World travel health alerts 20 May 2020

World travel health alerts for 20th of May 2020.

Fresh poliovirus cases reported

Four new WPV1 cases have been reported by the GPEI (three in Balochistan and one in Sindh), while Afghanistan’s one case was recorded in Kandahar province, taking its YTD total to 12. In the African region, cVDPV2 cases were reported in Chad (two from Hadjer Lamis and Logone Occidental provinces) and Côte d’Ivoire (one in the SW province of Cavally-Guemon).

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.

Ross River virus uptick on east coast

Late summer rains boosting mosquito numbers has led to a rise in Ross River fever cases in both NSW and QLD. According to a recent ABC radio news item, QLD’s confirmed cases have increased from just over 700 last year to 1,771 this year (571 vs 800 in NSW). While cold weather should limit more new cases in southern regions, warmer districts are expected to continue reporting infections during the winter months. More on Ross River fever from 2014 The Conversation explainer. Read more

COVID-19 ‘the defining health crisis of our time’

COVID-19 cases are accelerating, with daily confirmations sitting second only to those in the US (which are showing some decline). The national total has now risen to third globally, behind the USA and Russia. São Paulo and Rio de Janeiro are the infection epicentres. One media outlet forecast the potential for ‘a perfect storm’ of outbreaks of COVID-19, dengue, influenza and measles hitting the country at once. Read more

In the Middle East, per capita, COVID-19 cases are showing a markedly increasing trend in Qatar and to a lesser extent in Bahrain, Kuwait and the UAE, according to the May 18 Johns Hopkins newsletter. While in Africa, the WHO regional office now reports that all countries are affected, with urban areas most impacted by infections and no, or only sporadic, cases in rural districts to date. Read more in the May 19 WHO Sitrep.

In other news:

On May 14, the WHO issued a scientific brief on ‘Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19’.

Among the results from a Korea Centers for Disease Control and Prevention (KCDC) press release, Findings from Investigation and analysis of re-positive cases, published yesterday: ‘Based on active monitoring, epidemiological investigation, and laboratory testing of re-positive cases and their contacts, no evidence was found that indicated infectivity of re-positive cases’. Read more

JE season now underway in NE; Arrival of super cyclone imminent

Japanese encephalitis infections have been reported in the NE state of Assam, signalling the start of the annual peak season. The first cases have been treated in hospital in Jorhat, in the Brahmaputra Valley. Read more

PREPARATIONS, including evacuations and shelter-building, are being implemented in both India and Bangladesh as ‘super’ Cyclone Amphan nears land in the Bay of Bengal. The weather system is expected to compromise local responses to COVID-19 flare-ups being experienced by both countries. Read more  

Advice for travellers

A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to large urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE.

Ebola, cholera, measles and now SARS-CoV-2

No new Ebola cases have emerged in the last three weeks, however a single infected person who had escaped from a treatment facility remains at large (in an unsecured area). The WHO notes that intervention is needed to attend to the ‘outbreaks of measles and cholera, the low-level Ebola virus disease outbreak in North Kivu and COVID-19 … to avoid catastrophic consequences from one or the other’. Read more. In neighbouring Uganda, a limited outbreak of cholera was confirmed last week in the NE district of Moroto. To date 67 cases and one death have been recorded. Elsewhere, cholera cases continue to be reported in Kenya’s Marsabit County, one of five in which active transmission has been recorded this year, and a cholera outbreak has been in Cameroon’s most populous city of Douala, killing four people.

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.

Malaria spike in north

This week, senior government officials announced a near 4-fold rise in malaria cases in the country’s north - almost 11,000 cases and 32 deaths have been recorded. The health system is already said to be struggling under the burden of COVID-19, hepatitis E and tuberculosis. Read more

Advice for travellers

Malaria is endemic to many areas of southern Africa. Travelvax recommends that travellers planning a visit to malarious regions discuss their itinerary and preventative measures, including medication, during a pre-travel medical consultation. More on malaria.

Dengue hotspots east of capital

With public health efforts focused on the massive task of fighting an increasing incidence of COVID-19, the control of dengue fever has had to take a backwards step. Recent reports have emerged of suspected or probable dengue infections in Lima’s east, with the districts of La Molina, Comas and Ate all notifying recent cases. 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.

Parasite-related product recall

The discovery of the parasitic species of nematode Anisakis in several samples of a brand of locally produced anchovies in vinegar has led to a product recall in Andalusia and elsewhere in the region. To date three people have become mildly ill after consuming the anchovies. In related news, a study published earlier this year revealed that the global incidence of the Anisakis nematode in marine fish and invertebrates has increased 283‐fold over the past 55+ years. Read more, plus CDC FAQs  on anisakiasis.

North-east hit with dengue

Four NE provinces (Nakhon Ratchasima Chaiyaphum  Buri Ram and Surin) have experienced a spike in dengue fever cases already this year and authorities in Bangkok have admitted they are also on guard, warning residents to remove mosquito breeding sites as the peak rainy season approaches. 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.