World Travel Health Alerts 5 December 2018

World travel health alerts for 5th of December 2018.

Free MenB in SA a success

The South Australian (SA) Government is very pleased with the number of vaccinations being taken up by parents for their children, since it rolled out the free meningococcal B vaccination program on the 1st of October this year. More than 13,500 children have been administered the free vaccine and it is estimated that the program will help prevent more than 12 cases of the deadly disease in SA each year. Read more

Numbers surpass crisis hit Venezuela

The number of measles cases worldwide have jumped by 30% last year (2017) compared to 2016, with the Pan American Health Organization (PAHO) reporting on Friday [30 Nov 2018] that the numbers of cases in Brazil have surpassed those in crisis-hit Venezuela. In the Americas there have been more than 16 766 confirmed cases more than half of those have been reported in the past month. Brazil now has nearly 10 000 confirmed cases with 12 deaths; the vast majority of cases have been reported in Amazonas state. Venezuela which is still in the throes of a major economic crisis, leading to widespread shortages of medicine, has had 6300 cases confirmed in 2018 and more than 70 deaths. The World Health Organization (WHO) warns a spike in the number of measles cases globally is putting hard-won progress toward the elimination of this highly contagious, deadly disease at risk. A new WHO report states that multiple outbreaks of this killer disease since 2016 have caused an estimated 110 000 deaths in all regions of the globe, with the highest number of cases in the Americas, the eastern Mediterranean region, and Europe.

Advice for travellers

Measles is a highly contagious virus and can cause serious illness in people of all ages. Most cases reported in Australia are linked to overseas travel - both developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure. Read more

First Ebola then Malaria

Democratic Republic of Congo (DRC) has seen an 8 fold increase in the number of malaria cases in 2018 compared to 2017, in North Kivu province. DRC is the 2nd worst in the World for malaria (after Nigeria) and health officials are seeing around 2000 cases of malaria a week. North Kivu province is also the area where there is currently an Ebola outbreak. People suffering from suspected Ebola are seeking treatment at medical centres, however actually have malaria and are contracting Ebola in the process. This is making it very difficult to control the fast-spreading highly infectious virus. Of the 422 people thought to have been infected with Ebola during the DRC's outbreak, 375 of those have been confirmed. Health workers in the city of Beni, at the centre of the [Ebola] outbreak, have launched a 4-day door-to-door blitz to try and stem the flow of malaria cases. They will be giving out mosquito nets and antimalarial drugs to 450 000 people to stop them going to medical centres where they may catch Ebola. Read more


Spike in Malaria

Dominican Republic health official have seen an increase in the number of malaria cases in 2018 compared to 2017, over the same period. According to the General Directorate of Epidemiology (La Dirección General de Epidemiología (DIGEPI)) there has been a 21% increase in malaria cases, with 438 cases reported year to date in 2018 and only 360 for the same period in 2017. Of these cases 92% were Plasmodium falciparum and the remainder were P. vivax or mixed infections, there was one death. Read more

Advice for travellers

Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria

New requires proof of YF

Ecuador now requires proof of yellow fever vaccination for people arriving from countries with a risk of yellow fever, according to the World Health Organisation (WHO) update on the 15 Nov which states "Yellow fever (2018) Country requirement at entry: a yellow fever vaccination certificate is required for travellers aged 1 year”.

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.

Zika spreading

India is in the throes of the largest Zika virus outbreak ever experienced, with the majority of cases reported from the Rajasthan state capital of Jaipur, with experts warning other Indian cities and countries with close connections to the city to prepare for possible imported cases. As of the end of October, there have been 147 cases reported in Jaipur, a popular tourist destination, and the outbreak is spreading to neighbouring Gujarat reporting 1 case and Madhya Pradesh state reporting 3 infections. Of concern is the potential spread of the virus, with a group of a Canadian-led researchers finding that 94% of travellers travelling out of Rajasthan travelled to Indian cities, mostly Mumbai, New Delhi, Bengaluru, and Kolkata. International cities in the top 20 destinations included Bangkok, Muscat, and Singapore.

Advice for travellers

Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT). Read more about Zika

Syphilis at a 50 year high

Japan has seen the annual number of syphilis cases at the highest number in 50 years, with 6000 cases diagnosed by November 2018. Health officials are hastening to nip the epidemic in the bud ahead of the 2020 Olympics in Tokyo, however they are not sure what is causing this increase in numbers. According to the National Institute of Infectious Diseases, as of 19 Nov [2018], there have been 6096 cases of the sexually transmitted disease in the country [in 2018], the 1st time that number broke 6000 since 1970. Most of the cases were found in Tokyo, followed by Osaka, Aichi, Kanagawa and Fukuoka. Authorities have tried a variety of methods to stem the tide of syphilis, which was believed to primarily affect the LGBTQ community until a recent set of studies proved the sharpest rise was among men who have sex with women and women who have sex with men. Read more 

Advice for travellers

Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an effective antibiotic. Read more about syphilis and other STIs.

Measles outbreak CDC warning

The Centres for Disease Control and Prevention (CDC) has issued a Watch - Level 1 Travel alert on th, Practice Usual Precautions warning for Madagascar on the 30th of November, as the countries measles outbreak reaches 3239 cases. This CDC travel alert means visitors to Madagascar should ensure they are vaccinated against measles with the MMR (measles, mumps, and rubella) vaccine. This measles outbreak started in the capital city, Antananarivo, on October 4, 2018, when 3 measles cases were confirmed at the Pasteur Institute of Madagascar.   As of November 18th, a total of 3,239 measles cases have been reported, of which 182 were confirmed immunoglobulin M positive, and 3,057 were epidemiologically linked. 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. 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. Read more

Dire conditions at US-Mexico border

Amid shifting US border policies there are several thousands of Central American migrants living in filthy overcrowded sports complexes near the US-Mexico border. There have been a number of respiratory illnesses, lice and varicella plaguing the complex in Tijuana Mexico. Many of the individuals are living in tents made of rubbish bags or on patches of cold floor walled off with backpacks. Infectious disease agents such as varicella transmit rapidly under these conditions. Read more

Advice for travellers

Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.

Polio response to cVDPV1

There have been no new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) reported from Papua New Guinea (PNG) this week. So far in 2018 there have been a total of 25 cases of cVDPV1 reported. Health Authorities have established Emergency Operation Centres at a national level and in all affected provinces; environmental surveillance is functional in five sites in two major cities. Furthermore, three Supplementary Immunization Activities (SIAs) have been in place since July and have expanded from three provinces to nine, to nation-wide. The most recent was aimed at children under the age of 15, due to large numbers of poorly-immunized older children. Planning is underway for the next steps of the outbreak response, focusing on both vaccination and surveillance for polioviruses. Read more

Advice for travellers

Australian residents planning to visit PNG for less than 4 weeks should be up to date with their polio vaccination. For adults, this is a 3 dose primary course, with a booster within the last 10 years. For children, a 3 dose primary course with a booster at 4 years old is currently recommended. These recommended vaccines may be given before arrival in PNG.

Australian residents travelling to PNG intending to stay for longer than 4 weeks should have a documented polio booster within 4 weeks to 12 months prior to the date of departure from PNG. The booster may be given before arrival in PNG, as long as it is given within 4 weeks to 12 months prior to leaving PNG.

Individuals who are already residing in PNG for 4 weeks or longer should have a documented polio booster within 4 weeks to 12 months prior to departure from PNG (refer to WHO’s International Travel and Health website). The booster may have been given before arrival in PNG, as long as it has been given within 4 weeks to 12 months prior to leaving PNG. Individuals leaving PNG in less than 4 weeks should still receive a polio booster as this will still have benefit. Read more

Declared YF outbreak

The Sudan Ministry of Health has declared a yellow fever outbreak in Sakure, Nzara County, Gbudue state (formerly Western Equatoria state) on the 29th of November. The 1st suspected case was reported on Nov 23rd, after the State Ministry of Health (SMoH) received a report of a suspected case of Ebola at the point of entry in Sakure (a border town between the DRC and South Sudan). With the help of the World Health Organisation (WHO) a rapid response team, comprising of SMoH director-general, a medical officer, laboratory staff, a nurse and other partners from the Ebola Taskforce were deployed. However, testing at the National Public Health Laboratory proved the sample collected was negative for Ebola Zaire, instead a YF-specific PCR assay confirmed that the sample was  PCR-positive for yellow fever virus. Automatically triggering the activation of the YF incident management system.