Health Alerts
Brazil: ‘Spiked’ açaí juice; Floodwater risk in Petrópolis

Ripe açaí berries coming onto the market has led to a rise in the number of Chagas diseases cases in the northern state of Amapá, bordering French Guiana. Health inspections in seven towns have been ramped up, targeting establishments that sell blended açaí juice after a number of them were found to have equipment contaminated with the faeces of infected triatomine bugs. Read more
EVEN before this year’s rainy season has hit, leptospirosis cases have risen sharply in Petrópolis. Authorities in the city, a mountain retreat for nearby Rio de Janeiro’s residents, have issued warnings after cases rose by almost 80 percent. Read more

Advice for travellers: Chagas disease (American trypanosomiasis) is widespread in Mexico, Central America, and South America. However, it presents a low risk to Australians travelling to the region who stay in air-conditioned or screened accommodation. Infected triatomine bugs infest poor-quality dwellings and take a blood meal from victims at night. However, as has become more common, the disease can also be transmitted through freshly pressed juice contaminated with the insects attracted to the ripening fruit. Read more on Chagas disease.

Democratic Republic of Congo: Ebola outbreak update, malaria in North Kivu

The number of confirmed Ebola virus disease cases (EVD) has reached 276, with a further 35 deemed probable and 65 more under investigation. CIDRAP reported today that ‘in research developments, scientists yesterday reported durable protection for three Ebola vaccines, including the one currently deployed in the DRC’. But Ebola is not the only crisis in North Kivu. Dr Pete Salama, Deputy Director-General for Emergency Preparedness and Response for the World Health Organization (WHO), tweeted news of a malaria outbreak in the region that is producing up to 2,000 cases per week.  More children have died in this, the country’s third largest EVD outbreak, mostly from receiving treatment for malaria in traditional healing clinics where EVD patients were also present amid poor infection control. 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: Zika case in Rajasthan’s neighbouring state; Late wave of dengue

With Rajasthan’s Zika virus disease count now at 147, a single case has been identified in Gujarat, the state to the south. It was in Gujarat that Zika was first identified in India, in January 2017. Read more. Public Health England and NaTHNaC have now raised the risk rating for Zika transmission in Rajasthan from moderate to high. Read more. A late surge in dengue fever infections in Hyderabad (Telangana) has gone against the annual trend of decreasing cases in October, while in Delhi the usual rise in cases that starts in October and continues through November has occurred, however the city has experienced a relatively mild season with less than half infections compared to last year  Hospitals in Tamil Nadu are currently reporting a steady stream of ‘fever’ cases. 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).

Namibia: Help to tackle Hep E outbreak

The WHO is providing assistance to government agencies to enforce efforts needed to contain the ongoing hepatitis E outbreak. Infections have been recorded in half of all regions: up to mid-October there have been 3,630 cases, many of those in Windhoek and Swakopmund. Read more

Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Infection during the latter stages of pregnancy carries a higher rate of severe disease and mortality. Unlike the Hep A and B viruses, there is no vaccine for this strain, which is especially common in communities with lower levels of sanitation and hygiene. Read moree about the virus and how to prevent it.

Nepal: Dengue in trekkers’ hub, capital

Dengue fever has sickened up to 35 people in the trekking hub of Pokhara, the gateway to the Annapurna Circuit. A local news source cites the chief of the local health division saying ‘this is the first time that such a large number of dengue patients have been reported in Pokhara’. Read more. ‘Dozens’ of dengue fever cases have been reported in the capital, Kathmandu, and the risk of spread within Kathmandu valley is said to be high during the October-December peak dengue season. 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.

New Zealand: Beach litter hazards

For beach-goers, the rates of injuries and infections from coming into contact with litter has been rising annually, now currently at five percent. A NZ Herald article on the hazards states ‘the most common injuries were infected wounds, soft tissue strains, damage to the eye and fractures or dislocations’. Read more 

Pakistan: Rabies vax shortage bites; Tick-borne infections in Sindh

Without supplies of Chinese rabies vaccines, health institutions have had to rely on Indian formulations, but those are now in high demand for the domestic market, limiting exports to countries such as Pakistan. At one hospital in Karachi the shortage means that ‘only a few and extremely serious patients would be vaccinated in case of dog-bite incidents’. Read more
OVER 100 cases of tick-borne Crimean-Congo Haemorrhagic Fever (CCHF) and 11 associated deaths have been recorded in Sindh province this year. The latest death occurred in a grazier from one of Karachi’s administrative districts, Malir. Read more. Moving livestock during drought conditions in regions of the north and west has led to a climb in CCHF cases in Afghanistan with cases almost doubling over last year’s – from 244 to 455. 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: More environmental polio samples, CDC issues travel notices on polio

The polio case count has risen to 19 with a new case identified in the Southern Highlands and three more under investigation. Read more. Intensified surveillance in the wake of the outbreak has uncovered more environmental samples of the circulating vaccine-derived poliovirus, this time in two ponds in Morata and Waigani, near Port Moresby. The lakes take sewage discharge from the city so the discovery is not unexpected – residents of the area have been warned to stay away from the ponds. Read more. The US CDC last week added five new Travel Notices (Alert Level 2, Practice Enhanced Precautions), for PNG, Democratic Republic of the Congo, Nigeria, Somalia, and Syria due to the ongoing polio outbreaks.  Details of the cVDPV2 cases in southern Niger have been published in a Disease outbreak news piece from the WHO published on Oct 30. 

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

Switzerland: TBE rise warrants higher vax coverage

Following a 30 percent rise in tick-borne encephalitis (TBE) cases this year, health authorities are considering broadening vaccination recommendations against TBE to ‘entire cantons or even for the whole country’. The 334 recorded infections constitute a new high in TBE case numbers with concerns the current vaccination coverage is inadequate. Read more

Advice for travellers: A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia; however, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE

Taiwan: Dengue total nears 170

The city of Taichung has recorded the highest dengue fever count this year with 101 of the 169 cases nationwide. Other affected areas include New Taipei, Kaohsiung and Changhua County. Read more

Thailand: Dengue at 20-year peak; Measles outbreak in south worsens

This year’s dengue fever season has been severe, representing a 50 percent rise in cases over the past six years and a 20-year high. According to one local news source, ‘the country could see up to 200,000 cases this year’ which would exceed the 174,000 reported in the largest outbreak in 1987. Read more
A DOOR-to-door vaccination campaign is underway in the southern province of Yala in response to the measles outbreak which has infected over 850 children in the 9 months to five years of age group and caused 10 deaths. 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.

United States of America: WNV cases top 2,000

To date this year the national death toll from West Nile virus (WNV) fever infections has reached 86 from approx. 2,000 cases. According to data from the CDC, ‘states that have reported more than 50 cases include California, Colorado, Illinois, Iowa, Louisiana, Michigan, Nebraska, North Dakota, Pennsylvania and South Dakota. Read 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

Yemen: Cholera’s comeback

IRIN reports that cholera has made a resurgence this year, after infecting over 1 million people and killing 2,510 last year. In a recent reporting week, there had been 15,000 suspected cases, with the conflict-torn Hodeidah province most affected. Read more. Xinhuanet.net reports that cholera vaccinations are being offered in the city of Aden with the assistance of the WHO.

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