Health Alerts
Brazil: Hope cooler months will ease outbreak

This season’s yellow fever outbreak has proved to be larger than for 2016/17. The Pan American Health Organization (PAHO) has declared the situation relating to both human cases and outbreaks in primate hosts (epizootics) across the Americas as ‘the highest observed in decades’. Case counts by state in descending order are: Minas Gerais (415 cases, 130 deaths), São Paulo (376, 120), Rio de Janeiro (123, 49), Espirito Santo (5, 0) and in the Federal District (1 death). The infection continues to spread through epizootics of infected non-human primates, particularly in the state of São Paulo, leading to concerns of a repeat of the SW movement seen in an earlier outbreak with Argentina and Paraguay impacted once again. It is hoped the onset of cooler weather will prevent this outcome. Read more

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

Cambodia: Hike in dengue rates

Dengue fever rates are more than 2 times higher this year than for the same period in 2017 and authorities are concerned there could be a large outbreak during the July/August peak summer season. Cycles of epidemics run every 5 to 6 years, the last being in 2012 when up to 40,000 cases and 160 deaths were reported. Read more. A study carried out in Taiwan and published earlier this month in the Canadian Medical Association Journal revealed that in the two months following dengue fever infection, the risk of stroke is increased by up to 2.49 times.

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.

Canada: Cholera from fish eggs

In an event that has surprised heath authorities, herring eggs found off the east coast of Vancouver Island have been found to be the source of cholera infections in four First Nations people. Measures, including closure of the affected area, have been instituted to check further infections. 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

China: Air pollution warnings

For the third time this year, Beijing has been hit by an ‘orange’ smog alert - the second highest degree after red. Some industries in the region of Beijing-Tianjin-Hebei are required to reduce production, and therefore emissions, during these alerts. Read more

France: Measles infections top 1,000

Currently 64 of the 94 metropolitan departments have recorded measles cases, with in excess of 1,000 infections from early November last year to March 19th. According to French public health authorities, 87 percent of cases were either unvaccinated or under-vaccinated. The highest incidence has been in infants under 12 months of age and Nouvelle-Aquitaine has reported 47 percent of all cases. Vaccination buses have been sent to university campuses amid warnings that one infected individual can transmit the infection to 15-20 others who are non-immune. Read more (translate from French).

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.

India: Blood-borne viruses surge in southern state

Lack of infection control during dental and endoscopic procedures, together with inadequate testing of donated blood are suspected to be the cause of a spike in the incidence of hepatitis B and C in the southern state of Telangana. Two cities situated in the SW of the state have Hep B rates of 15 percent, compared with the national rate of 3.5 percent. Read more

Advice for travellers: The hepatitis B virus is transmitted mainly through the body fluids of an infected individual. The infection can become chronic, increasing the risk of cirrhosis and cancer of the liver. The global burden of hepatitis B is high, particularly in the Western Pacific and in Africa, followed by the eastern Mediterranean region and SE Asia. The virus remains viable outside the body for ≥7 days and so remains a risk for unvaccinated individuals. A course of hepatitis B vaccinations offers high rates of protection for the long term. Read more about hepatitis B and hepatitis C.

Namibia: Zambezi’s malaria cases climb

Over 1,100 malaria cases (and three deaths) have been reported in the Zambezi region – the pan-handle area to the north of Botswana. The capital, Katima Mulilo (200kms west of Victoria Falls) has been hardest hit, followed by Sangwali, Sesheke, Choi, Sibbinda and Mosokotwani. Read more

Advice for travellers: Malaria is endemic in many areas of southern Africa. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.

Nepal: Security alert for Valley

Warnings have been issued to US government personnel in the region of Kathmandu Valley following threats made to public security in the area, particularly Chandragiri Hills Cable Car in Thankot, but including the whole Valley. The alert extends to the end of this month (March). Read more

Nigeria: Largest Lassa outbreak; Cholera in NW

A Mar 26 World Health Organization (WHO) statement announced that ‘the spread of Lassa fever in Nigeria is beginning to slow but the epidemic is far from contained,’ after several weeks of reducing case numbers. The likelihood of more infections is high due to the seasonal nature of the disease. While there has been no mutation of the virus leading to the large outbreak, disease levels remain above the norm for this time of year. Read more

THE NE state of Bauchi has recorded as many as nine cholera deaths from more than 320 cases. Read more

Advice for travellers: Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings before it’s passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. For 80% of people infected, Lassa fever is mild or has no observable symptoms. The remaining 20% can experience severe, often fatal, multisystem disease. Read more on Lassa fever.

Reunion Island: Rainy season infections rise

A dengue fever outbreak (588 cases in western and southern districts) is not the only threat arising from heavy rains, there has also been an increase in leptospirosis cases centred mainly on the south of the island. The incidence of leptospirosis increases each year from January to May, however the current case count (42, one death) is higher than previous years. Read more (translate from French).

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.

Singapore: HFMD peaks

Parents have been asked to be vigilant for the symptoms of hand, foot and mouth disease (HFMD) in their children after a rise in cases – the highest in almost two years. Advice is to use strict hygiene measures and exclude the children from school and crowded places if they display symptoms of the infection. Read more

Advice for travellers: Parents of young children should be aware of that seasonal epidemics of HFMD occur throughout Asia. The virus mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection.

South Africa: Water supply disconnect revised; Fourth rabies death in KZN; Malaria set to increase

Cape Town’s water supply cut-off, which was forecast for August, may not happen until next year if ‘good rains and consumers continued to stick to 50 litres a day.’ Some reports put the reasons for the later date as due to a substantial drop in water usage across the city and a marked reduction in inbound tourism. Read more

THERE has been another death from rabies in the province of KwaZulu-Natal – this time in the northern town of Vryheid. The man did not seek medical follow up and rabies post-exposure treatment after being bitten by his own dog. The Rabies Project Manager with the Department of Agriculture and Rural Development doesn’t name Vryheid as the current area of concern, instead it is the “coastal area from Richards Bay to Port Edward and all the towns 100km inward from there.” The national rabies toll for the year is now 7. Read more

A NOTE of caution from the National Institute for Communicable Diseases (NICD) this week that recent rains are likely to cause more malaria in endemic areas after the Easter break. The Institute advises that the affected regions include: ‘north-eastern parts, covering Mopani and Vhembe districts of Limpopo Province, and the western parts of the Waterberg district (Thabazimbi and Lephalale areas)… Other areas of high transmission risk include the lowveld of Mpumalanga Province, including the Kruger National Park and surrounds, and the northern KwaZulu-Natal Province-Mozambique border.’ 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 or scratched, 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.

South Sudan: Aid to tackle 3 outbreaks

A trio of infectious diseases has struck the central, north and NW regions of the war-ravaged country – Rift Valley fever, measles and meningococcal meningitis. 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. South Sudan 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 travel health advisory service (1300 360 164 - toll-free for landlines) for further advice. Read more about Men. meningitis.

Tanzania: Dengue in largest city

Insect control measures established following a large dengue fever outbreak in 2014 are to be introduced again in Dar es Salaam after several dengue fever cases were reported recently. Read more

Thailand: Beach safety concerns for resort area

A news source in Phuket has reported on the local conditions hazardous to swimmers at popular beaches in the resort area and made more dangerous by the absence of lifeguards. More information on beach safety in Thailand is offered through DFAT's smartraveller.gov.au.

Ukraine: Measles cases escalate

Far from waning, the current measles outbreak is intensifying with over 700 new cases reported last week, taking the total since the beginning of the year to 8,434 cases and seven deaths. The hardest-hit regions are Ivano-Frankivsk, Zakarpattia, Odesa, Chernivtsi and Lviv. Read more. In the United Kingdom (Wales & Surrey) and Ireland (Limerick), alerts have been issued as measles infections continue to circulate.

Vanuatu: Mumps, dengue cases emerge

Reports issued through ReliefWeb advise there are dengue fever and mumps outbreaks in Vanuatu; mumps in Chuuk state (Micronesia); dengue fever in Fiji, New Caledonia, Samoa, Tonga, as well as Vanuatu; and the Fiji Ministry of Health has declared an outbreak of meningococcal meningitis C after 18 cases were recorded for the year to Feb 21.

Advice for travellers: This outbreak of mumps highlights 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.

Venezuela: Regional diphtheria

More diphtheria infections have been reported since the beginning of the year, adding 36 additional cases to the 933 recorded over the course of the outbreak that started in July 2016. Two cases were also ‘exported’ to Brazil and Colombia, as notified in the PAHO report issued at the end of February. The same report notes that the long-running outbreak in Haiti has produced two to five suspected cases each week this year. Elsewhere, outbreaks of both diphtheria and cholera continue to assail Yemen, although the cholera situation has stablised somewhat in most regions (except Al Mahweet). The case count for cholera now sits at 1,080,422 with 2,266 associated deaths since April 2017; diphtheria 1,368 probable cases and 76 related deaths. Read more 

Advice for travellers: Spread by coughing and sneezing or or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more about diphtheria.