World travel health alerts 6 January 2021

World travel health alerts for 6th of January 2021.

3 sites of VD polio cases

As reported by the GPEI, Sierra Leone detected its first cVDPV2 cases last month – three in total from Western Area, Northern and North Western, while two other African countries added to their cVDPV2 counts: Guinea (seven cases in five different provinces) and Nigeria (a single case in Sokoto state). Elsewhere, Afghanistan logged 26 more cVDPV2 cases from across 10 provinces (nine of the cases in Kandahar). In the previous week (Dec 23), the GPEI registered infections in Afghanistan (two WPV1 cases), Pakistan (one WPV1 and 11 cVDPV2) and, in Africa, 18 more cVDPV2 cases: Burkina Faso (six), Chad (two), South Sudan (10). And in a sign of current virus transmission in a previously unaffected country, two cVDPV2-positive environmental samples have been reported in Liberia’s NW coastal county of Montserrado.

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.

Measles in northern state

Measles cases have been on the rise in the northern state of Amapá with most infections reported in two municipalities near the mouth of the Amazon River, Santana (106 cases) and Macapá (64). A vaccination campaign is underway targeting the most affected cohort - adults aged 20 to 49 years. 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.

Plague detected again in Ituri

Another flare-up of bubonic plague has been reported in the NE state of Ituri (Aru territory) with more than 256 suspected cases and seven deaths in Biringi health zone between mid-November and Dec 31. Aid agencies have assisted in the administration of chemoprophylaxis to local residents and fumigation of housing. Several camps housing South Sudanese refugees are located near the affected areas. Read more

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.

More cholera in capital district

This week the WHO has offered an update on the cholera outbreak affecting four health areas in the coastal city of Lomé, reporting a total of 67 suspected cases between Nov 11 and Dec 28, 2020, of which ‘19 (28%) were fishermen who move frequently between Togo and neighboring countries (especially Ghana, Benin, and Nigeria)’. The agency also noted that Lomé, Togo’s capital, is a known cholera hotspot and adjacent countries are cholera-endemic. Meanwhile in the Democratic Republic of Congo, almost 90 percent of recent cholera infections were recorded in the provinces of South Kivu, North Kivu, Haut-Katanga and Lomami, as outbreaks which had been easing were inflamed again after heavy rains; and in Yemen, cholera cases in the SE province of Hadramout have persisted three months beyond the annual peak season which usually ends in September, prompting an extensive vaccination campaign.  

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.

COVID-19 pandemic measures tightened

Restrictions have been strengthened and lockdowns extended in several European countries in response to surges in coronavirus cases and, in the case of Denmark, the local emergence of the VOC-202012/01 variant first identified in the UK which is expected to become dominant by mid-February. Read more. The Jan 5 WHO epi update observed that the VOC-202012/01 variant ‘has been detected in a small number of cases in 40 other countries/territories/areas in five of the six WHO regions, and the 501Y.V2 variant initially detected in South Africa in six other countries/territories/areas’. More in a Dec 31 WHO Disease outbreak news post and in an ECDC ‘Risk Assessment: Risk related to spread of new SARS-CoV-2 variants of concern in the EU/EEA’ published two days earlier.  

The WHO director-general announced in a briefing this week that ‘more than 30 countries have started vaccinating their high-risk populations with various COVID-19 vaccines’.

In other news:

-Authorities in some regions have sounded the alarm over advertisements for the sale of falsified COVID-19 vaccines on the dark web, as criminals pursue personal data and money; more activity is expected with demand high as vaccines are rolled out. The WHO advised that ‘so far there was no need to be concerned and appropriate regulatory action had been taken’ but to ensure vaccine doses are procured through regulated and controlled supply chains. Read more

-The Pfizer/BioNTech mRNA vaccine, branded as Comirnaty, has now been approved by regulators in the EU, Switzerland and in some countries of the Americas, and by the WHO under its non-proprietary name of tozinameran. Emergency Use Listing approval by the WHO ‘enables UNICEF and the PAHO to procure the vaccine for distribution to countries in need’ as well as facilitating countries’ regulatory processes for vaccine importation and administration.

-ABC news writes of Australian trials of 'backup' COVID-19 vaccines ‘that can be modified to fight virus mutations’ 

Yellow fever outbreak update

More on the yellow fever outbreak posted on Dec 2, with a WHO report updating the number of suspected cases by Dec 15 to 52 with 14 deaths.  While most cases (50) were detected in the NW (Koundara commune), there were two others in the districts of Dubreka (north of Conakry) and Kouroussa (central). The WHO warns that Koundara district has ‘risk factors for a spread of the yellow fever virus, including documented Aedes species, parks inhabited by monkeys, forests extending to neighboring countries (Senegal, Guinea Bissau) and suboptimal YF vaccination coverage’. Overall, the level of risk for spread at a national level ‘is considered high because of the large number of cases with an unusual age profile of young children in a short period of time’. Guinea’s yellow fever vaccination coverage was around 40 percent for the years 2016 to 2019. Read more

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.

Yellow fever confirmed in 3 regions

The WHO has reported on four yellow fever cases detected in the eastern region of Tambacounda between late October and mid-November, and by December, a further three YF infections were confirmed in neighbouring Kedougou and Matam regions – all remote, rural locations with low vaccination coverage bordering Mali and Mauritania. Two deaths have been recorded. In other YF news, the NCDC published a Dec 25 update on Nigeria’s widespread outbreaks, and a news source has detailed the detrimental effects that vaccine apathy and the preference for traditional medicine have had on the country’s YF vaccination coverage. Read more

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.

‘Aleppo boil’ cases spike in east

More than 1,700 cases of cutaneous leishmaniasis have been reported in villages near Deir Ezzor in the country’s east, along the Euphrates River and close to the Iraqi border. Total infections recorded, which are predominantly in the seven to 15 years age group, are expected to pass 3,000 soon – in 2019 there were 700 cases. Read more

Advice for travellers

Leishmaniasis is generally a low risk for travellers. The parasitic disease is 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. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention.

Flood-borne risk warnings

Advice from health authorities for people in southern provinces dealing with localised flooding includes the need to beware of the risk of leptospirosis when wading through contaminated waters. More than half of the 1,537 cases reported nationwide last year were in the south, with highest rates among adults aged 45 to 54 years as well as schoolchildren. Provinces with most cases were Rayong, Phang Nga, Yala, Phatthalung and Song Khla. Advice to residents includes wearing boots when wading through floodwater and ensuring any wounds are covered with waterproof dressings. 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.