Health Alerts
Brazil: Hep A spike; Chikungunya numbers rise again

The state of São Paulo has seen a rise in hepatitis A infections, mirroring the increase seen in Europe and associated with men who have sex with men (MSM). The age group most represented is from 20 to 49 years of age. Read more (translate from Portuguese)
CHIKUNGUNYA cases surged at the end of August - beginning of September, with one 14 day period bringing an increase of over 37,000 confirmed and suspected cases. Read more (Epi week 35).

Advice for travellers: Vaccine-preventable Hepatitis A (HAV) is one of the most common infections affecting travellers. It is a significant risk in most developing countries where sanitation and hygiene are lacking, with an estimated 1.4 million cases occurring worldwide each year. The virus is transmitted by the oral-faecal route, such as through contaminated food and water, and with some sexual practices. A course of hepatitis A vaccine offers immunity that’s 99%-plus effective and long lasting (20-30 years). It is also important to follow safe food and water guidelines.

Democratic Republic of Congo: Cholera now in many provinces

With 20 of the country’s 26 provinces now affected, the cholera outbreak that was declared on Sept 9th shows no sign of slowing; in fact the situation in over half of the provinces (11) is described as epidemic. Médecins Sans Frontières (MSF) has set up numerous treatment centres where upwards of 17,000 people have already been treated. 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.

Egypt: Dengue reappears

Dengue fever has been absent from Egypt for several years, but in the news this week an outbreak of dengue fever has been declared in the Red Sea port of El Quseir. The number of infections now sits at 686 and includes almost 100 with complications. The town lies half way between the 2 better known resort towns of Hurghada and Marsa Alam. 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.

Europe: HIV strikes older age group

There’s been a gradual rise in HIV diagnoses in the EU, affecting people aged over 50 who acquired the virus through heterosexual sex. A Reuters article, citing a publication in The Lancet HIV journal, states that new HIV cases in the older age group make up ‘around one in six’ of those notified in 31 EU countries and they ‘were also more likely than younger people to have advanced HIV’. As of 2015, Estonia, Latvia, Malta and Portugal reported the highest rates in the 50+ years' age group. Read more. More on HIV from the World Health Organization (WHO). 

India: Monsoon-associated outbreaks linger

Dengue fever continues to make its presence felt in cities and states across the nation: Mumbai, Delhi, Chennai, Karnataka, Haryana and Tamil Nadu. While in the state of Bihar, cases of Japanese encephalitis (JE) have topped 42 this season as doctors warn that the vaccine, which is given routinely to children in the state, is less effective when the child is malnourished. There are reports of previously vaccinated children contracting JE. 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

Italy: Chikungunya cases top 92

The most recent Communicable Disease Threats Report issued by the European Centre for Disease Control (ECDC) notes that: ‘As of 21 September, Italy reported 92 autochthonous (locally acquired) chikungunya cases in the Lazio region: Anzio (70), Rome (19) and Latina (3). The media are reporting one case in the city of Formigine, Emilia-Romagna region and one case in Castelplanio city, Marche region. Both of them had a recent travel history to Anzio prior onset of symptoms.’ The government has instituted heightened surveillance and mosquito control measures. Read more (translate from Italian). Also in the ECDC report, the cluster of chikungunya cases in the department of Var in SE France has grown to 9 (2 are unconfirmed) – all live in or near the town of Cannet-des-Maures. 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.

Madagascar: Plague brings more deaths

The death toll in the outbreak of pneumonic plague has reached 15 among nearly 100 suspected cases. Seventeen districts have reported cases, including the capital Antananarivo, but the Central Highlands has the highest count. With several months still to run in the current ‘plague season’, many more cases are expected. Read more (translate from French).

Advice for travellers: Plague occurs annually in Madagascar, but poses a low risk to most travellers. Most cases of plague are due to bubonic plague following the bite of an infected flea carried by rats. If left untreated, infection of the lungs causes the pneumonic form of plague, a severe respiratory illness, which can progress rapidly to death. Read more about the plague.

Mexico: Pink eye on peninsula

An average of 70 or more (mainly) children a day are being diagnosed with conjunctivitis on the Yucatan Peninsula, according to a local news source. Authorities have implemented a public awareness campaign that promotes good personal hygiene and advises against self-treatment with antibiotic drops. The Yucatan is the location for the tourist resorts of Cancun, Tulum and Playa del Carmen. Read more. More on conjunctivitis

New Zealand: Mumps sweeps across city

As the mumps outbreak continues its spread across Auckland, public health officials have confirmed that around 5 percent of the 440 infected individuals have required hospitalisation. A local news report quotes the area medical officer as saying that, currently, inflammation of the testicles, or orchitis, is the most common complication, however mumps-related meningitis has also been diagnosed. Read more.

Advice for travellers: These consequences of mumps infections 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.

Pakistan: Measles’ deadly toll

An outbreak of measles in Umerkot, Sindh Province, has proved devastating for the children of a colony of Mithoo nomadic people, with large numbers requiring hospitalisation and at least 10 deaths reported. 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.

Panama: Dengue surge in east

The province of Bocas del Toro on the Atlantic coast has reported the highest dengue figures this year. Nearly 2,400 cases have been recorded nation-wide, however the incidence of dengue fever in Bocas del Toro is 4 times higher than the rest of the country. Read more (translate from Spanish).

United Kingdom: Bad flu season forecast

Australia’s severe flu season could be a strong indicator of the upcoming influenza season in the UK, according to the chief executive of NHS England. The 2017 total for Australia is 184,438 laboratory confirmed cases and there are still some weeks to run until the end of the season. Read more.

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 for all travellers over 6 months. Read more on influenza.

United States of America: Mumps in 2 states; More hepatitis A notifications

Hawaii’s mumps outbreak continues: Four islands have reported cases (Oahu 334 cases, Kauai 32, Hawaii 17 & Maui 1). According to the state Dept of Health website, approx. 60 percent of the 384 cases have been adults aged 18 years or older. Read more. The 13 mumps cases reported this year in Alaska is a big increase on the 3 recorded over the last 5 years (all of which were contracted elsewhere) and the highest figures in decades. Read more.
CALIFORNIA is not the only state with a spike in hepatitis A cases. A Michigan-based news source states ‘from Aug. 1, 2016 to Sept. 15, 2017 there have been 319 confirmed cases of hepatitis A, including 14 deaths. Of those cases, nearly 86 percent have been hospitalized.’ Factors involved in the spread of the infection include sexual behaviours, illicit drug use and household member contact. Read more.

Vanuatu: Prepped for Games

Early in December Vanuatu will be hosting the 10th Pacific Mini Games when athletes and visitors will be arriving from Australia, New Zealand and many Pacific Islands & territories. A health guidelines factsheet has been published for those planning to attend the Games; it includes the recommendation to consult a medical practitioner regarding the need for routine and recommended vaccinations. Some emphasis is placed on avoiding insect bites as prevention against contracting dengue fever and malaria. Read more.

Venezuela: More disease woes

Three years after the country eliminated measles, it’s back. Guyana City in the state of Bolivar is the focus of an outbreak that has produced 38 confirmed cases and another 88 suspected. Read more. Doctors have held a demonstration at the local WHO office in an effort to get more resources to help fight off the resurgence of diseases such as diphtheria and malaria. Read more.