World travel health alerts 8 June 2022

World travel health alerts for 8th of June 2022.

Territorians alerted to JE risk

The federal government’s Japanese encephalitis virus (JEV) webpage advised that of June 1 there had been 30 confirmed cases and a further 10 probable infections based on ‘laboratory suggestive evidence’. Five cases in all were fatal. This week, a Northern Territory news source reports that around 40 feral pigs from the Litchfield, Marrakai-Douglas Daly and Cox-Daly region, as well as the Tiwi Islands had tested positive to JEV since March. Residents and visitors to the region are reminded of the measures needed to avoid mosquito bites, while the director of the territory’s Medical Entomology Unit said the risk of a bite from an infected mosquito is highest “after sundown within five kilometres of wetlands where feral pigs and water birds potentially infected with JE are present”. Read more

Advice for travellers

A mosquito-borne virus, JE is generally found in many parts of Asia, the Indian subcontinent, Southeast Asia, China, Indonesia and PNG, and now areas of southern and eastern Australia. In Asia, it is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to large urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE.

Severe dengue season forecast without control measures

Dengue fever cases are on the rise and authorities are predicting a more severe season this year if no vector control measures are introduced. Recent surveys have detected a high Aedes aegypti mosquito population in parts of the capital, Dhaka. On a global level, the latest ECDC update, which covered data for the past four weeks, has Brazil reporting most new dengue cases (over 507,000 infections), followed by Peru (13,830 cases) and Vietnam (10,990 cases). Brazil also had highest rates of chikungunya infections in the same period. 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.

COVID-19 pandemic evolution ‘remains unpredictable’

The highest increase in new COVID-19 cases reported in this week’s PAHO epi update was in the European region (up by 18 percent), followed by the Americas (up 3.7 percent), while deaths decreased in all regions except the Western Pacific. South America experienced the greatest rise in new weekly cases for the Americas’ sub-regions, according to the agency, with Brazil recording the largest proportion, followed by Chile. Read more

Related articles:

- Interim statement on hybrid immunity and increasing population seroprevalence rates: World Health Organization

- ‘Herd immunity was sold as the path out of the pandemic. Here’s why we’re not talking about it any more’: The Conversation

- Mask wearing in community settings reduces SARS-CoV-2 transmission: Proceedings of the National Academy of Sciences USA (PNAS)

Late season flu activity declining

Flu activity is on the decline across the region, however the ECDC reports seasonal influenza activity of 50 percent positivity in sentinel primary care in Finland. In North America, flu-like illnesses are at high or very high levels in increasing in four US states and DC, while in Canada, FluWatch reports on the ‘late-onset seasonal epidemic’ advising that activity is decreasing, ‘but remains above the epidemic threshold’. Read more

Advice for travellers

In most years, seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Whether you are travelling within Australia or overseas, vaccination is highly recommended and 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. Alcohol-based hand sanitiser is a convenient alternative if soap and water is not available.

Strawberry recall over potential Hep A contamination

A recall of imported organic strawberries has been ordered in both the USA and Canada after some batches of two brands were linked with confirmed hepatitis A cases. While the batches named in the recall have passed their shelf life date, some of the produce may have been frozen for later use but would remain capable of causing infection. Read more

Advice for travellers

Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through consuming contaminated food and water, by handling everyday items and through some types of sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and offers long term protection.

Ituri’s plague outbreak not over; No new Ebola cases

A pneumonic plague case has been confirmed in Ituri province, adding to the health burden created by the still-uncontrolled outbreak of the bubonic form. Local news sources are reporting the pneumonic infection in Djugu territory where more than 210 bubonic plague cases and five deaths have been recorded since March. Read more

THE LATEST update on the Ebola outbreak in the NW province of Equateur shows no change, with no new cases recorded since the last confirmed infection on May 19. 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.

Wild polio cases climb to 8

Yet another wild poliovirus type 1 case has been detected in North Waziristan, the eighth this year and the second for the district’s administrative centre, Miranshah. Plans for vaccination campaigns are underway to prevent further local spread, as well as combined strategies with Afghani authorities to stop viral transmission across borders. In other news on polio, the GPEI reported a single circulating vaccine-derived poliovirus type 2 (cVDPV2) case in the D R of Congo (Maniema province). 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.

SW Monsoon season begins

The South-west monsoon has set in and the Bureau of Meteorology’s updates show its current progress moving over parts of Tamil Nadu, Puducherry & Karaikal, southwest and west-central Bay of Bengal. Dengue fever and leptospirosis cases are already increasing in Kerala following recent heavy rainfall. Read more

CCHF cases in 11 governorates

According to a June 1 WHO Disease Outbreak News post, Crimean-Congo haemorrhagic fever (CCHF) infections spiked in April and May this year, racking up a 6-fold increase in cases over the same Jan 1–May 22 period in 2021. Almost half of the confirmed cases were in the SE governorate of Thiqar, but another 10 provinces also registered CCHF cases. The WHO reported most people who had acquired the infection had contact with animals as either butchers or livestock breeders. The risk of further spread remains high through the religious holiday period of Eid al-Adha in July. 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 disease, which has a fatality rate of 10-40%, is more common in Africa, the Balkans, the Middle East, and Asia, as well as countries south of the 50th parallel north. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to most travellers. Read more about the virus.

Rickettsial infections strike down kids in Coahuila

In the north-central state of Coahuila, health officials announced five child deaths from tick-borne infections (likely Rocky Mountain spotted fever) this year. In most years, the state records one or two fatal cases from Rickettsial diseases, however this year’s count is higher and, unusually, has involved young children. Read more

Advice for travellers

Although its incidence has increased in the past two decades, Rocky Mountain spotted fever is a low risk for most travellers visiting North America, however, it is advisable to take preventive measures to avoid tick bites when outdoors, particularly in warmer months (April-September) when ticks are most active. RMSF can be a severe or even fatal illness if not treated in the first few days of symptoms. Typical symptoms include fever, headache, abdominal pain, vomiting, and muscle pain – with or without a rash. Read more about RMSF.

Malaria uptick in NE border area

In the NE region of Kavango East, a year-on-year increase in malaria cases has hit hardest in the capital, Rundu, as well as the towns of Andara and Nyangana. A representative of the Ministry of Health and Social Services said the provision of mosquito nets and residual insecticide spraying continues to be affected by the pandemic. Read more

Advice for travellers

Travelvax recommends that travellers planning a visit to malarious regions discuss their itinerary and preventative measures, including medication, during a pre-travel medical consultation. More on malaria.

High snakebite toll in Terai

As the monsoon season approaches the number of people presenting at hospitals following a snake bite is growing – 34 envenomings were treated last week at Sukraraj Tropical and Infectious Disease Hospital in Kathmandu. The incidence of snake bites is said to be under-reported, however recent studies estimate the annual death toll from envenomings is 2,700, with most occurring in the Terai region. Read more

Flood risks in East Visayas

Residents of East Visayas have been warned by health authorities to either avoid wading in floodwaters or ensure they wear waterproof footwear and gloves, as the death toll from leptospirosis rose to eight from the 53 infections reported in the region this year. The risk of infection will be higher as the rainy season sets in. 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. The Philippines averages almost 7,000 leptospirosis cases and 40 fatalities a year, with the seasonal peak occurring during the rainy months from July to October. Read more about leptospirosis.

Monkeypox likely circulating for an extended period of time

In the month since the first monkeypox cases unrelated to travel were identified in the UK, new infections have been identified in at least 29 non-endemic countries - 1,088 confirmed cases in all up to June 7, according to the US CDC’s 2022 Monkeypox and Orthopoxvirus Outbreak Global Map. Most cases are in the UK (where from June 8 monkeypox will become a notifiable disease), Spain and Portugal, while in the US, the CDC is tracking at least two separate monkeypox outbreaks, finding links to imported cases identified in 2021. This suggests that strains of the virus have been circulating for some time. There have been no deaths reported and few hospitalisations associated with the outbreaks – the West African clade of the virus appears to be the only strain involved. The WHO hosted a meeting of experts last week to discuss knowledge gaps and research priorities for monkeypox. Meanwhile the agency has also warned that the incidence of diseases jumping species from animals to humans is becoming more common – borne out by the increased frequency of outbreaks of Lassa fever and Ebola. Read more in the June 4 situation update.  

Hajj/Umrah health requirements published

The Saudi Ministry of Health has published its requirements for pilgrims and workers attending the Hajj & Umrah sites during the 1443H (2022) season. The department’s document lists the required and recommended vaccinations, ‘Health practices for prevention of conditions of concern’ and encourages checks for ‘Physical Ability and Health Education’. Read more

Measles in Gauteng

A measles outbreak has been declared in two areas of Gauteng Province – the city of Tshwane with three (linked) confirmed cases, while a single case was reported to the SW of Johannesburg, on the West Rand. All four cases were reported late last month (May). Routine vaccination with a monovalent measles vaccine is administered as part of the Expanded Programme on Immunisation (EPI) in South Africa at the ages of six months and one year. 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.