Health Alerts
Brazil: More Bahia towns on YF list; Chikungunya cases rise; Rio’s malaria risk; STI strikes central highlands

The US Centers for Disease Control & Prevention (CDC) updated its yellow fever (YF) travel alert on Apr 13th to include those areas most recently categorised as potential YF risk sites. ‘Yellow fever vaccination is now recommended in all of Espiríto Santo and Rio de Janeiro states; São Paulo state, with the exception of the urban area of the city of São Paulo; and a number of municipalities in the state of Bahia.’ A list of those affected towns in Bahia state is provided.  
NEW chikungunya data provided to the Pan American Health Organization (PAHO) for the 2 weeks up to the end of March made up 90 percent of the reported cases for the region. Over 16,750 cases were recorded in Brazil, with Peru (78 cases) and Paraguay second and third (67). Read more
AT least 5 men (age range 16 to 54 years) have been diagnosed with malaria in Petrópolis, a city in the forested Serra dos Órgãos approx. 70kms from Rio de Janeiro. It is a popular winter tourist destination. According to the CDC, cases of malaria in this region are rare, but mosquito bite avoidance measures are always recommended. Read more.  
MEN aged 20 to 29 are among the worst hit in an epidemic of syphilis underway in the Federal District. A Portuguese-language report names the cities of Taguatinga, Paranoá and Planaltina as being most affected. Almost 1,300 cases of the sexually transmitted infection were reported there last 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

China: Bird flu on mainland, Tibet

A further 14 cases of H7N9 avian influenza were reported in the week of April 9-15, but there are hopes that the change in season, together with measures such as the banning of the sale of live poultry, will bring a drop in the viral disease’s incidence.Read Afludiary report. In a recent update on human cases recorded in Beijing, authorities have advised that there have been 10 cases during the current wave – made up of 4 locals and 6 others who are believed to be itinerant poultry traders from Hebei province. Read more.  And in Tibet, 2 men who also sell poultry at the Lhasa  market where the country’s first case worked have been diagnosed with H7N9 infection. Read more

Europe: Regional measles threat continues

The ongoing measles outbreaks was the topic of a WHO press release at the end of March, with concerns that 14 countries in the region remained endemic for the viral illness. This week the US CDC issued travel alerts connected to the outbreaks for Belgium, Italy and Germany. In related news from Portugal, a 17-year-old girl has died in Lisbon from complications of measles infection. She was one of 23 confirmed and suspected cases recorded in the country this year. 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.

Guadeloupe: Alarm over chickenpox spike

Chickenpox is spreading in the island group, with a sharp increase noted last week (approx.130 cases). According to the French language news report, Saint Martin has also seen a rise in incidence, even referring to it as an epidemic. Read more

Nepal: Chickenpox erupts in central region

In the south of the Central Development Region, scores of people in Rautahat district have been infected with chickenpox. All age groups have been affected. 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: Dengue toll hits 7

A news report has announced the 7th death due to dengue fever this season. The woman was a resident of Païta, a town approx. half way between Noumea and the airport at La Tontouta. Government figures on the outbreak have not been updated since Apr 12th when the total case count since Sept 1, 2016 was 2,556. Read more (translate from French). New infections are expected to dip in the early days following the recent activity of Cyclone Cook, but may rise again with standing water offering suitable mosquito breeding grounds. Read more.

Advice for travellers: 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 an effective repellent containing DEET, Picaridin, or PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

New Zealand: Auckland’s typhoid waning, mumps persists

While signs are that the typhoid outbreak is slowing, authorities will continue checking contacts of those infected within the affected Mt Roskill church’s wider community. To date there have been 22 cases, with one other likely. Read more.
MUMPS cases in West Auckland have increased from the 39 reported on Apr 3rd to 55, according to the latest update. School and university students of all ages have been hardest hit in the outbreak.

Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary specific, but is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

Nigeria: Plans to halt Men. meningitis epidemic

An April 17th update issued by the Nigeria Centre for Disease Control (NCDC) on the 6 states with Men. meningitis epidemics included the following details. ‘8,057 suspected cases have been reported; 230 (3%) are laboratory confirmed. A total of 745 deaths (9.2%) have been recorded. During the last four weeks, a total of 38 Local Government Areas (LGAs) across six states— Zamfara, Sokoto, Katsina, Kebbi, Niger, and Yobe—reached alert/epidemic threshold status. LGAs reaching the alert threshold trigger intensified epidemic preparedness; a full outbreak response is activated in LGAs reaching the epidemic threshold.’ NCDC Update (Week 17). International agencies, including the WHO, are currently sending vaccines for use in the planned extensive campaign. 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. Nigeria 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.

Qatar: MERS count increases again

With the MERS case reported last month still recuperating, a 25-year old man has been admitted to hospital for treatment of the coronavirus infection. He had no contact with camels and had not travelled outside the country. Read more. ProMED provides details of recent cases that continue to be reported in Saudi Arabia

Tonga: Measures to contain typhoid

The government has responded to an outbreak of typhoid by banning food production for public events and the serving of kava in town halls. Up to 11 cases have been identified, with 5 of those from the village of Veitongo, about 8kms from the centre of Nuku’alofa. Read more.

United States of America: Lone Star state mumps climbing

Texas has seen a surge in mumps cases, with health authorities advising that numbers have reached a 23-year peak. Reports have come from across the state – 221 in total for the year. Read more.

Advice for travellers: The outbreaks of mumps across many areas of North America 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.

Vanuatu: Dengue alert continues

The dengue fever outbreak that started back in November last year has produced at least 2,358 cases – testing was not carried out on the majority of cases so only 446 infections were actually confirmed as dengue. While cases are on the decline, with the recent cyclone activity in the area, as with New Caledonia, there is likely to be an abundance of mosquito breeding sites in the wake of flooding. Read more.

Vietnam: Diseases spike in north

According to the Hanoi Preventive Medicine Centre, there has been a rise in the incidence of measles, rubella and whooping cough in the first 3 months of the year; however it is the sharp increase in dengue fever cases that is worrying. Cases underwent a 44 percent growth over the same time 2016, the cooler, dry season of the country’s north. 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.