Health Alerts
Angola: Malaria escalation in south

In the province of Cunene, malaria cases reported from May to August have exceeded the total for 2016 (33,100 cases & 91 deaths). ProMED reports that, despite the fact that Angola is highly endemic for malaria, the southern province ‘is not usually regarded as a malaria high risk area. However, there has been several reports of increased malaria risk over the past few months from Botswana and South 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

Brazil: NE state records rise in chikungunya

The incidence of dengue fever and Zika virus may have dropped in the NE state of Piauí, but chikungunya has increased its presence - 2,779 cases have been recorded this year state-wide. The towns and cities with higher numbers of suspected cases are Teresina, São Raimundo Nonato, Parnaíba, Luís Correia and Floriano. Read more (translate from Portuguese). 

Democratic Republic of Congo: Cholera strikes 20 provinces

Cholera has struck in 20 of the 26 provinces, causing 1,500 infections each week and killing over 500 people across the capital, Kinshasa, and 9 other town/cities. 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

Grenada: ‘Pink eye’ increase

An outbreak of viral conjunctivitis or ‘pink eye’ which had caused intermittent cases in the region throughout the year has spiked this month producing as many as 40 cases in one district in the first week alone. Read more.

India: Monsoon, measles & flu

Mosquito larvae-eating Gambusia fish are just part of the arsenal being used by authorities in their battle against the vectors of dengue fever and chikungunya in New Delhi. Read more. Dengue cases have surged this month in Mumbai, with one hospital-based doctor saying that one-in-5 of cases admitted are related to dengue infection.Other published dengue reports have come from the states of Orissa,Telangana and Karnataka
It has been a bad year for influenza with some figures showing up to 1,530 deaths resulting from infections with the influenza A (H1N1) strain. Read more. Some better news on the measles front after the World Health Organization (WHO) announced that India’s cases almost halved over the 2014-16 period, however the country still reports 60 per cent of all cases in SE Asia. 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.

Italy: Chikungunya reaches Anzio

News this week of 3 locally-acquired cases of chikungunya in the coastal town of Anzio, south of Rome. As a precaution a pause in blood donations has been ordered for the Anzio area and may also apply to Rome. The mosquito-borne infection is rare in Italy – the last occurrence was ten years ago when 217 confirmed cases were identified in Emilia Romagna. In that outbreak, the index case was thought to be a resident who had returned from India; local mosquitoes then transmitted the virus to other residents. 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, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

Malaysia: More rabies sites in Sarawak

Over 35,000 animals have been vaccinated against rabies but Sarawak state authorities this week gave an update, advising of the 24th area affected by the virus. Testing showed up positive samples for rabies in animals from a housing area of Kuching and also near Serian town (approx. 60km south of Kuching). 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 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.

Nepal: Kathmandu hosts insect-borne infections

ProMED reported this week on the increased incidence of scrub typhus in the capital, Kathmandu. Up to 140 cases have been identified; suspected dengue and chikungunya infections have also surfaced recently. (See 10 Sep 2017, Vector borne diseases – Nepal)

Advice for travellers: Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents 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 occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases.

Romania: Measles now widespread

A local news report has now put the death toll in the measles outbreak at 34 (from 9,100 cases), with another 122 cases recorded last week. The outbreak is widespread and only one of the 41 counties has a clean sheet – Tulcea, a coastal area on the Black Sea. The European Centre for Disease Control report of Sept 3-9 outlines other EU countries reporting cases in 2017 (including Italy - 4,444 cases, Germany – 866 & Czech Republic - 136) and elsewhere on the site posts an update on West Nile Virus fever cases in the region. Read more

Advice for travellers: West Nile virus is endemic and epidemic in Eastern Europe and the Mediterranean basin, with epidemics regularly reported in summer and autumn since the 1950s. 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. Europe’s outbreaks are not as severe or widespread as in other regions where the virus occurs, notable North America.

South Africa: NE measles outbreak

Measles cases (23 to date) have been identified in 4 of the 11 provinces in KwaZulu-Natal – Ethekwini (14), Umgungundlovu (6), ILembe (2) and Uthukela (1). Local health authorities have planned vaccination campaigns and are attempting to address the concerns of some community members who are ‘hesitant to accept vaccination for religious reasons.’ Read more.

Sri Lanka: Programs to curb dengue

Dengue control programs are to continue during the upcoming inter-monsoon season and extend into the NE monsoons starting in December. New cases are the decline now, with 1,500 cases per week instead of 10,000 as was the case earlier in the year. The danger of dengue persists in many districts, including Colombo, Gampaha, Kalutara and Kurunegala and Kandy. Read more.

Advice for travellers: Dengue is spread by some types of Aedes mosquitoes. They 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.

Zimbabwe: Adult malaria burden, severe flu season

Over 227,000 influenza cases have been recorded this year – nearly 8,000 of those in one week in late August. In that same week the malaria case count topped 2,444 - mostly adult infections. Read more. Across the border in southern Zambia, malaria cases are surging in the districts of Luangwa and Kafue. Read more.

Advice for travellers: The 2017 flu season is well 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. Hand sanitiser is a convenient alternative if soap and water is not available.