Shifting disease patterns and outbreaks affect the recommendations and information we provide to travellers during a pre-travel consultation. Each week Travelvax updates the current travel health alerts to reflect those issues which could affect travellers heading to a particular region or country. We do this by scanning the websites of health agencies such as the World Health Organization and the European and US Centers for Disease Control, as well as international news media. Simply click on the point on the map of your area of interest for more details on the current health alert. We also include Advice for Travellers which gives background information and tips. If you have any further questions, of course you can give our Travelvax infoline a call during business hours on 1300 360 164.
World travel health alerts for 16th of February 2022
Measles deaths rising; New wild polio case
Expanded reporting on measles from the WHO, with infections surging since July last year and peaking in late January - over a two week period last month, cases rose by 18 percent and deaths were up 40 percent. Highest case counts have been in Balkh, Ghazni, Helmand, Kandahar, Kabul, Paktika and Paktya provinces. More than 35,000 suspected cases were recorded from Jan 1, 2021 until Jan 29 this year. While more deaths can be expected over the coming weeks, measles vaccination campaigns are underway in many of the affected provinces. The WHO believes the risk of measles spreading further remains very high within Afghanistan and is moderate on a regional level ‘due to the movement of people to Tajikistan, Iran and Pakistan’. Read more
FOUR CASES of wild poliovirus 1 were reported by Afghanistan last year, and the eastern province of Paktika is the location of the first in 2022, according to the GPEI. All other polio notifications in the weekly update relate to cVDPV2 infections with date of onset in 2021: five cases in Niger (regions of Maradi, Tillaberi, Zinder and Agadez) and two each in the D R of Congo (Maniema province) and Nigeria (Gombe and Plateau 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.
Rabies risk persists in NE province
Rabies continues to circulate in Newfoundland and Labrador’s wildlife after several infections were confirmed, and others suspected, in artic foxes in the north coast area around Nain. At the same time, there have also been a number of reports of some foxes ‘behaving unusually’, leading officials to warn residents of the potential risk presented by these animals and to encourage vaccination of pets. 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.
Outbreak source investigated
An outbreak of Salmonella linked to contaminated eggs was first confirmed in France in September last year and cases continue to emerge. The total number of infections climbed to 272 (and two deaths) by early January and another four countries have reported cases (Denmark, Norway, Spain, the Netherlands and the UK). The source of the outbreak has not been identified, according to an ECDC assessment, but ‘a wide distribution of the outbreak strain that could affect the food supply chain and/or earlier steps in the production chain’ is suggested and the strain ‘could also be circulating at other farms, inside or outside Spain’ (there was a historical link to an earlier outbreak originating in a Spanish farm). The risk of new infections within the region is said to be high.
Advice for travellers
Salmonella is a bacterium typically found in 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
Leptospirosis deaths reported
Health authorities have reported 74 confirmed leptospirosis infections this year and there are many more probable cases resulting from flooding after the recent passage of a cyclone. Eleven deaths have been registered to date, including a six year old child. The Western Division is now seeing rising hospitalisation and ICU rates which are attributed to delayed presentation for appropriate treatment of leptospirosis. Read more
Advice for travellers
Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.
Alert over haemorrhagic fever reports
The health minister has warned residents to be on the alert and maintain vigilance against Crimean-Congo haemorrhagic fever (CCHF) after two cases were confirmed earlier this month - both from the same pastoral region in the country’s interior. In related news, a study published this month in the February 2022 Emerging Infectious Diseases indicated the widespread distribution of the CCHF virus in ticks collected in 5 regions of central and SW Spain. 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.
High Lassa fever rates
A WHO Disease Outbreak News post published this week reports Nigeria’s Lassa fever cases in 2022 are ‘much higher than the previous epidemic seasons’ - more than 80 percent of infections have been in the states of Ondo, Edo and Bauchi. While Lassa fever is endemic, cases peak during the dry season that runs from December through to April, so the current surge in infections is likely to continue over the coming weeks. The majority of infections in Nigeria are contracted through contact with infected rodents or ‘indirect exposure (through food or household items contaminated by infected rats’ excreta)’.
Advice for travellers
Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings and it’s then passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. While Lassa fever is mild or has no observable symptoms in about 80% of people infected with the virus, the remaining 20% have a severe multisystem disease. Read more about Lassa fever.
Treatment medications in short supply
One news source is reporting that a shortage in medications used to treat malaria is concerning doctors in the districts of North Fly and Middle Fly in the Western Province as they care for an increasing numbers of malaria patients. 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.
COVID-19 update
The Feb 15 WHO weekly epi update reports relatively stable numbers of COVID-19 deaths across the globe, while there was a near-20 percent decline in new cases (but a 19 percent increase in the Western Pacific region and on a country level, Russia’s cases were up by 23 percent). More than 400 million COVID-19 infections have been recorded since the beginning of the pandemic – it took 155 days to rise from 200 to 300 million cases, but only 34 days to go from 300 to 400 million, according to the Feb 10 Johns Hopkins newsletter.
The WHO update also contains a focus on the BA.2 lineage of Omicron, noting its prevalence ‘appears to be increasing both in countries experiencing a decline in Omicron cases and in countries that are in the growing phase of the wave’. Evidence from limited studies suggest ‘BA.2 is 30% more transmissible than BA.1’ and has a higher secondary attack rate.
Related articles of interest:
- ‘Take a look at SARS-CoV-2's family tree. It's full of surprises’ in the NPR’s blog, Goats and Soda.
- Results from initial trials on vaccines developed for the Omicron variant summarised in the science journal, Nature.
- On the development, testing, manufacturing, and global distribution of COVID-19 vaccines: ‘Why Covid-19 vaccines are a freaking miracle’: STAT News
- Research continues into higher rates of aftereffects following COVID-19 infection suffered by adults aged over 65 years. Read more
Measles on Red Sea coast
A reactive measles vaccination campaign underway this month in the Port of Sudan is aimed at protecting children aged from six months to 10 years who are at risk from an outbreak recently declared in Red Sea State. To date, one fatal case has been reported from the more than 370 local infections. 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.
Zoonotic infection surges in 2021
Human Streptococcus suis infections are reported to have spiked in 2021, up by more than 65 percent over the previous year according to official records. While people can acquire the potentially fatal zoonotic infection from diseased pigs through working in meat processing or farming, it can also occur through the consumption of raw pork and pig’s blood. ProMED states that human infection can result in meningitis, sepsis or endocarditis, and ‘toxic shock has been reported if the pathogen produces the appropriate toxins’. Read more
Imported Lassa fever cases in family cluster
Three Lassa fever cases, comprising a family cluster of returning travellers from West Africa, have been confirmed in the past week in the east of England – one has since died at a hospital in Bedfordshire, another remains in hospital and the third has recovered. The risk of further spread to the public is considered to be low, however people designated as contacts are being monitored by health authorities. Read more
Advice for travellers
Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings and it’s then passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. While Lassa fever is mild or has no observable symptoms in about 80% of people infected with the virus, the remaining 20% have a severe multisystem disease. Read more about Lassa fever.