Travel Health Alerts

Measles outbreaks in several African nations

More than 355 measles infections have been diagnosed among children living in the town of Birni-N'Konni, adjacent to the Nigerian border in Niger’s SW region of Tahoua. Local media report that the number of cases is rising in the town and in nearby villages. In other news on measles, outbreaks have been declared in Chad (N’Djamena and Bongor), Togo (Yoto Prefecture), South Sudan (Torit, Maban and Tambura Counties), Guinea (Labé) and Congo. Read more. Elsewhere, the trend of new measles cases in Afghanistan is sharply increasing, with most of the infections among young children in the provinces of Helmand, Kandahar, Balkh, Paktika, Ghor and Ghazni. 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.

COVID-19 update

The Western Pacific region has once again reported an increase in new weekly COVID-19 cases and deaths (up 21 percent and five percent respectively), while for all other regions both figures were stable or decreasing. The Mar 22 WHO epi update signalled 10 countries in the Western Pacific where new cases increased by 20 percent or more: Laos (up 319 percent), Australia (up 161 percent), American Samoa (up 152 percent), Vanuatu (up 141 percent) and Fiji (up 135 percent). As noted in the update, all data published ‘should be interpreted with caution as several countries are progressively changing their testing strategies, resulting in lower overall numbers of tests performed and consequently numbers of cases detected’. 

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JE claims 3 lives; WA’s mosquito-borne risk

The federal health department’s Japanese encephalitis (JEV) update for March 21 puts the number of cases at 20 overall, including three deaths. The breakdown of cases is eight in NSW, seven in Victoria, three in South Australia and two in Queensland, while one death has been recorded in NSW, Vic and in QLD. JEV vaccines are being prioritised for people at high risk of infection and the government is sourcing more supplies from overseas to add to those already on hand in Australia. No JEV vaccinations are planned for animals as yet (none are currently registered in Australia), however formulations for both horses and pigs are in use in some SE Asian JEV endemic areas. 

ANOTHER mosquito-borne infection in Western Australia’s Kimberley region has prompted an alert from the state health department, after surveillance detected Kunjin virus activity in sentinel chickens. With no preventive vaccine or treatments, mosquito bite avoidance measures are paramount. The department’s Managing Scientist is quoted on their website saying that most Kunjin virus infections are asymptomatic, but “In rare cases, the disease can lead to nausea, drowsiness, headache, dizziness, neck stiffness, confusion and seizures. People experiencing these symptoms should seek medical advice urgently.” Read more

Advice for travellers

Japanese encephalitis (JE) is the most important cause of viral encephalitis in Asia. It usually occurs in rural or agricultural areas, often associated with rice growing and pig farming. JE virus is transmitted to humans through the bite of infected Culex mosquitoes. Most JE virus infections are mild (fever and headache) or symptomless, but around 1 in 250 infections results in severe and potentially fatal disease characterised by rapid onset of high fever, headache, neck stiffness, disorientation, coma, seizures, spastic paralysis and death. The risk to short-stay travellers and those who confine their travel to urban centres and use insect bite avoidance measures is low. Expatriates, repeat travellers and travellers living for prolonged periods in agricultural areas where Japanese encephalitis is endemic or where seasonal epidemics occur should consult their travel health provider about recommendations for vaccination. Read more.

Cholera lingers in 3 regions

Reactive vaccination campaigns have controlled cholera outbreaks in all but three of the regions affected since October last year. More than 2,000 cholera infections and 62 deaths have been recorded from five regions, and only South-West, Littoral and Centre continue to see new infections. 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.

Whooping cough deaths in ethnic community

The cause of death for 21 Kogui indigenous children since December, and the current hospitalisation of 17 more, has now been established – pertussis infection. The children are from a remote community, the Taminaka reservation, on the northern slopes of the Sierra Nevada de Santa Marta range and they were all unvaccinated. Read more

Advice for travellers

Travelvax recommends Australians travelling overseas check their immunisation status for childhood diseases such as whooping cough (pertussis), diphtheria, measles and mumps at least 6 weeks before departure. Read more about whooping cough.

Polio update, global digest

Test results are pending on five unvaccinated children to confirm positive stool samples containing circulating vaccine-derived poliovirus type 3 (cVDPV3), and there have been ‘preliminary findings in sewage sampling of the virus in Beit Shemesh, Modi'in Illit, and Tiberias’ (located between 35 and 115kms to the north, NW and west of Jerusalem). Read more. In other news from the GPEI weekly update, cVDPV2 cases were reported in the D R of Congo (three cases in Maniema Province, two with date of illness onset in 2022) and Nigeria (one case in Katsina adding to this year’s total – now three). And bivalent polio vaccination campaigns are now underway in four African countries, targeting 23 million children aged under five years. Initially planned for Malawi, Zambia, Mozambique and Tanzania, Zimbabwe will commence their immunisation program in May. 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.

Disease risks in major divisions

A further update on cases of typhoid fever, leptospirosis and dengue fever this year, with the most recent report on typhoid indicating a total of 67 infections confirmed, resulting in five deaths. The Western Division is seeing above average case numbers and there ‘are localised outbreaks in communities in Ra, Lautoka, and Nadi’. On leptospirosis, 240 cases were reported over the past week, over half of which were from the Central and Western Divisions, while dengue outbreaks are underway in the Western Division (Nadi, Tavua, Ba) and the Eastern Division (Levuka). Fiji’s health facilities are also dealing with a rise in influenza infections which could signal a return to pre-pandemic levels. Meanwhile, in New Caledonia and the Loyalty Islands, influenza A is responsible for an outbreak on Lifou and the virus is reported to be circulating in the capital, Noumea. Read more

Advice for travellers

Typhoid occurs in some 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. Read more about typhoid.

CCHF outbreak ‘seems under control’

The Crimean-Congo haemorrhagic fever (CCHF) outbreak that was first announced in early February continues and cases have now been identified from three regions (Hodh El Gharbi, Trarza and South-Nouakchott Waliyas) and six districts. The weekly WHO regional bulletin advised that while there was ‘no clear history of contact between the confirmed cases’ and the sources of infection had not been confirmed, the outbreak appeared to be under control. 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 majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about the virus.

Haemorrhagic fever toll climbs to 112

Lassa fever has claimed at least 20 lives from 160 cases in the southern state of Edo and, according to the NCDC, a total of 22 states have reported at least one confirmed case this year. Ondo is most affected with 70 percent of cases, followed by Edo and Bauchi. Read more 

Advice for travellers

Lassa fever is an acute viral illness that occurs in sub-Saharan West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5,000 deaths occur each year. However, Lassa is a remote risk for most 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. For 80% of people infected, Lassa fever is mild or has no observable symptoms. The remaining 20% can experience severe, often fatal, multisystem disease. Read more about Lassa fever.

Hantavirus cases increase

Health authorities have issued a warning after registering an early increase in hantavirus cases this year as well as a wider pattern of distribution across Los Santos province. Last year’s confirmed cases were located in Tonosi district, however in 2022 infections have been logged ‘in Las Palmitas in the Las Tablas district, El Guayabal and Los Olivos in Los Santos district, and in Tonosí and Macaracas districts’. 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.

Dengue co-infections reported

Health authorities have alerted the public to surging dengue fever cases and related deaths, forewarning the possibility of a severe season for the virus. News sources are reporting instances where people have been co-infected with, or mistake dengue for, COVID-19 and treated the symptoms with medications (aspirin, NSAIDs) that led to fatal bleeding disorders. 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.