World travel health alerts for 3rd of August 2022.
WHO global flu activity report
The latest WHO influenza update with data to July 10 indicated mixed flu activity in the southern hemisphere, with some countries logging declining numbers (New Zealand, South Africa and temperate South America) while others (such as parts of Australia, Palau and Samoa) were increasing. To the north, in SE Asia influenza virus detections increased in Malaysia, Singapore and Thailand - predominantly A(H3N2) - with similar activity in Bangladesh and Nepal in South Asia. In separate reports, flu infection rates are up in American Samoa, while authorities in Kiribati announced a recent sharp increase in cases of influenza-like illness. 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.
NT updates JE cases; Kimberley region mozzie warning
NT Health has reported two cases of Japanese encephalitis in the Territory – one is historical in an interstate visitor to the Top End in May last year, the other a child from a remote community who became symptomatic in June 2022. Both cases have recovered from their infections. Read more
WESTERN Australia’s health department issued an alert this week after a West Kimberley resident was found to have contracted Murray Valley encephalitis (MVE). The state’s last reported case was in 2018 and while the department classes the risk of infection as low, it also warned that there has been viral activity in the Kimberley as recently as June (confirmed through testing of sentinel chicken flocks). Locals and visitors are advised to avoid mosquito bites, particularly when fishing and camping. Read more
Advice for travellers
A mosquito-borne virus, JE is generally found in many parts of Asia, the Indian subcontinent, Southeast Asia, China, Indonesia and PNG, and more recently, in areas of northern, southern and eastern Australia. In Asia, it is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to large urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE.
COVID-19 update
The July 27 WHO epi update reported marked increases in new COVID-19 cases across three regions as the BA.4 and BA.5 Omicron subvariants continued to dominate: up 52 percent in the Western Pacific, 45 percent in the Eastern Mediterranean and 13 percent in SE Asia. Japan’s new case numbers reached record peaks on two consecutive days late last week, however the government is not considering limiting population movements to curb the spread of the virus. Read more. In Australia, the NCIRS conservatively estimated that just over 46 percent of the Australian public was infected with COVID-19 between January and June this year, while antibody positivity to SARS-CoV-2 was highest in the 18–29 year old age cohort (at 61.7 percent). Read more
Global monkeypox cases top 25,300
The US CDC global monkeypox (MPX) outbreak data to Aug 2 puts the current total at more than 25,000 cases from 76 countries that have not historically reported the infection. The USA now has the highest total of 6,325 cases, followed by Spain, Germany and UK. Five deaths have been recorded over the past week in non-endemic countries: two in Spain and one each in Brazil, Peru and India (ex-UAE). The two fatal cases in Spain were unlinked, occurring in previously healthy men aged 31 and 44 who succumbed to encephalitis. The WHO director-general said last week that around 10 percent of people infected with MPX are hospitalised to manage pain symptoms. Read more. An official with Africa’s CDC has divulged that MPX vaccines are yet to be supplied to the continent. The agency is working with regional governments to manage concurrent outbreaks of Lassa fever, measles, cholera and monkeypox. In Australia, on July 28 the Chief Medical Officer declared monkeypox to be a Communicable Disease Incident of National Significance. Limited stocks of a second MPX vaccine ‘have been secured by the Commonwealth and some States and Territories’. More from the WHO on global trends and a series of infographics on managing monkeypox infections at home. Read more
Advice for travellers
Closely related to the smallpox virus, monkeypox has its origins in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People travelling in endemic countries can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk in those regions. More recently, monkeypox has spread person-to-person around the globe, primarily through large respiratory droplets, but also via direct contact with skin lesions or body fluids (i.e. close or intimate contact) and indirect contact by way of contaminated bedding, clothes etc. Read more from the WHO on the current outbreaks of monkeypox.
Increasing trend in dengue
There has been a 2-fold rise in dengue fever cases over the same six month period in 2021 and recent increases have seen epidemic thresholds crossed in 10 of the 17 regions, including Cagayan Valley, the Cordilleras and Mimaropa. Elsewhere, Rohingya refugees living in camps in SE Bangladesh are being impacted by an extensive dengue fever outbreak, made worse by crowded living conditions and pools of stagnant water. 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 wild poliovirus cases, updates from Africa, USA
Three new wild poliovirus type 1 cases have been detected in Tete province, however only two of the isolates are linked with the index case that was confirmed in March. The third, taken from a resident of Magoé district bordering Zimbabwe, has similarities with the strain that emerged in Lilongwe, Malawi late last year. The GPEI noted that ‘there are clearly at least two transmission chains that are co-evolved after introduction of the virus in Tete province in Mozambique. While it is difficult to speculate, distribution of WPV1 and their genetic linkage suggests that missed transmission in bordering areas around Mozambique-Zimbabwe-Zambia cannot be ruled out’. In another development, two new linked cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) were reported from Mozambique’s Nampula and Zambezia provinces. Madagascar also logged cVDPV1 cases (three in total from Sud-Ouest and Menabe), while Chad (Chari Baguirmi) and the D R of Congo (Nord Kivu) registered one cVDPV2 case apiece. More on the paralytic polio case in New York State, USA announced in late July, with the strain genetically linked to two Sabin-like type 2 isolates collected from wastewater in Rockland County a month earlier, as well as earlier environmental detections in Israel and more recently, London, UK. An Aug 1 state health department press release said ‘Unvaccinated New Yorkers who live, work, go to school in, or visit Rockland County are at the highest risk of exposure’; polio vaccination rates for children at two years of age in the county are 60.5 percent. 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.
Ituri’s plague outbreak spreads
The bubonic plague outbreak in Ituri province continues and now the onset of the wet season has brought fears of further spread from hard-hit Lokpa to a local trading centre, Kpandroma. In a post on ProMED, it was revealed that many patients presented with lesions on their upper body and head which ‘points to contamination during sleep’. The elements have produced a boom in rat and flea populations in and around housing while residents are forced to stay inside out of the rain. 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.
Progress on measles outbreak in east
The WHO regional office announced a decline in new measles infections being reported in an outbreak that erupted in Manicaland Province in late March/early April. The agency’s weekly bulletin said that the first cases were within a Mutasa District community that did not espouse vaccinations. To July 19, the district bordering Mozambique recorded 421 cases and 38 deaths. Interruptions to national routine immunisation campaigns have seen coverage rates for measles vaccinations lag, and now reports are emerging of ‘unusually high numbers of suspected measles cases reported in districts of Hwedza, Makonde, Zvishavane and Centenary’. In related news, the measles outbreak in the province of Kasaï-Oriental in the D R of Congo has claimed 28 lives from approximately 2,800 cases recorded this year. 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.
Locally-acquired dengue case in SW
Health authorities in the SW region of Occitanie have announced a locally-acquired case of dengue fever in a resident of Perpignan, after it was determined that the person had not travelled to a dengue-endemic area in the previous two weeks. Insecticide fogging is planned in the inner city area and a door-to-door campaign will establish if any other residents have experienced dengue symptoms recently. 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.
Revision of Marburg virus case numbers
New information on the Marburg virus outbreak in Ashanti region emerged during the week, with one of the index cases removed from the case count following re-testing of samples. The remaining three cases are from one family – the father and young child are deceased and the mother is in isolation. Read more
Advice for travellers
Marburg virus disease is a rare but severe viral haemorrhagic fever, related to the Ebola virus, and there is no treatment. Found in the African fruit bat, Marburg typically appears in sporadic outbreaks and laboratory-confirmed cases have occurred in Uganda, Zimbabwe, the Democratic Republic of the Congo, Kenya and Angola. Preventive measures are not well defined, as study in how it is spread continues, but travellers should avoid contact with fruit bats and sick primates in central Africa. Read more
Mumbai reports hike in malaria cases
Monsoon-related illnesses have starting trending upwards in Mumbai, with malaria cases rising by more than 60 percent over the past week and dengue fever activity also showing a significant increase. 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.
Bacteria detected in Gulf Coast state; Legionnaires’ cases in Napa County
An investigation into two cases of melioidosis confirmed over two years has led to the first detection of Burkholderia pseudomallei bacteria in soils of southern coastal areas of Mississippi. The US CDC announced the discovery last week, issuing alerts to clinicians to be aware of the risk of melioidosis and to Gulf Coast of Mississippi residents with high-risk medical conditions to take precautions to protect themselves when in contact with soil or muddy water. Read more
RESIDENTS in California’s Napa County have been advised to seek medical attention if they experience pneumonia-like or respiratory symptoms after the Public Health Department was notified of 12 Legionnaires’ disease cases requiring hospitalisation (nine confirmed, two suspected cases, one probable) in people from the cities of Napa and Calistoga. The source of infections has not been identified as yet. Read more
Advice for travellers
Legionnaires’ disease occurs worldwide and outbreaks have been associated with cruise ships, hotels, and resorts. The bacteria that cause Legionnaires’ disease are found in the airborne droplets of warm, fresh water, such as from fountains, spas, showers and the cooling towers of buildings. Over 50s, current or former smokers, those with a chronic lung condition, and the immunocompromised are at higher risk of developing illness after exposure. Read more.
Malaria outbreaks in 5 sites
On July 12 a malaria outbreak was declared, affecting North East and West Coast Santo, South East Malekula, Epi Island and South East Vanua Lava. In the latest update from Health Promotions Vanuatu, 576 cases of vivax malaria had been confirmed, representing a 75 percent increase over all cases recorded last year. 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.
Dengue uptick set to worsen with rains
According to health ministry data there has been a 3-fold rise in dengue fever cases in the first six months of this year, with more than 136,000 and 41 deaths recorded. The arrival of the wet season will further aggravate the situation which has been most severe in western, central and southern regions - Ho Chi Minh City, in particular. 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.