World travel health alerts 24 March 2021

World travel health alerts for 24th of March 2021.

Polio cVDPV2 digest

Over the past fortnight, all polio notifications reported to the GPEI related to cVDPV2 infections: Tajikistan’s two cases were from the central Districts of Republican Subordination, while Afghanistan logged 15 cVDPV2 cases.  In Africa, the D R of Congo registered three cases (Equateur and Tshuapa provinces); Mali and Sierra Leone had five cases each; South Sudan’s four cases were in Unity, Warrap and Lakes; Nigeria’s three cases, its first in 2021, were in Sokoto and Kebbei states; and lastly a single case in Sudan (North Darfur).

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.

MVE suspected in NT death; Lockdown effects on disease transmission

The recent death of a Tiwi Islands resident due to encephalitis is initially being attributed to a mosquito-borne virus such as Murray Valley encephalitis virus or Kunjin virus. This week, Northern Territory Health alerted the Top End’s population to the risk of mosquito-borne diseases, with particular emphasis on activities near the insects’ breeding sites – ‘campers, infants and young children residing near mosquito-breeding areas … [p]eople in remote Top End communities and anyone visiting parks and recreation’. Read more 

RATES OF notifiable diseases such as influenza, pertussis and rotavirus declined between early April and late September last year in central QLD due to pandemic health measures (social distancing, enhanced hygiene), however there was ‘an increase in sexually-transmitted infections (STIs) such as newly-acquired hepatitis C, gonorrhoea and infectious syphilis’ which was echoed by similar trends for syphilis and gonorrhoea on a national level in 2020. Vector-borne disease were also reported to have increased in incidence across the central QLD region (Ross River virus, Barmah Forest virus and Q fever). Read more

Advice for travellers

While the risk of contracting MVE is low, the virus can cause severe illness, even death in very rare cases. The vector mosquitoes are active at dawn and dusk, particularly in the first two hours after dark. They pass on the virus to humans after feeding on infected birds attracted to flooded wetlands. Travellers to wetland areas of Australia should take all measures to prevent bites. Apply an insect repellent containing DEET, picaridin, or oil of lemon eucalyptus [PMD] to exposed skin when outdoors. More about MVE and Kunjin viruses.

COVID-19’s 3rd wave

Hungary and Poland are just two of the EU countries experiencing a third wave of COVID-19 cases. France is reporting a resurgence of infections and more restrictions have been imposed in Germany as new cases rose again due to a greater dominance of the B.1.1.7 variant. Elsewhere, the PAHO director warned on Mar 22 that the region is experiencing an active public health emergency as the pandemic accelerates across the Americas. The situation in South America was described as ‘particularly dire … where infection is reported to be spiking in Chile, Paraguay and Uruguay’ and cases are surging ‘dangerously’ in all areas of Brazil since the emergence of the more transmissible P1 variant. In our region, the WHO reported three consecutive weeks of increasing case numbers (29 percent more over the past seven days) with a fresh spike in cases in the Philippines that has led to the re-introduction of curfews and tighter restrictions. More global news in the Mar 23 WHO epi update.

More COVID-19 news:

-CIDRAP reported last week on the Novavax vaccine candidate, stating ‘Efficacy was 86.3% against the B117 variant. Results of a phase 2b trial in South Africa showed an efficacy of 48.6% against the B1351 strain. But, similar to the Johnson & Johnson vaccine, the Novavax vaccine demonstrated 100% protection against hospitalization in both trials, regardless of variant’.  A Mar 11 company press release announced that the data is expected ‘to serve as the basis for submission for authorization to various regulatory agencies worldwide’.

- The WHO has listed a fourth vaccine for emergency use – the Johnson & Johnson single-dose vaccine – which will pave the way for its inclusion in the COVAX facility. Read more

-STAT News article summarising preliminary data from an AstraZeneca vaccine study carried out on more than 32,000 subjects in the US, Peru and Chile and the subsequent US NIAID’s response to the inclusion of what may have been outdated data. AstraZeneca has indicated that the numbers represented ‘pre-specified interim analysis’ and it would issue further results within 48 hours.  

-COVID-19 tests carried out in Denmark have provided data on the duration of post-infection immunity, with people aged under 65yo conferred around 80 percent protection for at least six months, but that figure was closer to 49 percent for the over 65s. Read more in a new Lancet study.

-The decision has been made not to allow international visitors to attend Japan’s postponed summer Olympic Games or the Paralympic Games. Read more  

-A day after the EU proposed a digital green certificate as a type of vaccine passport, a WHO official revealed that the agency is developing a ‘smart digital certificate’, which would differ from a vaccine passport to reconcile the inherent ethical, practical and scientific issues. Read more

More YF monkey deaths in southern state

The discovery of more dead monkeys near four municipalities in Santa Catarina indicates the ongoing risk to residents from sylvan yellow fever, as health officials announced the state’s 2021 tally of YF cases. Neither of the two reported cases (from Taio, Alto Vale do Itajai and Grande Florianopolis) was vaccinated. Santa Catarina’s YF vaccination coverage is said to be 76 percent.

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.

Ebola outbreak response continues

Genetic analysis has provided strong evidence that the index case in the current outbreak in Nzérékoré had been harbouring the virus since 2016, when the extensive West African Ebola event ended. STAT news reports that the longest period of latency for the Ebola virus was previously around 500 days. As of Mar 19, there had been 18 confirmed cases and nine deaths, with two new suspected cases identified in Nzérékoré. Read more. While in the D R of Congo, the last Ebola case has been discharged from care and the 42-day countdown to the end of the outbreak has begun. Cumulatively, there have been 12 Ebola cases and 6 deaths amid confirmation from the WHO that the event was not a new spill-over - genetic analysis found links to the region’s 2018-20 outbreak.  

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.

Low flu activity maintained

The WHO advised in its latest flu update that ‘Worldwide, influenza B detections accounted for the majority of the very low numbers of detections reported’. The data, taking in activity to mid-February, noted influenza detections in several tropical African countries, as well as reports of influenza A(H3N2) viruses in India, Laos, Thailand, East Timor and Vietnam.

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.

 

Plague activity reported

In the first few weeks of the year more than 37 suspected bubonic plague cases have been reported, resulting in at least nine deaths. Disease activity has been highest in areas such as Alaotra-Mangoro, Analamanga, Haute Matsiatra, and Itasy. The country’s last extensive outbreak of plague was in 2017 when more than 2,000 cases of the pneumonic form were reported. Read more

Advice for travellers

Plague occurs annually in Madagascar, but poses a low risk to most travellers. Most cases of plague are due to bubonic plague following the bite of an infected flea carried by rats. If left untreated, infection of the lungs causes the pneumonic form of plague, a severe respiratory illness, which can progress rapidly to death. Read more on the plague.

More work needed to reduce TB burden

Today, March 24, is World TB Day and this week the WHO warned that Nigeria’s continued challenges in TB case detection and disease control were stumbling blocks to reaching a 2025 national target. Funding shortfalls are reported to have resulted in only 27 percent of all TB cases detected. Read more

Lima’s dengue alert

There have been calls for Lima’s municipal authorities to introduce insecticide fogging across 14 districts where locally-acquired and introduced dengue fever cases have been reported recently and/or confirmed presence of a dengue vector, the Aedes aegypti mosquito. The affected districts are Breña, Jesús María, La Victoria, Lince, Magdalena, Miraflores, Pueblo Libre, San Borja, San Isidro, San Juan de Lurigancho, San Luis, San Miguel, Surquillo and El Cercado. Read more

Advice for travellers

Dengue occurs both in urban and rural areas, around human habitation. 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.