World travel health alerts for 9th of January 2019.
Hantavirus warning for Azuero Peninsula province
A Jan 4 WHO Disease Outbreak News article detailed an increase in hantavirus cases in the province of Los Santos, situated on the Azuero Peninsula and approx. 300kms SW of Panama City. All but four of the 103 infections notified last year occurred in the province which is best known for the annual Las Tablas Carnival celebrations. The WHO states that the increase ‘could be related to changes in the abundance and distribution of rodent species, as well as strengthened surveillance and laboratory capacity at the provincial level’. World Youth Day 2019 is to take place in Panama City from Jan 22-27. A localised outbreak of hantavirus has struck in the western Argentinian town of Epuyén, approx. 160 kms south of San Carlos de Bariloche, killing six of the 19 infected. Cases of Andean hantavirus peak in this southern endemic region during the summer months. Read more
Advice for travellers
Hantavirus is passed on to humans through contact with hantavirus-infected rodents or their urine and droppings. Eliminating rats in and around living quarters is the main way of preventing hantavirus infection. Cases have been documented in Argentina, Brazil, Canada, Chile, Panama, Paraguay, and Uruguay, making HPS a pan-hemispheric disease. Read more about hantavirus.
Jellyfish pique QLD’s SE; Summer flu spike
The number of people reporting bluebottle jellyfish stings in SE Queensland soared to more than 22,000 over the past five weeks, with 5,000 last weekend alone. Weather conditions and warmer waters have caused the creatures to move towards the coast where they are likely to persist for some time. Read more
QUEENSLAND has also experienced increased influenza reporting over the summer so far, with more than 2,000 cases in December alone. This represents a five-year peak. Read more
Advice for travellers
Influenza is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination, when available, for all travellers over 6 months of age. Read more about influenza.
Yellow fever situation update; Lassa fever persists, moves across borders
From the latest WHO regional report on the yellow fever outbreak that began in Sept. 2017, ‘the continuation of the yellow fever outbreak in Nigeria and the rapid increase of the number of cases in Edo State is concerning.’ Almost half of the cases reported in the last three months of the year in Edo were from ‘a rural farming community whose population frequently travels to the nearby state capital, Benin City, with a population of 1.5 million people’. The second phase of a YF vaccination campaign is underway across six states and the Federal Capital Territory according to ReliefWeb.
LASSA fever data for the last week of 2018 revealed another 22 cases from the states of Edo, Ondo, Bauchi and Taraba which takes the yearly total to almost 3,500. A Nigeria Center for Disease Control (NCDC) report states that ‘80% of all confirmed cases are from Edo (44%), Ondo (25%) and Ebonyi (11%) states’. Cases generally peak in the first three months of the year. In north Benin, 15 people have been diagnosed with Lassa fever since mid-December in an outbreak that stemmed from a woman who had contracted the infection in Nigeria. Read more. Lassa fever has been diagnosed in a resident of Doufelgou district in NE Togo on his return after working in Nigeria for a year. Read more
Advice for travellers
Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.
Regional dengue updates
From the Pan American Health Organization (PAHO) dengue fever summary for the end of 2018: Brazil recorded over 240,000 suspected cases of dengue fever with all four serotypes circulating, while Mexico, Nicaragua, Colombia and Paraguay completed the top 5 dengue-reporting countries in the region. See all details in ProMED report Archive Number: 20190103.6240824
Advice for travellers
Don’t get bitten and you won’t get dengue. 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 fever is spread by two types of Aedes mosquitoes. Both 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.
Ebola outbreak into 6th month
The Jan 8 WHO situation report notes that the Ebola virus disease outbreak, now in its sixth month, remains ‘highly active’ across ‘geographically dispersed areas’ and that Butembo, Katwa, and Oicha are the hotspots. The latest newsletter update from the DRC Ministry of Health can be found here.
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.
Post-cyclone measures to avoid outbreaks
Cyclone Mona veered to the east of the main islands this week but the near-miss did result in some flooding, so the government is making plans to prevent disease outbreaks. According to one news source, the government is ‘strongly advising people to boil drinking water, practice good hygiene habits and ensure their homes, compounds and surroundings to be clean’. Read more
Dengue prevails in low season; Zika virus strains analysed; Capital’s ‘unhealthy’ air quality
Doctors in Telangana’s capital of Hyderabad are warning against the presence of dengue fever-carrying mosquitoes even into what used to be considered the low season. Read more
NATIONAL Institute of Virology testing of the Zika virus strains implicated in the outbreak that began in September last year found the Uganda strain responsible for the cases in Madhya Pradesh, a Brazilian-like strain in Rajasthan and Malaysian Zika strain was close to those found in Gujarat. Read more
RECENT rains in New Delhi offered some improvement in the poor air quality but it was short-lived. Today the Real-time Air Quality Index (AQI) indicates ‘very unhealthy’ conditions for many parts of the city.
Advice for travellers
Don’t get bitten and you won’t get dengue. 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 two types of aedes mosquitoes. Both 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. Read more about dengue fever.
Dengue cases pass threshold
After dengue fever cases mounted to 123, the health minister declared the epidemic threshold had been passed and has instituted measures aimed at curbing the outbreak. The highest incidence of infections has been reported from Kingston, St. Andrew, St. Catherine, Westmoreland and St. Ann. Read more
Advice for travellers
Dengue is spread by two types of Aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, 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 PMD when outdoors to all exposed skin. Read more about dengue fever.
Leishmaniasis warning in NW
Cases of cutaneous leishmaniasis have spiked in the NW city of Bani Walid, approx. 177 kms SE of the capital Tripoli. According to local news reports, there have already been 290 cases and calls have been made for those infected to have ready access to treatment medications. Last month the Director of the National Center for Disease Control forecast an increase in leishmaniasis cases in January and February this year after treatment programs were ceased. Read more
Advice for travellers
Leishmaniasis is a parasitic disease spread by infected sand flies and is found in the tropics and subtropics, as well as in southern Europe. There are two main forms – cutaneous and visceral. The former causes skin ulcers, the latter a severe systemic disease that is usually fatal without treatment. Read more on the disease, where it’s found and how prevent it. Read more about cutaneous leishmaniasis.
Capital’s measles outbreak
A measles epidemic has been declared in the capital Skopje after 19 cases were reported from all districts of the city over the previous two weeks. The ages of those infected range from an infant of eight months up to adults in their late 40s – all were unvaccinated. Read more. While in Portugal, authorities have advised there are currently three separate measles outbreaks which have produced a total of 37 cases to date. Up to 26 cases were reported in Cascais, west of Lisbon, while the remainder were in the nearby town of Oeiras and on the island of Madeira. Read more. Poland experienced a large increase in measles cases in 2018 (339 compared to just 63) with most (280 cases) reported in the final eight weeks of the year. Read more. Meanwhile, the Ukraine’s outbreak has carried into the new year with more than 2,000 new cases recorded already. The final 2018 case count was also announced - 54,481 measles infections from all oblasts and Kyiv. 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.
Muscat’s dengue count rises
The dengue fever outbreak reported in mid-December has expanded to new areas of Muscat – from Northern and Southern Al Hail to Al Mawalih - and the reported total of cases has risen to 40. Surveillance carried out since the first cases were identified has found the dengue vector to be present in coastal areas. Read more
Advice for travellers
Dengue is spread by two types of aedes mosquitoes which breed in shady areas close homes and other accommodation. Both bite mainly during the daylight hours, making them difficult to avoid outdoors. 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.
Surge of infections start the year
Ho Chi Minh City experienced increased reporting of measles, dengue fever and hand, foot and mouth disease in the first week of January, according to a local news source. The 60 measles cases, from 24 city districts, were of most concern as ‘there had been no measles cases in January 2018’. Read more. Provinces in the far south of Thailand remain in the grip of a measles outbreak which started in September. There have been more than 3,000 cases and 22 reported deaths in the region. 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.
Cholera reported in capital
Up to eight residents of Lubaga division in SW Kampala are undergoing testing for cholera infection. A vaccination campaign was carried out last year after four separate outbreaks were reported across the country. Read more
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. For general advice on vaccination options for your trip, call Travelvax Australia’s travel health advisory service (1300 360 164).
Disease risk mitigation for rainy season
With the arrival of the wet season, local authorities in the cities of Gweru and Bulawayo have set about developing public awareness and clean-up campaigns in order to prevent outbreaks of typhoid and cholera which pose a very real risk due to failing infrastructure. Read more. The government is having to contend with a strike by doctors, now into its second month. Read more