World travel health alerts 13 July 2022

World travel health alerts for 13th of July 2022.

Cross-border cholera spread

The cholera outbreak that was first reported in the autonomous Kurdistan region in June has now spread to the border areas of western Iran and there are fears that thousands of cases of acute watery diarrhoea that have occurred following the recent earthquake in Afghanistan could herald a regional cholera epidemic. Read more

Advice for travellers

Cholera is usually spread in contaminated water. For most short-stay travel, the risk of infection is low. Travellers to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera.

Re-occurrence of bat Lyssavirus, other rabies reports

ProMED provides more information on the local detection of bat Lyssavirus (EBLV-2): it’s been five years since Swiss veterinary officials last reported isolating the virus in a bat. ‘Although bat rabies is very rare in Switzerland, this case reaffirms the public recommendation to handle bats with utmost caution, if any.’ In related news, US media report that a bat infected with rabies was found in Douglas Island, Alaska. This was the first such instance for Juneau city/borough, however bat rabies has been detected before, on rare occasions, in the state’s SE. A separate ProMED article summarised recent rabies exposures in humans in six US states (Utah, Texas, North Carolina, Massachusetts, Georgia and New York), as well as the second documented human rabies case in the Federal District of Brazil. 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, including bats. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is generally 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.

Parasitic gastro warning for summer

The CDC has issued a seasonal warning relating to a rise in cases of the parasitic illness, Cyclosporiasis. Outbreaks are generally associated with the consumption of imported fresh produce (such as herbs, lettuce, snow peas and berries), as well as travel to tropical and subtropical regions. UK travel health authorities also advised their travellers to South/Central America and South/SE Asia to be aware of the risk of the gastro-intestinal illness caused by consuming food or drinks contaminated with the faecal matter of a Cyclospora-infected person. Read more

Yellow fever hotspots named; Weekly polio report

A reactive vaccination campaign has been launched in the province of Tandjilé in response to the detection of 25 yellow fever (YF) cases in Laï and de Deressia health districts, however from a separate report the current hotspots of YF infection are named as the southern provinces of Mandoul and Moyen Chari. Read more

CIRCULATING vaccine-derived polio type 2 (cVDPV2) cases reported in the GPEI weekly update were documented by: Chad (three cases from Chari-Baguirmi and N’Djamena), Yemen (four patients in Marib, Albaidah, Ibb and Sanaa) and a single case in Niger (Maradi). 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 malaria

Malaria cases are reported to be at a 5-year high and the majority of infections – 226 of the 256 recorded - were in Huetar Norte Region, bordering Nicaragua. Two other regions, Huetar Caribe and the Central Pacific logged the remaining 30 cases between them. In related news, the WHO has updated its recommendations for malaria chemoprevention and elimination. Read more

Advice for travellers

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.

COVID-19 update

Last week the WHO reported a fourth week of increasing COVID-19 cases; the information was qualified by the usual disclaimer of fewer tests and sequencing performed overall. Deaths declined by 12 percent on a global level. The greatest proportional increases in new cases were in France (up 33 percent) and Italy (up 50 percent). Of the Variants of Concern, the WHO notes that the proportion of BA.4 and BA.5 is increasing, however BA.5’s rate of increase is higher. Reinfections are also becoming more common, with estimates in the UK that around one quarter of new cases are in people who have previously been infected with SARS-CoV-2. Read more

In related news:

- The Australian Health Protection Principal Committee statement on COVID-19 winter update and ongoing health protection measures to support our community: Read more

- Prof. Raina MacIntyre writes on ‘Access to a second COVID booster vaccine has been expanded to people 30 years and over’ in The Conversation.

- The article ‘Whose breath are you breathing?’ focuses on high risk situations when dealing with an air-borne virus: Read more from

- Worst case scenario during a summer break on the Continent: ‘Italy, Spain, France: The latest COVID rules if you test positive while on holiday in Europe’. Read more  

Monkeypox cases continue to climb

Monkeypox cases across the globe passed the 9,000 mark this week and Spain now has the highest total, with the UK and Germany making up the top three. The UK Health Security Agency (UKHSA) has warned people with risk factors (new or multiple sexual partners) to ’be aware that many of the cases we're seeing are finding only a single, or few, lesions’. The WHO will reconvene the Emergency Committee by 18 July to determine whether the outbreak has met the IHR criteria for a Public Health Emergency of International Concern (PHEIC). Read more

IN OTHER REGIONAL news, each year the ECDC monitors the growth of non-cholera Vibrio bacteria in estuarine and closed waterways during warmer weather, issuing warnings when temperatures are high enough to signal bacterial growth that risks gastro-intestinal illnesses from consuming contaminated seafood, and wound and ear infections in people who have contact with the waters. Read more and in the ECDC Vibrio Map Viewer. On the same topic, in the USA, Florida's health department publishes a running count of Vibrio vulnificus infections acquired from sites of warm, brackish seawater - this currently sits at 15 cases from 13 counties and three deaths.

Probable Marburg virus cases in Ashanti

Two unrelated people from different parts of Ashanti region in the country’s south have become Ghana’s first suspected cases of Marburg virus disease – final confirmation from the Institute Pasteur in Senegal is pending. The WHO is assisting local authorities in their preparations in case of an outbreak. The last confirmed Marburg virus infection in West Africa occurred in Guinea in August last year; the situation was closed five weeks later without further cases. Read more

Advice for travellers

Marburg virus disease is a rare but severe viral haemorrhagic fever, related to the Ebola virus, and there is no treatment. Found in the African fruit bat, Marburg typically appears in sporadic outbreaks and laboratory-confirmed cases have occurred in Uganda, Zimbabwe, the Democratic Republic of the Congo, Kenya and Angola. Preventive measures are not well defined, as study in how it is spread continues, but travellers should avoid contact with fruit bats and sick primates in central Africa. Read more

JE cases follow monsoon flooding; Food-borne outbreaks reported

In the NE state of Assam, Japanese encephalitis cases are mounting as the monsoon season consolidates. Nearly 100 cases and 10 deaths have been recorded to date from locations that include Morigaon, Karimganj, Nagaon, and Sonitpur districts. Read more 

A CHOLERA outbreak in Karaikal (Puducherry) has health officials in the nearby states of Tamil Nadu and Kerala on alert, while a sharp rise in cases of typhoid fever in Telangana has been blamed on the consumption of a particular type of street food sold by vendors who lack basic hygiene measures. The public has been advised to avoid buying such foodstuffs during the monsoon season. Read more

Advice for travellers

Typhoid fever is endemic in many developing regions, although it 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, 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.

Invasive mosquito found in south

Larvae of the mosquito species capable of transmitting dengue fever and chikungunya have been found ‘in the neighborhoods and streets’ of the southern port city of Bandar Abbas, the primary base of the Iranian Navy situated on the Strait of Hormuz. Environmental health experts believe eggs of the Aedes albopictus mosquito may have been imported into the city carried in used tyres and bamboo. Read more

Cholera infections spread to new districts

The sale of street food has been prohibited in districts in an around Kathmandu as health officials work to prevent an escalation of the cholera outbreak. Cases have now been detected in Kathmandu, Lalitpur, Bhaktapur and Makawanpur districts. Read more

Advice for travellers

While the risk of infection with cholera is low for short-stay travellers, Australians travelling to regions where an outbreak is occurring should adhere to strict personal hygiene and choose food and beverages with care. Read more about cholera.

Dengue fever cases top 65,000

The number of dengue fever cases recorded this year has risen by 90 percent compared to the same period in 2021, with highest infection rates in Central Luzon, Central Visayas and the Zamboanga Peninsula. More than 65,000 people contracted dengue in the first half of this year. Read more

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.

Summer risks in the outdoors

The warm weather has arrived and it’s tick season. Health authorities in the region of Rostov have confirmed cases of tick-borne Crimean-Congo haemorrhagic fever, borreliosis and tularemia, and some 20 years after Q fever was last detected in Salsky and Remontnensky districts, 19 people have been diagnosed with the infection. Meanwhile in the Urals, the rates of tick bites in the population of Sverdlovsk Oblast have soared, estimated at one in every 100 people this season and cases of tick-borne encephalitis are reported to be 50 percent higher than for the same period in 2021. Read more

Advice for travellers

A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia; however the vaccine can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE.

Hot weather warnings

Heat wave conditions have been forecast for most of the UK later this week and into next, while high temperatures that had settled over the Iberian Peninsula are set to move over many areas of western, central and eastern Europe. Temperatures in the 40s are possible in many major centres. Read more