World travel health alerts for 20th of February 2019.
Influenza update; Ski resort measles spreads
The WHO global flu update issued this week notes that ‘influenza activity continued to increase across the continent, with most countries passing the epidemic threshold. High intensity was reported in nine countries of South West Europe. Hospitalisation rates were high in France and the United Kingdom.’ Elsewhere, China and Hong Kong continue to report high levels of influenza [(A(H1N1)pdm09 virus predominating], while rates in India are increasing.
THE ECDC assessment on the measles outbreak at France’s Val-Thorens ski resort, which is reported to have spread to other areas of France and to Denmark, Scotland and Belgium, is that additional cases are ‘likely to occur’ due to the popularity of the resort among locals and visitors from the Netherlands, the UK and Scandinavia in particular.
Advice for travellers
Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination, when available, for all travellers over 6 months of age. Read more about influenza.
Crew quarantined over viral illness
Rubella infections were suspected as the cause of illness of 16 crew members of a MSC cruise ship that sailed out of the city of Santos this week, however the São Paulo health department has now confirmed measles in eight of the cases with the remainder likely to have measles also. The department has advised vaccination for all passengers on the ship’s return to port (Santos). Read more
Advice for travellers
A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.
Measles, dengue updates; Regional hot weather advisories
Authorities in Ho Chi Minh City have reported more than double last year’s dengue fever cases for the first six weeks of the year, with over 6,700 people admitted to hospital for treatment. Dengue has also struck in the neighbouring province of Ba Ria-Vung Tau, with most cases reported in Vung Tau City. HCMC is also reporting a sharp rise in measles notifications – more than 900 cases up to mid-February, while increases have also been seen in Hanoi and in the province of Dong Nai. Read more.
PUBLIC health officials in the neighbouring countries of Cambodia and Thailand have issued warnings related to upcoming hot weather with temperatures expected to exceed 40 degrees in the next couple of months. Advice includes adequate hydration and care with food prepared, cooked or stored in an unhygienic manner.
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.
Measles imported into BC
Nine measles cases reported this month in Vancouver, British Columbia, relate to travel undertaken by unvaccinated individuals to Vietnam and the Philippines. Further spread has occurred in two local schools in the city’s south. Read more. While across the US border in Washington state, the confirmed case count in the measles outbreak declared in Clark County has risen to 62. A Feb 14 CDC update of cases in all states can be found here.
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.
Ebola, cholera, and measles
While the Ebola virus disease outbreak continues in 19 health zones of North Kivu and Ituri provinces, in January measles killed at least 137 children among more than 7,000 cases in Lualaba and Lomami provinces, in the country’s south-east. 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.
Northern department hit by dengue
Dengue fever case numbers have spiked in the northern department of Cortés, with the cities of San Pedro Sula and Villanueva most affected. More than 1,100 cases have been recorded this year - a 70 percent increase on last year, and six deaths are under investigation. 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.
Rabies reappears in NTB; Vaccine-derived polio in Papua
Six people have succumbed to rabies over the past two months in a province that had been declared free of the virus in 2016, West Nusa Tenggara (NTB). (It was one of nine announced together with Bangka Belitung, Riau Islands, Jakarta, Central Java, East Java, Yogyakarta, Papua, West Papua). It joins North Sumatra, Central and North Sulawesi and Ambon in reporting human rabies deaths this year. Read more
NEWS this week from GPEI that two cases of genetically-linked circulating vaccine-derived poliovirus type 1 (cVDPV1) have been identified in Papua province. They were detected in a case of acute flaccid paralysis and a healthy community contact. The GPEI states that ‘this outbreak is not linked to the cVDPV1 currently affecting neighbouring Papua New Guinea.’
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.
Recent WNV deaths
Last week authorities released information on 14 severe cases of West Nile fever requiring hospitalisation and three associated deaths. West Nile virus has been detected in mosquitoes in the regions of Caesarea, Binyamina and Gezer. Northern parts of the country are generally the most affected; the peak season for infections lasts from August to October. Read more
Advice for travellers
Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites. Read more on WNV.
Measles reports from 20 prefectures
A building in Osaka that contains a department store, restaurants and a railway station is the focus of a measles outbreak. There has also been confirmed spread of the infection in a local hospital and warnings have been issued for bullet train passengers on two separate days earlier this month. Up to Feb 12 Osaka prefecture had reported ‘more than triple the figure for all of 2018’ – 46 cases [now 47]. Nineteen other prefectures have also reported measles infections this year with national figures at a 10-year high. Read more
Advice for travellers
A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.
Dengue spreads beyond capital
The capital Male’ and two atolls (Raa and Baa) have reported many of the recent dengue cases – more than 500 in both December and January and another 107 up to Feb 12. The spread of dengue in the atolls (including Faafu) is ‘newly observed’. 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.
Violence in the Yucatán
Levels of violence associated with drug cartels has been on the rise in the popular tourist destination of Cancun and across the state of Quintana Roo. According to a news source, more than 775 homicides occurred in the peninsula state last year alone and the killings have continued into both January and this month. Read more
Measles deaths climb to 115; Dengue in Regions VII, X
The latest update on the measles outbreak notes that 17 regions are currently affected with nearly 7,000 cases and 115 deaths. Highest numbers have been reported from the National Capital Region (that includes Metro Manila) and Calabarzon which is comprised of the provinces of Cavite, Laguna, Batangas, Rizal and Quezon. Read more
A SURGE in the incidence of dengue fever has occurred recently in Central Visayas region (Cebu, Bohol, Siquijor and Negros Oriental), as well as Cagayan de Oro City in Mindanao. 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.
Dengue epidemic resurgence
The dengue fever epidemic has intensified again this year in previously affected areas and now in several new transmission zones - Ravine des Cabris, Saint Pierre, Saint Joseph and la Possession. More than 720 cases have been reported to Feb 19 and the view of Santé Publique France is that the outbreak will expand in numbers and locations in the coming weeks. 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.
Parasitic infection on Hawai’i; Valley Fever in California
The second case of angiostrongyliasis (or rat lungworm infection) diagnosed over the past three months was announced by the Hawaiian health department last week. Both cases contracted the infection on Hawai‘i Island. The department’s press release included the advice, ‘We know that most people get sick by accidentally eating infected slugs and snails. Taking precautions—such as washing all fresh produce before enjoying, and getting rid of slugs and snails around our homes and communities—can go a long way toward preventing infection’.
CENTRAL California experienced a rise in diagnoses of the fungal infection Valley Fever, or coccidioidomycosis, last year with over 8,100 cases reported by the Dept. of Public Health. Highest rates of infections were in the counties of Kent, Los Angeles, Fresno, Tulare and San Luis Obispo. The CDC reports that the majority of cases in the US are from Arizona and California and the infection is more common in people aged 60 and over. Read more