Health Alerts
Australia: Flu update; QLD’s mozzie burden

The Health Dept's most recent Influenza Surveillance Report notes that the components of this year’s flu vaccine look to be a good match with the current circulating strains. Low or sporadic influenza activity is being seen in some rural parts of WA, the NT and Far North Qld while the remainder of the country is following seasonal norms. The latest WHO influenza update reports that temperate regions of southern Africa and South America are showing increased influenza activity. 
A total of 1,830 mosquito-borne infections have been reported in Qld so far this year. The numbers include Ross River and Barmah Forest Virus cases from Cairns, Townsville and the Darling Downs.

Advice for travellers: The 2017 flu season is underway in the southern hemisphere and Travelvax Australia recommends vaccination for all travellers over 6 months. Seasonal flu is the most common vaccine-preventable travel-related illness, posing a risk aboard aircraft, in crowded airport terminals, and at your destination. Travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol wipes are a convenient alternative if soap and water is not available.

Bolivia: YF case for Cochabamba

A fifth case of yellow fever for the year has been identified in the central city of Cochabamba, approx. half way between La Paz and Santa Cruz de la Sierra. In response, surveillance has been stepped up in the area and vaccinations will be offered to at-risk individuals. Read more (translate from Spanish).

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. 

Brazil: Chikungunya strikes in Ceará

The state of Ceará in Brazil’s NE is experiencing a spike in chikungunya cases, with up to 60,000 recorded to date from most regions. Since the mosquito-borne viral illness arrived in the Caribbean in 2013, it has caused nearly 2.5 million infections. Read more.

Advice for travellers: Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

China: JE from donated blood

Hong Kong’s Centre for Health Protection last week confirmed a case of Japanese encephalitis infection contracted through the transfusion of donated blood. The patient, a 52yo man, is still undergoing treatment in hospital. Investigations of this first recorded local case, revealed the blood was donated by an asymptomatic man who lived in Tin Shui Wai in the New Territories. Read more. .

Advice for travellers: A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it can occur in or near cities. The risk to short-stay travellers and those who confine their travel to urban centres is very low. The recommendations for vaccination are itinerary-specific. Read more on JE

India: JE, dengue, chikungunya round-up

As the Japanese encephalitis (JE) season moves towards its peak, reports of JE infections and resulting deaths are emerging from both Uttar Pradesh and Assam, two of the states that record high annual JE rates Read more. As the monsoon season moves along, dengue and chikungunya infections are reported to be on the rise in Gujarat, Delhi, Karnataka and Kerala

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.

Kenya: Cholera lingers

International aid is being sought as the government attempts to stem a cholera outbreak that some doctors say has been ongoing since December last year. Areas affected include Lamu, Mombasa, Nairobi, and Kisumu. Hospitals are struggling to cope as staff numbers are already reduced due to a nurses’ strike which has been underway for more than 50 days. 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

Malaysia: Rabies alert spreads

Twenty-two areas of Sarawak have been declared rabies-affected, an increase of 2 from last week, as health authorities announced the death of the fifth victim on Sunday. Rabies awareness campaigns, dog bite clinics and vaccination drives are just some of the initiatives the local government has instituted in response to the outbreak. 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 through, rural areas. Read more on rabies. 

Nigeria: Hep E persists in Borno

In the NE state of Borno, hepatitis E continues to ravage communities, taking its toll on pregnant women in particular. Recent increases have been observed in Ngala and Damasak, but the state health ministry is reporting as many as 562 cases (both suspected and confirmed). Read more.

Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. The virus is found worldwide, mainly in communities with low levels of sanitation and hygiene. There is no vaccine. More than 60% of all hepatitis E infections and 65% of deaths occur in East and South Asia, with up 1-in-4 people in some age groups having been exposed to the virus. Women in their 2nd or 3rd trimester of pregnancy are particularly susceptible to severe complications. Read more about the virus and how to prevent it.

Pakistan: Measles toll tops 10

A measles outbreak in the SE port city of Chittagong has sickened over 100 children and killed 10. Many children remain in hospital for management of complications. Read more.

Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure.

Philippines: Dengue strikes island group

Half a million children in towns and cities in Central Visayas are eligible for vaccination against dengue fever. Currently young children are bearing the brunt of dengue infections in the province, making up most of the 72 deaths recorded this year (from 7,095 cases). The only available vaccine, which is licenced for the ages of 9 to 45, is recommended for residents of dengue endemic countries. Read more

Sri Lanka: Triple dengue effect

The dengue epidemic continues to rage and is concentrated on the western region. International headlines have been made as the death toll nears 300 from over 107,000 cases. A Red Cross official has called the situation ‘unusual’, adding that there is ‘always a peak [in dengue fever cases] during rainy seasons, but this one is three times higher.’ Read more

United States of America: Texas Zika case; Hawaii mumps tops 172

The US’ first Zika virus case this year – in Hidalgo County, Texas - was announced this week. A news release from the local health department said there was no risk the person could still transmit the infection as it ‘was probably transmitted by a mosquito bite in South Texas sometime in the last few months with having probably occurred weeks ago.’ Hidalgo County lies in the south of the state, bordering Mexico. 
HAWAII’S mumps case numbers haven’t been updated since July 20th when the health department put the figure at 172 cases - over 40 percent of those aged 18 and older. 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).

Vietnam: Dengue, north to south

An undersupply of treatment drugs and staff is hampering the government’s ability to tackle the dengue fever outbreak that has produced 58,000 infections and 15 deaths. The deputy head of the Health Ministry believes a ‘massive health crisis’ is looming. Areas badly affected include the 2 largest cities, Hanoi and Ho Chi Minh City, and Danang, Binh Duong, An Giang, Dong Nai, Dong Thap, Soc Trang, Khanh Hoa and Tien Giang. Read more.