Travel Health Alerts

Influenza activity increasing in temperate Northern Hemisphere

In its January 14 flu report, the ECDC has advised ‘widespread influenza activity and/or medium influenza intensity’ in Albania, Belarus, Georgia, Israel, Moldova, Norway, North Macedonia, Russia and Sweden - testing found an overall predominance of A(H3) viruses. While the WHO global update for mid-December notes that ‘H3N2 influenza is still the dominant strain in most parts of the world, except for China, where activity is rising with influenza B as the most common strain’. Read more. In other news on flu, an epidemic of A(H3N2) influenza is underway in French Polynesia after the event was declared by health authorities in week 51, 2021.

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.

COVID-19 update

For the week to Jan 16, the WHO announced a 20 percent rise in global new COVID-19 cases in its latest update, and only the African region reported a drop in the incidence of weekly cases. The top five countries with the highest numbers of new cases were the USA, France, India, Italy and the UK. At a regional level, SE Asia recorded the greatest increase in new cases (up 146 percent), with the highest proportional rises in Nepal, Bangladesh and the Maldives.

According to Our World in Data estimates, almost 60 percent of the global population has received at least one dose of a COVID-19 vaccine, however that applies to fewer than 10 percent of people living in low income countries.

In related news:

 - Plans for some African countries to produce COVID-19 vaccines Read more

- Why Covid-19 will never become endemic: The Saturday Paper

- Kirby Institute: What causes long COVID symptoms? Clues from under the microscope

- TGA recognises the Gamaleya Institute vaccine (Sputnik V, Russian Federation) for international travel to Australia

- The Conversation this week published an article ‘Time to upgrade from cloth and surgical masks to respirators? Your questions answered’

- The COVAX facility has now delivered its one billionth vaccine dose Read more

Vector control paramount

Measures to control Aedes aegypti mosquito populations are being ramped up for the ongoing rainy season in Amazonas state after Ministry of Health data confirmed a sharp increase in dengue fever infections last year. Around 20 percent of cases were in the state capital of Manaus. chikungunya and Zika virus cases also rose in 2021. 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.

SW region suffers Hep E outbreak

This week the WHO issued an update on an outbreak of hepatitis E affecting Lai district in the SW region of Tandjile since October last year. Only 12 of the nearly 400 suspected cases have been confirmed and two deaths have been registered. Heavy rainfall since mid-year had exacerbated ongoing problems with access to clean water that led to this outbreak, the first in four years. Read more

Advice for travellers

The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Infection during the latter stages of pregnancy carries a higher rate of severe disease and mortality. Unlike the Hep A and B viruses, there is no vaccine for this strain in Australia, which is especially common in communities with lower levels of sanitation and hygiene. Read more about the virus and how to prevent it.

More H5N6 bird flu cases reported in December

Five more human avian influenza cases caused by the H5N6 virus were reported in December 2021– two in both Sichuan province (fatalities) and Guangxi autonomous region and a single case in Zhejiang province – and they take the 2021 total to 36. All but one had confirmed exposure to live domestic poultry. Hong Kong’s Centre for Health Protection (CHP) is monitoring the situation – more in the Jan 18 Avian Influenza Report which also includes details of four recent H9N2 infections involving children (in the provinces of Hubei, Jiangsu and Guangxi). These ongoing alerts are a reminder to anyone travelling to China for the upcoming Lunar New Year celebrations to avoid contact with live or dead poultry, in particular in wet markets, and to ensure strict hand hygiene measures are maintained. 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.

Polio update, 2 countries report cases

Carrying over from 2021, four more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported by Yemen in the latest GPEI update, as well as three cVDPV1 infections. Elsewhere, the Democratic Republic of the Congo’s cVDPV2 2021 total rose to 19 with two more cases logged in Maniema province. Later this month, the Executive Board of the WHO will meet to discuss polio eradication and transition/post-certification planning. 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.

Cutaneous leishmaniasis uptick near capital

Health authorities have warned that cases of cutaneous leishmaniasis are on the rise in Varamin, a county located close to Tehran. At least 48 cases have been reported and all are receiving treatment. Separate cutaneous leishmaniasis reports have surfaced from Libya (Bani Walid) and in NE Syria.  Read more

Advice for travellers

Leishmaniasis is generally a low risk for travellers. The parasitic disease is found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention.

‘Cave fever’ in Haifa district

Tick-borne relapsing fever has been confirmed in two residents of Umm al-Fahm in Haifa district after they spent some time in a cave in Sharaya area. Both have since recovered following a 5-day hospital stay. Supplementary information posted on ProMED noted that the local tick vector ‘is widely distributed in the northern highlands, coastal plain and Negev desert’ in Israel and the ticks are often found ‘in the floors and crevices of caves’. Fever is the initial symptom of the infection, followed by others that can include a rash, cough, shortness of breath, nausea, and muscle and joint pain. Read more

2021’s cholera toll; Lassa fever takes off in the New Year

Last year, cholera deaths exceeded those caused by COVID-19 since early 2020, with more than 3,600 recorded from over 111,000 suspected cases, the highest count in several years. Northern states including Bauchi, Jigawa, Kano and Zamfara were particularly hard hit, logging over half of all cholera infections. Read more

A YEAR-on-year increase in Lassa fever infections over one 7-day period this month saw more than 220 suspected cases and two deaths recorded across 10 states, and this followed a late spike in cases in December 2021. While 17 states recorded Lassa fever cases last year, 83 percent of all infections were from Edo, Ondo and Bauchi. 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.

Rare STI case prompts warning

Late last year the UKHSA advised that a case of antibiotic-resistant gonorrhoea had been confirmed in a resident of London – the heterosexual man, aged in his 20s, is said to have acquired the infection in the UK in November last year. According to the agency, ‘Ceftriaxone resistance is common in the Asia-Pacific region but is rarely found in the UK’; consistent and correct usage of condoms is strongly advised. Read more

Attention to anthrax risk

As the country approaches the annual anthrax peak month (February), there are reports of infections in animals with possible spread to humans also in the coastal department of Rocha. According to a government communication, risk areas are those near waterways which are affected by flooding. Read more

Advice for travellers

The anthrax bacterium is transmitted to people in the form of spores which are can produce disease through consuming contaminated meat, through inhalation or via contact with the wool, hair or hide of infected animals. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about anthrax.