World travel health alerts 15 June 2022

World travel health alerts for 15th of June 2022.

Flu season in full swing

Influenza cases started ticking upwards in March and, according to the latest surveillance data, over half of the year’s nearly 89,000 flu cases were registered in the two weeks leading to June 5. The highest rates of notifications have been in the five to 19 years and under-5s cohorts. On the same subject, an article published by ABC News outlines the strange trends in influenza activity seen recently around the globe: ‘Flu seasons, like the COVID-19 pandemic, have become unusual and unpredictable. Here's why’. Read more

Advice for travellers

In most years, seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Whether you are travelling within Australia or overseas, vaccination is highly recommended and travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol-based hand sanitiser is a convenient alternative if soap and water is not available.

Ebola response slows

Response measures have faltered due to healthcare worker strikes in the Ebola epicentre of Mbandaka (Equateur province), so while no new Ebola cases have been confirmed in almost a month, surveillance has also been suboptimal. Read more

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.

First VD polio case, global digest

The GPEI’s June 9 polio update confirmed the two latest wild poliovirus type 1 cases in Pakistan (reported here last week) – a total of eight this year in North Waziristan where vaccine refusals and fake verification markings are common. The update also announced Eritrea’s first circulating vaccine-derived poliovirus type 2 (cVDPV2) case, with onset of paralysis on 3 September 2021. The strain has links to Nigeria, but more recently it was detected in Sudan. Other countries reporting cVDPV2 cases: Nigeria (Zamfara and Katsina states) and Yemen (28 cases from 12 locations), while Madagascar logged four cVDPV1 cases (Sofia and Menabe). 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.

Food poisonings on the rise

Warming oceans and seas have played a large part in more food fish becoming infested with parasites such as anisakid nematodes. When these fish are incorrectly prepared for consumption, this can result in food poisoning in the form of anisakiasis. Media report dozens of recent cases of anisakiasis from more than 25 prefectures, and withdrawal of fish products for sale at supermarkets in two - Gunma and Saitama. Read more

Cholera now in 3 Counties

The first cholera cases were confirmed in Kisumu County last month and the WHO reports the outbreak is now showing an ‘increasing trend and geographic spread’, after acute watery diarrhoea infections were detected in Nairobi and Kiambu Counties. No links have been found between this outbreak and ongoing cholera surges in the neighbouring East African countries of South Sudan, Tanzania and Somalia. 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.

Hep A hits northern city

An outbreak of hepatitis A is spreading rapidly in the northern city of Tripoli and there are reports that infections are emerging in other districts. A local doctors’ group said a number of factors were to blame for the outbreak: ‘a shortage of potable water, poor healthcare and the lack of proper sanitation and hygiene’. 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.

Measles reported in NW district

Vaccine hesitancy is thought to be one of the reasons behind an outbreak of measles in the NW district of Mushindano. Response measures, including dispatching vaccination teams to the area, are underway to prevent further spread beyond the current 23 suspected cases and three deaths. In related news, the WHO weekly bulletin reports a measles outbreak in Outapi district, Omusati region of Namibia’s north. More on global measles cases from the ECDC. 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.

Dengue and JE alert for Bicol

Health authorities in Bicol region have flagged the need for insect bite avoidance measures during the rainy season, with dengue fever cases up by more than 200 percent this year compared to the same period in 2021 and seven Japanese encephalitis infections (in total) reported from Camarines Sur, Sorsogon and Albay – last year there were none. Read more

Advice for travellers

Japanese encephalitis (JE) is the most important cause of viral encephalitis in Asia. It usually occurs in rural or agricultural areas, often associated with rice growing and pig farming. JE virus is transmitted to humans through the bite of infected Culex mosquitoes. Most JE virus infections are mild (fever and headache) or symptomless, but around 1 in 250 infections results in severe and potentially fatal disease characterised by rapid onset of high fever, headache, neck stiffness, disorientation, coma, seizures, spastic paralysis and death. The risk to short-stay travellers and those who confine their travel to urban centres and use insect bite avoidance measures is low. Expatriates, repeat travellers and travellers living for prolonged periods in agricultural areas where Japanese encephalitis is endemic or where seasonal epidemics occur should consult their travel health provider about recommendations for vaccination. Read more.

COVID-19 update

The ECDC’s COVID-19 epidemiological update this week commented on the rise in prevalence of the BA.4 and BA.5 Omicron sub-variants which first hit Europe in Portugal, causing an uptick in cases. Another 10 EU countries are starting to see case numbers rise and the ECDC projects the two sub-variants will become dominant in the region in coming weeks due to their growth advantage (BA.4/BA.5 are also gaining ground in the USA according to Nowcast). Last week’s WHO epi update noted that ‘Accumulating evidence from several countries indicates that there has been no observed increase in severity associated with BA.5 and BA.4.’ Meanwhile, the Delta variant has been relegated to the ‘previously circulating Variant of Concern (VOC) category’ by the WHO due to the low numbers found in submitted sequences over the past three months. The agency will continue to monitor for any signs of resurgence from previously circulating VOCs. Read more

Decreasing trend in malaria burden

Installing community health workers (CHW) in every village at risk of malaria is one of the successes in the country’s battle against the parasitic disease. The efforts have paid off: over the five years to 2021, malaria cases fell from five million to one million and deaths declined from 700 to 69. 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.

Fears of record dengue season

The early spike in dengue fever cases is still trending upwards and the NEA anticipates weekly cases to exceed the previous record in 2020. More than 15,000 cases have been logged by the agency to June 14 and 131 of the nearly 400 dengue clusters have a red alert (location of more than 10 cases). The less common serotype 3 (DENV-3) was detected in the majority of red clusters. 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.

Leishmaniasis cases up in east

One eastern state has experienced an increase in cases of visceral leishmaniasis (VL) this year. The El Gedaref Health Ministry announced 952 cases and 17 deaths during the first quarter of 2022. Read more

Advice for travellers

Leishmaniasis is generally a low risk for travellers. The parasitic disease is 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. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention.

Reports of monkeypox from 35 non-endemic countries

The global total of monkeypox cases has risen to more than 3,100 confirmed and suspected cases from seven endemic countries in Africa and 35 countries where it is not usually found. With 452 confirmed cases in England at last count (June 13), the UKHSA continues to manage contact tracing and has undertaken patient interviews ‘to understand transmission and to determine how to target interventions’. The WHO published its update on the outbreak on June 10, including a description of atypical disease presentations: ‘Many cases in this outbreak are not presenting with the classically described clinical picture for monkeypox’. Read more. The agency has published Interim Guidelines for Vaccines and immunization for monkeypox, with advice that includes: ‘Mass vaccination is not required nor recommended for monkeypox at this time’, and ‘contacts of cases should be offered post-exposure prophylaxis (PEP) with a vaccine within four days of first exposure to prevent onset of disease’. The WHO has jointly produced a document with the ECDC, titled Interim advice for public health authorities on summer events during the monkeypox outbreak in Europe, 2022’. Lastly, a meeting of the IHR Emergency Committee will convene on June 23 to determine if the ‘clearly unusual and concerning’ global outbreak represents a public health emergency of international concern. Read more

Influenza A in 2 cities

Flu-like illnesses have surged in the two largest cities, Port Vila (Efate) and Luganville (Espiritu Santo), prompting the declaration of an influenza A outbreak in those areas. Authorities have stated that ‘Spread to other islands is expected’. Read more

Advice for travellers

In most years, seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Whether you are travelling within Australia or overseas, vaccination is highly recommended and travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol-based hand sanitiser is a convenient alternative if soap and water is not available.