World travel health alerts for 23rd of December 2020.
All cVDPV2 cases in weekly report
The GPEI reported an unusually high number of cVDPV2 cases from Afghanistan in its latest update after 54 infections were recorded, mostly from Kandahar (19), Hilmand (14), and four in each of Uruzgan, Wardak, Zabul provinces. In Africa, two cVDPV2 cases were registered in the DRC (Maindombe province), Nigeria (Zamfara province) and also in Chad where outbreaks have seeded into neighbouring countries - this week infections were logged in Sudan (two cVDPV2 cases) and South Sudan (six cases). More on a new approach to controlling cVDPV2 from the GPEI (August 2020). 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.
Malaria elimination delayed
The 21 locally-acquired malaria cases recorded this year in the southern district of Sarpang (adjacent to the Indian state of Assam) mean that Bhutan’s malaria eradication targets have to be re-set and are now planned for 2022. At the earliest, certification would be approved by the WHO in 2025 if zero incidence of indigenous malaria is maintained over the three intervening years. Dengue fever does remain a public health issue and cases are reported from all but one of the country’s 20 dzongkhags. Around three-quarters of the 1,000+ cases this year were in the town of Phuentsholing, located in another border district, Chukha. 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.
Dengue outbreak foreshadowed
Wet weather and reported high Aedes mosquito larval counts have prompted the government to warn of an expected rise in dengue fever cases and the risk of Zika and chikungunya infections. More than 800 dengue cases have been recorded over the past month, but this figure is likely to be an under-reporting due to the changes in the local population’s healthcare-seeking behaviour during the pandemic. Read more. And in the Caribbean, at last a downward trend in dengue reporting in the French Antilles as new suspected cases dropped from 3,140 to 1,925 since the last update. The latest ECDC dengue update notes that Paraguay, Brazil, Mexico, Vietnam and Malaysia have recorded the highest dengue case counts this year. Most Asian countries have seen a reduction in dengue incidence this year, the exception is Singapore which has had a record year for dengue and weekly averages are ‘still relatively high for this time of the year’.
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.
9th rabies death in Sarawak
The state of Sarawak has recorded its ninth rabies death in 2020 after a woman from Selangau district near Sibu succumbed to the infection weeks after being bitten by her pet dog. News reports state she had not sought medical follow-up for the bite. Read more
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, including bats. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is generally 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.
Testing to confirm 3 polio cases
Analysis is underway into the cause of acute flaccid paralysis in three children from Kambia, Tonkolili and Western Area Rural. The last WHO African region communication, issued on Dec 17, stated that 'Poliovirus 2' was detected, but this remains to be confirmed through testing being performed by the NICD in South Africa. 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.
COVID-19 cases pass 2 million
Global weekly incidence and mortality both rose last week to new records according to the latest WHO epi update. After the inclusion of 800,000 cases previously unreported asymptomatic infections, Turkey's cumulative total climbed to more than 2 million and vaulted it into seventh ranking in total incidence. Thailand has recorded a sharp spike in new cases this week with more than 800 infections stemming from the Talad Klang Kung seafood market in Muang district (central province of Samut Sakhon). The outbreak has since spread to seven provinces and Bangkok where 10 control measures have now been put in place. Read more
In related news:
-More information on the new B.1.1.7 or VUI-202012/01 variant in the United Kingdom from Public Health England and a Dec 21 WHO Disease Outbreak News post which flagged early analysis indicating the variant may spread more readily between people (an estimated increase in transmissibility of between 40-70 percent). The post went on to state that ‘Investigations are ongoing to determine if this variant is associated with any changes in the severity of symptoms, antibody response or vaccine efficacy’. The ECDC’s Rapid Assessment offered one possible explanation for the emergence of the variant in the UK, perhaps stemming from a ‘prolonged SARS-CoV-2 infection in a single patient, potentially with reduced immunocompetence’. A different variant that emerged around the same time in South Africa shares a mutation with the UK variant and the WHO is now working ‘to understand how these genetic changes affect how the virus behaves’. More from a STAT news article, ‘The looming questions scientists need to answer about the new variant of the coronavirus‘.
-From the WHO: the agency is finalising emergency use authorisation (and a guide of recommendations for use) for the Pfizer/BioNTech vaccine with hopes it will be completed in the next couple of weeks which should allow ‘for faster registration of the vaccine in many countries’. Meanwhile, the EU’s green light for conditional marketing authorisation of the Pfizer/BioNTech vaccine (Comirnaty) paves the way for the European Commission to give the final go-ahead for its distribution across the bloc (and Switzerland) with vaccinations due to start early next week. Read more
-The lightning-fast quest for COVID vaccines — and what it means for other diseases Read more
-Our World in Data is tracking announcements relating to national vaccination programs to gauge their progress and global distribution – to date, the information published is from campaigns in Canada, China, Israel, Russia, the UK and USA, but more countries’ input will follow. The site also has global details of vaccination policies for vaccination delivery to different groups. Read more