Health Alerts
Australia: Hep A increase in NSW; Flu lingers; NW chickenpox spike

A sharp increase in hepatitis A infections has been reported in the Sydney region, 12 in the past 5 weeks. There is some urgency to determine a local source of the infections as 10 of the people infected had not travelled overseas within the incubation period. Most cases notified in NSW are related to travel to endemic countries. Three of the patients required admission to hospital. Read more
THE record flu season continues here, while the peak appears to have passed in other temperate regions of the Southern Hemisphere according to the World Health Organization (WHO) global flu update. Activity has decreased in South Africa, South America and New Zealand, however cases continue to rise in New Caledonia. Read the full report with details of increased flu detections in tropical regions of Asia. 
LOCAL health authorities in West Australia’s Pilbara region have warned parents to be on the alert for symptoms of chickenpox following an outbreak affecting schools in Hedland and Karratha. Read more.

Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with the faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and with 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.

Brazil: YF outbreak over; Sand fly infection strikes north

After a total of 777 yellow fever infections and 261 related deaths, this week the Health Ministry confirmed the end of the 9 month outbreak. Over 36 million yellow fever vaccines have been distributed in the affected states ‘both for routine vaccination and for boosters’, while next year the vaccine will be provided to children from 9 months of age in their routine schedule. Read more (translate from Portuguese) 
FIFTY suspected cases of kala-azar (or visceral leishmaniasis) have been recorded this year in the town of Tocantinópolis, near the NE state borders of Tocantins and Maranhão. Dogs and humans are among the reservoirs of the parasite which is transmitted by over 90 species of sand flies. Read more (translate from Portuguese).

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

Cape Verde: Travel warning issued

The unprecedented malaria outbreak affecting the capital Praia is behind a travel advisory issued by the Portuguese government. The health department has recommended that pregnant women in particular delay their travel to Praia and for other travellers to ensure they use repellent and take malaria chemoprophylaxis. Read more.  More on malaria

India: Diphtheria in Karnataka’s east; Monsoon-related diseases surge

Testing is underway on 33 people suspected of having diphtheria, with 11 confirmed infections to date in the district of Raichur in NE Karnataka state. Contacts of the patients are being given prophylactic antibiotics and vaccinations are to be offered in the local community. Read more
A common health threat during the monsoons, dengue fever is on the rise: reports from Delhi, Kolkata, Lucknow, Hyderabad and Chandigarh, while in Mumbai authorities have issued alerts due to the heightened risk of water-borne infections such as diarrhoea, hepatitis and leptospirosis.  The regional flooding has already caused disease outbreaks in Bangladesh, Nepal and the adjacent Indian state of Bihar, with reports of dengue, malaria and diarrhoeal illnesses on the rise. Read more.

Advice for travellers: Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.

Italy: Malaria mystery in north

Doctors in the northern region of Trentino are urgently investigating the death of a 4yo girl following confirmation the cause was cerebral malaria. She had not travelled out of the country but had been admitted (for unrelated issues) to a hospital where 2 other children were being treated for malaria contracted in Africa (Burkina Faso). As Italy is free of the malaria vector, Anopheles mosquitoes, there is one reasoning that some insects may have been transported to the local area with air passenger arrivals from Africa. Read more.

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.

Japan: Mumps complications outlined

A study conducted into the rate of mumps complications has shown that for the last 2 years a total of 261 individuals – 154 of them aged between 5 & 10 years – have suffered severe hearing loss as a consequence of the viral infection. Routine vaccinations to protect against mumps were ceased in Japan in the early 1990s and now, with the release of this study, specialist ENT doctors are calling for its reintroduction into the childhood immunisation schedule. Read more.

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.

Myanmar: JE vax to be routine

News this week that over 14 million children will be vaccinated against Japanese encephalitis (JE), starting in December. This year there have been over 200 JE cases across the country. According to the WHO factsheet, the JE virus ‘is the most important cause of viral encephalitis in Asia’ and it primarily affects children. 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

New Zealand: Mumps in Auckland, Dunedin

Young adults of Pacific Island origin make up almost two-thirds of the 300 mumps cases recorded in Auckland this year, with a further spread to Dunedin in the South Island also reported. The spike in cases in Auckland means that this year cases have exceeded the sum total of the previous 16 years. Many of those infected were unvaccinated and the wider community is being urged to ensure they have received 2 doses of the MMR vaccine (provided free by the government). Read more.

Pakistan: Fourth polio case

A total of four polio cases have now been recorded across the nation this year, with news this week of the first in 20 months for its most populous city, Karachi. The latest casualty, a young child of Afghan refugees, had an incomplete polio vaccination course after his parents refused more vaccine doses. 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 advised for travel to affected regions, while some countries have temporary vaccination recommendations as outlined by the WHO. If at risk, adults should have a booster to the childhood series. More on poliomyelitis.

Philippines: JE in Luzon 'rice granary'

Central Luzon has reported the nation’s highest figures for Japanese encephalitis (JE) infections this year, followed by Pangasinan and Laguna. While there have been 133 JE cases nationwide, over 50 were from Central Luzon, the main rice-growing region which is located north of Metro Manila. The death toll from JE this year is currently at 9. Calls have been made for the vaccine to be provided in the expanded immunisation program however, currently, all efforts are being made towards removing mosquito breeding grounds. Read more.

Sierra Leone: Cholera vaccination drive

Major flooding and the ensuing landslides near the capital of Freetown have caused hundreds of deaths and put the lives of countless others in danger as contaminated water supplies bring the risk of cholera. Local and international health agencies are planning cholera vaccinations for later this month in the 25 affected regions. 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

South Africa: East Rand hit with measles

Over 20 measles cases have been recorded in the last 8 weeks in Johannesburg’s east (Benoni in East Rand), prompting health authorities to urge parents to ensure their children are fully vaccinated – 17 infections were diagnosed in the last month alone. This follows another measles outbreak earlier this year, also in Gauteng province. 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.

Sudan: SW cholera trials

Central and southern regions of Darfur in the country’s west are suffering outbreaks of cholera, or ‘watery diarrhoea’ as the government is naming it. Wet weather has hit areas where camps for displaced people are located, further exacerbating the situation. There are fears in the South Darfur capital of Nyala that the outbreak there is spiralling out of control. Read more.

United States of America: Hawaii mumps tops 300

Oahu has recorded the highest numbers of mumps cases in the ongoing outbreak, 277 of the 312 from across the state up to Aug 31. Other islands reporting cases are Kauai (26), Hawaii (8) and Maui (1). Read more.

Zimbabwe: Malaria in north

Rates of malaria in Mashonaland Central, located in the country’s north, are the highest in the country, with over one-third of the 2,035 cases reported in the week of Aug 20. The year-to-date total is 346,211 malaria cases and 421 associated deaths. Read more.