Travel Health Alerts

Summer flu surges; Northern flu vaccine composition

After experiencing low levels of flu activity for most of the pandemic, there has been a summer surge in influenza cases arising from the city of Buenos Aires and the provinces of Buenos Aires, Salta, Santa Fe and Tucuman. The predominant influenza virus strain behind the spike in infections is A(H3N2), and it is also responsible for an increase in cases within the region (Brazil, Peru, Colombia and Chile). In other news on influenza, the WHO has released its vaccine composition recommendations for the 2022-2023 northern hemisphere season and they are nearly identical to those being used for the south’s peak flu period over the 2022 winter and spring. 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.

JEV-infected pigs detected; Gastro uptick in childcare centres

Mosquito-borne diseases have spiked in a number of states as La Niňa’s soaking wet weather provided optimum conditions for the insects’ breeding. Both NSW and Victorian health departments have advised that a number of farmed pigs in southern and western NSW and just over the border near Echuca in Victoria have been infected with the Japanese encephalitis virus (JEV), so the virus is likely to be circulating in local mosquitoes. The Victorian health advisory also mentions JEV in pigs in Goondiwindi, in southern Qld. In South Australia, the cause of seven acute encephalitis cases (one fatal and four in hospital) is still to be determined, however several had visited the Murray River area prior to illness onset. The SA health department this week published a health warning ‘Be Alert for Flaviviruses’ due to the risk of JEV, Murray Valley encephalitis (MVE) and Kunjin virus (KUN); and all three health agencies stress that protecting against mosquito bites is best way to prevent infection. A Mar 1 article in The Conversation explains ‘Japanese encephalitis virus has been detected in Australian pigs. Can mozzies now spread it to humans?’. Read more

WITH NUMEROUS childcare centres in Victoria and NSW reporting surges in viral gastroenteritis cases, alerts have been issued by the respective health departments for parents and carers to keep sick children at home and ensure regular hand washing with soap and water, maintain basic hygiene measures and thoroughly clean and sanitise contaminated surfaces.

Advice for travellers

Extremely contagious, norovirus infection is typically intense but generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands thoroughly with soap and water after using the toilet and before eating, and practice good hygiene. Read more on norovirus.

Monkeypox cases reported in 3 regions

The number of suspected and confirmed monkeypox infections has continued to rise since the first case was detected in Centre Region in December 2021, and now North-West and South-West regions are also affected. According to the WHO regional weekly bulletin, ‘more than half of the regions in the country reported at least one case of monkeypox’ over the past two years, with the majority in the North-West and South-West regions. Read more

Advice for travellers

Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox.

Another bird flu death, more cases

Four more human H5N6 avian influenza cases have been reported from four separate provinces (Fujian, Sichuan, Guangxi and Jiangsu); all were known to have visited a live bird market or had contact with poultry. According to Hong Kong’s Centre for Health Protection (CHP), of these cases with date of illness onset in late January, one was fatal and the remaining are said to be in a critical condition in hospital (youngest is six years old). More avian influenza reports from the CHP. Read more

Advice for travellers

There are several strains of bird flu and while the high pathogenic strains can be fatal, infection generally poses a low risk for travellers – even for those heading to a region where the disease is present or an outbreak is occurring. Travellers should avoid contact with birds or poultry in marketplaces, wash hands thoroughly before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.

Malaria risk spreads in north

Health authorities have warned that malaria continues to pose a risk in Zona Norte and there has been further spread from the three earlier reported localities to Santa Cecilia and San Francisco. While just across the border in Nicaragua, an incremental rise in malaria cases was reported in the first week of February. 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.

Measles hotspots emerge

Response measures to measles outbreaks in several health zones of Kasaï-Oriental province were already underway when a separate measles event was declared in the neighbouring province of Lomani. A number of rubella infections were also identified, mostly in the over 14 years’ age group. The WHO weekly bulletin notes that many of the confirmed measles cases in recent outbreaks (from 93 health districts across 23 affected provinces, including the capital of Kinshasa) were ‘either zero dose or unknown vaccination status’. More than 55,000 measles cases and 825 deaths were recorded last year in the DRC. 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.

Polio update – 4 countries report cases

The GPEI update this week reported circulating vaccine-derived poliovirus types 1 and 2 (cVDPV1/2) cases in addition to its notification of the WPV1 infection in Lilongwe, Malawi (posted in last week’s alerts). Of the cVDPV2 cases, two were logged in the D R of Congo (Maniema province – one from 2021 and the other with date of onset this year), and three cases each from Nigeria (Borno and Kano states dating from 2022) and Yemen (governates of Abyan, Ad Dali and Al Hudaydah which add to the 2021 total). The two cVDPV1 patients reported in Madagascar were from the regions of Diana and Sofia (one in 2021 and the other this year), while cVDPV1 positive environmental samples were obtained from three sites in Analamanga, the central region comprising the capital Antananarivo and surrounding areas. 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.

COVID-19 update

Again this week the WHO epi update advised that the Western Pacific region had recorded an increase in new COVID-19 cases and deaths (up 32 and 22 percent respectively), while all other regions saw declining case numbers, and only the Eastern Mediterranean region reported a rise in new deaths (up four percent). On a country level, Germany and South Korea registered more than one million new cases but the increase was steepest in the latter, up 69 percent. 

In related news:

- Findings from a National Centre for Immunisation Research and Surveillance (NCIRS) study reinforce public health measures needed to limit the spread of the Omicron variant.

- Background on long covid from New Scientist and what is on the horizon for treatment options. 

- Contraception needed when taking COVID-19 antiviral medication Read more

- An article in The Conversation explains why Australia might experience a ‘bounce back’ in respiratory infections like the flu and whooping cough this year.

Rift Valley fever threat

A Food and Agriculture Organisation report has warned that wet weather, changes in vegetation and animal movements have raised the risk of Rift Valley fever outbreaks in animals and humans over the next couple of month, potentially affecting numerous areas of southern Africa. The report names South Africa, Botswana, Eswatini, Lesotho, southern Zimbabwe, southern Mozambique, NE Namibia, SE and western Angola (also localised hotspots in Madagascar, Malawi and Zambia) and calls for contingency plans to be implemented. This alert follows a Feb 15 FAO report relating to RVF for 11 countries in eastern Africa. Read more

Advice for travellers

Rift Valley fever (RVF) is an acute viral disease that typically infects domesticated herd animals. It is generally found in eastern and southern Africa where sheep and cattle are raised, as well as in West Africa, Madagascar, and more recently Saudi Arabia and Yemen. People are infected after exposure to blood, body fluids, or the tissue of RVF-infected animals, or from the bite of an infected mosquito. The virus presents a low risk to travellers, but is another reason to use personal insect repellent and take other steps to minimise insect bites in places where it occurs. Read more about RVF.