World travel health alerts 30 June 2021

World travel health alerts for 30th of June 2021.

Measles hits northern Sindh

Measles infections have now killed 50 children within a 6-week period in the northern Sindh district of Jacobabad, while more cases and fatalities have also been reported in nearby Sukkur region. Read more. In related news, measles is circulating in seven of Cameroon’s 10 regions but the majority of suspected cases to date have been in the East and Central.   

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.

A focus on leishmaniasis

The latest WHO regional bulletin covers in some detail the burden of visceral leishmaniasis (VL) in Chad and also notes an increase in cases since mid-2018 which has affected N’Djamena and, in particular, gold miners in the desert provinces of Borkou and Tibesti. Peak transmission periods are said to be between April and November. VL is not a notifiable condition in Chad and the true extent of the disease incidence is far from clear due to a lack of control programs and surveillance.

Advice for travellers

Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. The former causes skin ulcers and the latter a severe systemic disease that is usually fatal without treatment. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil account for 90% of visceral leishmaniasis, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia and Argentina. Read more on the disease and prevention.

Global flu activity remains low

The latest WHO global influenza update indicates either no or ‘a few’ detections across most regions. Activity in the northern temperate zone showed slight increases in influenza B/Victoria lineage, particularly in China, and influenza B was reported in the majority of the very low global numbers. As with most updates issued since the beginning of the pandemic, caution is advised in interpreting the information due to its effects on testing and health seeking behaviours and enhanced hygiene measures of the public.

Advice for travellers

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.

COVID-19 deaths down in most WHO regions

The June 29 WHO epi update’s global overview saw the lowest weekly mortality figure since early Nov 2020, however disease incidence ‘remains very high’. All regions recorded a fall in death rates except Africa, which was the stand-out with sharp increases in both mortality and new cases (42 and 33 percent respectively). Highest increases in new case numbers occurred in Russia (24 percent), India (12) and Colombia (5), but on a per capita basis the top three ranking countries were the Seychelles, Namibia and Mongolia.

In the Western Pacific region, weekly new cases have declined since a peak in mid-May, however Indonesia is currently reporting test positivity rates of 22 percent and the IFRC judges it to be balancing ‘on the edge of a COVID-19 catastrophe’.

The Tanzanian president has given an update on COVID-19, the first in over a year, declaring there have been 100 infections since the third global wave hit and ‘about 70 are on ventilators’. Read more

In related news:

- The ECDC has issued an updated warning on the implications of the delta variant in the region this northern summer, estimating that as many as 90 percent of infections will be due to the VOC by late August.

- Thailand is planning to fully open its borders in October when it is hoped that 50 percent or more of the population will have received a vaccine. In the meantime, visitors with proof of vaccination will be allowed in to some of the smaller tourist destinations, starting with Phuket this week and followed by Ko Samui on July 15 and Krabi and Phang Nga in August. A government minister said that visitors will incur costs for ‘requirements such as $100,000 Covid insurance cover and the cost of multiple tests’. Read more

- On June 24 the TGA announced it had granted provisional determination for the Moderna COVID-19 vaccine, Elasomeran.  

- ‘The mRNA Vaccines Are Extraordinary, but Novavax Is Even Better’. Read more in The Atlantic.

- ‘Stopping, blocking and dampening – how Aussie drugs in the pipeline could treat COVID-19’, explained in The Conversation.

Polio cases climb to 15

In the latest GPEI update, there were a further nine cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) reported from Khatlon province, near the borders of Uzbekistan and Afghanistan. And in Africa, also relating to cVDPV2 infections, Nigeria recorded three cases (Jigawa and Yobe), South Sudan’s two cases were in Unity and Upper Nile states and Côte d’Ivoire logged a single case in Bafing.

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.

PAHO updates diphtheria cases, deaths

Updated PAHO information disclosed the pandemic’s detrimental effects on diphtheria vaccination rates, which were already low for Haiti’s men and young children. For the year to mid-June, the country has reported 12 cases from 111 suspected infections, three of them fatal. The PAHO report notes that immunisation rates for the four doses of diphtheria-containing vaccines given to infants before their second birthday is under 50 percent. In the neighbouring Dominican Republic, there have been 35 suspected diphtheria cases and 10 deaths this year. Read more

Advice for travellers

Spread by coughing and sneezing or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more on diphtheria.

Stray dogs and rabies risk

The risk presented by the rabies virus circulating in the stray dog population was raised in a news report on a recent incident in Qena, north of Luxor, when 11 residents were attacked by a rabid animal. It was revealed that the number of dog bites in Egypt had risen by 100,000 in the three years to 2017 and more than 230 people have died since then from rabies and other consequences of the injuries sustained.

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.

Respiratory virus reports surge

Health authorities have reported five consecutive weeks of increasing respiratory syncytial virus infections (RSV) from across 3,000 paediatric department networks. Case numbers are said to have exceeded the last peak seen in 2018 and, unlike in previous years, the surge has come during the warmer months. Read more

Tick-borne infection deaths in NW state

The tick-borne infection Rocky Mountain spotted fever has sickened 23 people so far this year in the state of Baja California and killed eight of the youngest victims. It has been suggested that children and adolescents have been impacted the most due to their close association with pet dogs, which may harbour the infected ticks. Areas of concern include Mexicali, Guadalupe Victoria, Ejido Nuevo Leon, the Rio Hardy neighbourhood and Maclovio Rojas area of Tijuana. Read more

Advice for travellers

Although its incidence has increased in the past two decades, Rocky Mountain spotted fever is a low risk for most travellers visiting North America, where over 50 percent of cases occur in 5 US states – Arkansas, Missouri, North Carolina, Tennessee, and Virginia. However, it is advisable to take preventive measures to avoid tick bites when outdoors, particularly in warmer months (April-September) when ticks are most active. RMSF can be a severe or even fatal illness if not treated in the first few days of symptoms. Typical symptoms include fever, headache, abdominal pain, vomiting, and muscle pain – with or without a rash. Read more about RMSF.