Health Alerts
  • Australia: Timely cryptosporidiosis warning, Buruli ulcers FNQ

    Director of Health Protection at NSW Health, Dr Jeremy McAnulty, has provided a timely warning with the start of the holiday season, for parents and carers of young children in particular to take steps to prevent the spread of this parasitic intestinal infection. Cases of cryptosporidiosis are expected to rise over summer. Director of Health Protection at NSW Health, said people of all ages, particularly parents and carers of young children, should take steps to prevent the spread of the parasitic intestinal infection. “Cryptosporidiosis is easily spread from person to person in swimming pools, splash parks, interactive fountains, spas or jacuzzis,” Dr McAnulty said. Read more

    Another case of a Buruli ulcer (flesh-eating disease) has emerged in the Far North, leading health officials to issue another warning about protecting against mosquitoes. Tropical Public Health Services acting director Dr Madhumati Chatterji said in both cases, there was most likely local exposure. “It is not known how the infection is contracted, there are various theories including the possibility of insect transmission,” she said. “While research is ongoing into how the infection is transmitted, people are advised to avoid contact with soil or water where possible, particularly in the Daintree/ Mossman area and to avoid mosquito bites by covering the body with clothing and using insect repellent.” Read more

    Advice for travellers: Outbreaks of ‘Crypto’ are well documented, mainly as a result of swimming in swimming pools and water parks harbouring the parasite. While the parasite can be spread in several ways, swallowing contaminated drinking or recreational water is the most common. Cryptosporidium is a leading cause of water-borne disease in most developed countries, including Australia. For further information, see the NSW Health cryptosporidiosis factsheet.

    Brazil: Summer Dengue outbreaks, YF changes

    With Brazil entering its summer season, there have been a number of dengue outbreak reports country-wide, due to some heavy summer rains, there has been an increasing number of Aedes Aegypti mosquitoes carrying the virus. The highest number of cases were recorded in Goiás - 80,000 cases (about one-third of all cases nationwide); seven cities at risk of outbreaks. Minas Gerais had 26,000 cases and 8 deaths so far in 2018 and São Paulo - 8,900 cases through November 2018, including cases reported in the municipalities of São Paulo, Ribeirão Preto, Sorocaba and Jundiaí.

    According to the Pan American Health Organization / World Health Organization (PAHO/WHO) Yellow Fever (YF) in Brazil has a seasonal pattern, based on historical analysis of human cases and epizootics due to yellow fever in the past 20 years, with 2 different periods: higher transmission occurring between December and May (seasonal period) and lower or interrupted transmission occurring between June and November. However in the last 3 years there has been a change in transmission for YF in Brazil. During 2018, viral circulation continued during the period of low transmission (June to November).

    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 and preventing insect bites.

    Cambodia: 15,000 cases of dengue this year

    The Cambodian National Centre (CNM) for Parasitology, Entomology and Malaria Control says that cases of dengue fever have increased this year, including the number of those who died from the virus. The director for CNM Huy Rekol advised that there have been more than 15,000 recorded cases of dengue so far this year, an increase of 36% when compared 2017 ( 11,000 cases). The areas most affected were the capital Phnom Penh and the provinces of Preah Vihear, Siem Reap, Kandal and Kampong Chhnang. Read more

    Democratic Republic of Congo: Ebola outbreak

    The Democratic Republic of the Congo (DRC) has recorded 2 new Ebola cases this week, increasing the outbreak total to 500, including 289 deaths, in what is believed to be the world’s second largest Ebola outbreak. According to the latest weekly update from the World Health Organization's (WHO's) African regional office, among the 500 cases are 3 healthcare workers who have been infected since Dec 1st Since August, when the outbreak began, 49 healthcare workers have been infected, and 15 of those have died. 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.

    Fiji: Typhoid in Naitasiri

    The Fijian Minister for Health, Dr Ifereimi Waqainabete has confirmed that there is an outbreak of typhoid in the Naitasiri subdivision, with 31 confirmed and 14 suspected cases of typhoid. Naitasiri is one of the 14 provinces of Fiji and one of 8 located on Viti Levu, Fiji's largest island. Read more

    Advice for travellers: Typhoid occurs in Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters. 

    Nigeria: YF Outbreak in Edo State continues

    Nine people in Edo state, Nigeria, have died from yellow fever infections in the last month, according to Nigerian health officials. Nigeria has been battling a yellow fever outbreak since Sep 12, 2017. As of Nov 25, 2018, a total of 3,510 suspected cases, including 74 deaths, have been reported in all 36 states. The case-fatality rate is 2.1%. 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.

    Malaysia: 2 new Rabies suspected cases reported in Sarawak

    Sarawak has 2 new suspected cases of rabies, health authorities are waiting on laboratory test results for confirmation. The first case was a 64-year-old man living in Kuching, Sarawak. In mid-September 2018, the patient was bitten on the calf by a puppy that also had bitten his wife on the thumb. The second suspected case was in a 74-year-old man from Kuching, Sarawak. He died on the 7th of December. Since June 30, 2017 to date, the number of confirmed cases of rabies in Sarawak is up to 14 people including 13 deaths and one (1) home-treated case with neurological complications. 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. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is normally 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.

    Philippines: Measles at alarming levels

    According to the Department of Health-Center for Health Development (DOH-CHD) the number of measles cases in Western Visayas has reached alarming levels with 170 cases and 3 suspected deaths. Many parents are refusing to vaccinate their children following the problems encountered with the dengue vaccine. Parents have concluded that the issues will be the same with well-tested vaccines such as measles, mumps, rubella (MMR) vaccine. 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.

    United States of America: Mysterious acute flaccid myelitis

    New data from the US Centers for Disease Control and Prevention (CDC) shows that the number of cases of the polio-like illness, acute flaccid myelitis [AFM] has increased by 24 more cases this week, bringing the outbreak total to 158. The outbreak now surpasses 2016's total of 149 confirmed cases, which was the previous high. The AFM outbreak in 2018 has been quite widespread with cases reported in 36 states (see map of confirmed cases by state as of 7 Dec 2018) About 90% of patients with AFM report mild respiratory illness in the week prior to symptom onset. Read more about AFM.

  • Australia: Free MenB in SA a success

    The South Australian (SA) Government is very pleased with the number of vaccinations being taken up by parents for their children, since it rolled out the free meningococcal B vaccination program on the 1st of October this year. More than 13,500 children have been administered the free vaccine and it is estimated that the program will help prevent more than 12 cases of the deadly disease in SA each year. Read more

    Brazil: Numbers surpass crisis hit Venezuela

    The number of mealses cases worldwide have jumped by 30% last year (2017) compared to 2016, with the Pan American Health Organization (PAHO) reporting on Friday [30 Nov 2018] that the numbers of cases in Brazil have surpassed those in crisis-hit Venezuela. In the Americas there have been more than 16 766 confirmed cases more than half of those have been reported in the past month. Brazil now has nearly 10 000 confirmed cases with 12 deaths; the vast majority of cases have been reported in Amazonas state. Venezuela which is still in the throes of a major economic crisis, leading to widespread shortages of medicine, has had 6300 cases confirmed in 2018 and more than 70 deaths. The World Health Organization (WHO) warns a spike in the number of measles cases globally is putting hard-won progress toward the elimination of this highly contagious, deadly disease at risk. A new WHO report states that multiple outbreaks of this killer disease since 2016 have caused an estimated 110 000 deaths in all regions of the globe, with the highest number of cases in the Americas, the eastern Mediterranean region, and Europe.

    Advice for travellers: Advice for travellers: Measles is a highly contagious virus and can cause serious illness in people of all ages. Most cases reported in Australia are linked to overseas travel - both developing and developed countries. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure. Read more  

    Dominican Republic: Spike in Malaria

    Dominican Republic health official have seen an increase in the number of malaria cases in 2018 compared to 2017, over the same period. According to the General Directorate of Epidemiology (La Dirección General de Epidemiología (DIGEPI)) there has been a 21% increase in malaria cases, with 438 cases reported year to date in 2018 and only 360 for the same period in 2017. Of these cases 92% were Plasmodium falciparum and the remainder were P. vivax or mixed infections, there was one death. Read more

    Advice for travellers: Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.

    Democratic Republic of Congo: First Ebola then Malaria

    Democratic Republic of Congo (DRC) has seen an 8 fold increase in the number of malaria cases in 2018 compared to 2017, in North Kivu province. DRC is the 2nd worst in the World for malaria (after Nigeria) and health officials are seeing around 2000 cases of malaria a week. North Kivu province is also the area where there is currently an Ebola outbreak. People suffering from suspected Ebola are seeking treatment at medical centres, however actually have malaria and are contracting Ebola in the process. This is making it very difficult to control the fast-spreading highly infectious virus. Of the 422 people thought to have been infected with Ebola during the DRC's outbreak, 375 of those have been confirmed. Health workers in the city of Beni, at the centre of the [Ebola] outbreak, have launched a 4-day door-to-door blitz to try and stem the flow of malaria cases. They will be giving out mosquito nets and antimalarial drugs to 450 000 people to stop them going to medical centres where they may catch Ebola. Read more

    Ecuador: New requires proof of YF

    Ecuador now requires proof of yellow fever vaccination for people arriving from countries with a risk of yellow fever, according to the World Health Organisation (WHO) update on the 15 Nov which states "Yellow fever (2018) Country requirement at entry: a yellow fever vaccination certificate is required for travellers aged 1 year”.

    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.  

    India: Zika spreading

    India is in the throes of the largest Zika virus outbreak ever experienced, with the majority of cases reported from the Rajasthan state capital of Jaipur, with experts warning other Indian cities and countries with close connections to the city to prepare for possible imported cases. As of the end of October, there have been 147 cases reported in Jaipur, a popular tourist destination, and the outbreak is spreading to neighbouring Gujarat reporting 1 case and Madhya Pradesh state reporting 3 infections. Of concern is the potential spread of the virus, with a group of a Canadian-led researchers finding that 94% of travellers travelling out of Rajasthan travelled to Indian cities, mostly Mumbai, New Delhi, Bengaluru, and Kolkata. International cities in the top 20 destinations included Bangkok, Muscat, and Singapore.

    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 on smartraveller (DFAT).

    Japan: Syphilis at a 50 year high

    Japan has seen the annual number of syphilis cases at the highest number in 50 years, with 6000 cases diagnosed by November 2018. Health officials are hastening to nip the epidemic in the bud ahead of the 2020 Olympics in Tokyo, however they are not sure what is causing this increase in numbers. According to the National Institute of Infectious Diseases, as of 19 Nov [2018], there have been 6096 cases of the sexually transmitted disease in the country [in 2018], the 1st time that number broke 6000 since 1970. Most of the cases were found in Tokyo, followed by Osaka, Aichi, Kanagawa and Fukuoka. Authorities have tried a variety of methods to stem the tide of syphilis, which was believed to primarily affect the LGBTQ community until a recent set of studies proved the sharpest rise was among men who have sex with women and women who have sex with men.

    Advice for travellers: Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an effective antibiotic. Read more about syphilis and other STIs.

    Mexico: Dire conditions at US-Mexico border

    Amid shifting US border policies there are several thousands of Central American migrants living in filthy overcrowded sports complexes near the US-Mexico border. There have been a number of respiratory illnesses, lice and varicella plaguing the complex in Tijuana Mexico. Many of the individuals are living in tents made of rubbish bags or on patches of cold floor walled off with backpacks. Infectious disease agents such as varicella transmit rapidly under these conditions.

    Advice for travellers: Chickenpox 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.

    Papua New Guinea: Polio response to cVDPV1

    There have been no new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) reported from Papua New Guinea (PNG) this week. So far in 2018 there have been a total of 25 cases of cVDPV1 reported. Health Authorities have established Emergency Operation Centres at a national level and in all affected provinces; environmental surveillance is functional in five sites in two major cities. Furthermore, three Supplementary Immunization Activities (SIAs) have been in place since July and have expanded from three provinces to nine, to nation-wide. The most recent was aimed at children under the age of 15, due to large numbers of poorly-immunized older children. Planning is underway for the next steps of the outbreak response, focusing on both vaccination and surveillance for polioviruses.

    Advice for travellers: Australian residents planning to visit PNG for less than 4 weeks should be up to date with their polio vaccination. For adults, this is a 3 dose primary course, with a booster within the last 10 years. For children, a 3 dose primary course with a booster at 4 years old is currently recommended. These recommended vaccines may be given before arrival in PNG. Australian residents travelling to PNG intending to stay for longer than 4 weeks should have a documented polio booster within 4 weeks to 12 months prior to the date of departure from PNG. The booster may be given before arrival in PNG, as long as it is given within 4 weeks to 12 months prior to leaving PNG. Individuals who are already residing in PNG for 4 weeks or longer should have a documented polio booster within 4 weeks to 12 months prior to departure from PNG (refer to WHO’s International Travel and Health website). The booster may have been given before arrival in PNG, as long as it has been given within 4 weeks to 12 months prior to leaving PNG. Individuals leaving PNG in less than 4 weeks should still receive a polio booster as this will still have benefit. Read more

    Madagascar: Measles outbreak CDC warning

    The Centres for Disease Control and Prevention (CDC) has issued a Watch - Level 1 Travel alert on th, Practice Usual Precautions warning for Madagascar on the 30th of November, as the countries measles outbreak reaches 3239 cases. This CDC travel alert means visitors to Madagascar should ensure they are vaccinated against measles with the MMR (measles, mumps, and rubella) vaccine. This measles outbreak started in the capital city, Antananarivo, on October 4, 2018, when 3 measles cases were confirmed at the Pasteur Institute of Madagascar.   As of November 18th, a total of 3,239 measles cases have been reported, of which 182 were confirmed immunoglobulin M positive, and 3,057 were epidemiologically linked.

    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. 

    South Sudan: Declared YF outbreak

    The Sudan Ministry of Health has declared a yellow fever outbreak in Sakure, Nzara County, Gbudue state (formerly Western Equatoria state) on the 29th of November. The 1st suspected case was reported on Nov 23rd, after the State Ministry of Health (SMoH) received a report of a suspected case of Ebola at the point of entry in Sakure (a border town between the DRC and South Sudan). With the help of the World Health Organisation (WHO) a rapid response team, comprising of SMoH director-general, a medical officer, laboratory staff, a nurse and other partners from the Ebola Taskforce were deployed. However, testing at the National Public Health Laboratory proved the sample collected was negative for Ebola Zaire, instead a YF-specific PCR assay confirmed that the sample was PCR-positive for yellow fever virus. Automatically triggering the activation of the YF incident management system.

  • Australia: Pertussis alerts in 2 states

    A rise in the notifications for pertussis (whooping cough) in NSW and Tasmania has health authorities in the two states advising vaccination of new parents and pregnant women to ensure newborns are protected against the infection. Read more on whooping cough.

    Brazil: Rio’s chikungunya surge; Regional dengue update

    A local news source is reporting that the year-to-date count of chikungunya infections for Rio de Janeiro state has tipped 36,000 (to Nov 13), with a further 13,886 dengue fever cases and 2,223 Zika virus infections. Awareness campaigns have been rolled out for the peak summer season. Read more
    THE Pan American Health Organization (PAHO) regional summary of dengue fever notes that Brazil is one of 13 countries reporting a year-on-year rise in cases, the others being Antigua and Barbuda, Argentina, Chile, Colombia, El Salvador, Guatemala, Guyana, Honduras, Jamaica, Mexico, Paraguay and Venezuela. 2018 data up to early November for the region: more than 446,000 cases and 240 related deaths. Read the PAHO report here.

    Advice for travellers: Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

    Chile: Raw fish meal with tapeworm larvae

    Several residents of the Los Lagos town of Puerto Octay have been diagnosed with diphyllobothriasis, a tapeworm infection contracted by consuming larvae residing in raw (mostly) freshwater fish. In this case, it appears most of those infected had eaten ceviche – a dish of raw fish cured with citrus juice. Read more. More on diphyllobothriasis from the US CDC. 

    Democratic Republic of Congo: Ebola cases rise to 421, Uganda vaccinates HCWs in west

    As reported in the Nov 22nd WHO Disease Outbreak News update, ‘The risk of the outbreak spreading to other provinces in the Democratic Republic of the Congo, as well as to neighbouring countries, remains very high’. As a precautionary measure, the Ugandan government is vaccinating healthcare workers against Ebola virus in the four western districts of Kasese, Ntoroko, Bundibugyo and Kabarole. Read more. The latest Ministry of Health data for the outbreak 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.

    France: More local dengue fever cases announced

    Earlier this month a further two cases of locally acquired dengue fever were identified in Clapiers, near Montpellier. This takes the yearly total to seven, after five earlier cases were found in Saint Laurent du Var (Provence-Alpes-Côte d'Azur). According to Santé Publique France, the ‘two episodes of autochthonous transmission were not epidemiologically linked and the viruses were of different serotypes’. Read more

    Honduras: Dengue strikes in north

    The northern city of San Pedro Sula is experiencing a sharp rise in dengue fever cases with more than 1,130 cases and three deaths recorded in the city and nearby towns including Villanueva. The upcoming holiday season is likely to exacerbate the outbreak according to the region’s health minister. 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 and preventing insect bites.

    India: Zika update for 2 states; Dengue delayed in Delhi

    A local news report (since clarified) puts the confirmed Zika virus disease case count in Rajasthan at 154 and 127 in Madhya Pradesh, while local authorities are concentrating on mosquito control measures to ensure a re-emergence of Zika virus does not occur during the next peak season. 
    NEW Delhi’s dengue season could be prolonged with some reports that cases could continue to emerge until the middle of next month. More than 800 cases have been recorded in the city this month. 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 on smartraveller (DFAT). 

    Nepal: Mosquitoes + infections spread

    Warmer and wetter weather conditions more conducive to mosquitoes have spurred on the dengue outbreak in Pokhara, with over 150 cases now reported. Other mosquito-borne illnesses such as malaria and Japanese encephalitis are likely to rise in incidence as a result of the favourable conditions. Read more

    Advice for travellers: A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. 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 urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Netherlands: Serious infections in travellers returning from Africa

    ProMED reports on infections diagnosed in two separate Dutch travellers following holidays in Africa: one, an unvaccinated man in his 20s who was diagnosed with yellow fever after spending two weeks in the Gambia (Mansa Konko) and three days in Senegal (Niokolo Park game reserve); the second, a woman who had undertaken an eight day safari visiting several parks in the north of Malawi and contracted human African trypanosomiasis (sleeping sickness).

    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 – an effective vaccine is available and strict insect bite avoidance measures are recommended. 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

    Nigeria: YF alert for Edo state; Lassa fever in 2018: 22 states

    The Nigerian Centre for Disease Control (NCDC) is reporting nine confirmed cases of yellow fever in the southern state of Edo - official confirmation from the WHO is pending. According to the NCDC, ‘There are ongoing plans to begin a reactive vaccination campaign in the affected Local Government area in response to the cluster of cases’. Read more. The recent cases are part of a near-15 month outbreak of YF which has so far caused 1,640 cases in the states of FCT, Kogi, Anambra, Nasarawa, Zamfara, Edo and Benue. Read more
    LASSA fever cases continue to emerge; three states (of the 22 recording cases this year) have had the highest rates of infections - Edo, Ondo and Ebonyi. 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.

    Papua New Guinea: 25th polio case recorded

    An update from the Global Polio Eradication Initiative (GPEI): as of Nov 20 a further three cases of circulating vaccine-derived poliovirus (cVDPV) were reported from the provinces of Enga (2 cases) and East Sepik (1), with the latest date of onset of paralysis on Sept 30. There have now been 25 confirmed cases of cVDPV in PNG. The US CDC has issued a travel notice - Alert Level 2, Practice Enhanced Precautions - this week relating to VDPV cases in Niger’s southern region of Zinder (genetically linked to cases in northern Nigeria’s Jigawa and Katsina states). 

    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 and vaccine-derived polio.

    Philippines: Western province’s malaria spike

    Following a dip in reported malaria cases from 2015 to 2017, the western province of Palawan has seen an uptick this year which has affected the southern mountainous areas (Rizal, Bataraza, Balabac, Quezon and Brooke's Point). Despite this, public health officials believe the planned elimination of malaria from the region by 2023 will be achieved. Read more

    Advice for travellers: Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria

    Poland: Measles cases crop up in capital region

    Poland is later than most European countries in reporting a rise in measles cases, but since early October, 79 infections have been reported in the province of Mazovia which includes the capital Warsaw. Read more. Meanwhile, Italy’s response to its ongoing measles outbreak is to instigate a massive vaccination campaign targeting 800,000 children and people who work in healthcare. Measles surveillance data to Sept 30, as provided by the ECDC, show Italy had recorded nearly 2,600 measles cases. Read more. In other news on measles, an update of the outbreak in Israel can be found here.

    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.

    Senegal: Dengue outbreak tops 2,500 cases

    The dengue outbreak continues with 19 health districts now reporting confirmed cases and three dengue serotypes in circulation. Three districts have been hardest hit - Touba, Fatick and Richard Toll – as the number of suspected cases rose to 2,567 on November 19. Read more

    South Africa: Testing for salmonella source

    Investigations are underway into whether related sources of contamination are responsible for a spike in Salmonella cases over the past few weeks in eThekwini Metropolitan Municipality (includes the city of Durban), KwaZulu-Natal province. Read more

    Advice for travellers: Salmonella is bacteria typically found is food, such as poultry, that causes diarrhoea, fever, and abdominal cramps between 12 and 72 hours after infection. Illness usually lasts 4 to 7 days, and most people recover without treatment, although diarrhoea may be so severe as to require hospital treatment. Young children and the elderly are at highest risk of severe illness. As there is no vaccine to prevent salmonellosis, it is best to avoid raw or undercooked eggs, poultry, or meat. Read more.

    Taiwan: Indigenous dengue count now 176

    More than 175 locally acquired dengue fever cases have been reported this year, with highest numbers in Taichung (107 cases), followed by New Taipei (43), Kaohsiung (12), Changhua County (8) and Taipei and Chiayi County (2). Notifications of new cases peaked in late August and have been declining since. Read more

    Vietnam: Da Nang’s dengue hike

    One hospital in the popular coastal city of Da Nang has been unable to cope with the rising numbers of dengue fever patients seeking treatment – more than 1,100 since the beginning of October. According to a local news article (computer translated), it has been necessary ‘to arrange additional beds in the corridors of the hospital in order to resolve the overload of patients’. 

    Zimbabwe: Cholera and typhoid cases continue

    While new cholera cases persist in the capital Harare, numbers are reducing (as is also the case with the concurrent outbreak of typhoid). In the most recent reporting week, a further 82 cases took the total for the outbreak that began just under three months ago to 10,141 with 55 deaths. Read the UNICEF report with details of cholera outbreaks in Eastern and Southern Africa. 

    Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination against typhoid fever 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.