Health Alerts
Bolivia: Flu surges in east

Influenza infections have escalated in the lowlands department of Santa Cruz, leading the government to institute a vaccination campaign aimed at high risk individuals. An outbreak alert was issued in early May and, by the end of the month, there had been ‘5,334 suspected cases, 1,428 positive cases and 23 deaths’. Influenza viruses A(H1N1) and B have been detected most often. Read more 

Advice for travellers: Seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Vaccination is highly recommended and 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. Alcohol wipes are a convenient alternative if soap and water is not available. Read more about influenza.

Democratic Republic of Congo: EVD spread ‘largely contained’

From the most recent health department update on the Ebola Virus disease (EVD) outbreak in Equateur province: ‘A total of 61 cases of haemorrhagic fever were reported in the region, including 38 confirmed, 14 probable and 9 suspected.’ There are three new suspected cases in Bikoro; a total of 28 deaths have been reported (14 of those were confirmed cases of EVD). An earlier World Health Organization (WHO) report notes ‘cautious optimism’ but continues, ‘attention is now focused on Iboko Health Zone, especially remote communities in Itipo health area, where the last confirmed case developed symptoms on 2 June 2018 and was confirmed on 6 June 2018.’

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.

El Salvador: Typhoid strikes in centre, west

A 'localised' outbreak of typhoid fever is underway in 26 towns and cities of the departments of Santa Ana, La Libertad and San Salvador, including the capital San Salvador. A senior public health official announced there had been 644 suspected cases of typhoid. Read more (translation required). And in Costa Rica, a rise in the incidence of malaria in the neighbouring countries of Nicaragua and Panama has led to the declaration of an alert which will allow for early detection of new cases. Over 20 nationals have returned to Costa Rica suffering from malaria, but the concern is greatest for the potential of spread to lowland areas harbouring the mosquito vector when infected individuals return home. Nicaragua has recently experienced a large outbreak of malaria, with more than 10,000 cases recorded. Read more

Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary specific, but is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

Fiji: Men. meningitis summary to June 4

There are just over two weeks to run in the national meningococcal C vaccination campaign aimed at immunising all children and adolescents aged from one to 19 years. In a summary of the situation up to June 4th, the Dept. of Health and Medical Services announced there had been ‘an average of 3.38 suspected cases per week in the last 4 weeks’ and ‘a total of 71 cases from January 1st to June 4th, 2018. Of these, 27 are laboratory confirmed, 7 probable and 37 suspected cases (WHO case definitions)’. Read more

Advice for travellers: Advice on the prevention of meningococcal infection, as stated on the Fiji Ministry of Health and Medical Services website, includes: Practicing good hygiene such as covering mouth and nose when coughing or sneezing and washing hands; don’t share utensils, cups/glasses, drinks at social gatherings, cigarettes, or kava bowls. If planning travel to Fiji, discuss whether vaccination against meningococcal meningitis would be appropriate for your itinerary with your travel doctor. Read more about Men. meningitis.

India: Disease uptick from monsoon rains

The reports of mosquito-borne disease are ramping up. This week, dengue infections are rising in Cuttack and Bhubaneswar (Odisha), Visakhapatnam (Andhra Pradesh), Kasargod (Kerala) and Mumbai (Maharashtra), while Japanese encephalitis infections have been reported in Bhopal (Madhya Pradesh) and in the state of Assam. Contaminated ice used at a private function for up to 2,000 people, has led to at least 84 cases of viral hepatitis in Kozhikode, Kerala. No indication of which faecal-orally transmitted virus, Hep A or E, was responsible for the contamination. The ice is sold by several factories and allegedly made with inadequate attention to hygienic techniques. 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 does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE

Kenya: Regional RVF threat

More than 230 suspected cases and at least 13 deaths have now been recorded in the outbreak of Rift Valley fever (RVF) which started in the NE, in Wajir County. Several other counties are on alert because, as noted in a WHO situation report, ‘the ‘high volume of movement of cattle and people in this area increases the risk of further spread of the outbreak both within Kenya, and to neighbouring countries’. Rwanda has already reported livestock deaths caused by RVF and Tanzania has issued an alert. Advice from the WHO includes being fully aware of RVF risk factors.

Liberia: Measles rife in region

Since the beginning of the year, more than 3,000 measles cases and 14 deaths have been recorded from 13 counties - almost two-thirds of all cases were children aged nine years or younger. Liberia is just one of 13 African countries with ongoing measles outbreaks that have so far caused 175 deaths from 26,000 cases. 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.

Mozambique: Tackling malaria toll

Health officials in the capital Maputo are introducing new measures to stem the number of malaria deaths which have risen even while overall cases have decreased (over last year’s figures). There were 25 recorded deaths from a total of 11,227 cases of malaria in the first three months of this year. Read more

Advice for travellers: For many 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

Nigeria: Cholera now in central state

There has been a reduction in cholera rates in the NE state of Adamawa, however, according to a WHO regional report, ‘the upcoming rainy season increases the risk of outbreaks of water-borne diseases such as cholera and hepatitis E, as well as an increase in vectors for malaria and other vector-borne diseases.’ The central state of Niger is now also reporting cholera cases, with eight districts affected. While no deaths have resulted, a local health worker stated that the ‘number of people with the symptoms is massive’. 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

Philippines: Dengue in Luzon, Western Visayas

Dengue fever case numbers have risen sharply over last year’s in the province of Cavite, situated on the south side of Manila Bay, Luzon. The three highest rating municipalities are Bacoor City, General Trias and Imus. Read more. In the region of Western Visayas, where the incidence of dengue infections has also risen, Cadiz City is one of five cities reporting dengue-related deaths. 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.

Thailand: Rains to generate more dengue

With the onset of the rainy season, a public health official has stated that the monthly dengue fever count across the country could reach 10,000. There have already been almost 20,000 cases this year and 21 people have lost their lives to the viral illness. Read more. Elsewhere in the SE Asian region, in Laos, two southern provinces (Attapeu and Champassak) have topped the dengue reporting rates, with 477 and 166 cases respectively, while Vientiane has recorded 102 cases this year. At a national level, there have been nearly 1,100 dengue infections and two deaths. Read more. In neighbouring Cambodia, dengue cases are on the rise with the onset of the rainy season. By the end of May, there had already been 960 suspected cases countrywide. Read more. The regions of Yangon, Tanintharyi, Ayeyarwaddy and Mon in Myanmar have logged the highest number of dengue fever infections in the first week of June, with more than 1,800; the national count was in excess of 2,690 cases. There were 18 recorded deaths in the same period. Read moreMacau has recorded the first locally-acquired case of dengue fever this year, a man from Areia Preta on the Macau peninsula. Read more

Ukraine: Measles reports soar

Over 1,400 new measles infections were recorded in the last week taking the year-to-date total to almost 22,000 with 11 deaths. A number of cities have each reported more than 1,500 cases this year: Lviv, Zakarpattia, Ivano-Frankivsk, Odesa and Kyiv. Read more

United States of America: Local and regional food recalls

A breakfast cereal and pre-packed trays of vegetables are behind multi-state (and in the case of the cereal, international) food recalls announced this past week. In Canada, some poultry products have been implicated in recent cases of salmonellosis in nine provinces and territories. Read more 

Advice for travellers: Salmonella is bacteria typically found is food, such as poultry, that causes diarrhoea, fever, and abdominal cramps between 12 and 72 hours after infection. Illness usually lasts 4 to 7 days, and most people recover without treatment, although diarrhoea may be so severe as to require hospital treatment. Young children and the elderly are at highest risk of severe illness. As there is no vaccine to prevent salmonellosis, it is best to avoid raw or undercooked eggs, poultry, or meat. Read more

Vanuatu: Dengue, mumps update

The dengue outbreak is over but the same cannot be said for mumps. A ReliefWeb summary of case numbers reveals there have been 619 cases since September last year, more than half in the central province of Shefa. The mumps virus is still circulating in Shefa, as well as Sanma, Malampa, and Tafea. Read more. Mumps reports updated for other Pacific destinations: Hawaii, USA and Auckland, New Zealand. 

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.

Vietnam: South’s dengue spike

Sixty dengue fever hotspots, most of which are downtown, have been identified in the large city of Can Tho in the Mekong Delta. Of the 213 cases recorded this year, 200 are from this month alone, with children suffering most. On a national level, there have been over 22,000 dengue cases and four deaths this year. Read more