World travel health alerts 24 June 2020

World travel health alerts for 24th of June 2020.

One wild polio case, four in Afghanistan

In the week to June 16 Pakistan logged one wild poliovirus1 (WPV1) case in Balochistan province and in Afghanistan, four WPV1 cases were reported (two in Hilmand and one each in Farah and Hirat); while in Africa, three provinces of Côte d’Ivoire recorded a single cVDPV2 case: Gbokle-Nawa-San-Pedro, GOH and Haut Sassandra. Read more. In other polio news, in August the Africa Regional Certification Commission (ARCC) will publish its decision on the certification of wild poliovirus eradication in the African region. It has already accepted documentation for Cameroon, Central African Republic, South Sudan and Nigeria - the last wild poliovirus endemic African country which has now recorded four years with no WPV cases. (At least 67 cVDPV2 cases have been reported from the region this year.) 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.

Rabies death in Rio

Health authorities in Rio de Janeiro have issued warnings to local municipalities after the (delayed) confirmation of rabies in a teenager who died back in March – he had been bitten by a bat in Angra dos Reis in January this year but had not sought post-exposure treatment. His is the first recorded rabies death in the state in 14 years. 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.

COVID-19: Most days bring ‘a new and grim record’

CIDRAP reports that ‘Chile and Peru, part of surges in Latin America, have passed Spain and Italy's case totals’ – Peru’s total of 257,447 cases is only slightly higher than Chile’s (250,767). They are numbered six and seven in the global confirmed case totals as listed on the Johns Hopkins dashboard – the first five countries are the USA, Brazil, Russia, India and the UK

Five countries in the African region have recorded 70 percent of cases and almost three-quarters of all deaths (South Africa, Nigeria, Algeria, Ghana and Cameroon). More global information in the June 23 WHO sitrep, which has also updated its Q&A page with information on Dexamethasone and COVID-19.

More Ebola cases in NW; Plague in Ituri’s endemic zone

Equateur’s Ebola outbreak now totals 24 cases (21 confirmed & 3 probable) with 13 associated deaths – two of the new confirmed cases are from the most southerly health zone, Iboko. More than 4,100 people have now received the rVSV-ZEBOV vaccine with agencies focussing on reaching out to ring contacts. Read more. Summaries of the North Kivu/Ituri outbreak have been published in a Stat News report and the June 23 WHO sitrep. It is hoped the epidemic will be declared over this week as no more confirmed cases have been reported since Apr 27.

AT LEAST 10 cases of plague (eight bubonic, two septicaemic) have been confirmed in an endemic zone of Ituri province; the outbreak is under investigation but there have been recent reports of a ‘rat die-off‘ in the two affected villages. 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.

YF confirmed in southern region

Local health agencies are working with the WHO to investigate a yellow fever (YF) infection in an elderly man from the southern city of Tchibanga (Nyanga province). Onset of symptoms occurred in January and over the next three months the man visited several medical facilities where he received treatment for malaria. Yellow fever infection was confirmed post-mortem. The last YF cases in Gabon were recorded in the far north region of Woleu-Ntem in 2019. 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.

Dengue in the time of COVID-19

It’s now past the annual dengue season (Nov-Apr), however national health authorities are still reporting anywhere from 100-500 new cases per day. Local news sources say several provinces with high dengue counts also have more COVID-19 cases - West Java, Bali, East Nusa Tenggara, East Java, Lampung, West Nusa Tenggara, Jakarta, Central Java, Yogyakarta, Riau and South Sulawesi are named. Co-infections are common. Read more. Many SE Asian countries have seen upticks of dengue fever infections during lockdowns with Singapore’s cases this year expected to exceed the previous maximum of 22,170 in 2013. The highest weekly totals ever recorded were registered in the past two weeks, taking the YTD total to nearly 13,000.

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.

Sand fly-borne infection strikes Kitui’s children

Mounting numbers of children, most of them under 10, suffering from visceral leishmaniasis (kala-azar) have been arriving at local hospitals in the northern county of Garissa for treatment. Many had travelled from Kitui County but there are verbal reports of others left behind without treatment due to medication shortages. Since March last year, five counties have reported outbreaks - Garissa, Kitui, Mandera, Marsabit and Wajir. Read more

Advice for travellers

Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. The former causes skin ulcers and the latter a severe systemic disease that is usually fatal without treatment. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil account for 90% of visceral leishmaniasis, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia and Argentina. Read more on the disease and prevention.

Secondary effects of lockdown

Thirteen local government areas (LGAs) have registered an increase in measles cases resulting from the COVID-19 lockdown – mostly attributed to parents keeping their children away from medical and immunisation facilities due to fears of contracting the coronavirus. A further three LGAs (Bosso, Munya and Suleja) have maintained higher measles infection levels over recent weeks. 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.

Capital records rising dengue numbers

Dengue fever activity has carried over into the winter season and while it is said infections are occurring over most of the island, the south continues to be the most affected region (recent increases in Avirons). While in the north, numbers are rising in the capital, Saint-Denis. More than 13,500 cases have been recorded since the beginning of the year. 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.

Hajj adapts to pandemic threats

Just a few weeks before the annual Hajj was set to begin (July 28 – Aug 2), it has been announced that the pilgrimage will be restricted to ‘limited numbers’ comprised of Saudi residents only of various nationalities - almost 2.5 million people were present at last year’s Hajj. Earlier this month both Indonesia and Malaysia issued a Saudi Arabia travel ban for the Hajj this year, and back in March the Saudi government suspended all visits for Umrah. The Eastern Mediterranean region is reported to be a current COVID-19 hotspot. Read more

Typhoid in southern governate

At least 130 typhoid fever infections have been reported in the large southern governate of Tataouine, with investigations into the source continuing. Two weeks ago a directive was issued in the city of Tataouine to ban the sale of a local drink made from palm sap in markets due to concerns of bacterial contamination. 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.

Dengue case for the Keys

Florida’s Monroe County has recorded its second dengue fever case this year: a locally-acquired infection in the Keys. The case confirmation and the boost in mosquito numbers due to early rains, has triggered enhanced health inspections and surveillance in the Key Largo area. 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.