Health Alerts
American Samoa: Chikungunya epidemic 'slowing'

After more than 500 confirmed and suspected chikungunya cases in the past month, the epidemic seems to be slowing. Read more

Advice for travellers: The symptoms of Chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. There is no vaccine or prevention medication: Using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. While fatal cases are rare, but painful joints may persist for weeks or months after the acute phase has ended. Read more about Chikungunya

Bangladesh: Deadly fish meal kills 4

A meal of puffer fish bought at local markets in Dhaka has killed 4 members of a family and sickened another. Puffer fish possess a potent neurotoxin, tetradotoxin (TTX) which can cause paralysis of the peripheral nervous system. Read more.

Caribbean: Dip in Chikungunya cases

New cases of Chikungunya across the region fell dramatically in the past week, increasing by only 1.7% (9798 cases) – well below the 8% and 12% rises of the previous 2 weeks. The fall may be due to a downturn in transmission, or delays in reporting. Most of the new cases were reported in El Salvador, Guadaloupe, Martinique, and Puerto Rico. The additional cases take the total to 585,798, including 37 deaths – an increase of 5. Read more (PAHO table). 
IN Jamaica, the number of locally acquired Chikungunya infections has risen to 8, with 2 imported cases. Affected parishes include St Thomas, St Catherine, St Ann and Kingston, and St Andrew. Read more
ST KITTS-NEVIS has now 59 confirmed or suspected cases, while there have been more than 80 confirmed or suspected cases in Trinidad and Tobago in the month since Chikungunya arrived. 

China: Dengue hits Guangzhou; New JE case in Hong Kong

Dengue fever is spreading in Guangzhou, China’s largest southern city. The highest number of infections have been reported in the districts of Yuexiu (191 cases), Nansha (97), Baiyun (48). The outbreak has yet to peak, authorities say. Read more
IN Hong Kong, a fourth case of Japanese encephalitis has been reported in a 34-year-old man thought to have been bitten by an infected mosquito near his home in the city of Tuen Mun (Castle Peak). Read more

Advice for travellers: JE is usually found in many part of Asia, including China, and the Indian subcontinent, as well as Indonesia, the Torres Strait and PNG. While it is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, it also occurs in or near cities. The risk to short-stay travellers and those who confine their travel to urban centres is very low. Expatriates and travellers living for prolonged periods in agricultural areas where Japanese encephalitis is endemic or where seasonal epidemics occur are at greater risk and should consider vaccination.

Ethiopia: Spike in meningitis, measles cases

Increasing numbers of meningitis cases are being reported from either end of the country, including the northern Amhara, Gambella, Oromia, and Tigray regions, and the SNNP (Southern Nations, Nationalities and Peoples) region in the south. Read more
THE Amhara and Oromia regions have recorded around half of the 160 suspected measles cases reported nationwide in the first week of August. Read more

Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person by coughing and sneezing. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. Ethiopia lies on the eastern edge of North Africa’s ‘meningitis belt’, where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). 

Ghana: Boy’s death prompts rabies warning; Accra’s cholera at ‘staggering’ levels

Scratches from a rabies-infected cat has killed a 10-year-old boy in the Ashanti region in the southern central region of the country. Vets have warned of an increasing number of animal cases. Read more
POOR sanitation and overcrowded health facilities have led to the rapid spread of cholera outbreak in Ghana's capital, Accra, where the disease has reached ‘staggering’ levels, according to a health official. There have been 3100 infections in the capital, including 40 deaths. 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. Generally, the risk of rabies for most short-stay travellers is low. Vaccination is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas. Read more on rabies

Greece: West Nile season begins

The first case of West Nile fever inside the European Union for the 2014 transmission season was reported in an elderly man in East Attica region last week. Earlier cases have been reported in neighbouring countries: 2 in Israel in July were reported last week, while Russia, Serbia and Bosnia and Herzegovina have reported 25 probable and confirmed cases to date. The ECDC provides weekly updates of case numbers and accompanying maps. 

Advice for travellers: WNV is endemic in much of the EU and the transmission season is now underway. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk to most travellers is generally low, those visiting regions which have reported human cases should take measures to avoid mosquito bites

Guinea, Liberia, Nigeria, Sierra Leone: No end in sight to Ebola

The Ebola virus disease outbreak region reported 113 new cases and 84 deaths in the 3 days to August 16, taking the overall total to 2240 infections and 1229 deaths. Liberia heads the count with 48 new cases and 53 deaths, lifting its totals to 834 and 466 respectively. In other outbreak countries, Sierra Leone reported 38 cases and 17 deaths, while Guinea recorded 24 cases and 14 fatalities. In Nigeria, 3 more cases are linked to its original imported case. Read more (WHO update, WHO assessment
Read the latest developments in West Africa’s Ebola outbreaks from ProMED

India: Encephalitis ‘under control’; Dog sparks rabies panic; Dengue deaths; Cholera, diarrhoea outbreaks

West Bengal’s encephalitis outbreak, which has claimed 254 lives, is ‘under control, officials say. Of the 254 deaths from Acute Encephalitis Syndrome (AES), 45 were due to Japanese Encephalitis (JE). Read more
IN Goa, a rabies-infected dog has bitten 25 people during a rampage in the village of Cansaulim. The victims received post-exposure treatment for the deadly disease. Read more
DENGUE is believed to have killed at least 5 people in the Raichur district in Karnataka State’s north, and taken the lives of two children in Sagar district of (Madhyapradesh). 
MORE than 250 people in the village of Niphad (Maharashtra State) are being treated for acute diarrhoea, while cholera has surfaced in the town of Godhra (Panchmahal district, Gujarat state).

Jordan: Shigella infects 150, closes restaurant

Infected hummus is thought to be the cause of an outbreak of Shigella involving 150 patrons of a restaurant in the Karak district of Shihabieh. An unspecified number of diners were admitted to hospital, while the restaurant was closed pending further investigations. Read more

Advice for travellers: Caused by Shigella bacteria, Shigellosis can result in diarrhoea, fever, and stomach cramps starting a day or two after exposure – usually through contaminated food. Persons with mild infections usually recover quickly, but antibiotic treatment is recommended for patients with more severe symptoms. Read more

Philippines: Measles rates soaring; Dengue alert in Catanduanes

The number of measles cases in the Philippines continues to skyrocket. The national total rose to more than 77,000 cases, with 30,000 since June, according to WHO figures
A DENGUE alert has been declared in Virac municipality (Catanduanes Province) following 36 cases in the past week. Read more
AT least 4 towns in Iloilo Province – Igbaras, Tigbauan, Carles, and Guimbal – report suspected outbreaks of Chikungunya virus. Last year, the Philippines recorded 1609 cases of the disease – three times 2012 levels – with outbreak in several locations across the nation. Read more

Samoa: Chikungunya numbers rising

Based on week-old figures, there have been 8 confirmed and almost 100 cases of Chikungunya fever in an outbreak which has spread from nearby American Samoa. Read more

Saudi Arabia: MERS-CoV death in Riyadh

In Riyadh, a 72-year-old man has died of Middle East respiratory syndrome coronavirus (MERS-CoV). No new cases were reported; 27 people are being treated in hospitals. Since June of 2012, Saudi Arabia has reported 723 MERS-CoV infections, including 300 fatalities. Read more

South Sudan: Upper Nile cholera easing

Widespread cholera epidemics in the states of Upper Nile, Eastern, and Central Equatoria have left at least 123 dead. The outbreak in the Upper Nile town of Wau Shiluk has slowed after 894 cases and 17 deaths to August 10. Read more

Sri Lanka: Metro areas top dengue count

As the rainy season continues, dengue numbers are rising – most notably in the metro districts of the capital, Colombo, Gampaha, and Kalutara in Western Province, home to more than a quarter of the population. Around 20,600 cases were reported in the first half of 2014. Read more

Taiwan: Dengue at 11-year high

The number of locally acquired dengue cases has reached an 11-year high of 878, including 120 imported and 758 locally acquired infections. The week was also marked by the first death from dengue haemorrhagic fever in an elderly woman from southern Kaohsiung, and a second case of the more severe form of the disease.  Kaohsiung City is a hot spot for the disease, with 147 cases in the first week of August. A series of explosions in underground gas lines in the city on July 31 damaged some of the city’s drainage systems, allowing mosquitoes to breed in water-filled ditches after rain. Read more

United States of America: Record whooping cough; Measles epidemic wanes; Cat had rabies; West Nile death in Miss.

In California, 2014 has seen a record 1183 cases of whooping cough (pertussis) – almost 3 times last year’s figure – with 288 cases in recent weeks. 
OHIO’S 377-case measles epidemic is finally coming to an end. The outbreak began in March when unvaccinated Amish missionaries infected in the Philippines brought the disease to their largely unvaccinated Amish community. Most of the nearly 600 cases of measles in the USA this year have involved unvaccinated people. Read more
EIGHT people have received post-exposure treatment after coming into contact with a rabies-infected cat in an animal shelter in Pennsylvania. Read more
MISSISSIPPI has reported its first human death from West Nile virus for 2014. A new human case in Wilkinson County follows cases in 3 other counties. Read more

Advice for travellers: Outbreaks of whooping cough and measles in the USA and other developing countries highlight the importance of current immunisation against contagious childhood diseases to all destinations.

Vietnam: HCMC's soaring dengue cases

Doctors at Ho Chi Minh City’s Hospital for Tropical Diseases say they have seen an alarming recent spike in the number of dengue fever cases among adults, as well as an increase in infections among children. Other hospitals in the southern city report similarly high numbers. Read more

Zimbabwe: Dirty water brings more typhoid

Outbreaks of typhoid in the cities of Harare and Mutare, and the town of Chegutu, have now left at least 9 people dead and sickened 370. A lack of safe drinking water is behind the outbreak, with some suburbs without a treated supply for months. Nationwide, there have been 24,430 cases (76 deaths) from dysentery this year, while diarrhoea has left 573 dead and sickened 358,391. Read more

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 is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices.