Health Alerts
  • Brazil: Vax rates in 3 states below 50%

    The populations of São Paulo, Rio de Janeiro and Bahia states are under notice from the Ministry of Health (MOH) - find their nearest health clinic and get a yellow fever vaccination promptly. The three states are well short of the 95 percent vaccination coverage needed to protect the population adequately – their rates are between 41 and 55 percent at this stage. From a MOH update: ‘From July 1, 2017 until April 10, the Ministry of Health registered 1,127 confirmed cases of yellow fever. In total, 5,052 cases were reported, of which 2,806 were already discarded and 1,119 were still under investigation…the yellow fever virus today circulates in metropolitan regions of the country with the largest population, reaching 35.6 million people living in areas that have never had a recommendation of vaccine.

    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

    Canada: Hep A risk from strawberries; BC norovirus spreads

    Products that contain frozen strawberries imported from Egypt have been withdrawn from sale amid concerns they might be contaminated with hepatitis A virus. Packs of the frozen fruit had already been recalled and more recently mixed juices/smoothies that included the suspect fruit have been added to the recall list. Read more. Across the border in the USA, over two million eggs have been recalled from sale after an outbreak of salmonella was linked to a producer that supplied eggs to retailers and restaurants in nine states. There have been 23 confirmed salmonella infections attributed to the eggs thus far. Read more. PUBLIC health authorities have acknowledged that British Columbia oysters contaminated with norovirus are still in the marketplace after the number of infections increased from 40 to 126 and two further provinces reported cases – Alberta and Ontario. While the source of the outbreak has been confirmed, the source of the contamination has not. More advice can be found on the Public Health Agency of Canada website.

    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 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Czech Republic: Local and regional measles

    There has been a spike in measles infections affecting mainly the capital Prague and, to a lesser extent, the Central region; however another six regions are also reporting cases. Read more (translation required). Also read an update on the outbreaks in France (new data), Greece, Ireland, Italy, Portugal and Romania as provided by the European Centre for Disease Control (ECDC) which notes ‘of particular concern is the situation in France and Italy, with cases almost tripling in France since the previous update in March, and more than doubling in Italy.’ Read more . There is also a separate report from Valencia, Spain

    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.

    Fiji: Outbreak news updated

    The Minister for Health and Medical Services announced updated figures in the meningococcal C outbreak: for the year to April 12, a total of 46 cases and four related deaths. Twenty-seven cases were from the Central Division, followed by 16 in the Western Division and one each in Eastern and Northern Divisions. The Ministry had noted a rise in meningococcal cases in the latter months of 2017. Read more.

    Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or close living quarters. More about meningococcal meningitis.

    India: Western state’s measles spate

    Actual numbers of measles infections are many times higher than official figures in the coastal towns of Kutch district in Gujarat state, according to some reports, after six outbreaks occurred in the first three months of the year. A large mobile workforce and low vaccination rates among the local population have attributed to an increase in the incidence of the highly infectious viral illness. Read more

    Kenya: Measles cases top 112

    More than 110 measles cases and one associated death have been reported in the north-eastern counties of Wajir and Mandera, bordering Somalia and Ethiopia. The region’s low vaccination rates have caused health authorities to reinforce the message on the importance of routine immunisations for children. Read more

    Niger: Meningitis belt update

    The number of meningococcal meningitis cases hasn’t been disclosed for three health districts in the regions of Maradi and Tahoua, but the epidemic threshold has been exceeded; a further four districts in Maradi, Tahoua and Est have reached epidemic levels. Read more (translate from French).  Across the meningitis belt region of Africa this season, the Democratic Republic of Congo, Nigeria and Burkina Faso have recorded the highest rates of meningococcal meningitis. Read more

    Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. Niger lies in North Africa’s ‘meningitis belt’, where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). If you plan to visit this region, call Travelvax Australia’s free travel health advisory service (1300 360 164 - toll-free for landlines) for further advice. Read more about Men. meningitis.

    Nigeria: Lassa numbers fall; Cholera in NE spikes again

    News on a positive note regarding the Lassa fever outbreak, with the latest NCDC Sitrep stating last week’s five new confirmed cases were ‘the lowest weekly case count since the first week of January 2018.’ The outbreak, which has struck 21 states, has killed one-quarter of those infected. The annual ‘season’ for Lassa fever extends until June. In Liberia, Lassa fever cases have been confirmed in four central counties (Nimba, Montserrado, Bong and Grand Bassa). Read more. THREE deaths have been recorded from over 700 cholera cases in the NE state of Borno, near Lake Chad. International aid agencies are in the region providing immunisations and other disease prevention initiatives. Read more

    Advice for travellers: Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings and it’s then passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. While Lassa fever is mild or has no observable symptoms in about 80% of people infected with the virus, the remaining 20% have a severe multisystem disease. Read more on Lassa fever.

    Philippines: Measles prompts CDC travel advisory

    The US Centers for Disease Control and Prevention (CDC) has issued a travel advisory for the Philippines in view of its large ongoing measles outbreak. The advice includes ensuring MMR vaccinations are up to date. In other regional measles news: A visiting Taiwanese national infected with measles has sparked at least 40 more cases in Okinawa, Japan, before travelling by bullet train to Nagoya, increasing the likelihood of a further outbreak. Read more

    Reunion Island: Dengue epidemic continues, leptospirosis cases climb

    With a further 396 locally-acquired dengue fever cases in the last week, the total for the year now sits at 1,388 - the majority of cases are from the western and southern areas of the island. The regional health agency expects current mosquito densities and weather conditions to intensify and prolong the outbreak. Read more (translate from French). There has also been a hike in the incidence of leptospirosis this year, with 65 cases compared with approx. 15 throughout all 2017. Most cases were admitted to hospital and one-third required high dependency care. 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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Russia: Flu season lingering

    While most countries in the current influenza transmission zones have declining flu numbers, Eastern Europe (in particular Russia & Latvia), Egypt and Kazakhstan continue to report infections. Read the latest World Health Organization (WHO) global influenza update.

    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, if available, for all travellers over 6 months.

    Saudi Arabia: MERS advice for pilgrims

    The ECDC has issued recommendations for pilgrims travelling to Mecca for the Umrah, including advice relating to the MERS Co-V outbreak: ‘avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas. Most commonly, coronaviruses are transmitted by respiratory droplets when an infected person coughs or sneezes… Pilgrims may be at increased risk of infection in crowded baths, packed transportation and confined accommodation.’ From the most recent update from EMRO (March), Saudi Arabia had reported 1814 MERS cases, including 708 related deaths.

    Zimbabwe: Cholera SE of Harare

    Cholera has broken out in the settlement town of Stoneridge, about 15km SE of the centre of Harare. The Health and Child Care Secretary announced eight cases and two deaths over the past fortnight and added that numbers may be under-reported. Clean water supply and sanitation infrastructure are poor in the affected area and there is a marked risk of more water-borne diseases. A previous cholera outbreak in Chegutu, Mashonland West, was resolved in late March. 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: Campaigns to target polio

    Earlier this week, Afghanistan and Pakistan initiated polio vaccination campaigns aimed at interrupting wild poliovirus transmission. This year, there have been eight cases from the two countries – only one of those in Pakistan (Balochistan province). 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. 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 poliomyelitis

    Angola: Malaria’s tragic toll

    The four provinces of Luanda, Benguela, Uige and Bié have recorded over 400,000 of the nation’s year-to-date 720,000 malaria cases. Measures are being employed tackle the huge burden of the disease, which is responsible for the most deaths, hospitalisations and absenteeism in the country. Read more (translate from Portuguese).

    Advice for travellers: For most travellers, Africa presents a significant malaria risk. Travellers can discuss their itinerary and the need for anti-malaria medication with a trained travel health professional at their nearest Travelvax clinic. For details call 1300 360 164. Read more about malaria.

    Brazil: YF arrives on coast; Measles for Amazon, northern state

    News from São Paulo this week that two monkeys died of yellow fever (YF) infection in areas of the state’s north coast: One in Ubatuba (300kms to the west of the city of Rio de Janeiro) where a human death is also being investigated for possible YF causes. As under half of Ubatuba’s population has been immunised against YF, a reactive vaccination campaign is under way. Read more. MANY of the growing number of suspected measles cases reported in the states of Amazonas and Roraima (bordering Venezuela) have links to the ongoing outbreak in Venezuela (also producing cases in Colombia and Ecuador). 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

    Canada: Tainted oysters in BC

    Two oyster farms on the east coast of Vancouver Island are closed while investigations continue into an outbreak of norovirus that has sickened at least 40 people. It is believed that human waste contaminated the waters near the farms. Read more

    Advice for travellers: While it is extremely contagious, norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands after using the toilet and before eating, and practice good hygiene. Read more on norovirus.

    China: HFMD cases surging

    Public health officials have warned of rising rates of hand, foot and mouth disease (HFMD). In excess of 28,000 cases were recorded in March which was double the previous month’s total, signalling the start of the infection’s peak season that generally runs from April to July. Each year China reports over two million cases of HFMD. 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 in Australia, but good hand hygiene will greatly reduce the risk of infection.

    Fiji: Men. meningitis response

    In a media release, the Ministry of Health and Medical Services advised that adverse weather conditions had delayed the administration of meningococcal vaccinations planned for students at a Tailevu high school until April 5th. As six (of the country’s 38 cases) were at the school, regular medical checks of the students were also carried out and antibiotics administered as a preventive measure. All 38 cases were under 19 years of age. Read more

    Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. More about meningococcal meningitis

    France: Local & regional measles persists

    Another 192 measles cases were recorded in the week from Mar 28 to April 3 taking the total since early November to 1,605, with Nouvelle-Aquitaine still in epidemic mode. According to a French Public Health bulletin, infants under 12 months of age are most affected and more than 20 percent of all cases have required hospitalisation. Read more. While in England there have been almost 700 measles cases this year - currently there are alerts in Birmingham, Kent & Medway; in Ireland the outbreak is now in its fourth month, with many of those infected aged between 15 and 50 years.

    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.

    India: Tick-borne disease in 2 states; Ice tests reveal bacterial load

    The districts of Sattari in the NE of Goa state and Sindhudurg in Maharashtra are the focus of two outbreaks of Kyasanur Forest Disease (KFD). Approx. 50 cases have been identified this year in Sattari, and this is the third consecutive year of cases in Sindhuburg, with 60 reported. As many as 500 cases of KFD occur each year nationally, with a case fatality rate of 3%-5%. Mainly seen in the dry season, the tick-borne viral disease occurs in humans and monkeys. YOU may have heard it before, but the advice is to avoid ice in drinks unless you know it is made from purified water. From a local news source: recent testing of ice sold at various food outlets in Mumbai found 98 percent of the 410 samples were contaminated with E Coli, a common cause of gastrointestinal illness. Health authorities have tried to crack down on the sale of the impure ice, but the numbers of facilities producing ice in the hotter months surges.

    Iran: Hep A in SW

    Drought conditions have led to an increase in the number of hepatitis A cases and heightened the risk of cholera in the SW province of Khuzestan, including its capital Ahvaz. 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 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Liberia: Regional alert for south

    Four cases of Monkeypox have been confirmed in the south-central county of Rivercess and an additional two are under investigation. As a precaution, the Chief Medical Officer has issued an alert for the region. 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

    Mexico: Peninsula reports rise in chickenpox

    The Yucatan Peninsula has recorded a rise in the number of cases of chickenpox, with nearly 1,500 to March 25 - 46 percent more compared with the same period last year. Read more

    Advice for travellers: Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.

    New Caledonia: Two dengue virus types circulating

    The case count in the current dengue fever epidemic (to Apr 6) is now 589. Dengue serotype 2, which is also behind other outbreaks in the region (Vanuatu, Fiji, American Samoa, Samoa and Tonga) is dominant, however DENV 1 is also circulating. Yaté, Nouméa and Dumbéa have the highest infection rates. Read more (translate from French).

    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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    New Zealand: South Island measles scare

    Contact with a person infected with measles at Queenstown airport has generated five more cases in Queenstown, Christchurch, Wanaka and Nelson – at least four of whom were unvaccinated. Some of those infected had gone on to visit other areas of the South Island and taken domestic flights, sparking fears of a widening outbreak. Read more

    Nigeria: Lassa fever update; Cholera surges in 9 states

    Since mid-February there has been a gradual decline in the numbers of new Lassa fever cases – a further eight were recorded last week from the states of Edo, Ondo, Bauchi, Plateau and Abia (42 percent of the 1,706 suspected cases were from Edo). According to a Nigeria Centre for Disease Control (NCDC) Sitrep, ‘From 1st January to 8 th April 2018, a total of 1781 suspected cases have been reported from 20 states.’ And ‘Since the onset … there have been 101 deaths in confirmed cases, 9 in probable cases.‘ The World Health Organization (WHO) expressed concern that ‘the peak transmission period is not yet over’ and issues including ‘poor sanitation conditions in high burden communities and multiple outbreak activities in some States are limiting commitment to the Lassa fever outbreak response.’ Read more. A RISE in cholera cases this year also has the NCDC concerned: Nine states have reported a total of 2,000 cholera cases and 37 related deaths. Bauchi, Borno, Ebonyi, Kano, Yobe and Zamfara are most affected. Read more

    Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for most travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

    Papua New Guinea: Fears for post-quake disease risk

    International aid agencies consider the risk of water- and vaccine-preventable diseases will be high in those areas of the highlands affected in the recent earthquake. Immunisation rates are very low and the condition of the children and their surroundings is poor. Read more

    Peru: Dengue climbs in Piura

    The year’s dengue burden is considerably lower than last year’s in the NE district of Piura. Six municipalities, including the district capital Piura, have recorded highest rates to date. Read more

    Philippines: Luzon dengue rates grow

    While dengue fever cases have risen by over 180 percent this year in the province of Pangasinan in western Luzon, highest infection rates have been in Calabarzon, followed by Metro Manila. Read more

    Reunion Island: Dengue advice for tourists

    Advice given to arriving travellers on the current dengue fever epidemic includes the need to avoid mosquito bites and to monitor themselves for symptoms of dengue during the stay on the island and for one week after leaving. To April 10, the bulk of the 955 confirmed cases have been in western and southern districts; however isolated infections have also been found in the north. Read more (translate from French).

    Saudi Arabia: Scabies hit schoolkids

    Over 2,760 infections have so far resulted from a scabies outbreak that began in late March. Mainly affecting school students in Makkah there have also been cases in Jazan and areas as far away as Riyadh, Hail and in neighbouring Kuwait. Read more. More on scabies

    Serbia: Measles death toll rises

    A two-year-old girl from Kragujevca is the latest fatality in the measles outbreak that started in October last year, taking the death toll to 13 from 4,507 cases - the majority were not vaccinated. Read more (translate from German).

    Thailand: New Year dengue risk

    This weekend is the Thai New Year festival, or Songkran, and health authorities are warning of a possible flare-up in dengue fever cases due to recent rains. Bureau of Epidemiology data reveal 3,878 cases reported from 74 provinces to Apr 9. Southern and central provinces have been most affected – highest rates were in Phuket, Samutsakorn, Pangnga and Nakornsrithamarat. Read more

    United States of America: Mumps, measles reports persist

    Mumps cases continue in Hawaii – up to Apr 5 the total had reached 949. The State Department of Health reports that ‘Nearly 60% of cases have been in adults aged 18 years and older. There have been 29 reports of complications due to mumps infection (e.g., orchitis, hearing loss).’ FIVE measles cases in the Bay area of San Francisco (Santa Clara and Alameda Counties) have been linked to an infected traveller returning from Europe; one further contact of the initial case also became infected and had travelled on to Nevada. The San Francisco Department of Public Health advisory stated that none of those infected were vaccinated.

    Advice for travellers: These consequences of mumps outbreaks 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.

    Zambia: Cholera situation deteriorates again

    Following significant improvements in the rates of cholera after early-year vaccinations, existing poor water infrastructure and large population movements have led to a re-emergence of the bacterial infection centred primarily in the Kanyama district of the capital Lusaka. Current bad weather conditions are expected to worsen the situation. Read more. Zambia is just one of the countries highlighted in a cholera report from across the Eastern and Southern African region.

  • Australia: Measles imports from Asian hotspots

    Four West Australian residents have returned from holidays in SE Asia infected with measles in the past month. All cases are unconnected and had recorded travel to either Bali, Thailand or Malaysia. Read more. NSW Health also recorded four measles cases in March following travel that included Pakistan, India and The Philippines. As two of those reported were infants, the department’s Director of Communicable Diseases proffered the advice: ‘“Families taking young infants to Asia are also urged to discuss vaccination with their GP before they travel, as the measles vaccine can be given earlier than the first birthday if they are likely to be exposed to measles while travelling.”

    Advice for travellers: Measles is a highly contagious virus and can cause serious illness in people of all ages. Most cases reported in Australia are linked to overseas travel - both developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure.

    Brazil: YF vaccine for entire country

    From a Mar 28 Ministry of Health news update, ‘yellow fever virus now circulates in metropolitan regions of the country with the largest population, reaching 35.8 million people who live in areas that have never had a recommendation of vaccine. In the past seasonality, for example, the outbreak reached a population of 9.8 million people.’ In response and as a preventive measure, the government has plans to vaccinate the entire population against yellow fever by April next year.

    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

    Fiji: Men. meningitis outbreak; Floods post-cyclone

    On April 2, the Ministry of Health & Medical Services updated information on the ongoing meningococcal meningitis C outbreak: 38 confirmed and suspected cases for the year to Mar 29, averaging 2 cases per week for the past month. Six cases were in a school situated in the north of Tailevu province (east coast of Viti Levu); antibiotics have been administered to students and they will be given serotypes ACWY vaccines today. Read more. Kiribati has been screening international air passenger arrivals from Fiji as a precaution due to the meningococcal outbreak. Read more. EXTENSIVE flooding has resulted from the recent cyclone and towns and roads have been flooded across many areas, with Ba on Viti Levu particularly hard hit. Read more

    Guinea: Alert for inland districts

    Eight inland prefectures have been put on alert for outbreaks of meningococcal meningitis as the number of cases recorded this year reached 95. Sentinel sites have been established in the 17 prefectures that are located within the African ‘meningitis belt’. Read more (translate from French).

    Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. Guinea lies in North Africa’s ‘meningitis belt’, where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). If you plan to visit this region, call Travelvax Australia’s free travel health advisory service (1300 360 164 - toll-free for landlines) for further advice. Read more about Men. meningitis.

    India: Water-borne illnesses surge in Guntur

    Leaking water pipelines are believed to be the cause of a sudden spike in cases of hepatitis A and diarrhoeal disease in Guntur, in the SE state of Andhra Pradesh. To date there have been at least 17 deaths and over 200 people have sought medical assistance for symptoms. 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 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Kenya: Vaccine scam in capital

    Several Nairobi city health officials have been arrested after they were found to have substituted water for the yellow fever vaccine given as a requirement to travellers heading overseas, including the international certificate of vaccination; the fake vaccines were offered at a discounted, cash price. Read more

    Malaysia: Dengue tops 15,000

    In the year to April 4, the nation’s dengue fever case count neared 15,200 infections. While all provinces are reporting cases, highest numbers are in Selangor, W P Kuala Lumpur, Penang, Johor and Sabah. 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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Mozambique: Cholera set to worsen

    An uncontrolled cholera outbreak in the province of Cabo Delgado could deteriorate further with rains due soon. Drinking water shortages in the province and in the capital, Maputo, may further ‘exacerbate poor hygiene and sanitation practices,’ according to the World Health Organization (WHO). 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

    Micronesia: Mumps in 2 states

    Following last week’s report on an increase in mumps cases in the island state of Chuuk, ReliefWeb this week has posted news of cases on Yap; the outbreak also continues in Vanuatu.

    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.

    Myanmar: ‘Snail fever’ in west coast town

    Testing carried out after a number of residents reported symptoms of schistosomiasis in the coastal town of Sittwe (Rakhine state) has confirmed the presence of the parasitic infection. ProMED surmises that ‘rather than the emergence of a new infection … it might have existed in the area but had never been tested before’. (Archive 20180329.5717098) 

    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).

    Nigeria: Cholera in 2 states; Lassa fever update

    Dual cholera outbreaks have struck Bauchi state and its north-east neighbour, Yobe. The outbreak in Bauchi is the largest – almost 560 people have been sickened, many are under the care of Médecins Sans Frontières. LASSA fever cases continue to be reported: six more in the week to Apr 1 from five states, taking the total of suspected cases to 1,706 for the year. The Nigeria Centre for Disease Control update notes that: ‘81% of all confirmed cases are from Edo (42%) Ondo (23%) and Ebonyi (16%) states’.

    Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

    Philippines: Vaccine scarcity strikes; Measles cases, deaths climb

    Compelling advice to dog owners on the need to vaccinate their animals against rabies as the country copes with a shortage of rabies vaccine for humans, used to prevent the fatal infection as both pre- and post-exposure measures. Read more. THE incidence of measles has risen this year with nearly 600 cases recorded till mid-March and 12 resulting deaths (from Davao Region, Soccsksargen, Central Luzon, and the National Capital Region (NCR)). Read more

    Advice for travellers: Despite successful efforts to control rabies through canine immunisation in several provinces of the Philippines, rabies remains a major problem in many regions. However, 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 is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.

    Portugal: Measles count now 82

    A measles outbreak continues in the northern city of Oporto. Healthcare workers at a local hospital make up over three-quarters of the number of infected individuals, however more cases have been identified at other hospitals in Gaia, São João, Matosinhos and Braga. Up to Mar 30, 82 cases have been confirmed and a further 20 are under investigation. One of the initial cases had travelled from France, the epicentre of a large outbreak. Read more. More on the outbreak in Greece here.

    Reunion Island: Dengue numbers rise

    The dengue fever outbreak underway in the island’s western and southern districts could spread to the north after two cases were identified in Sainte-Clotilde, a neighbourhood of the capital, Saint-Denis. There have now been 755 dengue infections for the year; 167 more in the last week. Read more (translate from French).

    Russia: Flu season lingers

    The WHO influenza update of Apr 2 notes that or most of Europe flu activity has declined, however Eastern Europe has rising rates of predominantly influenza A. The Russian Federation is most affected, showing high rates ‘with all seasonal influenza subtypes co-circulating’.

    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 flu vaccination for all travellers over 6 months of age.

    South Korea: New meaning for ‘spiked’ drink

    As fads go, this one definitely lacks medical endorsement: mixing Soju, the nation’s favourite distilled alcoholic beverage, with wasps. Supposedly of benefit for diabetes and hypertension, the Ministry of Food and Drug Safety cites the risk of allergic reactions and choking for cracking down on the retail and online sales of the drink. Read more

    Sri Lanka: Dengue toll now 15

    The districts of Colombo and Gampaha on the west coast and Batticaloa in the east have reported the highest number of dengue fever cases this year – between them they have had over one-third of the nation’s 14,000 cases (to Mar 28). Fifteen deaths have resulted. Read more

    Taiwan: Outdoor pursuits carry risks; Measles flies in

    At a time when the population is outdoors enjoying the Spring weather and participating in the rituals of Qingming Festival when ancestors are honoured and tombs are swept, the Centers for Disease Control (CDC) has warned of the risk of chigger bites and scrub typhus. Ahead of the June/July peak season, there have already been 67 scrub typhus cases, including 20 in Taitung County and 15 in the county of Hualien. Read moreTWO flight attendants with the airline Tigerair Taiwan have been diagnosed with measles after coming into contact with a passenger who became infected while in Thailand. Contact tracing is under way for all 852 passengers on the flights worked by one of the attendants – mainly between Taiwan and Japan or Macau. Read more

    Advice for travellers: Scrub typhus is a bacterial disease passed on to humans by mites, or chiggers, that normally live on rats infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus is endemic throughout the Asia-Pacific region and more than a million cases occur annually. There is no vaccine or prevention medication: the best way to avoid scrub typhus is to avoid being bitten by mites. Protective measures include the use of an effective personal insect repellent, wearing protective long clothing, and a thorough end-of-day self-examination after visits to rural areas. Due to the disease’s 5- to 14-day incubation period, travellers may only experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Treatment involves taking antibiotics and should begin as quickly as possible. Always see a doctor as soon as possible if you develop a fever after the trip and remember to discuss any recent overseas travel. Read more about rickettsial diseases.

    Uganda: Cholera persists in west; Measles infects northern kids

    The cholera outbreak that had first struck Congolese refugees in the western district of Hoima continues unabated and has now spread to the local population – 500 more cases have occurred in the past fortnight and the death toll has reached 40. Read more. IN the northern district of Amuru, over 40 children aged under 14 years have been diagnosed with measles infections. Vaccination rates in the area are low. Read more

    United Kingdom: Highly resistant STI ex-SE Asia

    Public Health England (PHE) has issued warnings on the importance of safe sex practices after a resident returned from South-East Asia infected with a highly resistant form of gonorrhoea. The man had reported having sexual contact with a woman while overseas. The infection was resistant to the 2 first-line antibiotics (& others); further tests are due in the middle of this month to determine the efficacy of his current treatment. The common sense advice from PHE: ‘It is better to avoid getting or passing on gonorrhoea in the first place and everyone can significantly reduce their risk by using condoms consistently and correctly with all new and casual partners.’ Read more

    Advice for travellers: Read more about sexually transmitted infections here. Fit for Travel, NHS (Scotland).