World travel health alerts 14 April 2021

World travel health alerts for 14th of April 2021.

3 countries register polio cases

Once again, all cases reported to the GPEI last week were due to cVDPV2: A single case each was recorded by Sierra Leone (Northern province) and Burkina Faso (city of Banfora in Comoe province), while Afghanistan logged five cases (four in Zabul province and remainder in Badghis province). And in Cameroon, six million children under 5yo will receive polio immunisations later this month in a campaign that will cover all 10 regions.

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.

COVID-19 cases yet to peak

Last week, even as the number of vaccine doses administered across the world reached 780 million, global COVID case totals were at their fourth highest for a single week and the WHO director-general noted that several Asian and Middle Eastern countries had reported ‘large increases in cases’. India has passed Brazil and is now sitting in #2 place globally for highest case numbers after recording an average daily count of 133,918 COVID-19 infections over the week to Apr 12 – an increase of 70 percent according to the latest WHO epi update. Despite the pandemic being far from over, Dr Tedros Adhanom said ‘we have many reasons for optimism’ if a concerted effort is applied to public health measures and equitable vaccination. Read more

In related news -    

  • On Apr 13, the TGA issued a statement regarding a probable second case of thrombosis with thrombocytopenia linked to the AstraZeneca vaccine. Common side effects of the vaccine, which last for 1-2 days, include fever, sore muscles, tiredness and headache, however the agency advised that ‘Consumers should seek immediate medical attention if, a few days after vaccination, they develop symptoms such:
    • as a severe or persistent headache or blurred vision
    • shortness of breath, chest pain, leg swelling or persistent abdominal pain
    • unusual skin bruising and/or pinpoint round spots beyond the site of injection.’
  • Pfizer/BioNTech has applied to the FDA for emergency use authorisation to administer their COVID-19 vaccine to adolescents of 12 to 15 years of age in the US. If granted, the vaccine could be rolled out to this cohort in mid-May. healio
  • COVAX reaches over 100 economies, 42 days after first international delivery: WHO
  • An Apr 8 TGA media release titled 'Approval of updated storage conditions for the Pfizer COVID-19 vaccine' advised that temperatures of ‘‑ 20±5°C for up to 2 weeks (even during transportation) within the 6 month shelf life when stored at -90 to -60°C has been approved’.
  • The WHO’s guidelines for religious organisations to aid in the planning of festivals and celebrations includes ’Safe Ramadan practices in the context of COVID-19’.
  • To assist in a safer re-opening of activities in New York, the Excelsior Pass is being used by businesses to check their patrons’ vaccination, negative PCR or rapid antigen test result credentials – a QR code is generated which can be scanned from the app or printed out and checked against photo ID. Read more    

NE state’s measles count swells; Bird flu infects 7 workers

Measles infections have soared in the NE state of Borno, with more than 1,150 children admitted to hospital in Maiduguri for treatment since December. Over half of all cases admitted to the MSF managed hospital in the state capital come from the nearby ‘volatile’ settlement of Zabarmari. Read more

OUTBREAKS of H5N1 avian influenza in poultry have flared up again in seven states this year and supplementary testing extended to bird handlers has uncovered six or seven probable influenza A(H5) human cases (confirmation from WHO Collaborating Centre pending) in Kano and Plateau. Afludiary reports that ‘HPAI H5 has been on the ascendant for the past 8 or 9 months, and we've started to see human infections again in China and Southeast Asia and simultaneous epizootics in Europe and in Asia’. In related news, a young boy has become Laos’ first human case of H5N6 avian influenza and the first case outside China. He lived in Luang Prabang province and had confirmed contact with poultry. Thirty H5N6 infections have been detected since 2014 in China. Read more.

Advice for travellers

There are several strains of bird flu and while the virus can be fatal, infection generally poses a low risk for travellers – even for those heading to a region where the disease is present or an outbreak is occurring. Travellers should avoid contact with birds or poultry in marketplaces, wash hands thoroughly before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.

Ebola situation update

Vaccinations are underway for contacts and other at-risk individuals associated with the most recent Ebola cases in N’Zérékoré - the outbreak total now sits at 23 cases (16 confirmed and seven probable), including 12 deaths. Recommendations from the WHO regional office include heightened surveillance and prompt testing of suspected infections as community resistance continues to be a major challenge. The 42-day countdown to the end of the outbreak was halted after a new case was detected on day 35. Read more. No further Ebola cases have emerged in North Kivu, D R of Congo as surveillance and response measures continue. Without new confirmed cases, the end of the outbreak will be declared in just under three weeks.   

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.

8 diphtheria deaths to date in 2021

Ten confirmed or suspected diphtheria cases have been reported in children under 14 years of age this year - eight of the cases proved fatal. As all cases were revealed to have incomplete vaccination courses, health authorities have urged parents to ensure childhood immunisations, which are provided free of charge, are received on time. In 2020, the country recorded a total of three diphtheria cases. Read more

Advice for travellers

Spread by coughing and sneezing or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more on diphtheria.

Dengue count rises

An Apr 8 dengue fever update issued by DASS puts the YTD case count at 61 confirmed or probable cases - the majority of infections were reported in Nouméa and Dumbéa. And in Fiji, dengue reports have been on the decline since early March – two serotypes are circulating (DENV-1 & 2). 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.

Malaria spread causes alarm

Doctors specialising in the treatment of malaria have expressed concern over the surge in cases which has also impacted areas of low transmission, such as Hauts-Plateaux. Supplies of treatment medications and impregnated mosquito nets, which have to be imported, have been limited during the pandemic. The country endured malaria epidemics over 2019-20, with districts such as Grand Sud experiencing a 400 percent increase in cases. 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.

Hep A outbreaks persist in 26 states

Hepatitis A outbreaks remain active in 26 of the 35 states reporting cases since 2017. The spread of the virus has been primarily from person-to-person among the homeless and illicit drug users. The CDC reports the states with the highest rates of hospitalisation and death are Florida and Kentucky. Read more

Advice for travellers

Hepatitis A (HAV) is one of the more common infections for overseas travellers. It is a significant risk in countries where sanitation and hygiene are lacking. The virus is transmitted by faecally contaminated food and water, or through some types of sexual contact. A course of hepatitis A vaccine offers immunity that’s highly effective and long-lasting. Travellers should also follow safe food and water guidelines.

Peak in HFMD infections

Several regions have recorded sharp rises in hand, foot and mouth disease infections, with HCM City’s increase significantly higher than for the same period in 2020. Illness caused by enterovirus-71 (EV-71) represents most of the severe cases requiring intensive care support. Vietnam is part way through the first of two annual HFMD peaks which occur from March-May and then again from September to December. Read more

Advice for travellers

HFMD mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection. Read more about HFMD.