Health Alerts
  • Brazil: Inadequate vax coverage in at-risk YF cities

    From a Ministry of Health update, published on Oct 8, containing yellow fever (YF) data for 12 months from July 1 last year: 1,376 confirmed cases of yellow fever, 770 still under investigation and 483 deaths. In a computer translation of the release, the ministry ‘warns the population for the arrival of summer, the period of greatest risk of transmission of the disease. This concern is due to the fact that recently affected areas with large populations, such as the metropolitan areas of Rio de Janeiro, Minas Gerais and São Paulo, still have large numbers of unvaccinated people, i.e., those at risk of infection. It should be noted that these states, since the beginning of this year, are already areas with vaccine recommendation (ACRV).’ Regarding YF vaccine usage, the release also notes ‘at present, fractional doses are not being applied, but rather the standard ones’. 

    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

    Democratic Republic of Congo: Decision pending on raised Ebola alert

    A decision will be made this week by a gathering of experts from the World Health Organization (WHO) on whether to escalate the Ebola outbreak in North Kivu and Ituri provinces to a Public Health Emergency of International Concern. Read more. The Oct 16 Ministry of Health update announced that there have been 216 cases of haemorrhagic fever, of which 181 are confirmed, 35 are probable and 32 suspected cases are under investigation. Of the 181 confirmed, 104 have died. It also notes that ‘The number of alerts in Beni has risen sharply indicating an improvement in the surveillance system and better collaboration of the community that uses emergency services’. 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.

    France: Single Côte d'Azur dengue case

    Reports last week of the first locally-acquired dengue fever infection in mainland France for 2018 – a resident of Saint-Laurent-du-Var in the Provence-Alpes-Côte d'Azur region, <10kms west of Nice. Surveillance has been increased in the area, but more cases are unlikely due to the onset of cooler weather. Isolated cases of dengue fever have been reported in the area in previous years; the Aedes albopictus mosquito was first detected there in 2004. 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.

    India: Zika cases rise to 72; Dengue, malaria persist

    There are some concerns for the upcoming tourist season in the northern state of Rajasthan as Jaipur’s Zika virus disease cases rose to 72. The health minister commented on the outbreak this week, stating that it was localised, monitoring and insecticide fogging are underway and quarantine measures have been applied to the area. Read more
    ELSEWHERE, there has been a late rise in dengue and malaria cases in Delhi, Kotkapura and Jalandhar in the state of Punjab, Lucknow (Uttar Pradesh) and  in areas of Telangana state.

    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). 

    Israel: Measles circulating

    The number of measles infections is climbing, with Jerusalem reporting over half of all cases (341) this year. One local news source quotes one doctor who claims there are five to 10 new cases per day in the city. An expansion of the outbreak to other towns and cities is on the cards due to low vaccination rates in some areas. 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.

    Laos: Flu season update

    A 5-year peak in influenza infections (predominantly A(H1N1)pdm09) affecting mainly children under 5yo has been reported in the latest WHO global flu update, while elsewhere in the region the same strain is behind a rise in flu notifications in India and Thailand. See the full WHO update here

    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 on influenza.

    Nigeria: Monkeypox export

    A third monkeypox infection originating in Nigeria but diagnosed outside the country has been reported, this time in Israel. The infected man, an Israeli working in Port Harcourt, Nigeria, is believed to have contracted the disease while in Rivers state. This is also where the two recent UK cases were infected (a third UK infection was healthcare-related). Read more

    Advice for travellers: Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox

    Papua New Guinea: Polio case count rises to 15

    As reported by the GPEI, a fifteenth case of polio (cVDPV1) was reported this week from the province of East Sepik and ‘two VDPV1 positive environmental samples, both collected on 5 September, were reported from Port Moresby’. Vaccination campaigns targeting all children under 15yo continue, while the WHO has released a report: ‘The First 100 Days of the Polio Outbreak Response in Papua New Guinea: A Summary’. 

    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

    Sudan: Chikungunya spreads to 7 states

    During the current chikungunya outbreak, the WHO has categorised the risk of further spread to other states to be very high due to the widespread presence of the mosquito vector. ‘From 31 May through 2 October 2018, seven States (Kassala, Red Sea, Al Gadaref, River Nile, Northern State, South Darfur and Khartoum) have been affected with a total of 13,978 cases of chikungunya, 95% of which are from Kassala State’. Read more

    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.

    Thailand: Measles outbreak in south kills 5

    A measles outbreak has struck the landlocked province of Yala in southern Thailand killing five children and infecting nearly 350 people since last month. Highest rates of infection have been recorded in Yaha district, Bannangsata and Than Toh. Other provinces reporting outbreaks were Prachuap Khiri Khan, Samut Sakhon, Chiang Mai and Amnat Charoen. Read more

    United States of America: Hep A toll continues to rise

    Hepatitis A cases, primarily among the homeless and illicit drug users, continue to mount, however, as noted by a ProMED moderator, ‘Spillover into other portions of the population, such as restaurant diners affected through infected food handlers will continue’. Kentucky (2,050 cases, 14 deaths since Aug “17) and West Virginia (1527 cases & 5 deaths since Mar ‘18) have been hardest hit among the 11 states cited in the ProMED post on Oct 16 (Archive Number: 20181016.6094878).

    Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Vietnam: Diphtheria returns to Central Highlands province

    Two deaths from diphtheria infection, and a further five suspected cases, have been reported in the central highlands province of Kon Tum, adjacent to the borders with Laos and Cambodia. These are the first diphtheria cases in 11 years in the province which has pockets of low immunisation in some communities. Read more

    Advice for travellers: Spread by coughing and sneezing or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more on diphtheria.

    Zimbabwe: New cholera cases slowing

    The death toll in the cholera outbreak has climbed to 54 with five fatalities reported in the village of Buhera, around 220kms south of Harare - all five were related. A second round of vaccinations is due to start this week aimed at halting the spread of cholera – with more than 9,000 cases now recorded. Read more. Harare has borne the brunt of the outbreak. As stated in a ReliefWeb post on Oct 12, ‘The ten hot spot areas in Harare are: Glenview, Budiriro, Mbare, Epworth, Glen Norah, Granary, Mabvuku, Mufakose, Stoneridge, and Kambuzuma'. 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

  • Afghanistan: Global polio update

    From the Oct 3rd global round up of polio: one case of wild poliovirus type 1 (WPV1) from Kandahar province, and in Pakistan, reporting of 7 WPV1-positive environmental samples. The 2018 year-to-date WPV count is now 19 - 15 in Afghanistan and 4 in Pakistan. No new circulating vaccine-derived poliovirus (cVDPV) cases were recorded in Papua New Guinea, Niger, the DRC and Syria in the previous week, however three more cases of cVDPV2 were reported in Nigeria (Jigawa). Read more

    Advice for travellers: Polio is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low, 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

    Central African Republic: Two disease alerts

    Outbreaks of both hepatitis E and monkeypox are ongoing: hepatitis E in the NW region (five localities in Bocaranga-Koui Health District) has international agencies on the alert due to the risk of further extension; while three southern regions have reported monkeypox - ‘in the rural district of Mbaiki, located 107 km from the capital, Bangui, and at the border with the Democratic Republic of the Congo and the Republic of Congo’. Read more. The CAR is just one of several countries in the region reporting monkeypox cases since 2016: Cameroon, Democratic Republic of the Congo, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. Read the WHO disease outbreak news on monkeypox in Nigeria dated Oct 5 here

    Advice for travellers: Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox

    Democratic Republic of Congo: Ebola-affected areas ‘now cover hundreds of kilometres’

    Community resistance continues in some areas in response to the measures required to limit the spread of Ebola – vaccination, contact tracing, 21 day monitoring and safe burials. This has allowed new cases and deaths to increase substantially this week, with 14 more cases reported over a 3-day period. Read more. The health ministry’s Ebola Surveillance Dashboard puts the confirmed and suspected cases at 188 with 118 deaths. The latest WHO situation report notes that ‘Beni, Butembo and Mabalako continue to report an increasing number of new cases, indicating the persistence of Ebola virus transmission in these areas.’ 

    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.

    Fiji: Typhoid in 2 Viti Levu provinces

    From early August until Sept 20th, a total of 26 typhoid fever infections were reported from two provinces on the largest island, Viti Levu. In a regional update, ReliefWeb posted that the affected provinces were ‘Naitasiri (in three villages and one settlement) and Navosa (Naveyago village)’, situated in the island’s centre and south-west. Investigations into the source/s of infection are ongoing. 

    Advice for travellers: Typhoid occurs in some Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters. Read more about typhoid.

    India: Zika in Rajasthan; Mozzies persist due to end of season rains

    From Jaipur’s first Zika virus infection, which was confirmed in the Rajasthan capital on Sept 23rd, further testing has identified a total of 29 cases - the largest count in India to date. All confirmed infections have been in a northern area of Jaipur, Shahstri Nagar. A team of experts has been sent to the city to assist with control measures while the NCDC (National Centre for Disease Control) monitors the outbreak. Read more
    INTERMITTENT rain is allowing disease-carrying mosquitoes to breed, adding to the number of dengue fever, chikungunya and malaria cases being reported in Delhi. The city has also experienced a sharp rise in flu infections.  A recent rise in chikungunya infections in the city of Vadodara, in the western state of Gujarat has officials concerned. The end of the monsoons will bring about a reduction in the number of leptospirosis infections which have killed 12 people in Mumbai this year, but dengue fever is likely to affect the city until November. Scrub typhus has killed more people than dengue fever in Himachal Pradesh – Shimla reported 12 deaths due to the mite-borne disease. In neighbouring Bangladesh, this year has proved to be a record for dengue fever infections – the highest tally since the virus was first detected in the country in the year 2000. Dhaka has recorded most cases. Read more

    Advice for travellers: Dengue occurs throughout India – both in urban and rural areas. The virus is spread by two types of Aedes mosquitoes. Both breed in shady places close to dwellings and bite mainly during the daylight hours, making them difficult to avoid when 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 (or PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Ireland: Mumps in western counties

    As many as 45 teenagers and adults up to 29 years of age have been infected with mumps over a 7-week period in three western counties - Galway, Mayo, and Roscommon. Read more

    Advice for travellers: These outbreaks of mumps highlight the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to any destination – be it a developed or developing country. Read more about mumps.

    Japan: Rubella cases top 770

    The outbreak of rubella (German measles) continues, with a further 104 cases recorded at the end of September taking the year-to-date total to 770 – an 8-fold increase on 2017 figures. While Tokyo is reporting most cases, according to a news report, rubella infections occurred in 40 of the 47 provinces in the week. 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.

    Mauritania: Dengue following rains

    A dengue fever outbreak is underway in the iron ore mining centre of Zourate, with one local news source claiming there are up to 20 new cases every day. Read more

    Mexico: Dengue in south, alert for north

    Almost half of all dengue fever cases recorded in Mexico have been in the southern state of Chiapas, bordering Guatemala. The state has also had 15 of the 19 deaths reported nationwide this year. Read more. While in Baja California, dengue alerts have been issued for four localities - Mexicali, San Felipe, El Rosario and Isla de Cedros – following recent flooding. Read more

    Spain: Locally-acquired dengue reported

    Health authorities reported on two locally-acquired dengue fever infections, and another which is suspected, from August. The confirmed cases live in the SE province of Murcia and had no history of travel. One of the dengue fever vectors, Aedes albopictus mosquitoes, has an established presence along Spain’s Mediterranean coastline. Read more

    United States of America: Flea-borne infection in LA County

    Up to 57 cases of murine typhus have been reported in parts of Los Angeles County over the past months – Pasadena, Long Beach and downtown LA. The Pasadena Health Department news item outlining the epidemic notes that ‘Flea-borne typhus is found regularly in Los Angeles County, especially Pasadena, with most cases occurring in the summer and fall months. Read more. The flea-borne infection is contracted when people come into contact with fleas infected with Rickettsia typhi – most commonly when an infected flea’s faeces are rubbed into broken skin. More on murine typhus from the US Centers for Disease Control and Prevention (CDC).

    Zimbabwe: Cholera outbreak deepens, first round of vaccinations in Harare

    In a further worsening of the cholera outbreak, the WHO reported at the end of last week that nearly 5,000 new cases have been identified since Sept 20th, taking the total number of cases to over 8,500 with 50 deaths. South-western districts of Harare remain those most affected, in particular Glen View and Burdiriro, but 135 cases have been reported in other provinces. The WHO assessment also notes that ‘available response capacities are overstretched as authorities are already responding to a large typhoid outbreak which started in August 2018’. Read more. A regional cholera update includes information on Tanzania (Arusha, Manyara and Rukwa regions) and Somalia (regions of Banadir and Lower Jubba).

    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

  • Chile: Hep A in central regions

    Hepatitis A cases have surged in the central regions of Bio Bio and Nuble, increasing by 140 percent since last year. One of the likely reasons given for the increase is the incorrect preparation of seafood for consumption – the coastal city of Coronel has recorded more cases than other districts. Read more

    Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    China: Hep E virus jumps species, from rat to human; More dengue in Macau; HIV/AIDS spike

    A man living in a public housing estate in Kowloon, Hong Kong, has been diagnosed with a form of hepatitis E previously found only in rats – the first such case. It is thought he may have become infected after consuming food contaminated with rat droppings containing the virus. The man’s abnormal liver function was being monitored after undergoing a liver transplant. Read more
    IN MACAU, a further three locally acquired dengue fever cases have been identified in a family group living near the landmark Ruins of St Paul. The first case was diagnosed last week, followed by the man’s son and grandson. Health authorities are working to clean up the area but say more cases could come forward. Read more
    HIV/AIDS diagnoses have increased by 14 percent in China this year - up by 100,000 to 820,000 cases - with sexual contact the most common form of transmission. Read more

    Czech Republic: First human WNV cases

    While mosquitoes and horses have been found to be infected with West Nile virus (WNV) in the Czech Republic, there had been no confirmed infections in humans – until this week. A senior health official confirmed the death of an elderly woman from WNV in the southern town of Breclav at the end of last week and, in a separate report, a man has been admitted to the same hospital for treatment of WNV infection. Read more. The 2018 WNV season has been particularly bad across the region with a three-fold increase in cases. This week the death toll from complications of WNV infection rose to 15 in the NE Veneto region of ItalyRead more

    Advice for travellers: Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites

    Democratic Republic of Congo: Risk of Ebola spread increased

    The combination of local conflict, a mobile population, community resistance and distrust of government activities has caused the WHO to raise the level of alert for the Ebola virus disease outbreak in the NE provinces of North Kivu and Ituri. The WHO announced ‘the risk of national and regional spread is very high’ while advocating that ‘it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities’. Read the latest situation report issued by the dept. of health in the DRC.

    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.

    India: Dengue updates for northern states

    Previously unaffected areas of the northern hill state of Uttarakhand, in the central north, are currently reporting dengue fever cases and, elsewhere in the north, after dengue outbreaks were announced in some Punjab districts health officials have put the city of Ludhiana on alert. Residents have been reminded to take measures to avoid mosquito bites during the day. The death toll from dengue fever is now 11 in West Bengal’s capital of Kolkata but it’s the northern districts of the state that are faring the worst from a rise in dengue infections. 

    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.

    Madagascar: Plague claims more lives

    Five regions (HauteMatsiatra, Amoron’I Mania, Itasy, Vakinankaratra, and Analamanga) which are endemic for plague have recorded cases since mid-August – of the 25, 19 are suspected cases. A WHO situation report notes ‘Although bubonic cases are predominantly reported during the endemic season [September to April], pneumonic cases are also expected’. To date, just over half of cases – both confirmed and suspected – have been the pneumonic form. Read more

    Advice for travellers: Plague occurs annually in Madagascar, but poses a low risk to most travellers. Most cases of plague are due to bubonic plague following the bite of an infected flea carried by rats. If left untreated, infection of the lungs causes the pneumonic form of plague, a severe respiratory illness, which can progress rapidly to death. Read more on the plague

    Malaysia: Rabies risk locations upped to 41

    Seven new rabies risk locations have been announced in Sarawak taking the total to 41. Two in Miri are hundreds of kilometres from previously identified areas (including the site of the most recent human rabies case in Sri Aman), while the remaining five are in Sibu, Bintangor and Kapit. A committee set up to manage disasters has instructed dog owners to get their animals vaccinated against rabies and report potential exposures promptly. 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. Vaccination recommendations are itinerary-specific but include those travellers planning to live in, or travel extensively or repeatedly through, endemic countries. Read more on rabies

    Papua New Guinea: Polio situation update, 1 death

    The regional WHO representative has announced the death of one of the (now) 14 polio cases, a child from Enga, and the reporting of a further two cases of circulating vaccine-derived poliovirus in the provinces of Jikawa and Eastern Highlands. The Global Polio Eradication Initiative organisation notes that ‘detection and reporting of new cases at this point in the outbreak response is not unusual or unexpected, as surveillance is being strengthened, and reported and confirmed cases had onset of paralysis prior to the commencement of comprehensive outbreak response’. The advice remains: ‘all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel’. Read more

    Advice for travellers: Polio is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low, 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

    Philippines: Luzon’s dengue surge; Bicol and measles

    Dengue fever cases have increased by almost 90 percent this year in the province of Pangasinan, in central western Luzon. The death toll now sits at 25, from more than 6,200 cases and a ‘dengue watchlist’ has been put in place for seven towns and three cities, including the provincial capital Lingayen. Read more
    THE REGION of Bicol has experienced a surge in measles cases this year – more than three times 2017 figures for the same period. Of the six provinces in Bicol, those with highest case numbers are Masbate, Camarines Sur and Camarines Norte. Six deaths have resulted from measles complications. Read more

    South Africa: Rabies cases hit 10-year high

    Included in a statement issued on the eve of World Rabies Day, the National Institute for Communicable Diseases called for a response to the 10-year peak in human rabies cases - seven cases in KwaZulu-Natal, six in Eastern Cape and two more suspected but unconfirmed – none of whom had ‘sought medical intervention after being bitten by a dog or cat’. Both provinces had reported outbreaks of rabies in dogs.

    Tunisia: Leishmaniasis spreading in Kairouan

    Over 65 cases of leishmaniasis have occurred in the inland Governate of Kairouan during the annual peak season for the sand fly-borne infection. Southern districts have reported the infections – Cherrarda, Bouhajla and Nasrallah. 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.

    Vietnam: Viral illnesses strike children in southern provinces

    The incidence of hand, foot and mouth disease (HFMD) has climbed sharply this month, with more than 12,000 new cases taking the total for the year to 42,700 – almost half of those have required admission to hospital. It’s the southern provinces that have been hardest hit - at just one of Ho Chi Minh City’s children’s hospitals, new HFMD cases increased 5-fold and doctors have confirmed that many of those hospitalised have the potentially severe EV71 strain. Up to 90 children a day suffering from HFMD are being admitted to hospitals in the neighbouring province of Dong Nai. Read more. Measles is also spreading fast among children in provinces surrounding Ho Chi Minh City, including Dong Nai (also Binh Duong and Ba Ria-Vung Tau). 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.

    Zimbabwe: Cholera situation a ‘serious concern’

    In a statement on the current situation of cholera in Zimbabwe, the WHO admits that the extent of the outbreak is a ‘serious concern’. Local and international agencies are working to halt the spread of cholera through vaccination, the provision of safe water and repairs to supply infrastructure. Up to Sept 28 there had been 7,148 cases and 49 deaths – more than half of cases with confirmed ages were in the five to 35 years age group. 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