Health Alerts
Angola: Zika suspected in microcephaly cases

News reported by the UK’s Fitfortravel website this week, ‘Public health authorities quoted by media in Angola have reported more than 70 children with defects suspected to have been caused by infection with Zika virus before birth. Zika virus was first reported in Angola at the end of 2017 and the appearance of birth defects suggests a widespread outbreak, but case numbers are uncertain’. Weak health infrastructure in Angola has meant that the extent of the outbreak cannot be accurately monitored. Read more 

Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT). 

Brazil: Measles update for 2 northern states

In an update of the measles epidemic that has roared through the northern states of Amazonas and Roirama: government data now puts the total number of cases at 2,192 and 12 deaths, but another nearly 8,000 cases are still to be confirmed. Reactive vaccination campaigns have been ongoing since the beginning of the year. Read more. Measles reports are many times lower in Argentina, however health authorities in Buenos Aires are still concerned about the ‘active viral circulation’ occurring in two health districts, also noting ‘at least three transmission chains were identified, without having been able to find the source of infection in any of them’. 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.

Central African Republic: Single YF case in Bocaranga

Two weeks after the announcement of a hepatitis E outbreak in the prefecture of Ouham-Pendé, a single case of yellow fever (YF) was identified in Bocaranga, an area situated in the prefecture and reported to have low YF vaccination rates and large numbers of the vector mosquitoes. The Minister of Health and Population has called for an ‘urgent response’ due to ‘the speed of its transmission on a large scale’. Read more

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

Democratic Republic of Congo: More violence slows progress in Ebola affected areas

Local conflict is slowing Ebola virus disease control measures, including vaccination and public awareness focused on the current epicentre, Beni. CIDRAP reported on a similar situation which occurred several weeks ago and ‘caused a second wave of the virus that is still wreaking havoc in Beni and Butembo’. There has been an update on the data from the Oct 23 WHO situation report: there have now been 244 cases of haemorrhagic fever (209 confirmed, 35 probable & 37 suspected) and 122 deaths. 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: Rajasthan’s Zika cases increase again; Dengue’s late strike

Shastri Nagar in Jaipur’s north remains the site of most recorded Zika infections as more cases were reported this week, taking the total to 131 including 41 pregnant women. Insecticide fogging is being carried out in the area amid intensified surveillance. Read more
JUST over half of Delhi’s dengue fever cases were recorded in the first three weeks of this month. Additionally, 103 people were confirmed to have malaria infection during the same period. Fines are being issued to households found to contain mosquito breeding. Dengue continued to produce cases in Gujarat’s largest city, Ahmedabad, in early October; among food and water-borne infections, the number of typhoid infections has risen compared with last with 233 recorded to date. At a national level, the number of dengue fever infections and related deaths is lower than last year. Of the states, Maharashtra fared worst (4667 cases), followed by Odisha (3883) and Kerala (3660). The death toll from dengue climbed sharply in Kerala following recent floods – 35 recorded for the year to the end of September. 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.

Japan: Rubella travel warning

The US CDC has now added the rubella outbreak (previously reported in our travel health alerts) to its list of travel notices, noting ‘Most cases continue to be reported in the Kanto region (Tokyo, Kanagawa, Chiba, and Saitama)’. A local news source stated earlier this week that the number of cases has risen to 1,103 and ‘about 70 percent of infected people are men in their 30s through 50s’. 

Advice for travellers: Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine. Highly contagious, rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Travellers should also check their immunisation status for all childhood diseases, including measles, mumps, tetanus, whooping cough and diphtheria as part of their pre-travel medical preparations.

Nigeria: Monkeypox alert

A CDC travel notice has also been posted in response to the year-long outbreak of monkeypox which has caused 115 cases (and 7 deaths) in 17 states up to Sept 15; three cases have also been diagnosed in travellers – UK (2) and Israel (1). The worst affected are Rivers, Bayelsa and Cross River, all of which fall in the South-South geopolitical zone. Read more

Advice for travellers: Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox

Papua New Guinea: Polio count climbs to 18

More polio cases have been diagnosed as heightened surveillance continues across the country; three cases from the provinces of Enga, Eastern Highlands and Madang were reported by the Global Polio Eradication Initiative (GPEI) on October 16th. Vaccination campaigns continue for all children under 15yo. The GPEI also reported on one new wild poliovirus case in Afghanistan’s Hilmand province and cVDPV cases in Somalia (1 case) and Niger (3). 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 and vaccine-derived polio

Philippines: Dengue in north, measles in Central Visayas

The Cordillera Administrative Region encompasses six provinces in the far north of Luzon, including the large city of Baguio. This year dengue fever cases in the region have risen to almost double those of last year. Most affected municipalities were Kalinga, Benguet, Apayao and Abra. In total there have been almost 6,000 cases and 11 deaths. Read more. Measles vaccinations are provided at no charge but not enough people have taken up the offer resulting in low immunisation rates and an almost 560 percent rise in measles cases in the Central Visayas. Read more 

United States of America: Hep A cases rise in Florida

Since March last year, the Centers for Disease Control & Prevention (CDC) has reported on a large increase in the incidence of hepatitis A predominantly among homeless people and illicit drug users, and this week health authorities in Pinellas County in Florida have announced they are closing in on a 13-year high in Hep A cases. Free vaccinations have been offered as a public health measure. 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.

Venezuela: Malaria cases rocket

Lack of funding is one of the reasons behind a spiralling of malaria cases with more than 665,000 recorded this year. Many medical facilities lack the necessary treatments and the president of the Medical Federation ‘also warned that "alarms are also activated" for an imminent epidemic of hepatitis and measles’. Read more

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

Zimbabwe: More cholera deaths in Buhera

The localised cholera outbreak in Buhera, south of Harare, has spread further within the local community. Thirty cases have been confirmed and 82 more are suspected plus there have been seven deaths. A vaccination campaign has been underway in Harare, then moving on to Epworth and Chitungwiza. 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