World travel health alerts 20 January 2021

World travel health alerts for 20th of January 2021.

Bumper season for mozzie pests; Concerted effort to end syphilis outbreak

More on mosquito-borne infections, with SA Health advising that Murray Valley Encephalitis (MVEV) and Kunjin viruses (KUN) were both detected recently during routine surveillance of sentinel chickens sited in Meningie, near the mouth of the Murray River. The agency did note that both infections are rare in humans in the state, but the public should take appropriate measures to avoid mosquito bites. Similar warnings, but related to Ross River virus, have been issued in for both the Surf Coast and Greater Geelong in Victoria as their early 2021 cases passed the 2020 total.

The AMA says a national response is needed to manage the 10-year syphilis outbreak that has spread ‘through parts of Queensland, the Northern Territory, Western Australia and South Australia since January 2011’. Of the more than 3,600 people infected, many are ‘young Aboriginal and Torres Strait Islander people living in remote and rural areas’. Read more

Advice for travellers

While the risk of contracting MVE is low, the virus can cause severe illness, even death in very rare cases. The vector mosquitoes are active at dawn and dusk, particularly in the first two hours after dark. They pass on the virus to humans after feeding on infected birds attracted to flooded wetlands. Travellers to wetland areas of Australia should take all measures to prevent bites. Apply an insect repellent containing DEET, picaridin, or oil of lemon eucalyptus [PMD] to exposed skin when outdoors.

Investigations into deaths in Maniema

National health authorities are seeking to verify reports of illness in upwards of 200 people (and numerous deaths) in the gold mining centre of Bikenge in Maniema province. Many of the sick are said to be suffering from symptoms that include fever, vomiting & diarrhoea, headache and anaemia, with some reports that malaria may be the cause. 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.

Dengue response hampered by pandemic

Dengue fever cases rose sharply across the country last year, climbing to levels last seen in 2017. Seventeen regions were affected throughout 2020 and more than 55,600 cases were recorded, as routine mosquito control measures foundered during the pandemic. A PAHO researcher said that the virus was no longer just circulating in tropical areas such as near the Amazon, but was now also found ‘in desert-type areas’. The health ministry warned late last year that Peru had the third highest mortality from dengue in the Americas (after the Dominican Republic and Venezuela). 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.

Typhoid, dengue reported

More on the health outcomes resulting from the devastation caused by Cyclone Yasa, with an update revealing that 10 typhoid fever cases had been confirmed on the island of Vanua Levu (provinces of Cakaudrove and Macuata) as of last week– two of the clusters were identified pre-cyclone. Additionally, there has been the usual uptick in dengue fever cases and dengue-like illnesses over the summer months; last week the health ministry advised that at least three cases are reported daily in the Central and Western Divisions. Read more

Advice for travellers

Typhoid fever is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary-specific, but is usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

COVID-19 update

The latest WHO epi update has Europe’s new COVID-19 cases declining by 15 percent over the past week, while the largest increase was recorded in the Western Pacific region (up 14 percent with highest numbers from Japan, Malaysia and the Philippines). The global total has now passed 96 million cases and two million deaths. The update includes a section, ‘Special Focus: Update on SARS-CoV-2 variants of concern’, which ‘includes routine assessment of SARS-CoV-2 variants to establish if they have altered transmissibility, clinical presentation and severity, or if they may respond differently to countermeasures, including diagnostics, therapeutics and vaccines’.

In response to the emergence of SARS-CoV-2 variants, from Jan 26 a requirement applicable to all passengers flying into the US has been expanded to include a negative COVID-19 test within 72 hours of departure, or documentation of prior infection (by providing both the test results and a written letter from a licensed healthcare provider that attests to the recovery). More details from the CDC.

In related news –

-Two airlines are among the early starters conducting trials of the IATA Travel Pass on selected flights, with the app’s digital passport allowing travellers ‘to verify their pre-travel test or vaccination meets the requirements of the destination’. Read more. Later this week, EU leaders will debate whether to adopt ‘a pan-European mutually recognized vaccination certificate’. Read more

-A Jan 19 STAT News article on SARS-CoV-2 variants, outlines ‘what’s known about the variants, why they’re getting so much attention, and what they mean for the trajectory of the pandemic’.  

Benue’s YF outbreak lingers; Lassa cases in 4 states

Yellow fever has killed 112 people in the central state of Benue since September last year and authorities fear that the outbreak in one of the affected local government areas (LGAs) won’t end anytime soon as a reactive vaccination campaign is meeting with local resistance over their traditional beliefs. The two LGAs at the centre of the outbreak lie close to the borders with Kogi and Enugu states. Meanwhile, also in Benue, state authorities are warning residents of Agatu and Guma LGAs near the Benue River against consuming untreated water after cholera caused the deaths of 25 people. Read more

THE NEW YEAR has begun with four states already reporting Lassa fever cases – Ondo, Edo, Bauchi and Ebonyi. A total of nine confirmed and 109 suspected cases were recorded in the first week of January, following a record year in 2019: ‘1,189 cases of the acute viral haemorrhagic illness were recorded in 27 states across the country in 2020, resulting in 244 fatalities’. 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. 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.

Polio cVDPV2 digest; Measles death toll rises again

A single cVDPV2 infection in Sindh province was reported to the GPEI last week, while the four cases that Sudan recorded were detected in the states of Kassala, Khartoum, Blue Nile and Red Sea. Additionally, Yemen logged nine cases of cVDPV1 in Saadah. Read more

AT LEAST eight children have now succumbed to measles infections in outbreaks spread across several villages in Chaman, in the SW province of Balochistan. Three new deaths were added to the five identified last week, prompting district officials to send a response team to control the outbreak. 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.