World travel health alerts 18 March 2020

World travel health alerts for 18th of March 2020.

COVID-19 update; Measles infections persist into 2020

As countries reporting cases of COVID-19 rose above 150 and Europe became the new epicentre of the global pandemic, EU authorities this week introduced a minimum 30-day travel restriction for non-essential purposes in the EU. Exceptions are being made for ‘Family members of European nationals, essential staff, such as doctors and nurses, and people transporting goods to the EU’.

The WHO Situation Report 57 published on Mar 17 has the latest global COVID-19 figures, while the ECDC interface provides more regional data.   

Elsewhere, the WHO called for ‘urgent, aggressive action’ in the SE Asian region as cases start to rise. Read more in the SEARO update and the case count by country to Mar 17. Details of cases across Africa are published in the weekly bulletin (with data to Mar 15).

The NIAID has commenced its phase 1 human trial of the mRNA-1273 vaccine after it showed ‘promise in animal models’; it should be complete by June.

A study by the Imperial College COVID-19 Response Team assesses the multiple interventions of public health measures (non-pharmaceutical interventions) necessary to ‘have a substantial impact on transmission’ and ‘to suppress transmission below the threshold of R=1 required to rapidly reduce case incidence’. And another study conducted on children with confirmed or suspected COVID-19 in China in Jan/Feb found that children generally have a lower risk of severe disease than adults, however ‘young children, particularly infants, were vulnerable to 2019-nCoV infection’.

Other perspectives:

COMMENTARY: Strange COVID-19 bedfellows: gnawing anxiety and under-reaction Read more

Coronavirus will also cause a loneliness epidemic Read more

Basic information for older people on COVID-19 produced by HelpAge Global Network Read more

COVID-19: IFRC, UNICEF and WHO issue guidance to protect children and support safe school operations Read more

UK aid to tackle global spread of coronavirus ‘fake news’ Read more

IN OTHER NEWS, measles outbreaks have continued into 2020 with 22 countries reporting cases – significant totals were in Romania (668), Bulgaria (160), France (87), Spain (63), Italy (52), Belgium (37), UK (31), Germany (27) and Switzerland (24) according to the ECDC. In other regions, the outbreak in the Central African Republic is into its second year and has now moved into the capital city of Bangui.  

Flu rates remain high

Influenza rates remained high in the week to Mar 8 (also in Kosovo) while intensity was classified as medium in several countries in the Balkan Peninsula as well as Germany, the Netherlands, Finland, Georgia, Romania and Moldova. Influenza A virus were most commonly detected across the region. Read more. The WHO global flu update with data to Mar 1 noted an overall decline in infection rates with the exceptions of Algeria, Tunisia and Bhutan.

Advice for travellers

Seasonal flu is a common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. 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.

Wild poliovirus cases in 3 provinces

There have now been 24 wild poliovirus 1 (WPV1) cases recorded this year with the latest registered in the Sindh (two cases) and the provinces of Khyber Pakhtunkhwa and Balochistan (one case each). In Africa, more cVDPV2 infections were reported – Angola (Cuando Cubango province – one case), the D R of the Congo (three total from Kwango and Kongo central provinces) and Ghana (one case, location not identified). The status of wild poliovirus across Africa will be reviewed by an independent commission in June. The last two recorded wild poliovirus cases were in Nigeria’s Borno state in August, 2016. 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.

Where to get your local COVID-19 advice

A comprehensive local resource for COVID-19 is the federal Department of Health which is ‘closely monitoring the COVID-19 pandemic. Our information provides daily updates, answering your questions about the latest news, current facts and figures, travel advice, key contact and phone numbers.’ More regional information can be sourced through the various state/territory health departments. While Smartraveller has now increased its overall travel alert for all countries to level 4 (of four) and now advises: ‘Do not travel overseas at this time. If you wish to return home, do so as soon as possible.’ The advice is applicable ‘Regardless of your destination, age or health’.

Dengue uptick

Efforts to prevent the introduction of COVID-19 infections are said to have left the country at risk of dengue fever, with no current plans for containment and cases starting to rise. There have been calls for plans to avoid a repeat of last year’s large outbreak which produced over 14,500 dengue cases and six deaths. On another note, national authorities in both Nepal and China have cancelled the annual Mt Everest climbing season this year. And Bangladesh is reporting higher densities of Aedes mosquito larvae in some Dhaka districts and a concerning 4-fold increase in dengue cases compared to the same period last year (the worst on record for dengue). Read more

Advice for travellers

Avoid mosquito bites to protect against 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.

Slow increase in dengue cases

From a health ministry update on the dengue fever outbreak first announced in late Feb last year, the slow trickle of new cases continues with 69 recorded in the six weeks to Mar 12. Raratonga has recorded most infections and at least one case in Aitutaki was said to be caused by a traveller from Raratonga.

Advice for travellers

Dengue is spread by Aedes mosquitoes which 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.

Risk of Ebola re-emergence to persist; Cholera in SE

Over half way into declaring the Ebola virus disease outbreak over is good news, particularly at this time. The latest WHO Sitrep still advises caution due to ‘the long duration and large magnitude of the Ebola outbreak in North Kivu, South Kivu and Ituri provinces in the Democratic Republic of the Congo (DRC), there is a risk of re-emergence of the virus during the lead up to the declaration of the end of the outbreak, and for several months following that declaration.’

A CHOLERA outbreak has struck several health districts in the country’s second largest city Lubumbashi and nearby Kafubu. Read more

Advice for travellers

Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling 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.

NW districts report rise in meningococcal deaths

Five municipal and district assemblies in the Upper West have recorded a marked increase in fatalities due to meningococcal meningitis, when compared to the same period in 2019. The affected districts all lie within the meningitis belt of Africa and are monitored during the peak (dry) season each year. Read more

Advice for travellers

Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions, extended contact with local people in crowded places and travel to sub-Saharan Africa’s ‘meningitis belt’ where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). Read more about Men. meningitis

Dengue takes off

After dengue fever cases topped 90,000 last year, the rates of infection have remained high – more than 10,000 cases were recorded to Mar 8 with highest counts in Central District (comprising the capital, Tegucigalpa), San Pedro Sula, Yoro, Cortés and El Paraíso. 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 update for UP

A rise in confirmed malaria cases in Budaun and Barielly (Uttar Pradesh) over the first two months of this year may result from more testing - both plasmodium falciparum and vivax infections have been detected. Also in Bareilly, there’s been a run on the free rabies post-exposure vaccinations given at one hospital due to shortages of the vaccine in the region and its cost when sourced at private clinics. According to a local article, in January alone, rabies vaccines were sought for people following ‘1,855 cases of dog bite, 166 cases of monkey bite, 27 cases of cat bite, 2 cases of horse bite and 1 case of crocodile bite’. Read more

Advice for travellers

Travelvax recommends that travellers visiting malarious regions discuss their itinerary and preventative measures, including medication, during a pre-travel medical consultation. More on malaria.