strain
A strain of dengue that is new to the archipelago (DENV-3) has been confirmed in two local residents with no history of travel. Read more
Advice for travellers
Dengue is spread by two types of aedes mosquitoes which breed in shady areas close homes and other accommodation. Both bite mainly during the daylight hours, making them difficult to avoid outdoors. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.
Polio’s 26th victim
From information supplied during the most recent reporting week (Dec 11), the country’s 26th polio case has been confirmed in East Sepik province. Additionally, positive environmental samples were obtained (in late Oct and early Nov) from locations in Port Moresby. The weekly GPEI report contains updates on all wild and vaccine-derived polio cases.
Advice for travellers
Polio is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low, however vaccination is recommended for travel to affected regions and is a requirement for travel to/from some countries. If at risk, adults should have a booster to the childhood series. More on polio.
Diphtheria cases mount in 4 regions; New infection threat in Baybay
While the incidence of diphtheria has dropped on a national level this year (from 168 in 2017 to 147), case numbers have risen in the regions of Bicol, Davao, Soccsksargen and the Autonomous Region in Muslim Mindanao. Read more
THE MOVEMENT of people from schistosomiasis endemic regions of Leyte province to unaffected areas is believed to be the cause of a local outbreak in Baybay City with as many as 57 cases recorded. According to the Philippine government newswire service, other highly affected regions include Samar and Eastern & Northern Samar.
Advice for travellers
Schistosomiasis or bilharzia is caused by a parasite which is released into fresh water by host snails. It burrows into the skin of people who swim or wade in rivers, streams and lakes containing the snail. With the rise in eco-tourism and adventure travel, increasing numbers of tourists are contracting schistosomiasis, according to a WHO fact sheet. Around 10% of travellers exposed to contaminated water will be infected. No vaccine or prevention medication is available, but schistosomiasis is treatable – especially if diagnosed early. Read more on the risk for travellers and how to prevent infection (Travelvax, WHO, CDC).
Summer season malaria warning
The peak summer malaria season has arrived, with warnings issued by the National Institute for Communicable Diseases to ensure adequate protection if travelling to domestic or international destinations. On a local level, ‘There has been some recent expansion of low or very low malaria transmission to some districts previously regarded as non-malaria areas in South Africa, such as parts of the Waterberg District.’ Read more
Advice for travellers
Malaria is endemic in many areas of southern Africa. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.
Chikungunya, dengue updates
The reporting of nearly 80 chikungunya cases in Phuket over the last few weeks has spurred local authorities to raise public awareness of the mosquito-borne infection and to commence insecticide fogging. Over 2,000 cases have been recorded countrywide until early December with highest rates in the provinces of Songkla, Satun, Narathiwat, Phuket and Pattani. Read more. Meanwhile, the national count of dengue fever cases has topped 80,000 this year.
Advice for travellers
The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.
Measles in 40 districts
Forty north-western, western and central districts have been experiencing measles outbreaks since October with two related deaths recorded. Read more
Advice for travellers
A highly contagious virus, measles occurs in developing and developed countries. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure.
New cholera cases persist in some areas
While the worst of the cholera outbreak is now over, cases continue to be reported (albeit in smaller numbers) with the latest increases seen in Mount Darwin (Mashonaland Central province) and Chiredzi (Masvingo province). 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.