World travel health alerts for 16th of January 2019.
Measles toll mounts
Over 27,000 measles cases were recorded across the country last year and 18 deaths resulted (in Ouargla, Relizane, Msila, Biskra, Tamanrasset and El-Bayadh) with the outbreak continuing into 2019. To the SW, there has been an increase in measles cases in Mauritania, with the latest reports from Boutilimit, approx. 150kms SE of the capital Nouakchott. 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 alerts for region
At least two regional neighbours have issued alerts in response to the dengue outbreak declared earlier this month – Grenada and the Cayman Islands, while Antigua has reported 10 cases of confirmed dengue fever, seven requiring hospitalisation, with ages ranging from 11 months up to 82 years from seven different localities (English Harbour, Jennings, Ovals, Ottos, Gambles, Potters and Gray’s Farm).
Advice for travellers
Dengue is spread by two types of aedes mosquitoes which breed in shady areas close homes and other accommodation. Both bite mainly during the daylight hours, making them difficult to avoid outdoors. 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 oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.
Measles imports in 4 states; Risks from rescuing bats
Two different alerts have emerged in NSW: Seven measles cases have been reported to NSW Health over the past three weeks, with travel to Thailand, Sri Lanka and the Philippines implicated in at least some of the infections. (Flutrackers has other measles reports from WA, VIC & QLD). Heatwave conditions have adversely affected bats and flying foxes and led to some Sydney and Hunter region residents becoming injured while trying to rescue the animals. As being bitten or scratched by a bat or flying fox constitutes exposure to the rabies-like Australian Bat Lyssavirus (ABL), NSW Health is warning the public not to touch them but to contact a wildlife rescue group instead. It was also reported that two of the bats recovered in the Hunter region were infected with ABL. Read more
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.
Juice ‘spiked’ by kissing bug; Climb in sand fly-borne infections
Two recent studies may offer some reasons why the incidence of Chagas disease jumps late in the year, coinciding with the harvesting of açaí berries. Consuming juice made from berries contaminated with the faeces of the triatomine bug is one of the main sources of infection, particularly in areas where the drink is popular: the Amazonas region and the state of Pará. Many Chagas disease infections are asymptomatic, meaning actual numbers could be much higher than reported to Brazil's Information System for Notifiable Diseases (SINAN). Read more
FROM a local news report: northern and north-eastern regions of the country recorded the highest incidence of the sand fly-borne infection leishmaniasis last year; overall, numbers had increased by almost 40 percent from 2017, to 17,000 cases. Read more
Advice for travellers
Although widespread in Mexico, Central America, and South America, Chagas disease presents a low risk to Australians travelling to the Americas. Travellers who sleep indoors in air-conditioned or screened hotel rooms are at low risk for exposure to infected triatomine bugs (aka kissing or assassin bugs), which infest poor-quality dwellings and are active mainly at night. However, as has become more common, the disease can also be transmitted through food and freshly pressed juice contaminated with the faeces of insects attracted to ripening fruit. Read more on Chagas disease.
EVD-affected health zones increase
Seventeen health zones have now been affected in the Ebola virus disease outbreak in the country’s NE - the latest being Manguredjipa - although at least 10 are considered active. Read WHO Deputy Director-General for Emergency Preparedness and Response, Dr Peter Salama’s twitter update. Read more in the Ministry of Health’s Jan 15 newsletter.
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.
Lunar New Year festivities and boost to mozzie risk
The National Environment Agency is calling for the public to do the ‘5-step Mozzie Wipeout’ after surveillance revealed more of the dengue vectors in December, rounding out 2018 with nearly 20 percent more dengue cases (compared to 2017). In the first two weeks of the year, 455 cases have been recorded and the NEA is monitoring 53 active clusters – 12 are considered high-risk. The five step process is even more important currently because ‘as the Chinese New Year festive season approaches, homes and other premises are decorated with more ornamental plants’ – popular breeding sites for Aedes aegypti mosquitoes. (Read the CDC Travel Notice re 2019 Lunar New Year travel.) Read more. While in Malaysia, statistics from the iDengue website, show cases since December 30 have climbed to more than 6,000 with most in the state of Selangor. Numbers had been trending upwards from mid-September to the end of the year, according to a WHO report.
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.
Polio in NW province
Two cases of circulating vaccine-derived polio (one with acute flaccid paralysis, the other a contact) have been identified in the NW district of Molumbo, Zambézia province. The last appearance of cVDPV2 in Mozambique was two years ago in the same province (Mopeia district), followed by a monovalent oral polio vaccination campaign. Read more
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.
Dengue case numbers jump
On December 21 a dengue epidemic was declared and the month finished with 142 cases reported. DASS figures now show that number was exceeded in the first 11 days of this month, with a further 143 cases detected (all DENV-2). The capital Noumea has recorded almost half of all cases since the beginning of December 2018. Elsewhere in the Western Pacific region, the first recorded outbreak of DENV-3 on Palau continues with 57 cases reported up to Jan 13. Read more
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.
More districts targeted for mosquito control
With 48 dengue cases now recorded in Seeb, containment measures are being rolled out to nearby provinces (Bausher, Muttrah and Muscat wilayats). Read more
Advice for travellers
Don’t get bitten and you won’t get 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.
Flu season update; Hep A outbreak in Ohio
Thirty states were reporting widespread flu activity in the most recent reporting week (ending Jan 5). Read more. CDC modelling suggests the number of hospitalisations for flu is lower than for previous years - between 69,000 and 84,000. An ECDC infographic shows low levels of flu activity for most of Europe in the first week of January, with the exception of the UK and Portugal (medium). Type A influenza viruses predominate according to the Communicable Disease Threats Report, week 2.
LAST month Ohio declared a hepatitis A outbreak and is currently reporting over 50 new cases per week. Over the past 12 months, over 1,400 cases have been identified - 60 percent were male. Read more. The adjacent states of Indiana, Kentucky, Michigan and West Virginia are also implicated in the multi-state outbreak which has been monitored by the CDC since March 2017 when infections first appeared among homeless people and users of illicit drugs. Read more
Advice for travellers
Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and offers long term protection.
Austral summer dengue spike
With the Austral summer in full swing, peak dengue season has also arrived. The regional health agency, ARS Indian Ocean, has advised that ‘the circulation of dengue fever has intensified on Reunion Island, with a significant upsurge in the number of cases reported.’ Most cases were in the southern and western zones. Read more
Advice for travellers
Dengue is spread by two types of aedes mosquitoes which breed in shady areas close homes and other accommodation. Both bite mainly during the daylight hours, making them difficult to avoid outdoors. 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 oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.
TBE risk in 17 cantons
A sharp rise in tick-borne encephalitis cases in 2018 now has the government advising TBE vaccination for all areas, replacing previous recommendations. According to ch.ch website – a service of the Confederation, cantons and communes - all or part of 17 cantons are now included in the advice but ‘no areas with ESME-infected ticks have been above an altitude of around 1000 m above sea level’ thus far. Lyme borreliosis is also present and is a risk in the tick-infected areas. (A map of risk areas for early summer meningo-encephalitis (ESME) is provided here.) Read more
Advice for travellers
A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia. However, vaccination can be obtained by doctors through a Special Access Scheme.
Rainmaking to clear capital’s pollution; Chikungunya near Malay border
Air pollution in Bangkok is expected to rise into the ‘unhealthy’ category later this week, with the Royal Rainmaking and Agricultural Aviation Department planning remedial activities. Eastern areas of the city and beyond, including Bang Na, Sai Mai, Lat Krabang and Bang Kapi are being targeted with rainfall generated to clear the air. Read more
LOCAL doctors have announced an outbreak of chikungunya in Hat Yai, SW of Songkhla’s provincial capital, in Thailand’s far south. ‘Dozens of patients’ are said to be infected. Read more. In response to the outbreak, authorities in the neighbouring Malay state of Kedah have announced that health screening will be carried out at border posts. Read more
Advice for travellers
Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent when outdoors to all exposed skin. Read more about chikungunya.
Measles deaths in west
Reports this week that the ongoing measles outbreak has now hit 56 districts; six children under 10 years of age from Hoima in the Western Region died from the infection in the past fortnight. 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.