World travel health alerts for 24th of April 2019.
Summer heat ups disease risks
Peak conditions for the growth of food- and water-borne pathogens during these summer months have caused a surge in people requiring treatment for diarrhoeal illnesses - almost 800 per day at just one facility in the capital Dhaka. Read more. (The heat is also affecting children in Vietnam’s Ho Chi Minh City with a news source reporting that one paediatric hospital treated thousands in a recent week for heat-related and seasonal issues such as respiratory/gastrointestinal illnesses and hand, foot and mouth disease). Health authorities have also warned that the recent early rains and humidity could produce a spike in malaria cases following a milder season last year.
Advice for travellers
Travelvax recommends that travellers visiting malarious regions discuss their itinerary and preventative medication with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.
Rodent transmitted virus kills 2
In the southern lowlands department of Tarija, hantavirus infection has led to the deaths of two soldiers (one confirmed, one suspected), nine others have been hospitalised and more than 80 are symptomatic. They were based at a military school in Sanandita in the city of Yacuiba (near the Argentine border); all soldiers have now been evacuated to Santa Cruz as a precautionary measure. Read more
Advice for travellers
Hantavirus is passed on to humans through contact with hantavirus-infected rodents or their urine and droppings. Eliminating rats in and around living quarters is the main way of preventing hantavirus infection. Cases have been documented in Argentina, Brazil, Canada, Chile, Panama, Paraguay, and Uruguay, making HPS a pan-hemispheric disease. Read more about hantavirus.
YF update; Rio’s chikungunya cases double in a month, dengue near Falls
A WHO summary of recent yellow fever activity notes that the current peak season (Dec-May) is milder than the two previous. The number of confirmed cases from July 2018 to March this year stands at 75 and includes 17 deaths from ‘the states of São Paulo (62), Paraná (12), and Santa Catarina (1). Of these cases, 88% (66/75) are males, the median age is 43 years, and 71% (53/75) are rural workers.’ The trend since 2016 has been of a ‘southward movement of the virus, which presents further risk to the states of Paraná, Rio Grande do Sul, and Santa Catarina. Furthermore, these areas have ecosystems favourable for yellow fever transmission and borders with other countries such as Argentina, Paraguay, and Uruguay.’
WESTERN districts of Rio de Janeiro, including Jacarepaguá, Curicica and Bangu, have been hard hit by an outbreak of chikungunya with one news report stating that cases in the city had ‘doubled in a month and went from six thousand to more than 13 thousand’ - this number is also a likely underreporting of the true situation. While Foz do Iguaçu, in the southern state of Paraná, has reported a 7-fold increase in dengue fever cases this year compared to the same period in 2018. Three serotypes are currently circulating. 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.
Global, regional, local measles update; Flu season ebbing
The CDC announced a further 71 measles cases up to Apr 19, taking the YTD total to 626 from 22 states. As of Apr 24, that number had risen to 695, making 2019 the worst for measles cases since the viral illness was eliminated from the US in the year 2000. More detailed information is available on the outbreaks in New York State, Rockland County, New York City, Washington, New Jersey, California, and Michigan on the CDC Measles webpage. Within the region, the PAHO summarises measles outbreaks in 12 countries of the Americas. Elsewhere, there are reports or updates on outbreak of measles in India (central Mumbai), the Philippines, Bulgaria, Georgia, Chad and New Zealand (Bay of Plenty).
FROM THE Apr 20 CDC flu update: ‘According to this week's report (Apr 7-13), seasonal flu activity decreased in the United States, but remains elevated. Eleven states are reporting widespread flu activity. CDC estimates that flu has caused as many as 41.3 million flu illnesses, 610,000 hospitalizations and 57,300 deaths so far this season.’
Advice for travellers
Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. In general the infection is relatively benign, but complications can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure. Read more about measles.
Local, regional dengue reports
The number of dengue fever infections (DENV-3) recorded since December last year rose to 164 by Apr 21 according to ReliefWeb. Also in the region, dengue outbreaks of varying magnitudes continue in New Caledonia (DENV-2), Cook Islands (DENV-1), Tuvalu and Vanuatu.
Advice for travellers
Avoid mosquito bites and you won’t get 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.
More security concerns in N.E.’s Ebola zone
Attacks carried out against healthcare workers over the weekend have slowed response activities in the Ebola-affected areas of the NE and are of ‘deep concern’ to the WHO. These security issues may denote that the actual number of new cases and deaths as reported by the Ministry of Health could be higher. 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.
Works to lower dengue risk
Clean-up campaigns are being promoted in Viti Levu’s SE as authorities seek to stem dengue fever infections with the national case count for the year approaching 1,900. The health minister is quoted in a news article as saying the highest incidence of infections has been in the Lami-Nausori corridor, near Suva. 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, 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.
Scabies, measles cases rise in NW state
Reports of scabies are said to be on the rise across the country with Hanover, capital of the state of Lower Saxony, currently reporting an increase in cases. As the infection is not generally notifiable, exact data is not available. Lower Saxony has also experienced a three-fold surge in measles cases this year. Read more
Advice for travellers
Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure. Read more about measles.
Malaria vaccine for kids under 2
Malawi is one of three African countries launching a pilot campaign to administer the malaria vaccine, RTS,S, to children up to two years of age. Kenya and Ghana are scheduled to start their vaccination programs ‘in the coming weeks’. A WHO news article of Apr 23 notes that ‘In clinical trials, the vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threatening severe malaria’. Read more
Cholera in 6 counties, Kala azar in 2
While 1,350 suspected cholera cases have been reported this year, 62 have occurred in the past month; one outbreak hit staff at a major hospital in Nairobi. But Nairobi is just one of five counties reporting cholera cases – the others are Kajiado, Narok, Machakos and Kiambu. Read more. In a separate UNICEF report on cholera in eastern and SE Africa, the county of Garissa in Kenya is mentioned as also having recently reported cholera infections. (The UNICEF post provides more details on the extensive outbreaks in Mozambique’s Beira, Dondo, Nhamatanda and Buzi districts following Cyclone Idai.) Of the two northern counties that have reported outbreaks of Kala azar, or visceral leishmaniasis, since January this year, Marsabit has been hardest hit. According to one news report, two to five new infections are confirmed each day and seven deaths have been recorded. Thirty-five cases were reported in Wajir county to Apr 18.
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.
Local dengue reports top imported cases
Around one quarter of the 75 dengue fever cases diagnosed this year are believed to have been contracted overseas – primarily in India or Reunion. Fumigation is to be carried out in areas reporting cases, including sites in the west: Vallée-des-Prêtres, Cité La Cure, Palma and Grand-Baie. Read more
Advice for travellers
Dengue is spread by two types of Aedes mosquitoes which breed in shady areas close homes and other accommodation. Both bite mainly during the daylight hours, making them difficult to avoid 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 (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.
RVF human cases mount
Health authorities renewed calls to the public for their cooperation in halting the spread of Rift Valley fever (RVF) among humans and animals after weekly increases in cases this month. From November last year to Apr 18, the human case count climbed to 122 while 104 foci have been identified among domestic animals. Read more
Advice for travellers
Rift Valley fever (RVF) is an acute viral disease that typically infects domesticated herd animals. It is generally found in eastern and southern Africa where sheep and cattle are raised, as well as in West Africa, Madagascar, and more recently Saudi Arabia and Yemen. People are infected after exposure to blood, body fluids, or the tissue of RVF-infected animals, or from the bite of an infected mosquito. The virus presents a low risk to travellers, but is another reason to use personal insect repellent and take other steps to minimise insect bites in places where it occurs. Read more about RVF.
Environmental polio samples in 3 states; Measles, Lassa fever updates
Cases of circulating vaccine-derived poliovirus (cVDPV) have risen to five this year with the latest case in Ogun state. Environmental samples proved positive in three other states - Borno, Kano and Lagos. Read more
BORNO in the country’s NE is also the site of an extensive measles outbreak with over 10,000 cases and 17 deaths recorded in a 14 week period. A vaccination campaign is to be carried out across 15 districts, including the state capital Maiduguri. Following recent trends, as the dry season ends new Lassa fever cases have declined in number. The WHO reports that more than 550 confirmed or probable cases 137 deaths have been recorded this year from across 21 states (Edo, Ondo, Ebonyi, Bauchi, Taraba and Plateau were most affected).
Advice for travellers
Polio 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.
Polio cases, samples in KP, Sindh
Renewed polio vaccination campaigns targeting 39 million children are to be carried out across the country. Another two wild poliovirus cases have been identified this week in Khyber Pakhtunkhwa (national YTD total now 8). While in the province of Sindh (cities of Karachi, Kambar, Jacobabad, Sukkur and Hyderabad), ongoing surveillance for polio virus in environmental samples returned positive results. In Karachi alone, eight of 11 sewage sites showed the presence of the virus. Read more
Advice for travellers
Polio 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.
Count in chikungunya outbreak surges to 8,000
The chikungunya outbreak declared in early February continues unabated and it has now spread to over half the country, sickening more than 8,000 people. While confirmed cases have been reported from the departments of Kouilou, Pointe-Noire, Niari, Bouenza, Pool and Brazzaville, alerts have been issued to all regions. Read more
Advice for travellers
The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. 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 cases near 2,600
Dengue fever cases have increased by more than three times over the same period in 2018 but they remain well below those experienced in 2016. The government is warning that the peak season is still to come and there are abundant mosquito vectors present. According to the NEA dengue website, there have been nearly 2,600 cases this year and six of the 25 active clusters are high risk (with 10 or more 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.
Perils of raw, undercooked pork
Exposure to Streptococcus suis bacteria has produced 50 serious infections in humans and resulted in 10 deaths so far this year, leading Thai health agencies to alert the public to the risks of eating undercooked or raw pig meat, organs or blood. The bacterium is commonly found in pigs and pathogenic strains spread to humans can present as meningitis, septicaemia, endocarditis and toxic shock syndrome. Recent studies have found that the highest prevalence rates are in Thailand and Vietnam (in the SE Asian region). Read more
School’s back, so is flu
Hospitals and schools are experiencing a rise in influenza cases among students after the start of the new term. Schools and medical practitioners are alerting the public to the increased flu activity across the Emirates, including some districts of Dubai. Read more
Advice for travellers
Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination for all travellers over 6 months of age. Read more about influenza.