World travel health alerts for 2nd of March 2021.
Slower start for WPV this year
A single case of WPV1 in Balochistan was the country’s first in 2021, as reported in the Feb 26 GPEI update, while there were also two more circulating vaccine-derived poliovirus 2 cases (cVDPV2). This time last year there had been 17 WPV infections, this year just two. Read more. Elsewhere, Afghanistan logged six cVDPV2 cases and, in Africa, the same VD strain was responsible for cases in Guinea (six cases from Nzerekore, Boke, Kankan and Faranah), Mali (two cases in Koulikoro) and one each in Congo and Ethiopia. The UK’s Travelhealthpro site notes that the seven countries with a change in their polio status since the 26th IHR emergency committee meeting in late October 2020 are: Congo, Egypt, Iran, Liberia, Sierra Leone, Tajikistan and Zambia.
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.
Bairnsdale ulcer cases in capital’s inner north; Biohazards after extensive rains
Victoria‘s health department has advised that cases of Buruli (or Bairnsdale) ulcer have appeared for the first time in Melbourne’s inner north, ‘the first non-coastal area in Victoria to be recognised as a potential area of risk, however, the risk of transmission in these areas is considered low’. While many of the cases had visited known risk areas, ‘genetic analysis of M. ulcerans isolated from them strongly supports a common link’. Essendon, Moonee Ponds and Brunswick West are mentioned as sites of recent cases but the infection is most prevalent around the Bellarine and Mornington Peninsulas. The department offers advice on prevention that largely centres on avoiding mosquito bites due to some evidence suggesting that mosquitoes play a role in M. ulcerans transmission. Victoria is the only non-tropical location reporting cases of Buruli ulcer.
FOLLOWING this year’s bumper wet season, health authorities have alerted people working with animals, particularly cattle and farm workers, to the heightened risk of leptospirosis when outdoors. To a lesser extent, the warning also applies to residents, keen gardeners and travellers/campers to northern areas who have also been asked to take precautions to prevent infections such as leptospirosis and melioidosis. Read more
Advice for travellers
Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.
Ebola vaccinations underway
The regional WHO office announced that Ebola cases in southern Guinea remain contained in the prefectures of N'Zerekore and Gueckedou and the situation as of Mar 1 was 17 confirmed or probable cases, eight deaths and more than 1,300 vaccines have been administered. Read more. While in the DRC, three new cases have been confirmed in the Butembo health zone - they were all monitored contacts of a previous case. Four health zones are now implicated: Biena, Butembo, Katwa & Musienene. International flow-on effects of both Ebola outbreaks include the US CDC introducing heightened (Level 3) travel warnings for both Guinea and the DRC, with travellers arriving from those areas to be monitored by the agency.
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.
Certified free of malaria
Another country – the 38th worldwide - has gained malaria-free status and this one is a first for Central America. Despite an outbreak 25 years ago, the government has slowly worked towards this target – reducing malaria cases from 9,000 in 1990 to 26 in 2010. The WHO reports that there have been ‘zero indigenous cases of the disease since 2017’.
COVID-19 cases uptick
Compared to the rest of Europe, Finland has suffered a less severe COVID-19 outbreak than many other nations in the region, but a recent surge in new infections – a record of 720 in one day late last week – has led to the declaration of a state of emergency which will allow for stricter containment measures such as bar and restaurant closures. Read more. This week the WHO director-general suggested that ‘relaxing of public health measures, continued circulation of variants, and people letting down their guard’ could be among the reasons for the end of six consecutive weeks of declining new case numbers across most of the globe - four of the six WHO regions reported an increase – only Africa and the Western Pacific differed.
In other COVID-19 news:
-In the US, the FDA has announced ‘More Flexible Storage, Transportation Conditions for Pfizer-BioNTech COVID-19 Vaccine’, stating that temperatures of -25°C to -15°C can be used to ship and store the vaccine for up to two weeks, shorter than the six weeks allowed for the 6-months at ultra-cold temperatures. Read more
-The Johnson & Johnson vaccine, which is currently in use in South Africa, has been granted emergency use authorisation by the FDA in the US for people aged 18 years and older. Benefits of the vaccine include the requirement for only one dose and it doesn’t need ultra-cold storage.
-This first version of the Drugs to prevent COVID-19: A WHO living guideline contains new information and a recommendation on hydroxychloroquine. WHO
-The WHO has announced a new policy brief relating to the 1 in 10 COVID-19 patients who report symptoms of ‘long COVID’, a syndrome that Dr A Fauci of the US’ NIAID last week gave a new acronym - post-acute sequelae of SARS-CoV-2 infection (PASC) when announcing a new study. Read more
-Australia is now one of at least 114 countries and territories to have commenced COVID-19 vaccinations for their populations. They now also include Cambodia, Ghana, Côte d'Ivoire, Angola and Nigeria, and the first country in South America, Colombia. Read more
-In response to the emergence of new SARS-CoV-2 variants, the international border ban in Australia has been extended for a further three months to June 17, 2021. Read more
Cholera’s death toll hits 55
No respite from the cholera outbreak in the northern province of Cabo Delgado, with people fleeing from conflict living in camps with poor sanitation and water quality. As many as 55 people have died of cholera this year from the almost 5,000 cases recorded, according to UNICEF. 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.
Dengue across the region
The 2021 dengue infection rates reported across the region by the ECDC have overall been lower than for the same period last year. The countries with the highest notifications are Vietnam (9,654 cases to Jan 31), the Philippines (3,353 cases to Jan 23) and Sri Lanka (just over 3,000 cases to end of Feb, with around 2,000 of those from Batticaloa). While to the south in the Indian Ocean, Reunion Island’s level 4 dengue epidemic persists. The situation for 2021 up to Feb 23 reveals almost three-quarters of new cases are in the west - Le Port and La Possession – and there had been 350 confirmed cases and 30 hospitalisations.
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 insect repellent containing an active ingredient, such as DEET, Picaridin or PMD when outdoors to all exposed skin. Read more about dengue fever. Read more about dengue fever.
H5N8 infections in humans
Seven asymptomatic farm workers in the southern oblast of Astrakhan were diagnosed with highly pathogenic avian influenza A(H5N8) last month; the first such cases in humans anywhere. The workers were part of a response team sent to the area to manage a H5N8 outbreak in poultry. The workers’ contacts were also tested and returned negative results. While the WHO has said that the risk of human-to-human transmission is low, travellers to areas reporting avian influenza outbreaks should use appropriate personal and food hygiene measures, as well as avoiding ‘farms, contact with animals in live animal markets, entering areas where animals may be slaughtered, or contact with any surfaces that appear to be contaminated with animal feces’.
Advice for travellers
There are several strains of bird flu and while the virus 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.
Rabies death near Durban
KwaZulu-Natal has recorded its first rabies death for 2021 as health authorities warn that the pandemic has caused fewer people to seek the appropriate vaccinations for their pets. The death occurred in a two year-old child from eNgonyameni who, reportedly, was not administered rabies post-exposure treatment following a dog bite to his head in January. KwaZulu-Natal recorded six of the national rabies deaths in 2020, Limpopo the remaining two.
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 – especially dogs, the main source of infection. If bitten or scratched, urgent first aid and post-exposure treatment is required. Vaccination recommendations are itinerary-specific but include those travellers planning to live in, or travel extensively or repeatedly through, endemic countries. Read more on rabies.
Norovirus gastro surges
Norovirus infections have surged since the Lunar New Year, with more than 138,000 cases of gastroenteritis identified last week alone. In the past month, the country’s CDC has reported 87 different clusters of diarrhoeal illness and advised that just over 70 percent of cases which tested positive for norovirus had been acquired in restaurants or hotels. Read more
Advice for travellers
While it is extremely contagious, norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands after using the toilet and before eating, and practice good hygiene. Read more on norovirus.
First YF monkey deaths for decades
No local human yellow fever (YF) cases have been reported for decades but after routine surveillance detected several dead red howler monkeys infected with the virus, health officials say they are on high alert and have advised the public to ensure their vaccinations are current. The animals were discovered in forested areas of the island’s east, near Plum Mitan and Biche. The national YF vaccine coverage sits below the recommended 95 percent, sitting at just over 89 percent.
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.