Health Alerts
Chile: Hep A in central regions

Hepatitis A cases have surged in the central regions of Bio Bio and Nuble, increasing by 140 percent since last year. One of the likely reasons given for the increase is the incorrect preparation of seafood for consumption – the coastal city of Coronel has recorded more cases than other districts. Read more

Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

China: Hep E virus jumps species, from rat to human; More dengue in Macau; HIV/AIDS spike

A man living in a public housing estate in Kowloon, Hong Kong, has been diagnosed with a form of hepatitis E previously found only in rats – the first such case. It is thought he may have become infected after consuming food contaminated with rat droppings containing the virus. The man’s abnormal liver function was being monitored after undergoing a liver transplant. Read more
IN MACAU, a further three locally acquired dengue fever cases have been identified in a family group living near the landmark Ruins of St Paul. The first case was diagnosed last week, followed by the man’s son and grandson. Health authorities are working to clean up the area but say more cases could come forward. Read more
HIV/AIDS diagnoses have increased by 14 percent in China this year - up by 100,000 to 820,000 cases - with sexual contact the most common form of transmission. Read more

Czech Republic: First human WNV cases

While mosquitoes and horses have been found to be infected with West Nile virus (WNV) in the Czech Republic, there had been no confirmed infections in humans – until this week. A senior health official confirmed the death of an elderly woman from WNV in the southern town of Breclav at the end of last week and, in a separate report, a man has been admitted to the same hospital for treatment of WNV infection. Read more. The 2018 WNV season has been particularly bad across the region with a three-fold increase in cases. This week the death toll from complications of WNV infection rose to 15 in the NE Veneto region of ItalyRead more

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

Democratic Republic of Congo: Risk of Ebola spread increased

The combination of local conflict, a mobile population, community resistance and distrust of government activities has caused the WHO to raise the level of alert for the Ebola virus disease outbreak in the NE provinces of North Kivu and Ituri. The WHO announced ‘the risk of national and regional spread is very high’ while advocating that ‘it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities’. Read the latest situation report issued by the dept. of health in the DRC.

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: Dengue updates for northern states

Previously unaffected areas of the northern hill state of Uttarakhand, in the central north, are currently reporting dengue fever cases and, elsewhere in the north, after dengue outbreaks were announced in some Punjab districts health officials have put the city of Ludhiana on alert. Residents have been reminded to take measures to avoid mosquito bites during the day. The death toll from dengue fever is now 11 in West Bengal’s capital of Kolkata but it’s the northern districts of the state that are faring the worst from a rise in dengue infections. 

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.

Madagascar: Plague claims more lives

Five regions (HauteMatsiatra, Amoron’I Mania, Itasy, Vakinankaratra, and Analamanga) which are endemic for plague have recorded cases since mid-August – of the 25, 19 are suspected cases. A WHO situation report notes ‘Although bubonic cases are predominantly reported during the endemic season [September to April], pneumonic cases are also expected’. To date, just over half of cases – both confirmed and suspected – have been the pneumonic form. Read more

Advice for travellers: Plague occurs annually in Madagascar, but poses a low risk to most travellers. Most cases of plague are due to bubonic plague following the bite of an infected flea carried by rats. If left untreated, infection of the lungs causes the pneumonic form of plague, a severe respiratory illness, which can progress rapidly to death. Read more on the plague

Malaysia: Rabies risk locations upped to 41

Seven new rabies risk locations have been announced in Sarawak taking the total to 41. Two in Miri are hundreds of kilometres from previously identified areas (including the site of the most recent human rabies case in Sri Aman), while the remaining five are in Sibu, Bintangor and Kapit. A committee set up to manage disasters has instructed dog owners to get their animals vaccinated against rabies and report potential exposures promptly. 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 or repeatedly through, endemic countries. Read more on rabies

Papua New Guinea: Polio situation update, 1 death

The regional WHO representative has announced the death of one of the (now) 14 polio cases, a child from Enga, and the reporting of a further two cases of circulating vaccine-derived poliovirus in the provinces of Jikawa and Eastern Highlands. The Global Polio Eradication Initiative organisation notes that ‘detection and reporting of new cases at this point in the outbreak response is not unusual or unexpected, as surveillance is being strengthened, and reported and confirmed cases had onset of paralysis prior to the commencement of comprehensive outbreak response’. The advice remains: ‘all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel’. 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 polio

Philippines: Luzon’s dengue surge; Bicol and measles

Dengue fever cases have increased by almost 90 percent this year in the province of Pangasinan, in central western Luzon. The death toll now sits at 25, from more than 6,200 cases and a ‘dengue watchlist’ has been put in place for seven towns and three cities, including the provincial capital Lingayen. Read more
THE REGION of Bicol has experienced a surge in measles cases this year – more than three times 2017 figures for the same period. Of the six provinces in Bicol, those with highest case numbers are Masbate, Camarines Sur and Camarines Norte. Six deaths have resulted from measles complications. Read more

South Africa: Rabies cases hit 10-year high

Included in a statement issued on the eve of World Rabies Day, the National Institute for Communicable Diseases called for a response to the 10-year peak in human rabies cases - seven cases in KwaZulu-Natal, six in Eastern Cape and two more suspected but unconfirmed – none of whom had ‘sought medical intervention after being bitten by a dog or cat’. Both provinces had reported outbreaks of rabies in dogs.

Tunisia: Leishmaniasis spreading in Kairouan

Over 65 cases of leishmaniasis have occurred in the inland Governate of Kairouan during the annual peak season for the sand fly-borne infection. Southern districts have reported the infections – Cherrarda, Bouhajla and Nasrallah. Read more

Advice for travellers: Leishmaniasis is a parasitic disease spread by infected sand flies and is found in the tropics and subtropics, as well as in southern Europe. There are two main forms – cutaneous and visceral. The former causes skin ulcers, the latter a severe systemic disease that is usually fatal without treatment. Read more on the disease, where it’s found and how prevent it.

Vietnam: Viral illnesses strike children in southern provinces

The incidence of hand, foot and mouth disease (HFMD) has climbed sharply this month, with more than 12,000 new cases taking the total for the year to 42,700 – almost half of those have required admission to hospital. It’s the southern provinces that have been hardest hit - at just one of Ho Chi Minh City’s children’s hospitals, new HFMD cases increased 5-fold and doctors have confirmed that many of those hospitalised have the potentially severe EV71 strain. Up to 90 children a day suffering from HFMD are being admitted to hospitals in the neighbouring province of Dong Nai. Read more. Measles is also spreading fast among children in provinces surrounding Ho Chi Minh City, including Dong Nai (also Binh Duong and Ba Ria-Vung Tau). 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.

Zimbabwe: Cholera situation a ‘serious concern’

In a statement on the current situation of cholera in Zimbabwe, the WHO admits that the extent of the outbreak is a ‘serious concern’. Local and international agencies are working to halt the spread of cholera through vaccination, the provision of safe water and repairs to supply infrastructure. Up to Sept 28 there had been 7,148 cases and 49 deaths – more than half of cases with confirmed ages were in the five to 35 years age group. 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