Health Alerts
Brazil: Pará state, rabies and kala-azar; Measles in Amazon hub

There are reports of up to 14 suspected rabies cases and eight deaths on the river island of Marajó, near the mouth of the Amazon River in Pará state. The last recorded cases in the state occurred 13 years ago and were due to bites from infected blood-feeding (haematophagous) bats. Read more. Also in Pará, leishmaniasis infections – cutaneous and visceral - have been detected in residents of the eastern districts of Canaã dos Carajás (22)  and Parauapebas (36), situated near to the world’s largest iron ore project. AUTHORITIES in Manaus (Amazonas state) have advised there were an additional 62 suspected measles cases in the week to May 15, taking the total for the year to 457. 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. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is normally recommended for longer stays, especially travellers planning to live in, or travel extensively through, rural areas and also for children; however the final recommendation is itinerary-specific. Read more on rabies.

China: HFMD cases soar in SE

Peak season for hand, foot and mouth disease (HFMD) has arrived in Guangdong after the province experienced a 73 percent rise in cases in the most recent week, up to over 12,400 in the 7-day period. This is however a decrease on last year’s figures for the same period. Read more. And in neighbouring Jiangxi province, health officials are anticipating a peak in the cycle of HFMD in the capital Nanchang this year. Read more (translation required).

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.

Democratic Republic of Congo: More Ebola cases, response progressing

Targeted vaccinations in Ebola-affected health zones, ‘strengthening of surveillance and contract tracing, laboratory capacity, infection prevention and control’ are just some of the priorities outlined by the World Health Organization (WHO) in its response to the outbreak in Equateur province. A May 22 health ministry press release tabled the current situation: 58 cases of which 30 are confirmed, 14 probable and 14 suspected. There have been 27 deaths. While the WHO has not recommended travel or trade restrictions, it does advise surveillance and preparedness in neighbouring countries and stresses the importance of ‘exit screening, including at airports and ports on the Congo river’. Read more

Advice for travellers: Ebola is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola Virus disease.

Europe: Hep A outbreak developments

Investigations are ongoing in a hepatitis A (HAV) outbreak affecting six EU countries, with infections related to virus strains from Morocco (intermediate HAV endemicity). Only three of the cases had travelled and it is believed the remaining 39 acquired the infection locally, ‘either through food handling or through direct person-to-person transmission’. Read the ECDC report

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

India: Deadly bat virus in south

Nipah virus (NiV) has killed 10 people (4 more are probable) of 13 confirmed cases (and 16 suspected), according to the latest update from the Kerala Directorate of Health Services; two further cases are under investigation in Karnataka. The patients, most of whom are from Kozhikode and Mallapuram districts (Kerala), are community contacts. It’s the first time the virus has been found in the country’s south. One news source asserts that the outbreak originated from a drinking well that was infested with bats. Transmitted by infectious fruit bats, including through consumption of raw date palm sap tainted by excretions from infected bats, Nipah virus can infect people and animals (mainly pigs). There is no preventive vaccine for this viral infection which has fatality rates of 40-70 percent. NiV is a Henipavirus, of the same genus as Hendra virus. Read more. Read more about Nipah virus from the US CDC and WHO.

Japan: No relief from measles

The city of Fukuoka (Kyushu) is now reporting measles cases as a rise in domestic travel seen during Spring adds to the transmission rates. Earlier this week, health authorities announced that the case count had risen to more than 170 from the four currently affected areas. 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.

Kenya: Cholera cases climb

Together with Somalia (Banadir, Lower Jubba), the number of cholera infections is rising in Kenya, with the counties of Garissa, Nairobi and Isiolo most affected in recent weeks. Read more in a UNICEF regional update.

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

Maldives: Flu ramping up

Both government and privately run hospitals are experiencing a surge in influenza cases – one facility is treating one hundred patients a day. A health official has advised people ‘to avoid public areas as much as possible to curb the flu spread.’ 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 influenza vaccination for all travellers over 6 months of age.

Mauritius: Capital focus for measles vax

Measles cases have started to rise in the island – from 17 just under two weeks ago, to 48 as of Monday. A vaccination campaign is underway in the capital district of Port Louis to ensure children and adults have received the two doses of MMR vaccine. Read more

Mexico: Southern state’s dengue spike

Dengue fever cases have risen sharply in the southern state of Chiapas, bordering Guatemala. While dengue infections have dropped on a national level, Chiapas’ case count is twice last year’s for the same period and two deaths have been recorded. Read more. While in Honduras, dengue fever and Zika virus infections climbed in the most recent reporting week. Read more (translation required). 

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.

New Caledonia: Second dengue death reported

The dengue outbreak has claimed its second victim this year, a six-month-old baby died of associated causes on Saturday. Read more. Of the 1,156 year-to-date cases, 768 have been dengue type 2 and just under one-third of all cases have been in the capital, Noumea. Over the past three weeks, infections have decreased in number and plateaued. Read more (translation required).

New Zealand: Mumps, north and south

Auckland’s mumps case numbers climbed to 1,269 this week and the South Island has also been facing an increase in notifications over the past 16 months. Most are associated with travel and are centred around Dunedin, Oamaru and Queenstown. Read more

Advice for travellers: These outbreaks of mumps 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.

Pacific: Situation update for regional dengue

Wallis and Futuna: There have been no further dengue fever cases reported since Monday this week and the case count currently sits at 127 suspected or confirmed cases; the 114 locally transmitted cases on Wallis have been from the districts Mua (71), Hahake (33) and Hihifo (10). Futuna has had two cases to date – only one was locally acquired. Read more (translation required). From a regional weekly bulletin issued through ReliefWeb up to May 13, dengue fever outbreaks are also underway in Kiribati, Vanuatu and Fiji (also see New Caledonia post).

Peru: Viral infection likely from jungle stay

Canadian health authorities have reported on a case of Mayaro virus, an emerging mosquito-borne virus that is present in northern South America, from a traveller who, among other activities, followed a typical tourist route through Puerto Maldonado in the Amazon jungle before returning to Canada in March. Read more. Mayaro virus is of the alphavirus family of viruses which includes chikungunya and Ross River virus. It presents very similar symptoms to dengue fever and chikungunya: fever, fatigue and joint pains. Read more about Mayaro virus

Saudi Arabia: Pilgrims, workers preventive health needs

The Ministry of Health has released the Hajj and Umrah health requirements (and recommendations) for this year’s pilgrimages and for those people working in the areas or residing in the holy cities. They include proof of vaccination against meningococcal meningitis, plus, for those travellers arriving from designated risk areas, yellow fever and poliomyelitis. Additionally, routine immunisations should be up to date, adhere to personal and food hygiene measures, pay attention to heat exposure, and, in reference to MERS Co-V, avoid contact with camels. Read more 

Sri Lanka: Impending dengue season

The monsoon season is looming, but rains have already caused flooding and landslides across many areas. Pooling of water makes ideal mosquito breeding grounds and so dengue fever cases are likely to spiral, adding to the over 19,000 suspected cases recorded this year. Read more

Taiwan: South’s first JE case

Confirmation this week of the first Japanese encephalitis (JE) infection in 2018, a farmer from Pingtung County in the country’s far south. The peak JE season extends from May to October; in 2017, there were 25 recorded JE cases. According to the Centers for Disease Control (CDC), ‘All cities and counties have reported sporadic cases and people of all age are at risk of contracting the disease. The majority of the confirmed cases are adults aged 40 and above.’ Read more

Advice for travellers: On average, 24 cases are recorded each year in Taiwan, mainly in the south from May to October, but peaking in June and July. Cases typically occur in rural, rice-growing areas where people live near the host animals, pigs and wading birds. While it is a low risk for most travellers staying in urban areas, expats and travellers spending extended periods in agricultural areas of Asia should consult their travel doctor about recommendations for vaccination. Read more about JE.

Thailand: Dengue count rising

As with other regional countries, the upcoming rainy season will bring a rise in the incidence of dengue fever – there have already been more than 10,000 cases and 15 associated deaths, but health officials expect the annual figure to be in excess of 74,000. Read more. Children and young adults have borne the bulk of the burden to date, with highest rates in those ‘aged between 15 and 24, followed by those aged 10-14’. Top morbidity rates were in Phuket and Krabi. Read more 

Vietnam: Varicella strikes scores of adults

One large hospital in Hanoi is reporting ‘hundreds’ of adults suffering from chickenpox (or varicella), many with complications of the viral infection. Read more

Advice for travellers: Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.