World travel health alerts for 13th of May 2020.
Polio digest, plans for new vaccine release
This week it was Afghanistan reporting higher case numbers of wild poliovirus type 1 (WPV1), with six detected (in Badakhshan, Balkh, Hirat, Kunar and Kandahar provinces), whereas Pakistan registered two (in Balochistan and Sindh provinces). The first circulating vaccine-derived poliovirus 2 (cVDPV2) infections for the year in Afghanistan were also reported (Nangarhar province) while Pakistan’s tally rose to 44 with one case each in Khyber Pakhtoon and Punjab. In Africa, both Chad (Tandjile province) and Niger (Tillaberi province) reported one cVDPV2 case each. Read more. There are plans, even with the challenges presented by the pandemic, that the (more genetically stable) novel oral polio vaccine type 2 (nOPV2) will be introduced into affected countries by mid-2020, pending approval through the WHO Emergency Use Listing process. 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.
NW province’s dengue surge
Dengue fever remains a threat to public health in the NW after the province of Jujuy reported a further 400+ cases in a recent 3-day period. Southern and eastern districts have recorded most cases and, of the 19 towns feeling the greatest impact, San Pedro Jujuy reported well over half. Local authorities have also stressed the increased risk of severe dengue in Fraile Pintado which has two dengue serotypes circulating. 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.
Global COVID-19 death toll nearing 300,000
COVID-19 cases in 212 countries and territories have now surpassed 4.3 million with more than 1.4 million of those in the US, according to worldometers (Russia is now second on the global scale of new case reporting). The May 12 Johns Hopkins newsletter notes that ‘Africa, Asia, and South America continue to represent an increasing proportion of the global COVID-19 cases—currently about 4.5%, 20%, and 16%, respectively’, while daily counts in Europe have been declining since early last month.
Healio reports that New York health authorities are now investigating up to 85 cases of a multi-system inflammatory syndrome related to COVID-19 infection in children (May 6 health advisory) – similar cases have also been detected in the UK and Italy, both having suffered large coronavirus outbreaks. Today, Australia’s Chief Medical Officer said that, to date, no cases have been seen here and, with such small numbers of children testing positive for the virus, the expert group ‘thinks it unlikely’ we will have cases. Read more
Multiple factors behind high risk measles transmission
Measles continues to spread from transit camps housing refugee arrivals from the Democratic Republic of Congo (DRC) to the local community in the NW border district of Cibitoke. The DRC has recorded more than 300,000 measles cases since early last year. A WHO risk assessment of the situation notes that the risk of measles remains high for Burundi in view of sub-optimal immunisation rates, gaps in disease surveillance, lack of infrastructure/resources and high population flow across the shared border. In other news relating to the DRC, read the May 12 Ebola WHO update. 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.
Guinea worm infections suspected in western region
The WHO regional office reports on investigations into the suspected recurrence of guinea worm disease (dracunculiasis) in Gambella region, in the country’s west. The seven suspected cases, together with ‘an emerged worm morphologically consistent with human guinea worm’, have surfaced after a 2-year lull in reporting. A national eradication program has been working with great effect since 1993, however the parasite persists in communities due to ‘low-level transmission in non-human hosts such as dogs and peri-domestic baboons’. More on dracunculiasis from the WHO. Read more
No let-up in dengue
The tally of suspected dengue fever cases has risen to more than 2,100 since late March, after a further 977 infections were added to the Apr 18 ECDC update. Martinique recorded 590 of the cases, followed by 220 in Guadeloupe (although it has fared worst since the outbreak began in October last year with almost 8,000 cases in total), 115 in Saint Martin and 52 in Saint Barthélemy. Three dengue serotypes are circulating. 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.
Bali’s dengue burden highest in 2 regencies
A further update on dengue fever cases in Bali with the YTD total to April climbing to more than 6,000 – roughly one third of those were from Buleleng Regency in the island’s north, while Badung (which takes in the tourist hotspots of Kuta, Nusa Dua, Jimbaran, Canggu and Uluwatu) has recorded up to 1,300 cases. Read more
Advice for travellers
Common in most tropical or sub-tropical regions of the world, dengue fever is spread by daytime-feeding Aedes mosquitoes. To avoid the risk of dengue 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, 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.
‘Black fever’ in 51 districts
Cases of visceral leishmaniasis (or kala-azar) are being reported at higher altitudes according to a local news article, with infections ‘expanding in the hill and mountain districts at an alarming rate’. The 51 districts now with cases include some not previously included in endemic areas as they were considered too high for the sand fly vector to survive. Read more
Advice for travellers
Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. The former causes skin ulcers and the latter a severe systemic disease that is usually fatal without treatment. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil account for 90% of visceral leishmaniasis, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia and Argentina. Read more on the disease and prevention.
Sindh’s struggle against rabies
Rabies continues to pose a significant risk to residents of the Sindh – 24 human rabies deaths were recorded in the province in 2019 and the city of Karachi has registered at least seven so far this year. Two recent deaths are reported to have resulted from failure to seek medical advice and an incomplete course of treatment following dog bites. 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.
Dengue risk rises
With peak dengue season now underway and continuing through to September, it is expected that this year’s outbreak (already totalling over 7,000 infections) will intensify. More than 500 dengue cases were recorded last week and the NEA is warning that more people working from home means the risk of exposure to mosquito bites is also higher. 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.
National malaria news
According to the WHO, Zimbabwe’s malaria cases this year have almost doubled over the same period in 2019, rising from 137,843 cases and 137 deaths to 236,865 cases and 226 deaths, with the greatest impact in the provinces of Manicaland and Mashonaland East and Central. The report also notes that the situation is overwhelming the provinces’ health facilities ‘in the context of COVID 19 pandemic’. 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.