World travel health alerts 4 March 2020

World travel health alerts for 4th of March 2020.

Measles virus circulates; Dengue cases up 20%; 2 more YF cases in SC

The measles virus continues to circulate widely after spreading from São Paulo state in April last year. A Feb 28 PAHO update reports that cases are now on the decrease after reaching 21 other states and the Federal District – this year there have been 2,184 suspected cases from 11 states (Alagoas, Bahía, Minas Gerais, Pará, Paraná, Pernambuco, Rio de Janeiro, Rio Grande do Sul, Santa Catarina, São Paulo, and Sergipe). The report also contains more details relating to last week’s post on the outbreak in Argentina: The vast majority of cases were either residents of Buenos Aires Province or the city of Buenos Aires and many were either unvaccinated (63 percent) or incompletely vaccinated (10 percent). In other measles news, the last measles case reported in Samoa was in mid-January (information as of Feb 28) and the country is now in a ‘response and recovery phase‘, while American Samoa’s most recent measles case was on Jan 27. In Africa, measles infections have sickened 73 people and killed two infants in four districts of Liberia’s SE Grand Kru County - Forpoh, Dorbor, Jloh and Barclayville.

IN THE first five weeks of 2020 and with weeks more of the peak rainy season to go, dengue fever cases rose by almost 20 percent over the same period last year, with 94,149 probable cases registered across the country. The three states with the highest incidence of dengue are Acre, Mato Grosso do Sul and Paraná.  

SANTA Catarina’s Vale do Itajaí (or ‘European Valley’) is the location of two more yellow fever cases reported in the media this week – a second case from Pomerode and the other from Indaial, 20kms to its SW. None of the six patients so far identified were vaccinated against yellow fever.

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.

Prepare for flu season; COVID-19: First steps to defeating epidemic

Compelling reasons from health authorities for all residents to get the annual influenza shot this year with the likelihood that a peak in flu activity could coincide with an increase in COVID-19 infections in the community (NSW has already reported higher flu rates from weeks one to five this year than for same period in 2019, however more testing may have been performed in response to news of COVID-19 outbreak). The federal Dept. of Health advises that vaccinations received in April will offer optimum protection over our peak influenza season (June-Sept). Read more plus a global update in the Mar 2 WHO report.

With at least 72 countries now reporting COVID-19 cases, the WHO has raised the regional and global risk assessment to ‘very high’. On Mar 2, the WHO Director-General stressed that ‘containment of COVID-19 is feasible and must remain the top priority’ and compared this outbreak to an epidemic of influenza epidemic which would have spread globally at this stage with no hope of containment. See more on the current status in Australia (Dept of Health Mar 4)

First 2 polio cases of 2020, more global polio news

With the addition of the six latest cVDPV2 cases (three each from the provinces of Bono and Bono East), 2019 finished with a total of 18 cases while there have now been two in 2020. Elsewhere in the region, Togo reported two cVDPV2 cases (Lome and Maritime provinces), only one of which had a date of onset this year, while Benin registered a case in Plateau province. Pakistan’s wild poliovirus1 cases has climbed to 12 after two more infections were reported this week – both from Punjab province. And in related news, last week the GPEI published the Global Polio Surveillance Status Report 2019. 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.

Health report update

At last a drop in the reporting of new malaria cases, but current numbers are still elevated - 100,390 cases and 452 fatalities since early January. The UN Office for the Coordination of Humanitarian Affairs (OCHA) also reported 372 measles cases, most of which occurred in rural areas outside the largest city, Bujumbura, but also in Cibitoke, Ruyigi and Cankuzo provinces. Read more

Advice for travellers

Sub-Saharan Africa presents a significant malaria risk. Travellers should discuss their itinerary and preventative measures, including medication, during a pre-travel medical consultation. Read more about malaria.

Disease outcomes resulting from crisis

The latest WHO weekly African region bulletin expands on the tragic health consequences produced by an ongoing humanitarian crisis, with malaria, typhoid fever and influenza syndrome named as the main causes of morbidity, in addition to outbreaks of leishmaniasis, yaws and cholera in some districts.

Advice for travellers

Typhoid fever is endemic in many developing regions, however vaccination recommendations are itinerary specific. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

Run of Ebola disease-free days; Plague in NE province

Most welcome news in the Mar 3 CMRE newsletter which announced the 14th consecutive day with no new Ebola virus disease cases and the last patient discharged from hospital (contacts are still being monitored). Beni health zone is still a focus as the location of the only two confirmed cases identified over the past three weeks, however surveillance continues in all health zones, as advised in the Mar 3 WHO Sitrep. The outbreak can only be declared over 42 days after the last confirmed cases are virus-free (countdown started on Mar 2).

SCATTERED suspected cases of bubonic and pneumonic plague have been reported in two areas west of Lake Albert in Ituri province (Aterlembe and Godjoka health areas). According to local health agencies, they have traced any contacts and instituted follow up treatment.

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.

Risk season for KFD in south-west

It’s now mid-season for Kyasanur Forest disease virus (KFDV) activity in the SW state of Karnataka and cases of KFD are on the increase, with recent deaths recorded in the districts of Uttara Kannada and Shivamogga. The viral illness, which is transmitted to humans through tick bites or contact with infected monkeys, is a risk for people who spend time outdoors in affected regions (recreational visitors, herders, forest/farm workers and hunters); a vaccine is available locally in India. Read more

Dengue surges in eastern Flores regency

More than 1,000 people have been infected with dengue fever, resulting in 11 deaths, on the island of Flores (in Sikka regency, East Nusa Tenggara province). In order to effectively manage the situation, back in January local government officials declared an Extraordinary Occurrence (KLB) which will enhance response measures through this month. Read more

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 repellent containing an active ingredient, such as DEET, Picaridin, or PMD when outdoors to all exposed skin. Read more about dengue fever.

Upcoming rains boost cholera threat

International aid agencies are concerned that the cholera and acute watery diarrhoea outbreaks currently affecting the regions of Hiran and Banadir could worsen with the onset of more rains due between April and June. More than 700 cholera infections and seven deaths were reported in the central and SE regions in the month to Feb 25. 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.