World travel health alerts for 22nd of December 2021.
COVID-19 update
The Dec 21 WHO epi update had the highest weekly increase in new COVID-19 case numbers reported in the USA (down 12 percent) followed by the UK (up 45 percent), but on a regional level it was Africa that recorded the largest spike in new cases and deaths (rises of 53 percent and 15 percent respectively). For our region, three countries showed an increase in case incidence of over 10 percent: Australia (up 80 percent), Japan (up 26 percent) and Vietnam. The Omicron variant of concern has now been detected in 106 countries since it was first identified on Nov 24 and the WHO notes that there is consistent evidence of faster COVID-19 spread through Omicron’s growth advantage over the Delta variant - it ‘is spreading rapidly, even in countries with documented community transmission and high levels of population immunity’.
In related news:
- Five of the most commonly self-reported symptoms experienced by Londoners (UK) with positive COVID-19 infections (Omicron and Delta) in the week to Dec 10 (from data compiled through the ZOE COVID app) were ‘cold-like’: a runny nose, headache, fatigue (mild or severe), sneezing and sore throat. Read more
- This week the WHO listed the 10th COVID-19 vaccine for emergency use: Nuvaxovid, an adjuvanted, recombinant spike protein nanoparticle vaccine and ‘the originator product for the Covovax™ vaccine that received WHO emergency use listing on 17 December’. This is expected to boost vaccine supplies for the COVAX facility due to its lower manufacturing costs and storage requirements (up to six months in normal refrigeration). The WHO has also issued ‘Interim recommendations for use of the Novavax NVX-CoV2373 vaccine against COVID-19’. Read more
- An article in Euronews focusses on a recent Belgian study in which it was found that symptomatic COVID-19 infection in men ‘could impact fertility for weeks after recovery’ due to the effects on sperm count and motility.
- NPR writes of ‘The riddle of Japan's dramatic drop in COVID numbers’.
- The European Commission has set ‘a binding acceptance period of 9 months (precisely 270 days)’ for its EU Digital COVID Certificate, which is used for travel within Europe. The initial six months validity has been extended ‘for a grace period of an additional three months … to ensure that national vaccination campaigns can adjust and citizens will have access to booster doses’. Read more
Chikungunya cases rise, dengue gaining ground
Chikungunya infections are reported to be up by almost one-third this year compared to 2020 – highest incidence in the Northeast, the Southeast and the Midwest. There were fewer dengue fever cases over the same period, but they still numbered more than 500,000 nationally. In related news, a study published recently in the journal PLOS proposed that Brazil’s dengue fever transmission zones have expanded ‘into previously unaffected parts of Acre, Amazonas, and further south into Paraná and Santa Catarina’ as geographical barriers no longer offer protection: cooler temperatures in the south, high altitude in SE and the remoteness of the Amazon. Read more
Advice for travellers
The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by day-time feeding Aedes mosquitoes. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.
Cholera in 3 regions
The WHO has reported on an outbreak of cholera underway since late October in the South-West, Centre and Littoral regions. In Centre, at least 50 suspected infections were in the region’s Biyem-Assi health district, which is situated in central Yaoundé, however the situation has eased there now with no cases logged over the past four weeks. The South-West outbreak remains active and the trend in new cases is increasing. The agency rated the risk of local and regional spread to be high, particularly to Nigeria (which has ongoing outbreaks in adjacent several states) and Chad as the rainy season approaches. And in Tanzania, cholera cases have been confirmed in Rukwa region of the southern highlands. Read more
Advice for travellers
While the risk of infection with cholera is low for short-stay travellers, Australians travelling to regions where an outbreak is occurring should adhere to strict personal hygiene and choose food and beverages with care. Read more about cholera.
More bird flu on mainland; Hantavirus in NW
Four human cases of avian influenza A(H5N6) in the mainland provinces of Guangxi and Hunan are being monitored by Hong Kong’s health agency (CHP) – they all had exposure to live poultry. Since H5N6 was first identified in humans in 2014, there have been 57 confirmed cases and the CHP has stressed the need for ‘strict personal, food and environmental hygiene both locally and during travel’. More advice from the CHP here. Read more
LOCAL MEDIA have reported an uptick in hantavirus infections in X’ian, the capital of Shaanxi province in the country’s NW. The increase emerged during the winter peak in infections (there is also a spring peak from March to May). Three hantaviruses are endemic in China and infections can result in haemorrhagic fever with renal syndrome (HFRS). Inactivated hantavirus vaccines are available in China and Korea. Read more
Advice for travellers
Hantavirus is generally spread from various rodent species to people, through aerosols shed in excreta, urine or saliva, but to a lesser extent via the bite of an infected animal. The syndromes resulting from infection vary by region - in Europe and Asia, the 'Old World' hantaviruses may cause haemorrhagic fever with renal syndrome (HFRS), while the New World' hantaviruses in the Americas can result in hantavirus pulmonary syndrome (HPS). Read more on hantavirus from the Taiwan CDC. Read more on hantavirus from the US CDC.
5 states report positive polio environmental samples, global digest
The GPEI reported a single confirmed cVDPV2 case last week – from Loh-Djiboua in the Côte d’Ivoire, while cVDPV2 positive environmental samples were obtained from sites in Guinea (Conakry), Senegal (Dakar) and in Nigeria (states of Borno, Kano, Katsina, Jigawa and Yobe). On a global level for the year to Dec 14, five cases of wild poliovirus had been recorded (138 in 2020), and 484 infections were due to circulating vaccine-derived poliovirus (cf. 809 in 2020).
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.
Ebola outbreak over
The end of North Kivu’s second Ebola virus disease (EVD) outbreak this year was declared on Dec 16 after running for just over eight weeks. The final case count from three health zones within the city of Beni was eight confirmed and three probable EVD cases, and a case fatality ratio among the confirmed of 75 percent. The WHO did say that more sporadic cases could be expected due to the presence of animal reservoirs in the region, and also possible transmission occurring from the body fluids of survivors who have retained the virus in immune-privileged sites. Read more
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.
Diarrhoeal illnesses spike
Six health centres are reportedly seeing a rise in acute watery diarrhoea cases among children, which goes against the trend for the same period in recent years. Surveillance has been heightened, particularly for children under five years, and testing will be carried out locally to determine if rotavirus is the cause. Strict personal hygiene measures and food/water precautions have been advised to stem further infections. Read more
Malaria, dengue peak in 2 cities
The more than 5,000 malaria infections reported in Mumbai this year are the highest for three years and have been attributed by at least one city official to work on the underground rail network. Dengue fever cases have also risen above the 2020 figures and are closer to those recorded prior to the pandemic. Read more. In Chandigarh, the capital of the northern Indian states of Punjab and Haryana, dengue fever cases have hit a 4-year peak as a longer monsoon season and public health priorities directed to the pandemic response saw mosquito populations surge.
Advice for travellers
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.
Chikungunya suspected in Central Java
There has been a rise in what is suspected to be cases of chikungunya in the regency of Klaten in central Java. Investigations are underway to confirm the cause of the infections which have been reported over recent weeks, many from Trucuk, Ceper and Cawas. Read more
Advice for travellers
The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by day-time feeding Aedes mosquitoes. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.
Typhoid takes off in the Sindh; Summary of dengue outbreak
Delays in providing typhoid conjugate vaccines to children in the Expanded Immunisation programme (EPI) are being blamed by some healthcare workers for a surge in typhoid cases this year. Almost 175,000 cases have been recorded in 2021 in the Sindh and 15 children have died as a result – Naushero Feroze has been hardest-hit. Read more
AN UPDATE on the dengue fever outbreak from the WHO, with more than 48,000 cases (and 183 deaths) reported from four provinces including Punjab, Khyber Pakhtunkhwa, Sindh, Balochistan, and two territories (ICT and AJK). Around half of all cases were in Punjab, which also recorded more than two-thirds of the fatalities. Vector surveillance and control activities have been put in place in the affected areas. 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.