World travel health alerts for 25th of March 2020.
Various COVID-19 updates
New COVID-19 cases in Europe and the USA made up 85 percent of global numbers recorded by the WHO over the previous 24 hours – 40 percent were in the US. Read more. With healthcare workers in some areas representing up to one in ten of infections, the Mar 21 The Lancet editorial, ‘COVID-19: protecting health-care workers’ calls for safeguards for frontline staff starting with sufficient PPE supplies, but also ‘other practical measures must be considered, including cancelling non-essential events to prioritise resources; provision of food, rest, and family support; and psychological support.’ More on the global situation in the latest WHO Sitrep (Mar 24), plus a call for ‘public health measures to avoid a resurgence of the virus later on’. Read more.
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A tweet from The British Association of Otorhinolaryngology contains a statement relating to anosmia or hyponosmia (loss or lowered sense of smell) as a marker of COVID-19 infection, with advice therefore for those people reporting the condition to self-isolate. According to the association, asnosmia was the presenting symptom in almost one-third of confirmed cases in South Korea. Read more
Deaths among members of the general public due to chloroquine overdosage and ingestion of a chloroquine compound used in cleaning fish tanks have been reported. Read more
The article, ‘Why the Coronavirus Has Been So Successful’ discusses why ‘this seventh coronavirus [was] the one to go pandemic’ – the other six infecting humans, consisting of SARS, MERS and four more which ‘have been gently annoying humans for more than a century, causing a third of common colds’. Read more
UNICEF, WHO, IFRC: Guidance for COVID-19 prevention and control in schools (March 2020)
Lastly, as reported in the Mar 19 WHO Sitrep, a WHO Health Alert messaging service has been launched in order to increase access to reliable information. The agency advises that the’ service will provide the latest news and information on COVID-19, including details on symptoms and how people can protect themselves. The Health Alert service is now available in English and will be introduced in other languages next week. To access it, send the word "hi" to the following number on WhatsApp: +41 798 931 892.’
5 more polio cases – total now 33
A further five wild poliovirus 1 (WPV1) cases were announced by the GPEI – Khyber Pakhtoon (2) and KPTD, Balochistan and Sindh (one each). More cVDPV2 cases were reported in Africa – Angola (one in Cuando Cubango province, Chad (one in the capital Ndjamena, the other in SE Ouaddai region) and Côte d’Ivoire (one in Sud-Comoé province, related to Togo outbreak). Malaysia’s fourth case was also announced (posted in our Mar 18 alerts from local media reports). Last week UNICEF released an update on the situation in the Philippines (no further increase in cases since mid-Feb) with details of case locations and response measures.
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.
Go early with flu shot; Recall of potentially contaminated salad products
With the potential for a convergence in the peak of COVID-19 infections and the annual uptick in influenza activity, the advice is to get your flu vaccination as soon as it becomes available to avoid even more stress on the health system. Read more
BACTERIAL contamination of several salad mixes sold at some West Australian stores have led to a recall notice. Salmonella bacteria were detected during routine testing; no associated illnesses have been reported as yet. Read more
Advice for travellers
What you need to know about coronavirus (COVID-19) from the Australian Department of Health. Read more
Measles uptick in central state
Measles cases are reported to be on the rise in the Valley of Mexico, related to an outbreak that started in a prison in nearby Mexico City. Of the 67 cases recorded from Mar 5-23, 62 were in the capital. Read more. Elsewhere, a measles outbreak in the Chittagong Hill Tracts of Bangladesh has killed at least five children and infected 100 in remote Rangamati villages.
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.
Impact of 3 diseases
A senior public health official in the eastern department of Santa Cruz signalled ‘an epidemiological storm’ in the presence of outbreaks of influenza, dengue fever and COVID-19 infections. A 14-day countrywide quarantine was declared on Mar 22 in response to the spread of SARS-CoV-2. Elsewhere in the region, Paraguay’s count of suspected dengue cases has now exceeded 200,000 with 51 deaths, and the dengue epidemic in the state of Paraná in southern Brazil has spread into 162 municipalities, including Iguaçu Falls. Read more
Advice for travellers
Dengue is spread by Aedes mosquitoes which breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid. 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 PMD when outdoors to all exposed skin. Read more about dengue fever.
Coronavirus intensifies public health crisis
Multiple health challenges are hitting the country at the same time: measles, meningitis, dengue and now COVID-19 are all placing more stress on a health system severely damaged by ongoing conflicts. The WHO warns that the ‘pandemic is beginning to move to Africa where most countries have weak health systems.’ 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.
Countdown to April 12
The NE provinces are now into the last weeks of the required two incubation periods without new Ebola virus disease cases which will hopefully culminate in the declaration of the end of the outbreak on April 12. More from the Mar 24 WHO Sitrep and the regional weekly bulletin.
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.
Dengue count continues to rise
Guadeloupe has borne the brunt of dengue fever infections recently, recording nearly 1,000 of the 1,519 new cases in the 16 days to Mar 8. Martinique was next with 355 cases. Between them, three different dengue serotypes are circulating: DENV-2 has been dominant in Guadeloupe and Saint Barthélemy, while DENV-3 has been diagnosed more often in Martinique and DENV-1 in Saint Martin. 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.
More on mumps
Teenagers and young adults aged from 15 to 24 years are being infected with mumps at higher rates than the rest of the community as the outbreak continues apace into 2020. Kerry and Cork have recorded 575 of the more than 2,300 cases recorded countrywide this year, according to local news sources. Read more
Advice for travellers
These outbreaks of mumps highlight the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to all destinations. Read more about mumps.
Lassa fever outbreak update
Suspected Lassa fever cases registered in the first 11 weeks of the year have more than doubled compared to reports for the same period in 2019 – the majority of confirmed cases were in the states of Edo, Ondo and Ebonyi. There have been calls for a national emergency to be declared to stem this outbreak and its high fatality rates, now the largest recorded in Nigeria. 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.
Battle against dengue continues
With much of the public health focus on COVID-19, a senior politician has called for continued action against dengue fever as the number of people infected this year rose above 4,500 (to Mar 24). According to the NEA, there are 101 active dengue clusters - two or more cases, infection onset within 14 days and located within 150m of each other – with 24 of them high risk (10 or more cases). 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.