Health Alerts
Brazil: Regional measles data update

A measles update issued by the Pan American Health Organization (PAHO) for the region has Brazil in second place behind Venezuela for the number of measles infections recorded this year. Many of the 677 confirmed and 2,529 suspected cases in Brazil were reported in Amazonas state (Manaus in particular). Read the Epidemiological Update for the Region of the Americas here.

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.

China: Upshot of vaccine crisis

In the wake of another breach in safety protocols reported by one of the country’s largest vaccine manufacturers, a number of Hong Kong clinics are reporting high volumes of enquiries from mainland parents requesting routine vaccinations for their children. Read more. Hong Kong’s Centre for Health Protection guarantees supply of vaccines to eligible local children and has a monthly quota for non-residents. Read more

Cuba: Dengue complications in central province

More dengue news from Cuba this week with reports of an unspecified number of severe infections (dengue haemorrhagic fever) in towns near the central city of Santa Clara (province of Villa Clara), known for its revolutionary landmarks. 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.

Democratic Republic of Congo: Welcome news on Ebola outbreak

On July 25, just over 11 weeks after the Health Ministry’s announcement confirming the Ebola virus outbreak, it has been declared over. The outbreak, the ninth in the DRC, posed several challenges, including the spread to four different locations involving ‘an urban centre with river connections to the capital and to neighbouring countries, as well as remote rainforest villages’. Read more from the Health Ministry and the World Health Organization (WHO). 

Haiti: Cholera tally continues to climb

The long-running cholera outbreak has slowed this year, but it is not over. There were more than 2,700 cases and 28 deaths to early July (the 2017 cumulative total exceeded 13,600 cases), however recent heavy rains have produced a surge in cases - highest incidence is being reported in the departments of Center and Artibonite. 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

India: Monsoon-related risks rise

Scrub typhus, a bacterial disease passed on to humans by mites that normally live on infected rodents, is being reported throughout the state of Himachal Pradesh – high rates in Bilaspur -  and in Mizoram where three deaths have resulted. A summary of vector-borne diseases reported this year notes there have been ‘102,351 malaria cases (till May 2018), 11,592 dengue cases (till July 8) and 1632 Chikungunya cases’. Dengue fever reports this week have come from Vasco, Goa and Vizianagaram, Andhra Pradesh, while doctors at one hospital in Hyderabad, Telangana are treating up to 100 patients per day for malaria. Water-borne infections, including cholera, have increased in Hoshiarpur, in the northern state of Punjab. In the south, Kuttanad in Kerala is recovering from flooding which raises the risk of diseases such as leptospirosis. And in Maharashtra, Mumbai’s rat populations are being culled in response to the death of a teenage boy from leptospirosis, the fourth due to the bacterial infection. 

Advice for travellers: Malaria is widespread in India and occurs year-round in both rural and urban areas, including major cities. Travellers visiting India should discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. Read more on malaria in India

Japan: Hot weather health effects

An extreme heatwave has led to a sharp rise in hospitalisations for heatstroke – more than 30,000 people (mainly elderly) required treatment and 77 have died of heat-related complications. The hot weather is set to persist into next month. Read more. The UK is also currently suffering high temperatures; there’s been a four-fold increase in people accessing a National Health Service website for advice on heat-related issues. Read more

Laos: Dengue deaths, cases surge

Compared to last year, dengue fever cases for the first half of the year increased more than two-fold, with Savannakhet province recording highest rates. The national case count: almost 2,500 cases and 12 dengue-related deaths. Read more

Malaysia: HFMD spreads; Sabah’s dengue uptick

A combined inter-departmental effort is being employed to tackle the high numbers of hand, food and mouth disease infections this year. More than 35,000 cases have been recorded and all states are affected. Read more. In Penang, shopping trolley handles and children’s rides were found to be contaminated with the bacteria that cause HFMD, prompting the health department to advise shopping centres that all such surfaces should be disinfected. Read more
ALMOST half of Sabah’s districts have experienced a year-on-year rise in dengue fever cases up to July 21. Highest numbers were recorded in Kota Kinabalu, Tawau, Kunak and Lahad Datu. Dengue-related deaths also increased, from four to 15. 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.

Mauritius: Measles toll now 3

Three women with compromised immune systems have died of measles infections in the past four months and a total of 435 cases reported. Western districts (chiefly Plaines-Wilhems, Rivière-Noire and the capital Port-Louis) have been hardest hit and infection rates were highest in the 0 to nine years’ and 20 to 29 years’ age groups. The majority of cases (>70 percent) either had not been vaccinated or their vaccination status was unknown. Read more (translate from French).  

Myanmar: Request for help with snail fever; Dengue in border state strikes kids

A health official released details of schistosomiasis rates in the states of Rakhine and Shan, and from Shwekyin in Bago region, which showed the highest incidence of infections was in children under 15 years of age. Specific locations of note were Pawktaw Town, Ponnagyun and Sittwe in Rakhine state and Inlay Lake in Shan’s south. The WHO is to provide medical and technical aid to help tackle the outbreaks. Read more
TO THE east and bordering NW Thailand, doctors in Karen state are dealing with a rise in dengue fever cases among children aged five to nine years. More than 430 cases have been recorded to mid-July. Read more

Advice for travellers: Schistosomiasis or bilharzia is caused by a parasite which is released into fresh water by host snails. It burrows into the skin of people who swim or wade in rivers, streams and lakes containing the snail. With the rise in eco-tourism and adventure travel, increasing numbers of tourists are contracting schistosomiasis, according to a WHO fact sheet. Around 10% of travellers exposed to contaminated water will be infected. No vaccine or prevention medication is available, but schistosomiasis is treatable – especially if diagnosed early. Read more on the risk for travellers and how to prevent infection (Travelvax, WHO, CDC).

Nigeria: Cholera crosses borders

Eight of the 16 states that have been fighting cholera outbreaks this year continue to report cases, however new infections are reducing in number. Read more. A cholera outbreak in the southern region of Maradi, Niger (247 cases and four deaths) appears to have been spread by cross-border travellers arriving from a cholera-affected area of Nigeria. Read more. And in Cameroon, cholera has spread to the northern, centre and Littoral districts. Read more.  The WHO Weekly Bulletin produced by the African regional office can be accessed here

Papua New Guinea: Polio travel requirements announced

The National Department of Health’s declaration of an emergency to deal with Morobe province’s polio cases includes measures charted by the WHO in 2014 in response to a ‘Public Health Emergency of International Concern (PHEIC)’. Travellers to PNG will be required to show proof of polio vaccination while Papua New Guineans must source vaccinations (and a certificate) four months prior to travel in order to obtain a visa. Read more

Advice for travellers: Poliomyelitis is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low, however vaccination is recommended for travel to affected regions and is a requirement for travel to/from some countries. If at risk, adults should have a booster to the childhood series. More on polio

South America: Local, and global, flu situation

As reported by the WHO, influenza activity increased in Chile, Colombia, Paraguay and Peru; in the Caribbean, flu detections continued in Guatemala and Honduras; and in SE Asia, Cambodia reported a rise in flu levels. ‘However, influenza activity remained below seasonal threshold in Australia and New Zealand.’ Read the July 23 influenza update (data to July 8) here

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.

Thailand: Rabies toll now 14

Two provinces - Buri Ram and Rayong - have reported their second rabies deaths this year. Including the single fatalities recorded in a further eight states (Surin, Songkhla, Trang, Nakhon Ratchasima, Prachuap Khiri Khan, Phatthalung, Nong Khai, Yasothon, Kalasin and Mukdahan), they take the year-to-date rabies death toll to 14. 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, urgent post-exposure treatment is required. Vaccination recommendations are itinerary-specific but include those travellers planning to live in, or travel extensively through, rural areas. Read more on rabies

Ukraine: Measles count tops 26,000 cases

The measles epidemic continues unchecked – more than 880 cases for the past week and 26,000 for the year, including 13 deaths from measles complications. Read more. Monthly measles and rubella surveillance data for the European Union can be accessed here.

Vanuatu: Mumps outbreak slows

The mumps outbreak has slowed considerably, however cases continue to be reported from the central province of Malampa. According to the WHO regional office’s bulletin, complication rates from the more than 6,600 recorded cases included ‘2% with Encephalitis and 1% with Deafness and Orchitis’. 

Advice for travellers: These consequences of mumps outbreaks 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.