World travel health alerts 26 May 2021

World travel health alerts for 26th of May 2021.

Temporary polio recommendations extended

The 28th (IHR) Emergency Committee meeting on polio was conducted last week from which it was announced that ‘WPV1 cases and [the] proportion of WPV1 positive environmental samples have decreased during the first quarter of 2021’, but transmission continues in cross-border reservoirs in two regions of Pakistan-Afghanistan, as well as in Karachi, so upsurges in infections are expected due to suboptimal immunisation rates in both countries. On circulating vaccine-derived polioviruses (cVDPV), the committee expressed concern over cVDPV2 spread to Kenya and Senegal and the new cVDPV1 outbreak in Madagascar. The decision was also made to ‘maintain Malaysia in the list of infected countries (despite more than 13 months since the last cVDPV detection), given the significant impact of the COVID-19 pandemic on the implementation of outbreak response’. In conclusion, there is a very high risk of international spread of both WPV1 and cVDPV2 and the Temporary Recommendations of the PHEIC will continue for another three months. In other news, the novel OPV2 (nOPV2) vaccine is already being administered in Nigeria and Liberia, and another four countries will start using it in the next week. Lastly, in a summary of weekly polio cases as reported by the GPEI, cVDPV2 infections were registered by Afghanistan, Pakistan, Mali and Nigeria, while a cVDPV3 positive environmental sample was detected in Shanghai, China. 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 update, news

New COVID-19 case numbers remained fairly stable over the past week in the Western Pacific region according to the latest WHO epi update, however it was the only region to report a rise in deaths, with the greatest increases recorded in Malaysia, followed by Japan and the Philippines. Elsewhere, Argentina registered a 41 percent hike in new cases and nearly 20 percent more deaths in the same reporting period. A strict 9-day nationwide lockdown was ordered on May 22 and the government announced that by the end of this week around 20 percent of the population will have received at least one vaccine dose. Worldwide, vaccination rates have been rising by around 13 percent per week and the percentage of the global population which is fully vaccinated is estimated to be just over 5 percent, according to the May 25 Johns Hopkins situation report. It is acknowledged that this ‘reporting is less complete than for other data’. Our World in Data

In other news:

- Australia’s TGA has joined with the EMA and the FDA in extending the approved timeframe for the storage of thawed, unopened and undiluted vials of Comirnaty up to one month, as detailed in updated product information. Read more

- From May 20th onwards, Australian citizens and permanent residents under 50 years of age who have an approved outwards travel exemption in an eligible category are able to access COVID-19 vaccinations. More information here.

- An agreement has been reached on the EU Digital COVID Certificate with plans to have it in use late next month. Key features of the digital certificate are that ‘it will cover vaccination, test and recovery; will be available in a digital and paper-based format, depending on the choice of the recipients, and contain a digitally signed QR code; will be free of charge, be obtained easily and also available to persons vaccinated before the EU Digital COVID Certificate Regulation has entered into force; and may also be used by Member States for national purposes, if this is provided for in national law.’ Read more. On the same day, the European Council updated its recommendation on restrictions to travel from third countries, potentially opening up the region to travellers who have received EU-approved COVID-19 vaccines.

- The Cov-Boost study gets underway in the UK early next month to trial a third dose of seven different vaccines to test the impact on the immune systems of participants. Read more

- COVID is surging in the world’s most vaccinated country. Why? The Conversation

- What scientists know about new, fast-spreading coronavirus variants: Nature

- COVID-19 factsheets have been published by the Aust. Govt covering Auslan and an easy to read format.

WHO 2021 edition of country list released

There are no changes to Australia’s yellow fever vaccination requirements for international arrivals in the 2021 updates of the WHO Country List and Annex 1: ‘a yellow fever vaccination certificate is required for travellers aged 1 year or over arriving from countries with risk of yellow fever transmission (with the exception of Galápagos Islands in Ecuador) and for travellers having transited for more than 12 hours through an airport of a country with risk of yellow fever transmission (with the same exception as mentioned above)’.   

Reports of chikungunya in NE province

A chikungunya outbreak has been confirmed in the NE province of Ratanakkiri, which abuts the borders of Vietnam and Laos. More than 100 cases were identified among people living in a forested area of Ou Chum district earlier this month. Local news reports state that most of those infected have since recovered and health authorities have undertaken mosquito control measures. Read more

Advice for travellers

Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Applying an effective repellent to all exposed skin and covering up are your best defences. Read more about chikungunya.

Plague uptick in NE

More bubonic plague infections have been reported in the NE province of Ituri, with health authorities confirming 15 new cases, 11 of them fatal, in the week to May 8. Since the outbreak was first confirmed in November last year there have been more than 460 cases in total and 31 deaths. Read more

Advice for travellers

Plague poses a low risk to most travellers. The majority of plague cases 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.

Tiger mosquito range extends north

The continuing spread of Aedes albopictus mosquitoes into new regions has been confirmed after specimens of the species were detected in the departments of Doubs and Jura in the Bourgogne-Franche-Comté region of eastern France. The mosquito is a vector of the dengue fever, chikungunya and Zika viruses. From a ProMED comment on the expanding geographic range of the mosquito, ‘the rapid expanse northward in France is noteworthy. It has gone from 41 departments reported in April 2018 to 51 departments in 2019, 57 departments in 2020 and now to 64 departments’. Doubs and Jura departments sit adjacent to the Swiss border. Read more

Countdown continues despite obstacles

Still no new confirmed Ebola cases reported, so hopes remain that the 42-day countdown to the end of the outbreak will proceed until its finalisation on June 19. Community resistance continues to challenge responders: new alerts are followed up in around half of all cases and there is evidence of unsafe burials occurring. Vaccination efforts are ongoing until the end of this month. 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.

Rabies outbreak toll rises to 34

Sarawak’s third human rabies death this year has been confirmed in a woman from a rural region NE of Sibu. She was due to receive follow up treatment following a dog bite in early March, but delayed it for another month. By early May, she was suffering symptoms of rabies and succumbed the day after tests results confirmed the diagnosis. Over the past four years there have been 34 human rabies infections in Sarawak resulting in 32 deaths. According to the health ministry, the two surviving cases are children ‘who survived with serious neurological complications’. 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.

Measles epidemics hit multiple regions

MSF reports that measles epidemics have hit 27 of the country’s 73 health districts this year and cases have risen nearly 3-fold over the same 4-month period in 2020. More than 6,000 suspected measles infections were logged in April and had the greatest impact on the populations of Agadez, Dosso and Tahoua regions. Vaccination campaigns organised by MSF have been running since February in response. Read more. More briefings on measles outbreaks in Africa are updated in the weekly WHO regional bulletin.

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.

Cholera in NE

An outbreak of cholera has killed at least 20 people and infected 300-plus in the NE state of Bauchi since April according to government sources. Read more

Advice for travellers

Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low but the recommendation if travelling to regions where a cholera outbreak is occurring is to adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera.

CCHF warnings to public

The Ministry of Agriculture and Water Resources has issued warnings to both nationals and expats on the risk of contracting Crimean-Congo haemorrhagic fever (CCHF) from infected ticks when dealing with animals. ProMED notes that CCHF cases have been rising over the past few years and ‘serosurveys have suggested widespread infection of humans and livestock throughout the country’. In Oman, infections are most commonly reported in men who work as butchers or in animal husbandry.  

Advice for travellers

CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about the virus.

2020 malaria report published

Just under 3,400 malaria cases were diagnosed in the kingdom last year: approximately 3,000 were in Jazan, the capital of Jizan Region in the country’s SW. Other locations which reported more than 100 cases in 2020 were Jeddah, Asir and Eastern. 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.