World travel health alerts for 6th of July 2022.
Zoonotic infection alert for BA province
Health authorities have expressed concern over a 10-year high in cases of Argentine haemorrhagic fever observed this year in Buenos Aires province. Recent cases of the disease, which is transmitted from Junín virus-infected rodents to humans ‘through contact with skin, mucosa, and inhalation of aerosolized particles carrying the virus’, have been detected in the northern districts of San Nicolás, Pergamino, and Ramallo, all of which are considered endemic – in the past, cases have also been recorded in Cordoba and Santa Fe provinces. A free vaccine is available to residents of affected areas from 15 years of age. Read more
Vax-preventable infections in northern NSW
Two children from the North Coast Public Health district in NSW have been diagnosed with diphtheria; one, the youngest at two years of age, is receiving intensive care treatment in Queensland. News reports state that neither child was vaccinated. Post-exposure prophylaxis has been provided to close contacts. 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.
Dengue cases near the 1.5 million mark
With nearly 1.5 million dengue fever cases recorded for the year to June 29, Brazil ranks first across the globe according to the latest ECDC update. Vietnam, Peru, Indonesia and the Philippines round out the top five, reporting figures which ranged from nearly 63,000 down to 27,686. Brazil also topped the list of countries with chikungunya infections and related deaths. In related news, local media are reporting a 6-year high in dengue fever cases in El Salvador, with months more of the rainy season to run. Lastly, a June 30 Science article outlined the findings from a recent Chinese study which suggested that a compound secreted by humans and mice infected with Zika and dengue viruses made them more likely to be bitten by mosquitoes. The research team will now move onto conducting trials of a medication to supress the compound’s effect on mosquito feeding. Read more
Advice for travellers
Dengue fever is common in most tropical or sub-tropical regions of the world. The virus is spread by daytime-feeding Aedes mosquitoes and to avoid it and other insect-borne diseases, travellers should apply an insect repellent containing an effective active ingredient, such as DEET, Picaridin or oil of lemon eucalyptus (PMD), to exposed skin when outdoors during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, as well as other times when the mosquitoes are active.
Dengue outbreak brewing
Authorities have warned that a dengue fever outbreak is imminent, with cases soaring from 757 in the first half of 2021 to almost 2,500 this year. To date, most cases have been in the provinces of Tboung Khmum, Kampong Speu, Preah Sihanouk, Kandal, Siem Reap, Kampong Chhnang and Banteay Meanchey. Read more
Advice for travellers
Avoid mosquito bites to protect against dengue fever. To avoid biting insects, apply repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) to all exposed skin when outdoors. 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 outdoors. Travellers should also cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active.
Progress of southern hemisphere flu season
Most countries of South America have recently reported a downturn in flu activity, however in Chile, as well as in Oceania and southern China, infections are on the rise - influenza A/H3N2 is dominant in most cases. Elsewhere, the jump in cases in southern Africa has largely been driven by influenza A(H1N1) viruses. Read more
Advice for travellers
The 2022 flu season has arrived in the southern hemisphere and Travelvax Australia recommends vaccination for all travellers over 6 months. Seasonal flu is the most common vaccine-preventable travel-related illness, posing a risk aboard aircraft, in crowded airport terminals, and at your destination. 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. Hand sanitiser is a convenient alternative if soap and water is not available. Read more on seasonal influenza.
E Coli infection risk elevated
A recent rise in cases of Shiga toxin-producing E. coli (STEC) infections has prompted a warning from public health officials who have highlighted the risks of consuming unpasteurised dairy products/undercooked meat and having contact with animals at farms or zoos, particularly for children under five who make up the majority of the cases. While all regions have reported infections, the capital Prague, South Moravia and South Bohemia have recorded most. More about STEC from Food Standards Australia New Zealand. Read more
Ituri's plague infections continue; Ebola outbreak ends
Suspected bubonic plague infections continue to emerge from Rethy health zone in Ituri province, with the count rising to 351 since March. While there have been several cases of the pneumonic form of plague, but they make up only 0.3 percent of the total. Read more
NEWS this week that the Ebola outbreak in Equateur province has ended after just over 10 weeks, however surveillance will remain a priority in the area to identify any sporadic cases that may occur. The province has recorded three Ebola outbreaks in the past four years. 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.
Fatal shark attacks near Red Sea resort
Two European tourists have died within days of each other following shark attacks near the Red Sea beach and diving destination of Hurghada. The attacks, said to be relatively rare events in recent times, were likely from mako sharks. In the wake of the tragic deaths, all water activities at Sahl Hasheesh were halted by authorities. Read more
Measles cases in 3 locations
A supplementary measles vaccination campaign for children is underway following the detection of six measles cases from three districts - Rewa and Nasinu on Viti Levu and Labasa on Vanua Levu. In other news, the health ministry is commencing a national roll-out of COVID-19 vaccinations for the five to 11 years cohort today (July 6). 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. In general the infection is relatively benign, but complications 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.
Regional cases of monkeypox triple
After the EU’s monkeypox cases increased 3-fold over the previous fortnight, the WHO’s regional director-general said there was no time for complacency, with ‘almost 90% of all laboratory-confirmed and globally reported cases since mid-May’ – more than 4,500 infections were confirmed and 10 percent required hospitalisation. The senior official also said that while 99 percent of cases to date have been male, ‘small numbers of cases have also now been reported among household members, heterosexual contacts, and non-sexual contacts, as well as among children’. The global total of infections (more than 6,200 at July 4 according to Our World in Data) is believed to be an undercount as community spread has been observed and testing can be hard to obtain in some jurisdictions. Read more
Seasonal rise in dengue cases
The uptick in vector-borne infections following the arrival of the SW monsoon has started, with reports of increasing cases of dengue fever in Mumbai (Maharashtra) and Hyderabad (Telangana). Doctors in Mumbai are also seeing more children presenting with chickenpox, flu-like illnesses and hand, foot and mouth disease after the recent start of the school term. Read more
Advice for travellers
Chickenpox (varicella) 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 cases review, June meeting of IHR Emergency Committee
Another wild poliovirus type 1 case has been recorded in the country’s NW near Afghanistan – the 11th this year for the district of Waziristan in Khyber Pakhtunkhwa province. Other cases announced in the latest GPEI update, all of which were cVDPV2: in Africa, Niger’s two cases were from Tillaberi, while Nigeria logged a single case from Zamfara. Meanwhile, in last month’s meeting of the polio emergency committee, topics of discussion included the threat of continued international spread of both wild and circulating vaccine-derived poliovirus. Ten countries/territories had changes to their polio status: Cote d’Ivoire, Eritrea, Ghana, Iran, Israel, Mozambique, Palestine Territories, Tajikistan, Togo and Yemen. 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 risks detailed ahead of Hajj
With the annual Hajj due to begin later this week, the ECDC has issued a timely reminder of the existing health-related concerns in the Kingdom: ongoing COVID-19, MERS-CoV (no cases recorded this year, 17 in 2021), schistosomiasis (north of Mecca/Medina, Jizan and the Red Sea Coast, urban areas low risk), endemic cutaneous leishmaniasis, and malaria (low risk in urban areas of Jeddah, Mecca, Riyadh, Medina, Taif). Health requirements for pilgrims are listed in detail by the Saudi Ministry of Health here. The ECDC notes, ‘As with other mass gathering events, the risk of communicable disease outbreaks is greatest for respiratory and food- and waterborne diseases.’ 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.
Cholera outbreak in western district
The WHO regional office provided an update on cholera in the country’s west, advising that Katavi region’s Tanganyika District is still reporting cases, however the outbreak is now controlled in the neighbouring region of Kigoma. The agency’s weekly bulletin stated that the case fatality rate of cholera infections in the densely populated district is almost three times the threshold of one percent and attributed it to poor sanitation practices. Read more
Advice for travellers
Cholera is usually spread in contaminated water. For most short-stay travel, the risk of infection is low. Travellers 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.
Reminders of Zika virus endemicity
A ProMED post detailed five Zika virus cases reported by travellers from the UK, Germany and Israel during travel to Thailand this year. The infections were acquired in locations visited between mid-March and early June; they included Phuket, Phi Phi Island, Koh Samui, Khao Lak, Bangkok and Chang Mai. While Thai health authorities have only been notified of a dozen Zika virus cases in residents this year, high rates of asymptomatic infections suggest an undercount among both locals and tourists alike. Read more
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 accessed through smartraveller (DFAT).
COVID-19: progress made, but pandemic not over
In England, a 33-34 percent rise in new infections and hospital admissions over the past seven days has seen some health districts reinstating mask mandates in hospitals less than a month after they were dropped. Read more. And in the Americas, the PAHO announced that South America’s cases had risen by nearly 25 percent over the previous week. The higher transmissibility of the BA.4 and BA.5 subvariants, plus early evidence of escape immunity from vaccination or previous infection, had them dominate global sequencing – 55 percent overall. Read more. Last week the WHO director-general said that the pandemic was changing and progress has been made, but it wasn’t over: ‘cases are on the rise in 110 countries, causing overall global cases to increase by 20% and deaths have risen in three of the six WHO regions even as the global figure remains relatively stable’. The burden of vaccine inequity remains, with on average just 13 percent of people in low income countries vaccinated.
Related news and articles:
- A meeting of the WHO and International Coalition of Medicines Regulatory Authorities at the end of June discussed the effectiveness of vaccines in the face of new SARS-CoV-2 variants that ‘may emerge rapidly and replace the currently circulating ones after short-lived waves’. Reviews underway include considering vaccines targeting the Omicron strain and other variants. Read more
- Long COVID: female sex, older age and existing health problems increase risk – new research published by GAVI.
- ‘Triple vaccination seems to reduce the chance of long COVID – but we still need to prepare for a jump in cases’: The Conversation
- ‘Australia is heading for its third Omicron wave. Here’s what to expect from BA.4 and BA.5’ authored by Prof. Adrian Esterman, University of South Australia and published in The Conversation on July 5.
HFMD cases spiking in south
Doctors working in infectious disease units of Ho Chi Minh City hospitals are reporting increasing numbers of children requiring admission or out-patient treatment for hand, foot and mouth disease (HFMD). Case numbers are said to be ‘alarming’ in several of the city’s districts - Districts 12, Binh Tan, Go Vap, Tan Binh, Hoc Mon outlying district and Thu Duc City. Other southern provinces recording HFMD outbreaks include Dong Nai, Binh Duong, Soc Trang and Ca Mau. Read more
Advice for travellers
HFMD mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection. Read more about HFMD.