Health Alerts
Algeria: Arrivals checked for cholera

A day after a regional news source reported up to four cholera cases undergoing treatment in the NW port city of Oran, passengers from a flight that left the city bound for Perpignan in southern France were given health checks on arrival after a child on board suffered gastrointestinal symptoms. The child and several other passengers seated nearby have been admitted to hospital, results of tests are pending. 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

China: Protective measures against dengue for schoolkids

At the start of term next week, schools near Hong Kong’s Lion Rock Park and Cheung Chau, the sites of confirmed dengue infections, will be employing mosquito control measures, limiting pupils’ time outdoors and permitting non-uniform clothing that covers more skin. Insect repellent will also be distributed to all schools. There have now been 28 dengue fever cases since mid-August, ‘the highest number reported in a year since records began in 1994’. 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. 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: Disquiet over latest Ebola death

From a summary on the Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces published by CIDRAP, including information from the WHO’s Dr Peter Salama, there is concern by aid agencies this week after a person fled from Beni to Butembo after falling ill and subsequently died of Ebola virus disease in the city, which is a large commercial hub. This occurrence has the potential to render containment measures more difficult. There has been resistance from some parts of the community in Beni to the work aid agencies are carrying out. To Sept 4th, there have been 96 confirmed EVD cases, 31 probable and 87 deaths. Read more 

Advice for travellers: Despite the latest development, the risk of Ebola infection for travellers is still considered to be low. A severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees), Ebola spreads through families and friends because they come in close contact with blood and infectious secretions when caring for ill persons. Read more about Ebola Virus disease.

Europe: WNV cases rise to 710

West Nile Virus (WNV) season continues in many EU countries – the ECDC update on the most recent reporting week notes a further 300 cases from ‘Italy (144), Romania (61), Greece (41), Hungary (38), Austria (8), France (6), Croatia (1) and Slovenia (1)’ and 24 deaths in ‘Romania (6), Serbia (6), Italy (7) and Greece (5)’. The Australian government's Department of Foreign Affairs and Trade’s Smartraveller website includes advice on WNV prevention for travellers to Greece.

Advice for travellers: Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites.

India: Flood-related illnesses warnings; Dengue, malaria reports

One result of Kerala’s recent floods has been a rise in leptospirosis, or ‘rat fever’, notifications – to date there have been more than 500 suspected cases and 34 deaths. Read more. Authorities are also on the alert for the emergence of new dengue, hepatitis and measles cases. Read more
BILASPUR and Solan have been hardest hit in Himachal Pradesh’s dengue fever outbreak, with 2,000 infections recorded. Dengue fever case numbers have risen five-fold over last year in the port city of Visakhapatnam (Andhra Pradesh), and by almost double in the wider coastal district. To the immediate north, in the state of Odisha, coastal areas have endured a harsh dengue season, with Cuttack hardest hit. In Maharashtra, Mumbai’s rates of malaria and dengue fever have climbed this year compared to the monsoon months in 2017, reaching a three-month total of 534 dengue and 803 malaria cases.

Advice for travellers: Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.

Indonesia: Malaria adds to quake woes

Villagers still recovering from Lombok's recent earthquakes are waiting on the delivery of mosquito nets after 32 malaria cases were recorded in Bukit Tinggi and Mekarsari in Gunungsari district, north of the provincial capital Mataram. One local official expressed concern that the malaria was occurring near shelters provided for the survivors. Read more

Advice for travellers: Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria

Mauritius: Measles persists in 5 districts

The protracted measles outbreak, now in its fourth month, continues with 800+ cases already identified. Five districts have reported higher case numbers - Port Louis, Black River, Pamplemousses, Plaines Wilhems and Grand Port. Over three-quarters of all infections have been in people who had not been vaccinated or were unsure of their vaccination history. The regional WHO report states ‘The age-group 0-4 years are the most affected, followed by the age-group 25-29 years’. Three related deaths have occurred – all were in immunocompromised individuals who were unable to receive the vaccine. 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.

Myanmar: Snail fever in Rakhine; Rabies strikes southern township

The WHO is assisting local authorities with plans to monitor, test and raise awareness for schistosomiasis in Rakhine state. Over 800 suspected cases have been detected and a recent outbreak was announced in MraukU and Sittway townships. Read more 
ONE hospital in Yangon has treated over 5,300 people who had been bitten by dogs, while also reporting 18 rabies-related deaths up to the end of August. A local new report claims that most cases were from Dala township, on the opposite bank of the Yangon River to the capital. 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

Niger: Risk of cholera spread to capital

There are fears that flooding during the current rainy season cause cholera to spread from an outbreak in the Madarounfa, Maradi Commune and Guidan Roundji health districts to the capital Niamey. According to a WHO regional report, over 18 percent of cases have come from the bordering Nigerian states of Zamfara and Katsina (a total of six states are reporting cases). Seven regions in Cameroon are also reporting cholera infections or are on alert. Read more

Papua New Guinea: Cases of polio climb to 9

The number of vaccine-derived polio (cVDPV) cases has risen to nine with a total of three from Morobe and two from each of the provinces of Eastern Highlands, Enga and Madang. Of the three most recent cases (from Morobe, Madang and Enga), two had received no polio vaccines and hadn’t travelled, the third, a boy of nine years of age, had been in other areas of Enga province, but his vaccination history was unknown. Read more. Read the global summary dated Sept 5th here.

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

Taiwan: Local dengue infections increase to 81

There are fines for failing to report having dengue fever and authorities are pushing this message as they attempt to limit new infections. The national case count rose to 81 this week with another six cases recorded in Taichung (taking its total to 46) and one case in Kaohsiung. New Taipei City has had 26 cases. Read more

Thailand: Dengue count tops 50,000

It’s the second smallest of Thailand’s provinces, but Phuket has the fourth highest number of dengue fever infections per capita – the other high ranking provinces are Nakhon Pathom, Phichit, Mae Hong Son and Nakhon Sawan. Currently, the national death toll from dengue fever is 65 from more than 50,000 cases, up by more than half from last year.
Read more

Ukraine: Marginal improvement in measles outbreak

Another 436 people were diagnosed with measles over the last reporting week, but it still represents a reduction by just over 18 percent from the week before. The year-to-date total is now in excess of 30,000 cases and 13 deaths. Highest infection rates have been recorded in the regions of Lviv, Zakarpattia, Ivano-Frankivsk and Odesa. Read more. While in England - last week’s post detailed measles infections imported into London from the Continent, but the capital is not the only large centre experiencing a surge in cases mostly related to travel to European destinations. Health authorities in Birmingham have advised that the midlands city’s measles notifications have risen more than five-fold compared to 2017. Read more

United States of America: Salmonella cereal alert not over

Delaware, Maine, and Minnesota have been added to the list of states reporting salmonella infections from a brand of breakfast cereal. There have now been 136 cases from 36 states according to the CDC. The cereal in question has been recalled - ‘in any size package and with any “best if used by” date’. Read more from the CDC

Advice for travellers: Salmonella bacteria are typically found in food such as poultry and raw/undercooked eggs and can produce diarrhoea, fever, and abdominal cramps between 12 and 72 hours after infection. The illness usually lasts 4 to 7 days and most people recover without treatment, although the diarrhoea may be so severe as to require hospital treatment - young children and the elderly are at highest risk of severe illness. Read more