World travel health alerts 10 March 2021

World travel health alerts for 10th of March 2021.

Polio update, annual vax campaign for Egypt’s children

The GPEI has reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) in its latest update: Afghanistan’s single case was in Badghis and Pakistan registered three infections from the Sindh and Punjab. In Africa, South Sudan logged seven cases (Jonglei, Warrap, Unity, Northern Bahr El Ghazal and Central Equatoria), while Ethiopia’s only case was from SNNP.  A polio vaccination campaign was launched last week in Egypt with plans to administer doses to more than 16 million children. The program is a ‘pre-emptive step’ in view of recent and ongoing polio outbreaks within the region. There have been six environmental samples positive for cVDPV2 in Egypt this year and one last year.

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.

Global flu levels lower than expected for time of year

WHO influenza data for the week to Feb 14 reveals that more testing hasn’t detected more flu – detections of influenza A and B viruses were sporadic and most northern countries had rates below baseline. Among countries in the temperate zone reporting sporadic detections, more influenza B was seen in Oman and Saudi Arabia, while it was influenza A(H3N2) in Armenia and the UAE. In tropical zones, SE Asia recorded influenza A(H3N2) activity in Laos, Thailand, East Timor and Vietnam. See more reports from tropical zones here.

Advice for travellers

Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination for all travellers over 6 months of age. Read more about influenza.


Stinger death in Qld’s north; Dengue mozzies detected in NT; The bees have it

Media reports emerged last week on the death of a young man from a Box jellyfish sting he sustained while swimming near the remote north Qld community of Bamaga. The regional health service’s director of medical services said there had been ‘sightings of both box jellyfish and jellyfish that cause Irukandji syndrome’ so the advice is to wear a stinger suit or stay out of the water in risk areas. Read more  

AEDES aegypti mosquitoes have made a fourth confirmed incursion into the Northern Territory (NT) since they were eliminated over 60 years ago - it is believed they must have arrived with heavy vehicle deliveries from Qld. The latest detection was well south of Darwin, in Tennant Creek, and further surveillance in the area is planned for later this month. Read more

A REPORT released last week by the AIHW estimated allergic reactions to bee stings were responsible for more than a quarter of the hospitalisations resulting from contact with a venomous animal or plant in 2017–18. Despite having ‘spiders, ticks, and 20 of the 25 most venomous snakes in the world … bees and wasps [were responsible] for 12 of the 19 deaths related to venomous bites and stings’. Hospitalisation rates for all venomous bites and stings by state/territory were highest for the NT (31 cases per 100,000 population) but very remote areas scored higher (49 cases per 100,000).  Also on the subject of allergic reactions to insect stings/bites, health authorities in Western Australia have warned that recent heavy rains have led to a surge in March fly numbers in the Gascoyne and Pilbara (especially Karratha and the Shire of Ashburton), with some reports of anaphylactic reactions to the bites. Read more

Advice for travellers

The jellyfish are present in our seas all year round but the risk is higher during peak season, which in the Top End coincides with the wet season from around October/ November until May. The season is usually a little shorter further south. Read more about venomous marine creatures.  

YF alert in southern Santa Catarina

Laboratory results are pending, but the deaths of 40 monkeys in a short period of time near five Santa Catarina municipalities are presumed to be caused by yellow fever infection. Local health officials have issued an alert for the cities’ residents while also mapping yellow fever vaccination coverage and escalating surveillance activities. 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.

Uptick in COVID-19 cases

The WHO has reported five weeks of declining weekly global COVID-19 mortality, but weekly incidence has steadied somewhat. The Eastern Mediterranean and African regions did record hikes in new cases of 11 and 10 percent respectively, with relative increases seen in Zambia and Ethiopia in Africa and Jordan and Iraq in the Middle East. Iraq recorded a 13 percent increase or 76.9 new cases per 100 000 population. Over the past fortnight, Brazil has recorded a 41 percent increase in its daily incidence and is now ranked above the USA in total daily incidence, taking top ranking globally according to the Mar 9 Johns Hopkins newsletter.

In other COVID-19 news –

- The Mar 9 WHO epidemiological update provides another special focus section on SARS-CoV-2 Variants of Concern.

-The European Medicines Agency (EMA) is currently evaluating Russia’s Sputnik V vaccine. Read more

-The World Tourism Organization (UNWTO) this week said that ‘one in three destinations worldwide are now completely closed to international tourism’, with the greatest impact in Asia, the Pacific and Europe. The organisation noted that ‘research also indicates a trend towards adopting a more nuanced, evidence and risk-based approach to implementing travel restrictions’, with more destinations requiring negative (PCR or antigen) tests for international arrivals. Read more

-On the weekend Fiji received its initial allotment of COVID-19 vaccines under the COVAX facility, the first such delivery in the Pacific region. This batch of 12,000 AstraZeneca vaccines is to be administered to frontline healthcare workers, selected airline and airport staff, as well as immigration department and quarantine workers.  

-Businesses in England are now able to order lateral flow tests (free of charge till the end of June) which it is hoped will prevent workplace outbreaks by quickly detecting asymptomatic cases among employees. Read more

Large-scale measles outbreak possible

Low routine vaccination coverage and incomplete measles vaccine courses are behind a growing number of measles cases, the increasing frequency of outbreaks and the virus’ geographical spread, according to the WHO regional office which ‘suggests the potential for another large measles outbreak in 2021’. Around 40 percent of the country’s 129 districts have reported suspected measles cases since the beginning of the year and nine are currently said to be in suspected epidemic phase (Abéché, Abougoudam, Bokoro, Fada, Kélo, Liwa, Mangalme, Massakory and Zouar). 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.

Rarotonga’s dengue cases rise

Just over a month after a dengue fever outbreak was declared, probable and confirmed DENV-2 cases have climbed to 63 and a third of those infected have been hospitalised. Highest rates of infection have been in ages 10 to 29 years. The health ministry reports there have been no cases in Aitutaki and the rest of the Pa Enua.

Advice for travellers

Dengue is spread by Aedes mosquitoes which 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 insect repellent containing an active ingredient, such as DEET, Picaridin or PMD when outdoors to all exposed skin. Read more about dengue fever. Read more about dengue fever.

Regional countries on board with Ebola response

Six regional countries have joined with Guinea in embarking on a combined response to the Ebola outbreak. There are plans to support virus containment processes, regulate vaccine and drug importations and reinforce the measures that brought the massive 2014-6 Ebola outbreak to an end. Read more. By March 8, the Guinea outbreak total was 18 confirmed or probable cases and 9 deaths, with three more suspected cases in N’Zérékoré. The number of people vaccinated has risen to more than 2,200, but challenges such as contact tracing remain. Read more. While in the D R of Congo, the last Ebola case to be confirmed was on Mar 1 in Butembo and there have been no further infections recorded so the outbreak total is 11 Ebola cases and four deaths. Vaccines have been administered to more than 1,100 people at risk. The Mar 7 regional WHO weekly bulletin assessed some of the issues facing the outbreak response include community resistance, ‘inadequate surveillance, contact follow-up and alert management’, particularly in Biena health zone.

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.

Chikungunya alert for KL suburb

Local media are reporting an outbreak of chikungunya in a northern suburb of Kuala Lumpur. Since mid-February, 56 cases have been confirmed in residential areas of Sentul and the government has responded promptly by fogging the affected areas, checking households for potential mosquito breeding sites and raising public awareness. Read more

Advice for travellers

The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by day-time feeding Aedes mosquitoes. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.

Update on disease burden

The health minister has provided an update on the uphill battle to tackle the country’s burden of malaria and tuberculosis, but there was better news regarding the prolonged hepatitis E outbreak, as pandemic health measures have kept new cases and deaths low. More than 12,500 malaria cases were recorded last year, compared with just under 3,000 in 2019, while ‘Namibia is ranked eighth globally and fifth in Africa among countries with a high TB burden’ but TB treatment successes are said to be high. Read more

Advice for travellers

Malaria is endemic to many areas of southern Africa. Travelvax recommends that travellers planning a visit to malarious regions discuss their itinerary and preventative measures, including medication, during a pre-travel medical consultation. More on malaria.

Hep A, leptospirosis infections continue amid new COVID-19 lockdown

Hepatitis A and leptospirosis infections are still increasing in the territory, while the health service, DASS, has also issued a recent update on dengue fever. In other news, a 2-week lockdown was enforced late on Monday, March 7 following an announcement that nine COVID-19 cases had been detected. The index case was a teacher on Wallis and Futuna who became ill in mid-February but is believed to have been infectious since January. Read more

Advice for travellers

Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through consuming contaminated food and water, by handling everyday items and through some types of sexual contact. A course of hepatitis A vaccine offers immunity that is highly effective and offers long term protection.

More states reporting Lassa fever

Eleven states had recorded 136 Lassa fever cases and 31 fatalities in the first eight weeks of the year, while deaths logged in the last week of February were in the states of Edo, Taraba, and Ondo. 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 5,000 deaths occur each year. However, Lassa is a remote risk for most 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.

1st local typhoid case for 2021

A teenage girl from Central Taiwan who was diagnosed with typhoid fever after falling in in early February is still receiving treatment in hospital. Hers is the first typhoid case in 2021 deemed to be locally-acquired as she had no history of travel; investigations are continuing into the source of the infection. Taiwan’s CDC has registered a total of 19 locally-acquired typhoid fever cases since 2017. Read more

Advice for travellers

Typhoid fever generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary specific, but is usually recommended for those staying or travelling extensively in rural areas of endemic regions, 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. Read more about typhoid fever.

Case of emerging zoonosis in SE Oblast

Local media has reported on a human case of the filarial nematode infection, dirofilariasis in the SE region of Zaporozhia. Dirofilariasis, which is transmitted through mosquito bites, is considered an emergent zoonosis in Europe and, in the case mentioned, the man was a resident of the city of Melitopol in an area which has seen more than 200 Dirofilaria repens cases over the past 20 years. More on Dirofilariasis from the CDC’s FAQs. Read more