World travel health alerts 9 June 2021

World travel health alerts for 9th of June 2021.

3 countries report VD polio

All cases reported to the GPEI last week involved circulating vaccine-derived poliovirus type 2 (cVDPV2): Afghanistan’s single case was in the southern province of Zabul, while the one case registered in Pakistan was from Balochistan. Nigeria logged a case each from Jigwa and Kebbi.

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.

Imported hantavirus infection

The NICD has reported an imported case of (Puumala virus) hantavirus haemorrhagic fever with renal syndrome (HFRS) in a businessman who had been working in Croatia. The man had visited horse stables in a rural location – a likely environment to find rodent hosts - before falling ill and a fellow visitor to the stables had subsequently been diagnosed with hantavirus. The May Communicable Disease Communique proposed that Europe’s rise in HFRS diagnosis over the past decade ‘warrant its consideration as a differential diagnosis, especially in travellers with suggestive clinical symptoms’. Read more

Advice for travellers

Hantavirus is generally spread from various rodent species to people, through aerosols shed in excreta, urine or saliva, but to a lesser extent via the bite of an infected animal. The syndromes resulting from infection vary by region - in Europe and Asia, the 'Old World' hantaviruses may cause haemorrhagic fever with renal syndrome (HFRS), while the New World' hantaviruses in the Americas can result in hantavirus pulmonary syndrome (HPS). Read more on hantavirus from the US CDC.

Typhoid deaths in Kwango

An outbreak of typhoid fever has killed seventeen people in the town of PopoKabaka, in the western province of Kwango. According to the Radio Okapi network, there have been more than 360 typhoid cases since the beginning of the year, prompting a public awareness campaign highlighting hygiene measures. 

Advice for travellers

Typhoid fever is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary specific, but is usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

COVID-19 gulf widens

The WHO Director-General this week said that COVID-19 infections around the globe are providing a ‘mixed picture’ even as ‘new cases of COVID-19 reported to WHO has now declined for six weeks, and deaths have declined for five weeks’. Countries or regions facing ‘an extremely dangerous situation’ include Peru, where a revision of deaths now gives it the highest COVID-19 mortality rate in the world, Malaysia which has seen cases increase by 60 percent over the past fortnight, and in Africa, with four consecutive weeks of increasing case numbers and vaccine supplies for under one percent of the population. Meanwhile in our region, Fiji has now recorded 775 COVID-19 cases since its latest outbreak started in April (and 845 total since Mar 2020). New cases have been reported in existing clusters which include the COVID-19 Incident Management Team and CWM Hospital in Suva.

In related news:

-  Bulgaria, Croatia, the Czech Republic, Denmark, Germany, Greece and Poland are the first EU countries to start using the EU Digital COVID Certificate now that the app is live, with remaining nations expected to implement it by July 1. The app provides QR code proof of vaccination (with an EU-approved vaccine) or negative COVID-19 test results/recovery from the illness. Read more

- Along with an overview of the current COVID-19 situation around the globe, the June 8 WHO epi update has a special focus on SARS-CoV-2 Variants of Concern (VOCs), including updates on emerging evidence surrounding their phenotypic characteristics - transmissibility, disease severity, risk of reinfection, and impacts on diagnostics and vaccine performance. Read more

- The TGA is reported to be considering a Pfizer proposal to approve its Comirnaty vaccine for adolescents aged from 12 to 15 years in Australia; the vaccine is already being used in this age group in the UK and US. Read more  

- The current status of vaccines under consideration for Emergency Use Listing by the WHO as of June 3. Read more

- Early studies carried out on mice by Qld scientists have provided promising results for a single subunit vaccine dose delivered by a skin patch. Read more

- An article published in The Conversation addresses a dog’s ability to detect the COVID-19 coronavirus infection by scent – ‘Yes, dogs can sniff out COVID. But not after dinner, when they need a nap’.

SE Ebola outbreak update

Ten days to run before the formal declaration of the end of the Ebola outbreak and challenges persist around community reporting, surveillance activities and unsafe burials, according to the WHO regional bulletin. More than 10,800 people have been vaccinated in Guinea and another 468 in neighbouring areas of Sierra Leone. Regarding Ebola vaccines, after granting prequalification to the J&J 2-dose vaccine regimen in April, the WHO has given it formal approval as per SAGE recommendations. The company states that it is ‘focused on securing national registrations for the vaccine in Ebola-affected countries in Africa’. 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.

Measles outbreaks ongoing; Schistosomiasis treatment for high risk areas

More than 650 suspected cases of measles have been reported from two counties on opposite sides of Kenya, Garissa in the east and West Pokot – this outbreak has been ongoing since Oct 2019. Vaccination campaigns for measles and polio are planned for outreach visits in the areas. While in Nigeria’s NE state of Borno, in one 7-day period in late May 600 suspected measles cases and 78 cumulative associated deaths were reported across four local government areas. Read more

A LOCAL NEWS source has reported a new program involving a Kenya/UK partnership which will provide free treatment medications for people living in regions of high prevalence for schistosomiasis and soil-transmitted helminthiasis: Lamu, Taita Taveta, Kilifi, Tana River, Kwale and Mombasa. Estimates put the number of Kenyans infected with Schistsomiasis at six million (15 million more are at risk).

Advice for travellers

Schistosomiasis or bilharzia is caused by a parasite which is released into fresh water by host snails. It burrows into the skin of people who swim or wade in rivers, streams and lakes containing the snail. With the rise in eco-tourism and adventure travel, increasing numbers of tourists are contracting schistosomiasis, according to a WHO fact sheet. Around 10% of travellers exposed to contaminated water will be infected. No vaccine or prevention medication is available, but schistosomiasis is treatable – especially if diagnosed early. Read more on the risk for travellers and how to prevent infection.

Malaria cases top 1,500

According to the health minister, an increase in malaria cases registered this year has mostly been within the known endemic areas of East Panama, Guna Yala region and Darien. Other areas cited in the minister’s report were Ngäbe Buglé region (68 cases) and Panama Metro (5). Read more. While in Peru, the health directorate of Loreto region reports that malaria cases have fallen by just under one third this year, compared to the same period in 2020. Of the 3,797 cases, which were recorded in 37 of the region’s 57 districts, almost 3,000 were due to Plasmodium vivax and the remainder P. falciparum. Ten districts in total are categorised as having either a very high or high risk for malaria transmission.


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.

Typhoid update for Luzon region

Thirty of the 68 typhoid fever cases reported in Calabarzon to the end of May were in the province of Laguna and another 26 were in Cavite, representing a fall in cases across the region compared to last year. Health authorities are reinforcing messages for the public on the need for strict hygiene measures and food and water precautions. Calabarzon comprises five provinces situated on the southern end of the island of Luzon. Read more

Advice for travellers

Typhoid fever is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination is itinerary specific, but is usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

Dengue hitting hard in west, more dengue reports

Twenty-four communes are currently reporting the majority of dengue fever cases, many of them in the island’s west - Saint-Paul, La Possession, Le Port, Saint-Leu and Trois-Bassins. To June 2 there have been more than 18,300 dengue infections and 12 associated deaths. Read more. The regional health agency, ARS La Réunion, is also reporting a surge in seasonal bronchiolitis cases which has started later this year, but at a lower intensity, than in previous years. Most cases have been in infants under two years of age. Read more. Also on dengue fever, the onset of warmer weather in Singapore has boosted Aedes mosquito populations and the NEA is warning residents that more dengue cases are to be expected. The risk of infection is compounded by less common dengue serotypes in circulation, together with many people working from home where mosquito activity is more likely.

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.

Diarrhoeal illnesses on the rise

The Ministry of Health and Medical Services has reported a spike in diarrhoeal illnesses in Guadalcanal, Honiara, Temotu and Western Provinces which has to date led to six deaths – five in Western Province. Children and infants aged under four years have been most affected. Rotavirus was isolated from some of the cases, however confirmation is awaited from specimens sent to Queensland for testing. Read more

Rabies risk elevated in Western Alaska

Officials with Alaska’s Dept of of Environmental Conservation have expressed concern over the continuing spike in rabies cases among wildlife which has hit ‘the coast from Bristol Bay to the North Slope, but Nome had the largest number of cases’ (Western Alaska and the Bering Strait region). There are reports of the virus spreading from arctic and red foxes to unvaccinated domestic pets, putting residents at risk. Read more

Advice for travellers

Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals, including bats. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is generally recommended for longer stays, especially travellers planning to live in, or travel extensively through, rural areas and also for children; however the final recommendation is itinerary-specific. Read more on rabies.