World Travel Health Alerts 12 December 2018

World travel health alerts for 12th of December 2018.

Timely cryptosporidiosis warning, Buruli ulcers FNQ

Director of Health Protection at NSW Health, Dr Jeremy McAnulty, has provided a timely warning with the start of the holiday season, for parents and carers of young children in particular to take steps to prevent the spread of this parasitic intestinal infection. Cases of cryptosporidiosis are expected to rise over summer. Director of Health Protection at NSW Health, said people of all ages, particularly parents and carers of young children, should take steps to prevent the spread of the parasitic intestinal infection. “Cryptosporidiosis is easily spread from person to person in swimming pools, splash parks, interactive fountains, spas or jacuzzis,” Dr McAnulty said. Read more

Another case of a Buruli ulcer (flesh-eating disease) has emerged in the Far North, leading health officials to issue another warning about protecting against mosquitoes. Tropical Public Health Services acting director Dr Madhumati Chatterji said in both cases, there was most likely local exposure. “It is not known how the infection is contracted, there are various theories including the possibility of insect transmission,” she said. “While research is ongoing into how the infection is transmitted, people are advised to avoid contact with soil or water where possible, particularly in the Daintree/ Mossman area and to avoid mosquito bites by covering the body with clothing and using insect repellent.” Read more

Advice for travellers

Outbreaks of ‘Crypto’ are well documented, mainly as a result of swimming in swimming pools and water parks harbouring the parasite. While the parasite can be spread in several ways, swallowing contaminated drinking or recreational water is the most common. Cryptosporidium is a leading cause of water-borne disease in most developed countries, including Australia. For further information, see the NSW Health cryptosporidiosis factsheet.

Summer Dengue outbreaks, YF changes

With Brazil entering its summer season, there have been a number of dengue outbreak reports country-wide, due to some heavy summer rains, there has been an increasing number of Aedes Aegypti mosquitoes carrying the virus. The highest number of cases were recorded in Goiás - 80,000 cases (about one-third of all cases nationwide); seven cities at risk of outbreaks. Minas Gerais had 26,000 cases and 8 deaths so far in 2018 and São Paulo - 8,900 cases through November 2018, including cases reported in the municipalities of São Paulo, Ribeirão Preto, Sorocaba and Jundiaí.

According to the Pan American Health Organization / World Health Organization (PAHO/WHO) Yellow Fever (YF) in Brazil has a seasonal pattern, based on historical analysis of human cases and epizootics due to yellow fever in the past 20 years, with 2 different periods: higher transmission occurring between December and May (seasonal period) and lower or interrupted transmission occurring between June and November. However in the last 3 years there has been a change in transmission for YF in Brazil. During 2018, viral circulation continued during the period of low transmission (June to November).

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.

15,000 cases of dengue this year

The Cambodian National Centre (CNM) for Parasitology, Entomology and Malaria Control says that cases of dengue fever have increased this year, including the number of those who died from the virus. The director for CNM Huy Rekol advised that there have been more than 15,000 recorded cases of dengue so far this year, an increase of 36% when compared 2017 ( 11,000 cases). The areas most affected were the capital Phnom Penh and the provinces of Preah Vihear, Siem Reap, Kandal and Kampong Chhnang. Read more

Ebola outbreak

The Democratic Republic of the Congo (DRC) has recorded 2 new Ebola cases this week, increasing the outbreak total to 500, including 289 deaths, in what is believed to be the world’s second largest Ebola outbreak. According to the latest weekly update from the World Health Organization's (WHO's) African regional office, among the 500 cases are 3 healthcare workers who have been infected since Dec 1st Since August, when the outbreak began, 49 healthcare workers have been infected, and 15 of those have died. Read more

Typhoid in Naitasiri

The Fijian Minister for Health, Dr Ifereimi Waqainabete has confirmed that there is an outbreak of typhoid in the Naitasiri subdivision, with 31 confirmed and 14 suspected cases of typhoid. Naitasiri is one of the 14 provinces of Fiji and one of 8 located on Viti Levu, Fiji's largest island. Read more

Advice for travellers

Typhoid occurs in Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters.

2 new Rabies suspected cases reported in Sarawak

Sarawak has 2 new suspected cases of rabies, health authorities are waiting on laboratory test results for confirmation. The first case was a 64-year-old man living in Kuching, Sarawak. In mid-September 2018, the patient was bitten on the calf by a puppy that also had bitten his wife on the thumb.  The second suspected case was in a 74-year-old man from Kuching, Sarawak. He died on the 7th of December. Since June 30, 2017 to date, the number of confirmed cases of rabies in Sarawak is up to 14 people including 13 deaths and one (1) home-treated case with neurological complications. 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.

YF Outbreak in Edo State continues

Nine people in Edo state, Nigeria, have died from yellow fever infections in the last month, according to Nigerian health officials. Nigeria has been battling a yellow fever outbreak since Sep 12, 2017. As of Nov 25, 2018, a total of 3,510 suspected cases, including 74 deaths, have been reported in all 36 states. The case-fatality rate is 2.1%. 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.

Measles at alarming levels

According to the Department of Health-Center for Health Development (DOH-CHD) the number of measles cases in Western Visayas has reached alarming levels with 170 cases and 3 suspected deaths. Many parents are refusing to vaccinate their children following the problems encountered with the dengue vaccine. Parents have concluded that the issues will be the same with well-tested vaccines such as measles, mumps, rubella (MMR) vaccine. 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. 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.

Mysterious acute flaccid myelitis

New data from the US Centers for Disease Control and Prevention (CDC) shows that the number of cases of the polio-like illness, acute flaccid myelitis [AFM] has increased by 24 more cases this week, bringing the outbreak total to 158. The outbreak now surpasses 2016's total of 149 confirmed cases, which was the previous high. The AFM outbreak in 2018 has been quite widespread with cases reported in 36 states (see map of confirmed cases by state as of 7 Dec 2018) About 90% of patients with AFM report mild respiratory illness in the week prior to symptom onset. Read more about AFM