World travel health alerts for 5th of May 2021.
Polio digest, 1st VDPV infection in Liberia
Six years after cVDPV1 was last detected in Madagascar, three infections have been reported by the GPEI from two different locations – two cases in the SE (added to the global count for 2020) and one in the SW, however there was also notification of positive environmental samples in the NW region of Boeny. The last cVDPV1 cases – 11 overall - were recorded in 2014-15 and polio-free status was granted three years later, in 2018. Liberia’s first reported cVDPV2 case, in the north-central county of Bong, comes only months after the announcement that positive environmental samples had been collected in Monrovia (linked to the Côte d’Ivoire outbreak). Elsewhere, more cVDPV2 cases were logged in the D R of Congo, Mali, Nigeria, Sierra Leone and South Sudan in Africa and one case each in Afghanistan (Hirat) and Tajikistan (Khatlon).
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.
Bacterial contamination suspected in gastro spike
Ten recent hospital admissions and numerous accounts of gastrointestinal illness are thought to be caused by conch poisoning, contracted by eating improperly stored or prepared molluscs - raw conch is a popular local dish. The agency charged with food safety noted that ‘conch poisoning is commonly caused by Vibrio parahaemolyticus, a bacterium found in the ocean that can be present on raw conch if not washed off properly with fresh, running water’. Investigations are continuing into the source of the infections. Read more
Advice for travellers
Read more about Vibrio parahaemolyticus from SA Health.
COVID-19 update and related news
New cases averaged out over the week have dropped to levels last seen in October in the US as the number of vaccines administered hit 248 million, according to CDC data. A mask mandate remains for passengers on all transportation networks to Sept 13 and the CDC has updated guidelines for international travellers: while testing is required for anyone arriving in the US by air, mandatory quarantine upon arrival in the US is waived for fully vaccinated individuals (only vaccines authorised by FDA and WHO). Read more. Also on the topic of easing of travel restrictions, news from the EU that 'the commission proposes to allow entry to the EU for non-essential reasons not only for all persons coming from countries with a good epidemiological situation but also all people who have received the last recommended dose of an EU-authorised vaccine'.
The WHO epi update on May 4 notes that India and Brazil account for more than half of last week's cases, as both new weekly cases and deaths increased yet again across the globe, remaining 'at the highest levels since the beginning of the pandemic' for two successive weeks.
In other news -
- Some US news sites are reporting that cruising out of the US may commence in mid-July, dependent on requirements set by the CDC. A number of clarifications of the Apr 2 additional guidance to the CDC’s Framework for Conditional Sailing Order have been provided to cruise lines. Read more
- The company behind the fourth vaccine for Australia’s roll-out, Novavax, is expected to file for regulatory approval in the US soon, with production to ramp up shortly afterwards throughout a network of facilities around the globe. Read more
- Exponential dynamics is used to explain the maths behind ‘the End of the Pandemic’ in a NY Times essay.
- Go Give One is a COVID-19 fundraising campaign with no borders created by the WHO Foundation. Through directly donating to COVAX, ‘the campaign calls on everyone, everywhere to play their part in helping to vaccinate the world’.
Yellow fever alert in southern state; Dengue & chikungunya in São Paulo
A public health emergency was declared in the state of Rio Grande do Sul last week after confirmation of yellow fever virus circulation in a red zone comprising 23 towns; another 72 municipalities were classified as at-risk (yellow zone). While no human cases have emerged as yet, more than 250 primates have been killed by the virus in the affected area. The health secretary spoke of the ongoing dengue fever outbreak in the state and called for an integrative response from all stakeholders. Vaccinations are planned for the municipalities in both zones ‘where rural and urban activities mix’. And in Santa Catarina, the most recent yellow fever case, a man from Blumenau in Valei do Itajaí, has taken the state’s total for the year to seven. Read more
SÃO PAULO’S health facilities have been dealing with a COVID-19 crisis for many months and are now facing the effects of twin mosquito-borne disease outbreaks, dengue fever and, for the first time, chikungunya. Two hard-hit locations signalled by local media are Baixada Santista on the coast and Tatuí in the interior. Read more. While in the NE state of Piauí, the first confirmed case of Oropouche fever was reported by the Municipal Health Foundation in the capital, Teresina, last month. To date, most notifications of Oropouche virus outbreaks in Brazil have been in the Amazon region.
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.
Variant flu in Manitoba
Two unlinked variant influenza cases in people with direct or indirect contact with pigs have been reported by Manitoba authorities, one H1N2v and the other H1N1v, continuing the sporadic reporting of flu variants in North America over the past 10 years. Read more and related information from the US CDC.
12th Ebola outbreak now over, concerns remain for Guinea’s situation
The end of the 3-month Ebola outbreak in North Kivu province was declared earlier this week. The final case count, which was kept low due in part to the rapid response and targeted vaccinations, concluded with 11 confirmed cases plus one probable, six fatalities and six recoveries across four health zones. And in Guinea, while there have been 21 days without any new confirmed Ebola cases, the WHO describes the situation as unstable, with one documented infection remaining in the community and the reporting of 19 new suspected cases, most of whom have refused testing. Read more
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.
Working towards meningitis target
With the aim of reaching the 2030 global target to eradicate meningitis, a lead doctor in the field with the Nigeria Centre for Disease Control said that their case numbers are falling – from more than 14,000 infections in 2016-17 down to fewer than 1,000 last year. While the low rates of bacterial meningitis last year could in part be attributed to enhanced hygiene and physical distancing measures, the meningitis A vaccine is now included in the routine vaccination schedule. Read more
Advice for travellers
Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions, extended contact with local people in crowded places and travel to sub-Saharan Africa’s ‘meningitis belt’ where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). Read more about Men. meningitis.
Dengue warning issued
With more than 2,300 dengue cases reported this year and virus activity in at least 20 clusters, the government is asking the public for vigilance and more effort in the fight against dengue. The risk of another surge is said to be high due to above average numbers of Aedes aegypti mosquitoes in March ‘and Dengue virus serotypes 3 and 4, which were previously uncommon in Singapore, have increased in prevalence’. Read more
Advice for travellers
Dengue is spread by Aedes mosquitoes which breed in shady areas close homes and other accommodation. They bite mainly during the daylight hours and can be found indoors, 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 oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.
CCHF case in NW region, Q fever in Basque cave climbers
The first case of Crimean-Congo haemorrhagic fever (CCHF) in 2021 was confirmed last month in a farmer ‘with recent exposure to tick bites’. The man lives in Castilla y Leon and is said to be in a stable condition. CCHF was first reported in Spain in 2016 (Ávila province in Castilla y León). In March, the ECDC published an updated map showing the current known distribution of the CCHF vector, the Hyalomma spp. tick, in the region, and a separate map for the tick vector found most often in Spain. Read more. To the NE, the Baltzola caves in the Basque region have been closed while investigations take place into five cases of Q fever diagnosed since December – four were cave climbers. The caves are a popular training site for spelunkers and a favourite for family day trips. Read more
Advice for travellers
CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers who take insect/arachnid bite precautions. Read more about the virus.