World travel health alerts for 14th of August 2019.
Genetically modified mosquitoes to eradicate disease
Australian researcher and leader of the project Dr Maciej Maselko, CSIRO Synthetic Biology Future Science Fellow advised the he and a team of researchers have commenced on a research project, in which mosquito colonies carrying viruses such as zika, dengue, Chikungunya and yellow fever will not be able to reproduce. The researchers genetically modified male mosquitoes and then allowed them to mate with female mosquitoes who transmit the diseases, producing no offspring, or producing sterile males.
Advice for travellers
Insects are real pests, and they are crafty: They not only cause discomfort, but for travellers they can transmit numerous major diseases, including yellow fever, malaria, dengue fever, Zika virus and Japanese encephalitis. The risk of insect-borne diseases is highest in sub-tropical and tropical, developing countries. Avoiding insect bites is essential - but easier said than done.
Fourfold increase in Dengue cases
Health Authorities in Bhutan have advised that there has been a fourfold increase (since the end of July) in the number of dengue cases in the Trashiyangtse district city Doskum (eastern Bhutan), with 314 cases as of yesterday evening. This is the first time dengue fever outbreak is reported in Doksum, the Vector-born disease control had reported the presence of the dengue vector back in 2014-2015. One death occurred in a 20 year old with severe dengue complications.
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.
Measles around the world
The latest PAHO measles summary for the year to 18th of June 19 notes that in the previous seven weeks ‘there has been a 70% increase in the total number of confirmed cases of measles reported, with 7 countries and territories reporting additional confirmed cases: Brazil (923 cases), Canada (17 cases), Colombia (50 cases), Curaçao (1 case), Mexico (1 case), the United States (128 cases), and Venezuela (85 cases)’. So far this year, the USA (current outbreaks in California, New York, Texas and Washington) and Brazil (Bahía, Rio de Janeiro, and São Paulo have active outbreaks) have recorded the highest number of infections.
Advice for travellers
Measles is a highly contagious virus and can cause serious illness in people of all ages. Most cases reported in Australia are linked to overseas travel - both developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure.
Malaria death toll tops 1800
The UN Office for the Coordination of Humanitarian Affairs (OCHA) is reporting the death of 1800 people in Burundi in 2019 from malaria. The OCHA is blaming the high death toll on a lack of mosquito nets, climate change and people moving from the mountain areas, who have no immunity to the mosquito-borne disease, to the plains.
Advice for travellers
For many travellers, Africa presents a significant malaria risk. Travellers can discuss their itinerary and the need for anti-malaria medication with a trained travel health professional at their nearest Travelvax clinic. For details call 1300 360 164. Read more about malaria
Hepatitis E infection related to rats
The Centre for Health Protection (CHP) of the Department of Health in Hong Kong is investigating a case of human infection of rat Hepatitis E virus (HEV). The case involves a 43-year-old man with underlying illnesses, who has presented with liver function abnormalities since May this year. It is unknown at this time how HEV transmits to humans.
Advice for travellers
The hepatitis E virus is usually transmitted through faecal contamination of drinking water, as well contaminated food and infected blood products. Over 60 percent of all hepatitis E infections and 65 percent of all hepatitis E deaths occur in East and South Asia. An estimated 3.4 million cases globally result in around 57,000 deaths each year. Read more about hepatitis E.
Measles epidemic declared, EBOLA update
The Democratic Republic of Congo (DRC) Minister of Health has declared a measles epidemic with over 106,870 suspected cases of measles in all provinces since June this year. This represents a 700% increase when compared to the same period in 2018. The DRC is implementing a number of mass vaccination campaigns nationally, as well as the management of measles and improvement of health facilities to treat measles cases, together with international organisations.
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in Democratic Republic of the Congo continues, with 63 new cases confirmed and 45 deaths. There is some hope on the horizon with drug trials conducted by an international research group co-ordinated by the World Health Organization (WHO), which began in November last year showing some great results. The drugs, named REGN-EB3 and mAb114, work by attacking the Ebola virus with antibodies, neutralising its impact on human cells. The four experimental drugs have been so far tested on around 700 patients, with results indicating that if treated early they can have a 94% success rate.
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.
Vaccine derived Polio threatens status
Ghana’s polio free status has come under threat with vaccine-derived poliovirus type 2 (cVDPV2) confirmed circulating in the country, related to a cVDPV2 affecting Jigawa, Nigeria. Neighbouring countries Togo, Benin, Côte d’Ivoire and Burkina Faso have stepped up surveillance.
Advice for travellers
Polio 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.
Rubella ongoing outbreak
The American CDC has reviewed their Alert level to a Level 2, Practice Enhanced Precautions for Japan, with the ongoing Rubella outbreak, encouraging those travelling to Japan to be up to date with their measles, mumps and rubella vaccinations. Authorities in Japan are reporting that most cases continue to be reported in the Kanto region (Tokyo, Kanagawa, Chiba, and Saitama).
Advice for travellers
Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine. Highly contagious, rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Travellers should also check their immunisation status for all childhood diseases, including measles, mumps, tetanus, whooping cough and diphtheria as part of their pre-travel medical preparations.
Rabies death and Dengue cases soaring
The Kuching Ministry of Health has confirmed the death of a 46-year-old man from Padawan at the Sarawak General Hospital (SGH) on Aug 7 was as a result of rabies. The man and his daughter had been bitten while trying to catch the family pet inside their house on June 15th, the daughter received post-exposure treatment, however the father never advised clinic staff he too had been bitten. He started showing signs of infection on the 29th of July, however failed to again advise clinic staff of his bite. There have been 19 cases of rabies in the district of Kuching since July 17.
Dengue cases are soaring with twice the number of cases this year at 80,000 compared to the same period last year. More than 70% of those cases occurring in urban areas.
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.
State of emergency declared
A state of emergency has been declared due to a dengue fever outbreak on Ebeye island in the Marshall islands, with 64 probable and confirmed dengue fever cases. Marshall Islands President Hilda Heine signed a proclamation ordering all government departments and agencies to coordinate relief efforts to affected communities and with very high rainfall there is a nationwide high alert.
Yellow Fever outbreak in Ebonyi State
The Nigeria Centre for Disease Control (NCDC) is investigating a suspected Yellow fever outbreak in Ebonyi State and has had a Rapid Response in place since end of July, supported by the WHO. The investigation has uncovered that between May 1 and August 7, 2019, there had been cases that fit into the case definition for Yellow fever with 20 deaths in Izzi LGA, Ebonyi State. Nigeria has been reporting Yellow Fever outbreaks all around the country since September 2017 with 78 cases laboratory confirmed in Nigeria as at the 31st of July 2019.
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.
Ongoing Chikungunya
The Ministry of Health and Population of Congo advised that the Chikungunya outbreak declared in February is ongoing. There have been a cumulative total of 11 230 suspected cases of Chikungunya with zero deaths reported between, the 7 January to 21 July 2019.
Advice for travellers
Chikungunya infections continue to spread across the Caribbean and Americas. The disease has symptoms similar to dengue fever and is transmitted by day-time feeding Aedes mosquitoes. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about Chikungunya.
Malaria concerns
Malaria concerns for Kampala with Dr Richard Idro advising that there were around 5 children each day admitted to the Acute Care Unit of Mulago National Referral hospital with convulsions and anaemia resulting from malaria infection. He said “It’s not only very young children who we used to see with such complications but now mostly bigger children in primary school with cerebral and severe malaria”, he said. The disease had been mostly eliminated in Uganda, but particularly Kampala, with outbreaks mostly only in the North.
2nd locally acquired Dengue case, new to County
Authorities in Miami-Dade County, Florida have confirmed a second case of Dengue. The 2 women aged 21 and 66 have confirmed locally acquired Dengue. Alvaro Mejia-Echeverry, MD, MPH, a medical epidemiologist with the health department said that the possibility of more cases occurring was dependent on the control measures instituted to reduce breeding sites and transmission.
Furthermore, the East Side Mosquito Abatement District and Stanislaus County Public Health have jointly announced the 1st detection of invasive _Aedes aegypti_ mosquitoes in the county. There have been other reports of _Aedes aegypti_mosquitoes in California, however never in Stanislaus County. This is of great concern to authorities as the mosquito is capable of transmitting viruses such as chikungunya, dengue, yellow fever, and Zika.