World travel health alerts 22 July 2020

World travel health alerts for 22nd of July 2020.

2 wild poliovirus cases, plus cVDPV2 infections in 3 countries; Typhoid surge in KP

As reported by the GPEI, two more wild poliovirus (WPV1) cases were reported this week - from Sindh province. While circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were detected in Afghanistan (Badakhshan and Nangarhar) and, in Africa, Angola registered a single case in Zaire province and Chad’s two cases were in Tandjile province. Read more

DOCTORS in Khyber-Pakhtunkhwa (K-P) are reporting a spike in typhoid fever cases in the province, with some claiming there are dozens of new infections each week. With K-P’s COVID-19 cases passing 32,200 this week, some doctors are recommending anyone with symptoms to be tested for both it and typhoid. 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.

3 countries with highest chikungunya case totals

An ECDC summary of global chikungunya cases flagged an increase of more than 2,300 cases since the last update, while Malaysia has seen a smaller rise (just over 600 cases), affecting mainly Perak and Penang. However it’s Brazil that has been hardest hit with chikungunya infections – almost 11,000 new cases since the previous report. The summary includes data on dengue fever, adding that ‘Since the beginning of the year, the majority of the cases were reported by Brazil, Paraguay, Bolivia, Argentina and Indonesia’. Thailand’s 2020 dengue count has now topped 25,000 and includes 15 deaths – most affected provinces are Chaiyaphum, Rayong, Khon Kaen, Mae Hong Son and Nakhon Ratchasima.

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.

Dengue downturn

Dengue fever season is now well advanced following the onset of the southwest monsoons in May, but cases are down dramatically this year, dropping from more than 28,000 in 2019 to 3,339. Deaths, mostly recorded in children, have also fallen – from 32 to four for the first half of the year. Read more

Advice for travellers

Dengue occurs both in urban and rural areas. The virus is spread by Aedes mosquitoes which breed in shady places close to dwellings and bite mainly during the daylight hours, making them difficult to avoid when 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 (or PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

NW Ebola outbreak now in 7 health zones

Confirmed Ebola cases in Equateur have now passed the province’s 2018 outbreak total, rising to 60 – 56 confirmed and four probable (and 24 deaths). WHO representatives are said to be troubled by the spread of this outbreak across seven health zones and the high risk presence of confirmed cases (and deaths) in the community. 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.

No end to outbreaks

In a July 12 follow up on the continuing dengue fever outbreaks in the four territories, the ECDC reported nearly 3,500 new suspected cases since its May 21 update, most of which were from Martinique (1,800 cases), followed by Guadeloupe (990), Saint Martin (450) and Saint Barthélemy (232). More locally-acquired cases are anticipated due to favourable conditions and the multiple serotypes in circulation have raised the risk of severe dengue. 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.

Dengue up in 20 cities, regions also record a spike

During the prevailing monsoon season, 20 cities and three rural regions have recorded high dengue fever case numbers, including the regions of Sagaing, Mandalay, and Mon state. Countrywide, dengue infections this year have climbed to 2,862 cases and 20 deaths to June 27 – the highest death count has been in Yangon region. Read more. While in Singapore, the NEA confirmed that last week’s total of 1,736 cases was ‘the highest number of weekly dengue cases ever recorded’, and made it six weeks in a row with totals exceeding 1,000. The year’s dengue-related death toll has risen to 19 after a further three deaths were recorded.

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.

Lassa fever cases up in 2020

The national Lassa fever case total is now climbing more slowly, passing 1,000 cases up to July 12 from 27 states (mostly from Ondo, Edo and Ebonyi) - the peak of the outbreak was in mid-February. Both confirmed and suspected cases have risen markedly this year compared to 2019 data. Read more

Advice for travellers

Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5,000 deaths occur each year. However, Lassa is a remote risk for most travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

COVID-19 surge a warning for region

A major challenge addressed in the latest WHO African region weekly bulletin is South Africa’s ‘massive, rapidly rising caseload’ - the country is now ranked fifth in COVID-19 case numbers across the globe, sitting behind USA, Brazil, India and Russia. The new hotspot for COVID-19 infections is now Gauteng Province ‘closely followed by increasing caseloads in Eastern Cape and KwaZulu-Natal’. The WHO chief of emergencies has said that the escalating situation in South Africa could be a forewarning of what could occur in the rest of the continent. More on the global outlook from the WHO Situation Report of July 21 and a summary of the latest developments by CIDRAP.

Malaria hits UN mission sites

Several locations under the management of UN peacekeepers have reported a rise in morbidity from malaria infections this year which has resulted in ‘rampant deaths’. Four Protection of Civilians Sites have registered the largest increases: Bentiu, Juba, Malakal and Wau. Read more

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.

Upsurge in HFMD cases

After a fall in hand, foot and mouth disease (HFMD) cases earlier this year, authorities have announced a recent uptick affecting cities and provinces including HCM City, Hanoi, Dong Nai, Binh Duong, Da Nang, Quang Ngai, Vinh Phuc, Hai Phong and Bac Ninh. The health ministry has pushed for enhanced hygiene measures in high risk areas, such as kindergartens. Read more

Advice for travellers

Seasonal epidemics of HFMD occur sporadically throughout Asia, mainly affecting young children. Asian countries with recent large increases in reported cases include China, Hong Kong (China), Japan, South Korea, Malaysia, Thailand, Taiwan, and Vietnam. Symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection.

Malaria deaths mount in eastern province

The district of Nyanga in Manicaland is reported to have the eastern state’s highest incidence of malaria with almost one-quarter of cases recorded this year. Across the state, malaria deaths have climbed from 46 in 2019 to 98 for the same 6-month period. 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.