Health Alerts
Australia: Pertussis alerts in 2 states

A rise in the notifications for pertussis (whooping cough) in NSW and Tasmania has health authorities in the two states advising vaccination of new parents and pregnant women to ensure newborns are protected against the infection. Read more on whooping cough.

Brazil: Rio’s chikungunya surge; Regional dengue update

A local news source is reporting that the year-to-date count of chikungunya infections for Rio de Janeiro state has tipped 36,000 (to Nov 13), with a further 13,886 dengue fever cases and 2,223 Zika virus infections. Awareness campaigns have been rolled out for the peak summer season. Read more
THE Pan American Health Organization (PAHO) regional summary of dengue fever notes that Brazil is one of 13 countries reporting a year-on-year rise in cases, the others being Antigua and Barbuda, Argentina, Chile, Colombia, El Salvador, Guatemala, Guyana, Honduras, Jamaica, Mexico, Paraguay and Venezuela. 2018 data up to early November for the region: more than 446,000 cases and 240 related deaths. Read the PAHO report here.

Advice for travellers: Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

Chile: Raw fish meal with tapeworm larvae

Several residents of the Los Lagos town of Puerto Octay have been diagnosed with diphyllobothriasis, a tapeworm infection contracted by consuming larvae residing in raw (mostly) freshwater fish. In this case, it appears most of those infected had eaten ceviche – a dish of raw fish cured with citrus juice. Read more. More on diphyllobothriasis from the US CDC. 

Democratic Republic of Congo: Ebola cases rise to 421, Uganda vaccinates HCWs in west

As reported in the Nov 22nd WHO Disease Outbreak News update, ‘The risk of the outbreak spreading to other provinces in the Democratic Republic of the Congo, as well as to neighbouring countries, remains very high’. As a precautionary measure, the Ugandan government is vaccinating healthcare workers against Ebola virus in the four western districts of Kasese, Ntoroko, Bundibugyo and Kabarole. Read more. The latest Ministry of Health data for the outbreak can be found here.

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.

France: More local dengue fever cases announced

Earlier this month a further two cases of locally acquired dengue fever were identified in Clapiers, near Montpellier. This takes the yearly total to seven, after five earlier cases were found in Saint Laurent du Var (Provence-Alpes-Côte d'Azur). According to Santé Publique France, the ‘two episodes of autochthonous transmission were not epidemiologically linked and the viruses were of different serotypes’. Read more

Honduras: Dengue strikes in north

The northern city of San Pedro Sula is experiencing a sharp rise in dengue fever cases with more than 1,130 cases and three deaths recorded in the city and nearby towns including Villanueva. The upcoming holiday season is likely to exacerbate the outbreak according to the region’s health minister. 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.

India: Zika update for 2 states; Dengue delayed in Delhi

A local news report (since clarified) puts the confirmed Zika virus disease case count in Rajasthan at 154 and 127 in Madhya Pradesh, while local authorities are concentrating on mosquito control measures to ensure a re-emergence of Zika virus does not occur during the next peak season. 
NEW Delhi’s dengue season could be prolonged with some reports that cases could continue to emerge until the middle of next month. More than 800 cases have been recorded in the city this month. 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). 

Nepal: Mosquitoes + infections spread

Warmer and wetter weather conditions more conducive to mosquitoes have spurred on the dengue outbreak in Pokhara, with over 150 cases now reported. Other mosquito-borne illnesses such as malaria and Japanese encephalitis are likely to rise in incidence as a result of the favourable conditions. Read more

Advice for travellers: A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE

Netherlands: Serious infections in travellers returning from Africa

ProMED reports on infections diagnosed in two separate Dutch travellers following holidays in Africa: one, an unvaccinated man in his 20s who was diagnosed with yellow fever after spending two weeks in the Gambia (Mansa Konko) and three days in Senegal (Niokolo Park game reserve); the second, a woman who had undertaken an eight day safari visiting several parks in the north of Malawi and contracted human African trypanosomiasis (sleeping sickness).

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 – an effective vaccine is available and strict insect bite avoidance measures are recommended. 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

Nigeria: YF alert for Edo state; Lassa fever in 2018: 22 states

The Nigerian Centre for Disease Control (NCDC) is reporting nine confirmed cases of yellow fever in the southern state of Edo - official confirmation from the WHO is pending. According to the NCDC, ‘There are ongoing plans to begin a reactive vaccination campaign in the affected Local Government area in response to the cluster of cases’. Read more. The recent cases are part of a near-15 month outbreak of YF which has so far caused 1,640 cases in the states of FCT, Kogi, Anambra, Nasarawa, Zamfara, Edo and Benue. Read more
LASSA fever cases continue to emerge; three states (of the 22 recording cases this year) have had the highest rates of infections - Edo, Ondo and Ebonyi. Read more

Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

Papua New Guinea: 25th polio case recorded

An update from the Global Polio Eradication Initiative (GPEI): as of Nov 20 a further three cases of circulating vaccine-derived poliovirus (cVDPV) were reported from the provinces of Enga (2 cases) and East Sepik (1), with the latest date of onset of paralysis on Sept 30. There have now been 25 confirmed cases of cVDPV in PNG. The US CDC has issued a travel notice - Alert Level 2, Practice Enhanced Precautions - this week relating to VDPV cases in Niger’s southern region of Zinder (genetically linked to cases in northern Nigeria’s Jigawa and Katsina states). 

Advice for travellers: Poliomyelitis 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: Western province’s malaria spike

Following a dip in reported malaria cases from 2015 to 2017, the western province of Palawan has seen an uptick this year which has affected the southern mountainous areas (Rizal, Bataraza, Balabac, Quezon and Brooke's Point). Despite this, public health officials believe the planned elimination of malaria from the region by 2023 will be achieved. 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

Poland: Measles cases crop up in capital region

Poland is later than most European countries in reporting a rise in measles cases, but since early October, 79 infections have been reported in the province of Mazovia which includes the capital Warsaw. Read more. Meanwhile, Italy’s response to its ongoing measles outbreak is to instigate a massive vaccination campaign targeting 800,000 children and people who work in healthcare. Measles surveillance data to Sept 30, as provided by the ECDC, show Italy had recorded nearly 2,600 measles cases. Read more. In other news on measles, an update of the outbreak in Israel can be found here.

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.

Senegal: Dengue outbreak tops 2,500 cases

The dengue outbreak continues with 19 health districts now reporting confirmed cases and three dengue serotypes in circulation. Three districts have been hardest hit - Touba, Fatick and Richard Toll – as the number of suspected cases rose to 2,567 on November 19. Read more

South Africa: Testing for salmonella source

Investigations are underway into whether related sources of contamination are responsible for a spike in Salmonella cases over the past few weeks in eThekwini Metropolitan Municipality (includes the city of Durban), KwaZulu-Natal province. Read more

Advice for travellers: Salmonella is bacteria typically found is food, such as poultry, that causes diarrhoea, fever, and abdominal cramps between 12 and 72 hours after infection. Illness usually lasts 4 to 7 days, and most people recover without treatment, although diarrhoea may be so severe as to require hospital treatment. Young children and the elderly are at highest risk of severe illness. As there is no vaccine to prevent salmonellosis, it is best to avoid raw or undercooked eggs, poultry, or meat. Read more.

Taiwan: Indigenous dengue count now 176

More than 175 locally acquired dengue fever cases have been reported this year, with highest numbers in Taichung (107 cases), followed by New Taipei (43), Kaohsiung (12), Changhua County (8) and Taipei and Chiayi County (2). Notifications of new cases peaked in late August and have been declining since. Read more

Vietnam: Da Nang’s dengue hike

One hospital in the popular coastal city of Da Nang has been unable to cope with the rising numbers of dengue fever patients seeking treatment – more than 1,100 since the beginning of October. According to a local news article (computer translated), it has been necessary ‘to arrange additional beds in the corridors of the hospital in order to resolve the overload of patients’. 

Zimbabwe: Cholera and typhoid cases continue

While new cholera cases persist in the capital Harare, numbers are reducing (as is also the case with the concurrent outbreak of typhoid). In the most recent reporting week, a further 82 cases took the total for the outbreak that began just under three months ago to 10,141 with 55 deaths. Read the UNICEF report with details of cholera outbreaks in Eastern and Southern Africa. 

Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination against typhoid fever is itinerary specific, but is usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices.