Health Alerts
Australia: RRV advice for south-west

Warnings on Ross River virus have been issued by WA’s health department this week to ‘residents and travellers in the south-west region of Western Australia, including the Perth metropolitan area, to take precautions to avoid mosquito bites over coming weeks’. Numbers are currently low, however the upcoming holiday season will bring an influx of tourists to the area and appropriate personal protection measures are advised. Read more

Advice for travellers: Cases of Ross River occur throughout Australia, including more temperate southern states. Travellers visiting areas of Australia affected by recent flooding or continuing rain should take measures to prevent mosquito bites. Use a personal effective insect effective ingredient such as DEET, Picaridin,or PMD when outdoors and wear long, loose-fitting, light coloured clothing – especially at dawn and dusk, the times of day when RRV-carrying insects are most active.

Bangladesh: Dengue peaks

Dengue fever cases in and around the capital Dhaka have reached an 18-year high, with over 9,500 to date. The rates of new infections have started to decline, however doctors are reporting more complications among those presenting with fever at hospitals in the city. 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.

China: Second rat Hep E case

Several local news sources in Hong Kong are reporting a second case of hepatitis E transmitted from rats to a human. Both cases were from nearby housing estates in Kowloon’s Wong Tai Sin District and were likely contracted through consuming food contaminated by rats. Read more. The US CDC’s Emerging Infectious Diseases journal  (Volume 24, Number 12—December 2018) contains an article on the initial case: ‘Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant’. Read more

Costa Rica: Rabies death from untreated bat bite

A biologist who was bitten by a bat while visiting a cave in Copey de Dota in August has succumbed to rabies infection. The man had not sought medical treatment following the bite and had onset of rabies symptoms approximately eight weeks later (‘numbness and paralysis of movements, difficulties swallowing and behavioral disorders). 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

Democratic Republic of Congo: Update on NE’s Ebola outbreak; Cholera uptick

The World Health Organization's (WHO) latest assessment of the Ebola outbreak in North Kivu and Ituri provinces notes that it ‘remains dangerous and unpredictable’ due to ‘escalating insecurity’ with fresh concerns, reported by CIDRAP, that it ‘could last at least another 6 months’. Latest data from the health ministry’s dashboard: 373 confirmed or probable cases, 71 under investigation and 217 deaths (170 confirmed as Ebola Virus disease).
THE WHO has also reported that cholera case numbers have started to rise again after a lull in early October, with the provinces of Tanganyika, Haut Katanga, Sankuru and Kasai-Oriental most affected. Cameroon’s Far North region is experiencing a flare up in its cholera outbreak and a high case fatality ratio has been registered for both the North and Far North regions. 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.

Guadeloupe: Dengue resurfaces

Mosquito bite avoidance measures are advised following the confirmation of a small number of local dengue fever cases (in Abymes, Pointe à Pitre, Goyave and Petit Bourg), the first in over two years. Read more 

India: Zika cases in MP climbs to 127; Punjab’s dengue lingers

Zika virus disease cases have now been reported in the regions of Vidisha, Bhopal, Sehore, Hoshangabad, Raisen and Sagar in Madhya Pradesh – a total of 127 to date. Read more. DENGUE fever rates remain high in the state of Punjab with reports this week from Amritsar, Patiala and Muktsar.

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). 

Israel: Travel notice for measles outbreak

Last week the US CDC issued a level 1 Travel Notice - Practice Usual Precaution – due to the ongoing measles outbreak with similar notices also added for Colombia, New Zealand and Moldova. While in France, there has been a recent spike in measles cases in Seine-Saint-Denis, in the NE of Greater Paris, with 11 requiring hospitalisation. Read more. The health ministry in Algeria reports that more than four million children are not vaccinated against measles due to hesitancy or parental refusal. This year there have already been 23,000 cases and 16 related deaths. Read more

Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.

Japan: Rubella count nears 1,900

The nearly four month-long outbreak of rubella continues with the latest count approaching 1,900 cases. Twenty-six prefectures are now reporting cases; one local news source states there has been a recent increase in cases in the Kansai region, which takes in the cities of Nara, Kyoto and Osaka. Sub-optimal vaccination rates among adults (particularly men) aged 30-plus are fuelling the outbreak. 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 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.

Madagascar: Measles in 25 districts

Of the 114 districts, 25 - including the capital Antananarivo - are now reporting measles infections. Since the outbreak began in early October, nearly 2,600 cases have been recorded. Read more

Namibia: Anthrax sickens 7

In the Kunene and Kavango regions, anthrax infections have spread from buffaloes to livestock and now to humans, with seven cases recently reported in Siesfontein. Read more

Advice for travellers: The anthrax bacterium is transmitted to people in the form of spores which are can produce disease through consuming contaminated meat, through inhalation or via contact with the wool, hair or hide of infected animals. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about anthrax

Papua New Guinea: Polio case count rises to 22

East Sepik is the latest province to report a case of vaccine-derived poliovirus, taking the total since June to 22. There are no other details of this last case other than it was in Angoram district, SE of Wewak, and had onset of paralysis on Sept 26. 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 and vaccine-derived polio

Philippines: Double hit in CAR

In Luzon’s far northern districts, cases of dengue fever and leptospirosis rose sharply this year. Dengue infections in the Cordillera Administrative Region have doubled compared to 2017 data, and the number of deaths attributable to leptospirosis trebled, from two to six. Read more

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.

Spain: Catalonia records dengue case

A sixth case of locally acquired dengue fever has been reported in a resident of Barcelona. The man who had no history of travel was diagnosed earlier this month. The five previous cases identified this year are believed to have been infected while staying in the SE region of Murcia. Read more

United States of America: Contaminated lettuce alert; Florida’s local dengue case

Until a source of contamination has been determined in a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7, the CDC is advising ‘U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any’. Cases have emerged in 11 US states (California, Connecticut, Illinois, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio and Wisconsin) as well as the Canadian provinces of Ontario and Quebec. (In Australia, the lettuce variety is known as Cos) Read more
WHILE fewer than 50 dengue fever infections have been diagnosed in travellers returning to Florida from overseas in 2018, this week the Department of Health in Miami-Dade County announced a single locally acquired case of dengue. Local authorities have initiated their ‘response protocol to eliminate breeding and adult mosquito activity in the area of the confirmed case’. Read more