World travel health alerts 16 December 2020

World travel health alerts for 16th of December 2020.

YF deaths in Paraná monkeys; Regional, global measles digest

Circulation of yellow fever virus close to urban areas of the southern state of Paraná has been confirmed with the deaths of eight monkeys (up from three on Nov 27) near the towns of Clevelandia, Coronel Domingos Soares, Mangueirinha and Cruz Machado. The detection comes earlier than the virus’ usual high transmission season from December to May. The state’s current YF vaccine coverage sits at just under 72 percent of the population protected. Read more

DATA from the PAHO report on measles for the year to early October: Brazil (8,202 cases, seven deaths), Mexico (196), Argentina (61 and one death), while in Africa, outbreaks were recorded in 15 countries. Globally, case numbers were lower during the usual northern spring peak season and the reasons behind this likely to be ‘Under-reporting, under-diagnosis or a real decrease due to the direct or indirect effects of the COVID-19 pandemic measures’. 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. Monkeys are the primary reservoir of the yellow fever virus and transmission occurs through mosquito bites which pass the virus on to other mosquitoes or to humans. 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.

cVDPV cases in weekly report

The GPEI report for this week referenced only circulating vaccine-derived poliovirus type 2 (cVDPD2) cases: Pakistan recorded six infections (Sindh, Balochistan and Punjab), and the remainder were in Africa: Central African Republic (Region Sanitaire 5), Somalia (Baidoa province) and, lastly, Chad (nine cases from across N'Djamena, Kanem, Logone Occidental and Oriental provinces). ProMED summarised the current state of affairs, explaining that ‘the WPV1 case count is higher than it was on this approximate date in 2019; the cVDPV case count is twice that for all of 2019 and is over 3 times what it was on this approximate date in 2019.’

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.

30 million to zero local malaria cases

An application has been made to the WHO for official recognition of China’s malaria elimination status, a process that starts with providing proof of interruption to local transmission and ‘a fully functional surveillance and response system that can prevent re-establishment of indigenous transmission’. August in 2016 was the last time a locally-acquired malaria case was recorded in China, a long way from the annual rates of 30 million and 300,000 deaths recorded in the 1940s. Read more

New COVID-19 case numbers steady

The Dec 15 WHO epi update observed that new COVID-19 cases in the European region have stabilised over the past three weeks but, on a global level, there were ‘new records in terms of both weekly incidence and mortality’. The largest weekly increases occurred in the African region (up 40 percent with a resurgence in Mali, Namibia, Nigeria, Senegal, South Africa), the Western Pacific (↑13% driven by increases in Japan, Malaysia and South Korea) and the Americas (↑11%). On Saturday, the JH newsletter stated that at that time the USA ‘represented a third of one-third of all COVID-19 cases reported globally each day and more than one-fifth of global deaths’.  

In related news:

-A new app, Re-open EU, has been developed to assist people travelling within the Schengen Zone by using regularly updated data from the ECDC (in 24 languages) to provide ‘information on the various restrictions in place, including on quarantine and testing requirements for travelers and mobile coronavirus contact tracing and warning apps’.

-To date, authorisation has been granted for distribution of the mRNA Pfizer vaccine, BNT162b2, in the UK, US, Canada, Mexico, Singapore and Bahrain, while the EU will finalise its assessment at a rescheduled meeting of the European Medicines Agency on Dec 21. An explanation of the ingredients of the vaccine - Read more

-Australian resources for COVID-19 vaccines include the Dept. of Health and the Therapeutics Goods Administration.

-More on the news this week of a new SARS-CoV-2 virus variant in the UK from COVID-19 Genomics UK (COG-UK) consortium and Public Health England – thus far around 4,000 mutations have been detected in the spike protein gene alone.

Dengue prevails

The dengue fever outbreak that erupted in May last year is ongoing with the total number of cases nearing 3,900 and two related deaths. Read more. While in Wallis and Futuna, that dengue outbreak is also unfolding - in the past fortnight, a further 10 cases were reported in the districts of Alo and Sigave on Futuna, taking the territory’s year to date total to 121.

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.

NE state’s late malaria surge; Delta’s YF epidemic yet to end

Médecins Sans Frontières workers in the NE state of Borno have confirmed a higher volume of malaria infections being reported beyond the usual peak season which ends in mid-October most years. This year’s extended malaria season coincides with a shortage in supplies of anti-malarial medications in Nigeria where more than 50 percent of West Africa’s malaria cases are reported. Read more

IN AN update on the yellow fever outbreak affecting five states, health teams charged with the response have completed vaccination campaigns but are battling to ‘contain and control’ epidemics in Delta State. Read more

Advice for travellers

Sub-Saharan Africa presents a significant malaria risk. Travellers should discuss their itinerary and preventative measures, including medication, during a pre-travel medical consultation. Read more about malaria.

Malaria incidence on the rise

Local news media reported on Venezuela’s burden of malaria which was gathered from estimates published in the WHO’s 2020 World Malaria Report. The country’s contribution to malaria cases across the Americas is in the region of 53 percent (between 415,000 and 538,000 cases), with most ‘originating from mining activity in Bolívar’. As a result of Venezuela’s rising incidence, WHO Global Technical Strategy’s (GTS) ‘ambitious but achievable goals’ for control and elimination by 2030 are under threat. Read more