Health Alerts
Canada: Measles ‘imported’ from Philippines

Two more cases of measles have been confirmed in Ottawa (Ontario). Both were linked to the original case, a traveller infected in the Philippines. 

Advice for travellers: Measles occurs in developing and developed countries and 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), mumps, and polio 6 weeks before departure.

Caribbean: Chikungunya still spreading

Chikungunya continues to spread to new cities on the islands of Martinique and Guadeloupe. To date, there have been 3211 confirmed/probable infections region-wide, including 5 deaths and 15 282 suspected cases. Read more
ON St Maarten, a sudden spike in Chikungunya fever infections took the number of cases from 123 to 224 over a week, with another 325 cases suspected. Read more
IN French Antilles and Guiana, 40 new cases of the virus have taken the total to 1780, while in French Guiana most of the 35 cases have been reported in the city of Kourou.

Advice for travellers: Chikungunya fever is similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus species. Chikungunya symptoms include acute joint pain with a rash. While fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication: Using an effective, tropical-strength repellent to avoid insect bites is the best form of protection.

China: New cases of bird flu

Fujian, Jiangsu, and Hunan provinces have each reported a new H7N9 influenza case over this week, continuing a trickle of infections. They boost the total to 405 cases, including 122 deaths.  To date, 269 illnesses have been reported since October in the second wave of infections, following 136 cases last spring. Read more

Advice for travellers: Human H7N9 cases continue to be reported throughout South China, although sustained person-to-person transmission has not been confirmed. While bird flu poses a low risk to most travellers, those travelling to a region where the disease is present or an outbreak is occurring, should avoid contact with birds or poultry in marketplaces, wash their hands thoroughly before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it. 

Dominican Republic: Chikungunya epidemic suspected

More than 1100 cases of suspected Chikungunya fever have been reported for the first time by Spanish-language news sources. Read more

El Salvador: 10-fold spike in dengue

There’s been a 10-fold increase in dengue infections in the first quarter, with 1831 confirmed and 4915 suspected cases compared to 497 in the same period of 2013. These include 44 severe cases and 1 death, with 20 municipalities considered to have a heightened risk for the disease. Read more

Europe: Seasonal flu in decline

Flu activity continued to diminish last week. Of the 29 countries providing data, only Estonia, Greece, and Romania reported medium-intensity flu activity, while others were low. The H3N2 flu strain was much more prevalent, making up 118 (71.5%) of 165 influenza viruses, compared with 47 (28.5%) 2009 H1N1. Read more. 

Advice for travellers: Seasonal flu is the most common vaccine-preventable travel-related illness. It’s not only a risk at most destinations, but also aboard aircraft and in crowded airport terminals. The southern flu season is underway and Travelvax recommends vaccination for all travellers over 6 months. Travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing your 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.

Fiji: Dengue tally reaches 19,000

More than 3500 dengue fever cases were diagnosed last week, bringing the epidemic’s total to 18,969 cases, including 12 deaths. Authorities warn the outbreak may continue until June and predict a peak of 25,000 cases - a 40-year high. Read more

Advice for travellers: Travellers to Fiji should be aware of the risk of dengue. The virus is spread by daytime-feeding Aedes mosquitoes and travellers should apply an insect repellent containing an effective active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin when outdoors during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, as well as other times when the mosquitoes are active.

Guam: Measles linked to Philippines

An unvaccinated child has returned from the Philippines with measles, putting the US territory on alert for more cases. Read more

Guinea, Liberia, Sierra Leone: Ebola update

In West Africa, Guinea’s health authorities have now reported 122 cases of Ebola virus disease (EVD), including 24 lab-confirmed, and 98 probable or suspected infections. In its latest statement, the WHO said cases have been reported from the capital, Conakry (11), Guekedou (77), Macenta (23), Kissidougou (8), and Dabola and Djingaraye (3). Liberia has 8 likely cases (2 confirmed), while Sierra Leone has advised that its only confirmed cases involved 2 people from 1 family who died in Guinea and their bodies repatriated to Sierra Leone. WHO does not recommend any travel or trade restrictions to West Africa at this time. Read the WHO statement and more on Ebola virus disease.

Indonesia: Dengue centred on Kembangan

In West Jakarta, 603 dengue fever cases were reported in the first quarter, with the majority in the Kembangan (157), Cengkareng (124), and Kalideres (103) districts. Read more

Italy: Measles sails on

A measles outbreak that began on a Mediterranean cruise ship in late February has now infected 37 people, including 21 crew members, 7 passengers, and 9 contacts of passengers. Read more

Laos: Bird flu sparks alert

After a 5-year absence of H5N1 avian flu, Laos is on alert for human cases after it killed a village’s flock of more than 5000 ducks and chickens. No human cases have been associated with the die-off, with 10 people experiencing flu-like symptoms testing negative, Xinhua reported. 

Liberia: Lassa reported near capital

14 cases of Lassa fever, including 1 fatality, have been reported, mainly among police and peace-keeping personnel in a UN camp in Margibi County. They are the first cases in Margibi, which is close to the national capital, Monrovia. Read more

Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

New Zealand: Imported measles spreads

In Hamilton, measles ‘imported’ by a traveller from the Philippines last month has resulted in 2 additional cases, although more are expected. Read more

Nigeria: Lassa spreading

There have been 208 cases of Lassa fever – including 17 fatalities – to March 16, the outbreak now effecting 9 states. Edo has been hardest hit with 173 cases. Read more

Norway: New Hep A spike

Of the year’s 28 Hepatitis A cases, around half were contracted abroad while the locally acquired cases were likely caused by eating contaminated (possibly imported) food, health authorities believe. Last year Scandinavian countries reported an outbreak of Hep A caused by imported frozen berries. Read more

Philippines: Capital abuzz

The national capital, Manila recorded 363 cases of dengue in the first quarter, while key cities in the wider metro area reported another 1266 cases, including 5 deaths. Among them was Quezon City (302 cases), Las Piñas (139), Pasig (133), Caloocan (118), Parañaque (108), and Taguig (103).  A media article reported swarms of so-called ‘household mosquitoes’ (Culex quinquefasciatus) in the metro areas. Read more

South Africa: Malaria hits northern towns

Malaria is on the rise in the northern-most province of Limpopo, with hundreds of cases a day reported last week in the hard-hit townships of Phalaborwa and Giyani, which lie along the eastern border of Kruger National Park, one of the country’s premier tourist destinations. More than 60 people have been admitted for treatment. Read more

Advice for travellers: Malaria is present year-round in the low altitude areas of the Mpumalanga Province (including Kruger National Park), Northern Province, and northeastern KwaZulu-Natal, as far south as the Tugela River. The risk is highest from September to May, and lower (but not absent) during the winter months.

South America: Dengue reports for Brazil, Peru

In Brazil, 59 dengue cases have been reported in the municipality of Humaita (Amazonas State). In Peru, the number of infections in the north-western Piura region has risen to 170 confirmed or suspected cases. Read more

Sri Lanka: Dengue hits the west

The year’s dengue count has reached 6104 cases, with around 60% of the cases recorded in Western Province. Read more

Tanzania: Dengue revisits Dar es Salaam

Dengue has returned to the capital, Dar es Salaam, with most of the 140 cases (1 death) recorded since January occurring in the Kinondoni district. Outbreaks were reported in 2010 and 2013. Read more

Tonga: Measles epidemic hits capital

A measles epidemic has erupted in Nuku’alofa, with 400 suspected cases reported last week. Around 25 people have been admitted to hospital. Read more

United Kingdom: Scarlet fever rate doubles

Scarlet fever cases stand at 3752 – around double the average number seen in the peak season (Sept-March. Most were reported from Cheshire and Merseyside (13.0%), East Midlands (11.9), Avon Gloucestershire and Wiltshire (10.6), Thames Valley (9.5), North East (9.7), and Northern Ireland (9.2). Experts attribute the rise to changes in the virulence of circulating strains or increased incidence among particular risk groups, particularly children under 10. Read more

United States of America: Spike in measles, whooping cough; Flu waning

Federal authorities are concerned about an increase in whooping cough (pertussis) cases. The latest outbreaks have been reported in California (San Diego County, Tehama County), Idaho (Canyon and Ada counties), and Michigan (Antrim County).
ALSO in California, 21 Orange County residents have been diagnosed with measles – 7 admitted to hospital. Another 26 cases have been reported state wide. Meanwhile, the measles outbreak centered on Northern Manhattan has resulted in 21 cases, with new cases also reported in Brooklyn and the Bronx.
INFLUENZA activity continued to wane last week, with only Texas and New York City reporting moderate influenza-like illness (ILI). The CDC also reported 4 new paediatric flu-related deaths, bringing that total for the season to 79. 

Zambia: Cholera on move in north

There are fears a waning outbreak of cholera that began in January in the northern town of Mpulungu (Northern Province) will surface 200km west in the flood-affected Kaputa District. Read more