World travel health alerts 29 April 2020

World travel health alerts for 29th of April 2020.

Global Covid-19 infections exceed 3.1 million

Large totals added by outbreaks in Russia, South American and the USA have helped boost the global case count from two to three million in just 12 days. Meanwhile the WHO is ‘concerned about increasing trends in Africa, Eastern Europe, Latin America, and some Asian countries’ even as some nations in Europe and our region plan a gradual loosening of current restrictions. Read more.

Other news:

The Apr 28 WHO Sitrep includes a link to the lists of drug and non-drug experimental treatments for COVID-19 (‘R&D Blueprint: COVID-19 Experimental Treatments’) as well as a call for ‘countries to ensure that usual immunization is maintained wherever possible and surveillance for vaccine-preventable diseases is not disrupted during the ongoing pandemic’.

News articles have been published this week on the progress of vaccine development in Qld and recruiting volunteers for a vaccine trial in Western Australia.

The WHO published a scientific brief on Friday to explain its reservations over some countries’ plans to issue ‘immunity passports’ to those people deemed to have recovered from Covid-19 infection. The agency explained that the variable accuracy of antibody tests and the unknowns of the degree of protection SARS-CoV-2 infections confer and how long it lasts are at issue. There is also the risk the assumption of immunity may lead ignoring public health advice and continued transmission. The brief will be updated as more information comes to hand.

Polio digest, vaccine news

While Pakistan’s YTD total of wild poliovirus 1 cases rose to 41 this week with two more cases reported (one each in Balochistan and Sindh), Afghanistan’s single WPV1 case from Nimroz province took the country’s count to four for the year. In Africa, Cameroon recorded two cVDPV2 cases (Est and Littoral provinces) and Chad registered six (two in Hadjer Lamis province and one each in Batha, Kanem, Lac and Sila provinces). Read more. More information has emerged on the cases in Niger reported last week – the WHO advised that they were located in Niamey and Tillaberi region. More polio news: A dose-sparing inactivated polio vaccine, Picovax, has been pre-qualified by the WHO. 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.

Malaria burden greatest in the poor

An update on the national outlook issued in conjunction with World Malaria Day on Apr 25: While the death toll from malaria has plummeted over the past decade, infections persist to the tune of almost 50,000 each year, mostly affecting poor communities in rural, forested and border areas. The solution is not straightforward, or cheap, for those infected as drug-resistance is expanding in the Greater Mekong region. Read more

Rains predicted to intensify dengue outbreak

More this week on the burden of dengue fever in Central America with reports of up to 2,000 cases in Honduras this year (worst affected are the regions of Huetar Caribe and the Central North). The government is requesting assistance from the population in removed mosquito breeding sites as the peak, rainy season approaches. 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.


Ebola situation update

According to the WHO Sitrep of Apr 28, the Ebola-infected individual who fled from a treatment facility last week continues to pose a risk to the community as he remains at large, with accounts that he is hiding in an area controlled by the militia. The news source also reported that a seventh case, a close relative of a recent fatal case, has been confirmed in Beni. 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.

Mozzie habitat clean up

With a view to managing the (limited) risk of mosquito-borne infections during summer months, a useful job to do around the house that has been suggested during lockdown is the removal of potential breeding sites. Locations in the south (particularly SE districts and Corsica) have reported increasing numbers of dengue and chikungunya infections in recent years, during warmer weather. Read more

Dengue burden highest in Bali’s north

The dengue count in Bali’s capital, Denpasar, has risen to 832 this year compared to just under 600 for the same period last year – highest rates of infection were in Sanur. More than 2,100 cases were recorded across the island for the year to early April with Buleleng regency in the island’s north most affected. Read more. Also this week, updates on dengue outbreaks in Singapore, in the Pacific – with news on French Polynesia and the Marshall Islands – and Mayotte, in the Indian Ocean. 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.

Drop in population flow improves malaria status

Sabah’s reported malaria cases this year have declined by more than 40 percent to Apr 18 compared to 2019 figures. A senior doctor attributes the drop in part to the movement control order put in place as a cordon sanitaire against SARS-CoV-2 in mid-March. Read more

Measles outbreak update from WHO

The measles outbreak in Mexico City and the state of Mexico continues and the situation summarised in an Apr 24 WHO Disease outbreak news post. To date around one-quarter of those infected were males aged between 20 and 29 years and the outbreak has now spread across 14 municipalities in Mexico City and eight in neighbouring Mexico state. Up to eight suspected measles cases are also under investigation in the state of Campeche, on the Yucatán Peninsula. In other measles news, compliance with Portugal’s National Immunisation Program slipped last year: ‘at 13 months of age, 14% of children had not yet started vaccination against measles or the invasive meningococcal disease of group C, which must be administered at 12 months’.

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.

Confusion over viral symptoms

As the weather warms, doctors in Myagdi district near the Annapurna Conservation Area have told the local population not to panic unduly. A number of residents have sought medical assistance believing they had early COVID-19 symptoms which turned out to be dengue fever or scrub typhus, or both. Dengue cases have been reported earlier than usual this year. Read more

Advice for travellers

Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases.

Memento of TC Harold in far north island province

A limited outbreak of malaria has flared up in Sola, the capital village of the northern province of Torba (Vanua Lava island). It follows widespread destruction and flooding in the wake of the recent tropical cyclone. Read more