World travel health alerts 27 April 2022

World travel health alerts for 27th of April 2022.

Flu activity increasing

The latest WHO global influenza update takes in reporting from late March to April 3, noting an overall increase in activity since February in the Northern Hemisphere. Increasing flu detections were recorded in Tunisia, Georgia, East Timor, Argentina and in North America. The situation in Europe is relatively stable, despite some countries appearing ‘to be experiencing a late influenza season’, with widespread activity in the western-central part of the region. Countries reporting positivity in sentinel primary care that exceeds 50 percent: Netherlands (74 percent), France (55 percent) and Luxembourg (53) – influenza A(H3N2) viruses are predominant. Closer to home, Malaysian health authorities have reported an uptick in influenza activity. Read more

Advice for travellers

In most years, seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Whether you are travelling within Australia or overseas, vaccination is highly recommended and travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol-based hand sanitiser is a convenient alternative if soap and water is not available.

Details on Wakiso district yellow fever

A summary of the outcome on seven suspected yellow fever cases reported in early March in the Central Region’s Wakiso district - only one has been laboratory-confirmed. The WHO notes that ‘13 countries in the WHO African Region have reported probable and confirmed yellow fever cases and outbreaks, including an ongoing outbreak under close investigation in neighbouring Kenya’. While the risk of the spread of yellow fever in Uganda remains high on a country and regional level, the agency also said that yellow fever outbreaks have occurred in areas of East, Central and Western Africa where gaps in immunity exist in population groups that have missed vaccination campaigns, and ‘these reports indicate a resurgence and intensified transmission of the yellow fever virus’. In other news on yellow fever, the WHO African regional office has reported a fatal case in Boussé district, Plateau Central Region of Burkina Faso in March. 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.

Yellow fever vaccinations to stem rising incidence

Yellow fever (YF) vaccinations are being rolled out to people in Adamaoua and West regions as health agencies aims to reduce the disease’s incidence which has been increasing in all 10 regions since 2017. This year, 47 yellow fever cases and seven deaths have been recorded and the most affected areas are currently ‘the health districts of urban Ngaoundéré (Adamaoua), Malantouen and Foumbot (West)’. The national immunisation coverage for the yellow fever vaccine is low at 57 percent. 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.

Human H3N8 bird flu case detected

The first spillover event involving avian influenza virus H3N8 infection in humans has been reported in a young boy from Henan province (Zhumadian City); poultry was kept at his home and wild ducks were present in the area. No further cases have been identified. While this is the first such case in humans, the virus has been found to infect horses (global distribution), dogs, birds and seals. Read more

Advice for travellers

There are several strains of bird flu and while the high pathogenic strains can be fatal, infection generally poses a low risk for travellers – even for those heading to a region where the disease is present or an outbreak is occurring. Travellers should avoid contact with birds or poultry in marketplaces, wash hands thoroughly before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.

Wild polio case detected, global news; Cholera outbreak in Karachi

After 15 months without a wild poliovirus type 1 case detected in Pakistan, news this week of a confirmed infection in a 15mo child from North Waziristan. A closely related virus was isolated from an environmental sample taken from the province’s Bannu district earlier this month. On circulating vaccine-derived poliovirus type 2 (cVDPV2) cases announced by the GPEI last week, three countries reported infections: the DRC (five in Maniema province and one in North Kivu province), Nigeria (a single case in Katsina state) and Yemen (34 cases from across 11 governates). Read more

HEALTH OFFICIALS from several Karachi hospitals claim that ‘the worst outbreak of cholera in recent years’ is building, with cases of acute watery diarrhoea soaring over the past few weeks. Hundreds of adults and children are presenting at the hospitals each day. 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.

14th Ebola outbreak declared

Aid agencies are assisting local officials in tackling a new Ebola outbreak in the city of Mbandaka, NW province of Equateur. The index patient, a 31yo man (who received the Ebola vaccine in 2020 and is not known to be an Ebola survivor) sought treatment for symptoms earlier this month and was treated at home for several days before being admitted to an Ebola treatment centre – he died the same day. Early testing suggests a new animal spillover event and not a recurrence. In the last day, the man’s sister-in-law who was considered a high-risk contact, was confirmed as a second (fatal) case according to the regional WHO office. This is now the third outbreak in Equateur province since 2018 and the 14th in the DRC since the mid-1970s. Supplies of the Ebola vaccine (Ervebo (rVSV-ZEBOV)) are kept in the DRC and will be used for man’s contacts in the coming days. 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.

Dengue cases rising

Dengue fever cases are reported to have nearly doubled compared to the same period last year, with the majority diagnosed in residents of Santiago, Santo Domingo and the National District, however authorities note that fewer malaria cases have been confirmed (most in San Juan and La Altagracia). 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 typhoid in north and west

This week the Ministry of Health & Medical Services advised that typhoid fever infections have fallen below alert thresholds in both the Western and Northern Divisions, however cases continue to emerge with four more in both the North (Bua, Cakaudrove and Macuata) and Western Divisions (Ra, Nadroga/Navosa and Tavua). The typhoid fever death toll has risen to six this year after a fatal case was reported in the latest update. Read more (includes dengue, leptospirosis news)

Advice for travellers

Typhoid occurs sporadically in some Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters. Read more about typhoid fever.

Lassa fever reported in southern region

A case of Lassa fever has been confirmed in a teenage girl living in the southern prefecture of Guéckédou (Nzérékoré region). No further cases have been detected to date, however contact tracing and other investigations are underway. Read more

Advice for travellers

Lassa fever is an acute viral illness that occurs in sub-Saharan 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. For 80% of people infected, Lassa fever is mild or has no observable symptoms. The remaining 20% can experience severe, often fatal, multisystem disease. Read more about Lassa fever.

Heat wave conditions in North/Central regions

Local media have reported an early spike in temperatures over many northern regions, with high readings already registered over several weeks in areas including Delhi, and Karachi in neighbouring Pakistan. The India Meteorological Department has forecast heat waves across most northern and central sub-divisions for the next few days. Read more  

Syphilis, ‘a common venereal disease’

According to local reports, there has been an ‘explosive growth’ in syphilis infections over the past nine years, with cases in 2022 already greater than for the same period last year (up from 1,595 to 2,592). Rates of infection have been highest in women aged in their 20s. Read more

Advice for travellers

Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an effective antibiotic. Read more about syphilis and other STIs.

Measles outbreak deteriorates

The latest WHO regional bulletin reports a ‘flare-up’ in measles cases since March, with 12 of 15 counties affected in the outbreak that first started in December 2021. Infection rates are highest in the counties of Montserrado (location of the capital, Monrovia), Nimba and Margibi. 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. 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.

HFMD rates on the rise in Selangor

Clusters of hand, foot and mouth disease (HFMD) have surfaced in facilities caring for young children in the state of Selangor recently and there have been more cases overall than in the same period in 2021. To date this year, just under 4,400 HFMD cases have been recorded in the state. Read more

Advice for travellers

HFMD mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection. Read more about HFMD.

COVID-19 update

The WHO COVID-19 dashboard shows a decreasing weekly incidence of new cases across all regions and reported deaths were at their lowest total since March 2020, however trends must be interpreted with caution as testing rates are estimated to have dropped by between 70 and 90 percent. Read more

South Africa has reported a 3-month high in infections with cases attributable to BA.4 and BA.5 sub-lineages on the rise. And in the USA, using seroprevalence data the CDC wrote that ‘As of February 2022, approximately 75% of children and adolescents had serologic evidence of previous infection with SARS-CoV-2, with approximately one third becoming newly seropositive since December 2021’ as the Omicron variant spread. Across all age groups, just over 57 percent of Americans had been infected by February. Within our Western Pacific region, four island nations have not recorded a case of COVID-19 to date: Federated States of Micronesia, Pitcairn Islands, Tokelau and Tuvalu. Read more

In related news:  

- An article from The Conversation offers advice which could prove of use for Australian voters next month: ‘Don’t bring COVID home on election day. Plan your vote to stay safe’. 

- With winter approaching, more about the spread of SARS-CoV-2 and our heightened risk of COVID-19 infection. Read more

- The European Society of Clinical Microbiology and Infectious Diseases has released results from a study of 2,000 people who had been hospitalised for COVID-19, finding around only one in four ‘feel fully recovered’ after a year. Read more

Child hepatitis cases in at least 12 countries

Investigations continue into the growing numbers of paediatric hepatitis infections and they were the subject of an update provided by the WHO director-general on Apr 26: 169 cases have now been reported from 12 countries (plus suspected cases in Romania and Japan) – 17 have required liver transplantation and there has been one death. Case ages ranged from one month to 16 years and adenovirus has been detected in at least 74 cases, however ‘this and other hypotheses are being explored’. Read more

3 districts reporting cholera cases

A week after a single cholera infection was reported in the capital’s densely populated district of Matero on April 11, authorities announced several more suspected and confirmed cases from the districts of Lusaka, Chilanga District and Nsama. An update from the Red Cross Red Crescent Movement notes that there is a potential risk of a recurrence of the 2017-18 cholera outbreak which started in the capital before seeding into other areas. Read more

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.