World travel health alerts for 2nd of January 2019.
Regional Zika virus summary
On Dec 26, ProMED published a summary of news reports on Zika virus infections across both South and Central America for the last months of 2018 which included Brazil (10 Nov) 7544 cases, Bolivia (15/11) 482 cases and Mexico (19/11) 607 cases from 19 states. (Archive Number: 20181226.6223397). The January 2019 WHO Bulletin contains an article on Zika and the need for continuing vigilance - ‘Zika: the continuing threat’. Read more
Advice for travellers
Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).
Cholera hits in SW
In the south-west city of Rumonge, flood damage to vital infrastructure and a shortage of drinking water has resulted in at least 45 cases of cholera. The city lies on the shores of Lake Tanganyika on the frontier with the Democratic Republic of Congo where cholera killed more than 800 people last year. 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.
Management of dengue threat
The government plans greater efficiencies for insect control teams as it tackles dengue fever outbreaks in Cienfuegos and Sancti Spíritus provinces (and to a lesser extent in Villa Clara, Holguín and Havana). While in six provinces, authorities have identified shortages of the repellents and insecticides needed to manage the mosquito-borne threat. 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 and preventing insect bites.
TBE’s 12-year peak
According to the National Institute of Public Health, tick-borne encephalitis cases rose to a 12-year high in 2018 after more than 690 cases were reported. While the Czech Republic has one of the highest rates of TBE in Europe, the preventive vaccine is not funded by the government. Read more
Advice for travellers
A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. VACCINE: While safe and effective vaccines are available in Europe, none are licensed in Australia; however, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE. https://www.travelvax.com.au/holiday-traveller/vaccinations/tickborne-encephalitis
Ebola case count nears 600
As the case count in the Ebola virus disease (EVD) outbreak climbs to 598 confirmed and probable cases (with 363 deaths), the continuing unrest has caused a halt in vaccinations in Goma, Beni, Butembo, Katwa, Komanda and Mabalako. In the latest WHO update, the agency notes that ‘Katwa, Komanda and Mabalako remain the main hot spots of the outbreak’ and concludes with: ‘Five months following the confirmation of the first case of EVD the outbreak is still ongoing, with almost a fifth of the total case load reported in the past 21 days’. The WHO ‘continues to respond and remains committed to ending the outbreak’. 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.
Zika alert review request
A local news service reports that Indian authorities have requested a review (withdraw or modify) of the CDC travel notice advising precautions related to the Zika virus cases in Jaipur and nearby states. Read more
Advice for travellers
Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).
Dengue surge over Christmas
Kingston’s Bustamante Childrens’ Hospital has recorded a rise in cases of suspected dengue fever and also severe dengue. Vector control measures are being carried out in areas with high mosquito density, including the capital’s satellite district of Gregory Park (Portmore). 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.
Measles count passes 16,000
Active measles transmission continues in all 22 regions, including the capital Antananarivo, and the case count has now exceeded 16,000 with 39 deaths, although the WHO reports that actual numbers are likely to be higher. The agency also pointed to a risk of further spread in the region ‘given the frequent flights to neighbouring Indian Ocean islands and other African countries.’ Further vaccination campaigns are planned early in the New Year, aimed at infants and children from nine months to nine years of age in 13 regions. More on measles in the African region from the WHO here. Read more
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.
Duo of viral infections
Concurrent outbreaks of dengue fever and influenza have been reported on Hoarafushi, an island in the northern atoll of Ihavandhippolhu. To date one adult and eight children have been diagnosed with dengue. 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.
No respite from Hep E
The 14-month long hepatitis E outbreak continues at a slower pace but has spread to a further two regions (Otjozo and Hardap), with nine northern and central areas now affected. Over 4,000 cases and 34 deaths have been recorded to date, the majority from informal settlements in the central regions of Khomas and Erongo. Read more
Advice for travellers
The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Infection during the latter stages of pregnancy carries a higher rate of severe disease and mortality. Unlike the Hep A and B viruses, there is no vaccine for this strain in Australia, which is especially common in communities with lower levels of sanitation and hygiene. Read more about the virus and how to prevent it.
Dengue epidemic declared
Dengue fever cases are on the increase again, with nearly 50 reported in the capital Noumea for the four weeks from November 26th. DENV-2 has been the predominant serotype. ReliefWeb lists the new outbreak in New Caledonia, while also providing news on dengue in Palau and Wallis and Futuna. 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.
Yellow fever, monkeypox updates
From the Nigerian Centre for Disease Control (NCDC) update on the yellow fever outbreak which first began in September 2017: ‘3,902 suspected cases have been reported from all 36 States and the FCT ... 78 positive cases from 14 states (Kwara, Kogi, Kano, Zamfara, Kebbi, Nasarawa, Niger, Katsina, Edo, Ekiti, Rivers, Anambra, FCT, and Benue States) have been confirmed’. Reactive vaccination campaigns have been carried out in 12 states. In other NCDC news, monkeypox cases continue to occur – the 45 confirmed cases (from a total of 114 suspected infections) in 2018 (to Dec 13) were reported from 13 states. In a ProMED post, a moderator describes the outbreak as unusual as ‘Rather than sporadic or rare cases, there have been over 100 cases scattered over a large geographic area this year [2018]’. (Archive Number: 20181231.6237302) Read more
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.
Cebu’s dengue spike
A severe wet season is blamed for the late surge in dengue fever cases in the province of Cebu, with the municipalities of Naga City, Talisay City, Toledo City, Minglanilla and Liloan hardest hit. 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.
Peak dengue season starts anew
A further 20 dengue fever cases were confirmed in the first two weeks of December, taking the 2018 year-to-date total to more than 6,700 as strict containment measures continue to be implemented. The latest outlook from the Pasteur Institute is that while the outbreak is currently at lower levels, it has the potential to increase rapidly over the coming months. 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.
Dengue, flu updates
Current National Environment Authority (NEA) information on dengue fever clusters indicates 25 active locales (five are high-risk) in widespread districts of the island-nation. Recent data from the NEA shows a slight increase in the weekly reporting of dengue infections. In other news, Singapore was one of three countries in the region to report a rise in influenza-like illness activity in the latest WHO global flu report; the others were the Philippines and Laos. Elsewhere, flu rates are rising in Europe, Mexico, Canada and some SE and NE US states. Read more
Advice for travellers
Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination, when available, for all travellers over 6 months of age. Read more about influenza.
Measles takes off again in east
Just prior to Christmas a measles epidemic was declared in eastern Slovakia, affecting the town of Trebišov and surrounding villages (including Sečovce, Parchovany, Hrčeľ, Veľká tŕňa, Egreš, Kravany, Zemplínska Teplica and Bačkov). Nearly 90 cases have been identified to date, leading to an expanded vaccination campaign targeting children who are unvaccinated or had an incomplete measles vaccine course. Read more
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.
Dengue alert for west
As the 2018 national total of dengue fever cases approached 50,000 (and 52 related deaths), government surveillance identified high risk areas with an increased presence of the dengue vector - Aedes mosquitoes. Parts of the Western Division, including Colombo, Gampaha and Kalutara were put on alert; between them they had recorded more than one-third of all dengue fever cases last year. 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.
Measles alerts for NY State
New York State’s Health Dept. has issued a warning on ongoing measles outbreaks affecting Rockland, Orange and Ocean counties. Read more
Advice for travellers
Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. In general the infection is relatively benign, but complications 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.