World travel health alerts for 12th of January 2022.
RRV detected in 3 VIC LGAs
Ross River virus has been detected in three Central Victorian LGAs and visitors and residents are being warned to be vigilant particularly along parts of the Murray River from Gunbower to Yarrawonga, where mosquito numbers have been predicted to be particularly high. Read more
Advice for travellers
Cases of Ross River occur throughout Australia, including more temperate southern states. Travellers visiting areas of Australia affected by recent flooding or continuing rain should take measures to prevent mosquito bites. Use a personal effective insect effective ingredient such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors and wear long, loose-fitting, light coloured clothing – especially at dawn and dusk, the times of day when RRV-carrying insects are most active. More about Ross River Virus
SE Asia's increased dengue activity
The US Centers for Disease Control and Prevention (CDC) has advised that a number of SE Asian countries (India, Bangladesh, Pakistan and Sri Lanka) are reporting higher-than-usual numbers of dengue cases. Read more
In Sri Lanka the Director of the National Dengue Control Unit has reported that the number of dengue cases in the last two months of 2021 doubled, with a total of 4,561 dengue cases in November and 8,740 in December. Two thirds of the cases were reported from Western Province and the rest from the limits of the Colombo Municipal Council (CMC), the Colombo District, Gampaha District and Kalutara. 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.
YF Outbreaks Central/West
Yellow fever outbreaks have been ongoing and growing in numbers throughout 2021 in the WHO Africa Region of Cameroon, Chad, Central African Republic, Côte d’Ivoire, the Democratic Republic of Congo (DRC), Ghana, Niger, Nigeria, and Republic of Congo. Of particular concern is that these outbreaks are occurring across such a large geographic area in the West and Central regions of Africa where, despite large-scale mass vaccination campaigns having been conducted, there remains persistent and growing gaps in population immunity provided through routine immunisation and/or secondary to population movements. Probable YF cases have also been reported from Benin, Burkina Faso, Gabon, Mali, Togo, and Uganda. 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 – 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.
Chagas linked to food
Colombian Army authorities have reported an outbreak of the parasitic disease, Chagas disease, which infected a number of soldiers at a military base in Cesar, in northern Colombia. According to reports 2 soldiers died and 7 are in intensive care, with the outbreak linked to the consumption of food. Read more
Advice for travellers
Although widespread in Mexico, Central America, and South America, Chagas disease presents a low risk to Australians travelling to the Americas. Travellers who sleep indoors in air-conditioned or screened hotel rooms are at low risk for exposure to infected triatomine bugs (aka kissing or assassin bugs), which infest poor-quality dwellings and are active mainly at night. However, as has become more common, the disease can also be transmitted through food and freshly pressed juice contaminated with the faeces of insects attracted to ripening fruit. Read more on Chagas disease.
Influenza and COVID co-infection
Seasonal influenza vanished in 2020 as a result of COVID-19 and pandemic suppression measures such as social distancing, hand washing, face masks, and school closures. However there have been signs of its return toward the end of 2021/early 2022, with many pandemic restrictions dropped and the resumption of international travel. This is of particular concern as it adds a particularly unpredictable complication to the Omicron-enhanced COVID-19 pandemic and there is only limited experience with co-infection with influenza and COVID. Most of the seasonal influenza circulating in Europe thus far has been influenza A (H3N2) so at this time it is too early to tell how this co-circulation will affect the population. Read more
Advice for travellers
Get vaccinated at the earliest opportunity and when called to do so by your local health authority, particularly if you are in an at-risk group or are working in a health-care environment.
COVID-19 UPDATE
According to the World Health Organisation (WHO) weekly epidemiological update (11th of January) the number of new weekly COVID-19 cases globally has increased strikingly by 55%, while new weekly deaths continued to be similar to those reported during the previous week. This equates to over 15 million new cases and over 43,000 new deaths. As of the 9th of January, there are over 304 million confirmed cases and over 5.4 million deaths reported globally. The South-East Asia region reported the largest increase in new cases (418%), followed by the Western Pacific Region (122%), the Eastern Mediterranean Region (86%), the Region of the Americas (78%) and the European Region (31%). Read more
COVID-19 numbers in Africa have been steadily increasing in the past four weeks as the region’s fourth wave continues to spread. There are 27 countries (Angola, Burundi, Cape Verde, Comoros, Congo, Côte d’Ivoire, Equatorial Guinea, Ethiopia, Gabon, Gambia, Guinea-Bissau, Kenya, Liberia, Malawi, Mauritania, Mozambique, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Sudan, Togo, Uganda, and Zambia) that have reported a 20% increase in COVID-19 cases in comparison to last week. There was also a significant increase in deaths compared to the past week, as a result of an increase in deaths reported from South Africa and Zimbabwe. The slow vaccination roll-out will continue to pose a challenge to the COVID-19 response efforts in Africa. Read more
In related news:
NEJM: Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients
ABC News: Melbourne researchers trial use of common blood-thinning drug heparin to combat COVID-19
New Scientist: 2022 news preview: What will the coronavirus do next?
Malaria - no room for complacency
Indonesian health authorities are confident that the nation is winning the fight against malaria and that they will meet their target for disease elimination by 2030. There is no room for complacency though with 235,700 cases a year even though there has been an impressive fall of around 50% when compared to the 465,700 cases in 2019. As outlined in a recent report Malaria Elimination Amidst COVID-19: A Test of Resilience in Asia Pacific, national malaria control, surveillance and case management has come under significant strain due to the evolving COVID-19 emergency, with many Asia/Pacific nations having to develop strong leadership and strategies to adapt to these challenges. Read more
Advice for travellers
Malaria is endemic in many areas of SE Asia and Asia. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.
Polio ongoing, counterfeit malaria meds challenges
Nigeria continued to report outbreaks of vaccine-derived poliovirus type 2 (cVDPV2) in 2021 and is classified by the International Health Regulations (IHR) as a state infected with cVDPV2 with potential risk of international spread. There were no reported cases in the past week, compared to late December (Dec 21 GPEI update) when there were 14 cases in six states. Nigeria saw 385 cases of cVDPV2 cases in 2021. Read more
COUNTERFEIT medical products are a significant problem in Africa, with an estimated 116,000 deaths in the Sub-Saharan region related to their use. Substandard and falsified (SF) medications accounted for 67% of all medicines available in Nigeria in 2001, however the National Agency for Food & Drug Administration (NAFDAC) looked outside itself and built relationships with other countries such as India and China. As a result, within 3 years the reporting of SF medications dropped to 16%. Fake medicines remain an enormous problem in the fight against malaria and a sustained multi-pronged approach will be needed to ensure Nigerians have access to best quality medicines. 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.
Human Avian influenza reported in Devon
The UK Health Security Agency (UKHSA) has confirmed the first British person to be infected with the avian influenza is from the Devon region. Authorities have continued to assure the wider public that the risk of catching bird flu continues to be very low, but have advised people not to touch sick or dead birds. The government has instituted several new measures such as a 3 km captive bird (monitoring) controlled zones, enhanced surveillance and legal restrictions in order to try to tackle UK’s biggest ever outbreak of bird flu in the South West. Across the UK there have been more than 60 cases of avian flu reported. Read more
Advice for travellers
While bird flu is often fatal in humans, there has been no sustained person-to-person transmission. Infection occurs after contact with infected birds, which makes the disease a low risk for travellers. Australians travelling to a region where the disease is present or an outbreak is occurring should avoid contact with birds or poultry in marketplaces, wash their hands before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.
Rabies risk in bats
The US Centers for Disease Control and Prevention (CDC) says the United States has been able to significantly reduce the number of people who become infected each year with rabies. However the deaths of three people, including one child, in late September and early November serves as a stark reminder that rabies can be transmitted by bats. None of the three individuals sought medical treatment for post-exposure prophylaxis (PEP), which can prevent rabies from developing if administered before symptoms start. 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