World travel health alerts 1 April 2020

COVID updates, resources

Now reporting more confirmed COVID-19 cases than any other country, the USA’s case count has exceeded 160,000 and may not reach its peak until mid-April, according to analysis. The US is one of 202 countries and territories reporting infections.

The WHO has called for strategies to suppress disease activity during lockdowns put in place by many nations; these would include ‘aggressively’ identifying and caring for patients. Read more. Data from the latest WHO Sitrep (Mar 31) show both the reported global COVID-19 cases and deaths more than doubled over the previous seven days.

CIDRAP is reporting that UK researchers have developed a ‘new case-fatality rate estimate of 1.4%, based on all available data on deaths in and outside of China’; it was also shown to decline ‘to 0.66 after adjusting for undiagnosed cases’. The report was based on an article published in The Lancet Infectious Diseases on Mar 30.

Various articles:

More from one of the authors of ‘The proximal origin of SARS-CoV-2’ on how ‘two tiny tweaks to the virus’ genetic code have made a huge difference’.  

Coronavirus treatment: Vaccines/drugs in the pipeline for COVID-19 Read more

Can mosquitoes spread coronavirus? Read more

The third animal to test positive in Hong Kong Read more

Risk factors, safety precautions for carry out foods during pandemic Read more

Local, African polio update

The YTD total of wild poliovirus 1 cases has risen to 32 with the addition of two more cases from the Sindh. In the African region, cVDPV2 cases were reported in Angola (two from Moxico province), Chad (two in Batha province and one each in the provinces of Guera, Tandjile and Barh el Gazel), one case in Cameroon and, in Ethiopia, three in Oromiya province. Read more

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.

Northern provinces report dengue spike

Local news sources have reported an increase in dengue fever cases in a number of northern provinces, including Corrientes, Santiago del Estero, La Rioja, Catamarca and Tucumàn. Read more. And in Paraguay, more dengue cases are likely while weather conditions remain conducive to mosquito breeding, however this season’s extensive outbreak season which resulted in 53 deaths has been declared over.

Advice for travellers

Dengue fever is common in most tropical or sub-tropical regions of the world. The virus is spread by daytime-feeding Aedes mosquitoes and to avoid it and other insect-borne diseases, travellers should apply an insect repellent containing an effective active ingredient, such as DEET, Picaridin or oil of lemon eucalyptus (PMD), to exposed skin when outdoors during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, as well as other times when the mosquitoes are active.

Dengue reappears in Townsville; Local COVID resources, news

Three suburbs of Townsville have been named as the sites of locally-acquired dengue fever infections, with two confirmed cases (suburbs of Stuart and Condon) and one suspected (Northern Beaches) – there is said to be a link between the cases. An ABC report notes that the Northern Beaches area was not included in the Wolbachia trial. Read more

THE FEDERAL government has developed more sources whereby reliable information on COVID-19 can be accessed: ‘Message +61 400 253 787 or go to http://aus.gov.au/whatsapp  in your web browser to get #COVID19 information you can trust from the official Australian Government chatbot and the Australian Government has released an official app with the information you need to know about #coronavirus - search "Coronavirus Australia" in the Apple App Store and on Google Play.’ Also, the government-funded service, Healthdirect, hosts an online symptom checker. In other COVID-19 news, Australian healthcare workers will participate in a WHO-endorsed trial using the BCG vaccine to protect against COVID-19 infection: ‘the BRACE trial builds on previous studies which showed that BCG reduces the level of virus when people are infected with similar viruses to SARS-CoV-2’. Read more

Advice for travellers

Avoid mosquito bites to protect against dengue fever. To avoid biting insects, apply repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) to all exposed skin when outdoors. 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 outdoors. Travellers should also cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active.

Fears of another dengue record

This year has started badly on the dengue fever front, reporting a 4-fold increase infections compared to early last year – 2019 went on to finish with a 20-year high in infection rates. Read more

Advice for travellers

This year has started badly on the dengue fever front, reporting a 4-fold increase infections compared to early last year – 2019 went on to finish with a 20-year high in infection rates. Read more

COVID-19 adds to disease threats

The protracted outbreak of measles continues with a further 2,878 cases and 49 deaths reported in the week to Mar 15. Recently infections have started to decline though – the most affected areas are the provinces of Mongala, North and South Ubangi, Maindombe, Kongo-Central, Equateur, Kwilu, Kasai and Sankuru. In a Mar 31 statement, UNICEF expressed concern that the Ebola outbreak and now SARS-CoV-2 are taking much needed resources away from ‘already enfeebled healthcare facilities’ dealing with outbreaks of measles and cholera. 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. In general the infection is relatively benign, but complications 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.

Rabies strikes again in Sarawak

A young girl from Sibu in Sarawak, who was bitten by a stray dog early in March, has succumbed to rabies infection. While she had received post-exposure treatment, according to a news article, it did not include a vital first aid step – immediate, thorough wound cleansing. There have now been 23 rabies-related fatalities in the state in almost three years. 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. In the event of an at-risk exposure, urgent first aid and 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.

Hep E outbreak slowing

Twelve of the country’s 14 regions have reported hepatitis E cases at some stage during the outbreak that started in late 2017, however there has been recent improvement in the situation with a decline in new cases observed. A local news source cites the health ministry stating that ‘cases are still being detected in areas where water and toilet facilities are limited, particularly in Khomas and in Erongo regions’. The regional WHO office reports that just over 40 percent of the 59 deaths reported to Dec 29 last year were in pregnant or post-partum women. 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 in Australia, which is especially common in communities with lower levels of sanitation and hygiene. Read more about the virus and how to prevent it.

Defer Hajj plans

With the year-round Umrah pilgrimage already suspended, the government has requested that plans for attending this year’s Hajj (held in late July to early August) be put on hold until there is ‘more clarity’ with the progress of the COVID-19 pandemic. More than two million Muslims attend the annual ritual each year. Read more

Yellow fever confirmed near southern border

n the Week 13 WHO African region bulletin, confirmation of yellow fever infection in two people from Kajo Keji country in areas near to those which were the subject of a Jan 27 WHO statement regarding yellow fever cases and deaths. 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.

Hep C spreading among MSM cohort

Early last month, details of a study conducted in Bangkok on hepatitis C infections among men who have sex with men (MSM) were presented at the 2020 Conference on Retroviruses and Opportunistic Infections. One of the conclusions reached in the study: hepatitis C is spreading rapidly through sexual transmission among HIV-positive MSM men in the city, and is associated with use of crystal methamphetamine. Read more

Advice for travellers

Hepatitis C is a viral infection of the liver which is most commonly contracted through intravenous drug use, but transmission has also has been reported infrequently through modes such as unsafe MSM sex with an HCV-infected person (a higher risk if that person is also HIV-infected), sharing personal care items (i.e. razors) contaminated with blood and unregulated tattooing. For up to 30% of infections, it is a short-term illness and the individual may not have symptoms; but for the majority it can become a chronic infection which can produce long-term health issues and potentially lead to death. Antiviral medications have been developed which have been shown to successfully treat the majority of Hep C infections. Read more on hepatitis C from the WHO.