Health Alerts
Algeria: Five districts hit by cholera

Cholera infections have been confirmed in 59 people and killed two in five health districts - Blida, Bouira, Tipaza, Medea and Ain Defla; the deaths occurred in residents of Boufarik (30kms SW of Algiers). Up to 172 suspected cases have been hospitalised. 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. For general advice on vaccination options for your trip, call Travelvax Australia’s travel health advisory service (1300 360 164). Read more about cholera.

Brazil: Amazon measles outbreak persists

Confirmed measles infections continue to occur in the Amazonas capital Manaus, with 90 more recorded in the past week and the number of suspected cases now over 5,700. (The US CDC has issued a travel advisory relating to the outbreak.) While children under five make up almost half of the confirmed cases, of the suspected infections, over half are teenagers and adults – 15 to 29yo. Read more. A country-wide measles vaccination campaign is drawing to a close, whereas in the neighbouring country of Venezuela, international agencies are trying to reduce the enormous burden of measles: over 3,500 infections this year and 62 deaths. Read more. Other regional countries are on the alert for infectious illnesses, including measles, carried by people fleeing Venezuela (Colombia, Ecuador and Peru).

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: Dengue fever count now at 27

In what had already been considered a peak in locally acquired dengue fever cases in Hong Kong, a total of 27 people have now contracted the mosquito-borne infection since Aug 14th. Almost one-third of cases appear to have been infected on the popular tourist island of Cheung Chau, and this has resulted in a drop in visitor numbers; others had been to Lion Rock Park and nearby Wong Tai Sin – the park is currently closed. A month long operation is underway to employ insecticide fogging near the homes of those people infected with dengue. More information is available on the Centre for Health Protection website

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. 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: Race to contain Ebola

Government and aid agencies are ramping up their efforts to contain the Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces as they attempt to keep the affected areas within ‘within 20-30 km of the epicenter. Next 7 to 10 days critical to turn the outbreak around while still confined to relatively accessible security zones’, according to the WHO Deputy Director-General for Emergency Preparedness and Response, Dr Peter Salama. At the latest count, there have been 115 haemorrhagic fever cases - 85 confirmed as EVD, 29 probable and the death toll stands at 77. Read more

Advice for travellers: Ebola Virus disease 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.

India: Monsoon season reaching its peak

The incidence of malaria has spiked in eastern divisions of Maharashtra state, with more than 2,000 cases of malaria in Gadchiroli district (and a further 188 of dengue fever in Nagpur). This rise has occurred roughly one month ahead of the expected increase. Read more. Haryana is also experiencing a surge in malaria and dengue, but authorities say case numbers are lower than last year. he current reporting of Japanese encephalitis (JE) infections in Bhopal (Madhya Pradesh) has authorities planning the vaccination of the susceptible population and monitoring of the disease vectors and hosts – mosquitoes and pigs. Since the end of last month dengue fever cases in the city of Bhilai Nagar (Chhattisgarh) have shot up, with more than 2,700 recorded and at least 27 deaths.  Up to 28 districts of Odisha have been hard hit by dengue infections which have sickened more than 1,800 people and caused the deaths of three – a significant rise on 2017 notifications. Doctors in Rajasthan have identified three separate vector-borne infections occurring simultaneously in two people from neighbouring districts in Rajasthan. The patients from Jaipur and Dausa have been diagnosed with dengue, chikungunya and scrub typhus infections. Read more. Elsewhere in Rajasthan, scrub typhus has caused the deaths of six people in Kota. 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

Japan: Rubella spikes in capital region

Up to 110 people have contracted German measles (rubella) this year in Tokyo and Chiba prefecture on the eastern side of Tokyo Bay, echoing a rise in infections across the country. A combined measles, rubella vaccine is given as part of the immunisation schedule in Japan at the ages of one and five years. Read more.

Advice for travellers: Rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine, one of the routine immunisations in Australia which should be current for prior to overseas travel. Travellers should also check their immunisation status for tetanus, diphtheria, and whooping cough. Read more about rubella.

Kiribati: Dengue case numbers dwindle

The seven month-long dengue outbreak is waning. Since February, nearly 1,800 people have been infected and two children have died of dengue-related complications. Read more 

Malaysia: HFMD cases top 55,000

Hand, foot and mouth disease (HFMD) cases have more than doubled this year compared to 2017 figures for the same period, climbing to 55,860 up to Aug 27th. Nearly 90 percent of cases were in children under seven and there have been two deaths (in Sarawak and Penang). 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.

Myanmar: Malaria rates reported

A national report on malaria incidence has highlighted a rise in the number of drug resistant cases even while overall numbers have dropped. The states with highest figures are Kachin, Rakhine and Sagaing, but more than 31 million people remain at risk of malaria infection. Read more. As stated in the UK’s Fit for Travel website  , ‘Malaria risk is present throughout the year in all areas except the major cities Mandalay and Yangon. Risk is highest in Chin, Kachin, Kayah, Rakhine, Sagaing and Tanintharyi states.’

Advice for travellers: 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

Papua New Guinea: Polio count hits 6

The number of polio cases affecting children under five has climbed to six with confirmation this week of two more cases – from Madang and the Eastern Highlands. A reactive vaccination campaign continues countrywide. Read more

Advice for travellers: Polio 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 poliomyelitis

Republic of the Congo: Two southern districts with suspected YF cases

Two adjacent departments near the southern border with Angola have reporting suspected yellow fever infections. Seventy cases are under investigation in Kouilou and Pointe-noire but there have been no deaths to date. Read more (translate from French).  Another news source puts the case count for the year at 186. 

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

Taiwan: Dengue cases rise to 53

More locally-acquired dengue fever cases being identified, with the majority in Taichung (25) and the district of Sinjhuang in New Taipei City (22). Other affected areas are Taipei, Chaiyi County, Taoyuan and Kaohsiung. Read more

Tanzania: Cholera persists near northern border

The reporting of cholera continues with an average of 60 new cases each week. The majority of cases during the week ending Aug 18th were from Arusha region (Ngorongoro District) – a pattern repeated over the past month (> 80 percent of cases were from this district, one of three with active transmission). Read more

United Kingdom: MERS import; Measles targets capital

A person infected with the MERS coronavirus has travelled from the Middle East to the UK, where the diagnosis was confirmed. Public health agencies are on the alert, particularly as this has occurred as millions of pilgrims return home from Saudi Arabia after performing the Hajj. Read more. Public Health England has issued advice for those ‘travelling from the Middle East to be aware of the symptoms of MERS’. 
ONE important consideration for those travellers planning a trip to England and its capital – over one-third of all confirmed measles cases in England this year have occurred in London. The message from health authorities – it’s never too late for unvaccinated children and adults to have the 2-dose MMR vaccine. Read more

United States of America: WNV season peaks

The height of summer in August brings an increased risk of transmission of the mosquito-borne West Nile virus, as monitored by the CDC.  While around 80 percent of infections are mild or not apparent (and therefore not likely to be reported in official figures), the complications of WNV that affect the central nervous system (neuroinvasive) occur in around one in 150 cases. Read more. Latest news reports can be found on the Flutrackers website. Five European countries have recorded a total of 39 deaths from WNV this year – Serbia (15), Greece (11), Italy (6), Romania (6) and Kosovo (1); Hungary, France and Croatia have also reported confirmed cases. Read more

Zimbabwe: Concerns over Midland’s typhoid outbreak

The WHO regional report on typhoid in the Midlands (Gweru) gives the number of cases as of Aug 26th as: ‘a total of 1,657 suspected typhoid fever cases, including eight deaths’. Despite the introduction of control measures, the agency remains cautious about the outcome in view of ‘only two antibiotics remaining for treatment. In this regard, there is an urgent need to ensure rational use of antibiotics, including dissuading the public from self-medication, as part of efforts to prevent antibiotic resistance.’ Over 160kms to the north, authorities in Kadoma are investigating an undisclosed number of suspected typhoid cases. 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 against typhoid is itinerary specific, but is usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices.