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 28th of July 2021
Malaria imported from western state
A rare outbreak of malaria reported in a southern region of Bahia state is believed to have started with the arrival of a traveller from Manaus in Amazonas. Since the first case was detected in Itabela, a total of 53 infections have been confirmed, with further transmission also recorded in Porto Seguro and Itamaraju. Response measures have included testing of the affected communities and distribution of treated bed nets. Eleven species of mosquitoes capable of transmitting malaria are found in Brazil. Read more
Advice for travellers
Malaria is considered a risk for western states in the Amazon basin, rare cases occur in rural areas of several others. Travellers visiting Brazil should discuss their itinerary and the required and recommended vaccinations and medications during a pre-travel medical consultation. Read more about malaria.
Growing burden of typhoid
While 715,000+ suspected typhoid fever infections were recorded last year, the WHO regional office now advises that that total has already been passed in the first half 2021. The cases have been detected across several health zones. Read more
Advice for travellers
Typhoid fever is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination 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. Read more about typhoid fever.
Copenhagen 2021 celebration next month
This year the Danish capital and Malmö in Sweden will host WorldPride and EuroGames, described as ‘an eclectic arts and culture program, and the biggest ever LGBTI+ human rights forum’ which is to take place from August 12 to 22. Health recommendations for participants have been posted on the UK’s Fitfortravel website.
VD polio cases in 5 states, global digest; Cholera outbreaks growing
Over the past fortnight, the GPEI has reported cVDPV2 infections in Nigeria (10 in total from Jigawa, Kaduna, Kebbi, Yobe and Kano), Ethiopia (eight in Oromyia and two in Amhar), Senegal (three cases from Diourbel and Thies), and a single case each from Tajikistan (Khatlon), Liberia (Nimba) and South Sudan (Upper Nile district). In Madagascar, a further two cVDPV1 cases were identified, taking the YTD total to six.
CHOLERA outbreaks have flared up over the past three weeks in the Federal Capital Territory (FCT) as well as the states of Kaduna, Jigawa, Bauchi, Kano, Niger, Zamfara and Plateau. Health authorities have announced that the death toll has risen to 529, up from 325 in late June amid reports that the cholera vaccine is in short supply. 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.
Monkey B virus risk warning
A veterinarian in the state of Kerala has reminded the public to avoid contact with macaques when visiting forests and around temples due to a risk of Herpes B virus through scratches or bites from the animals. The news story was published following a report from China of a veterinary surgeon who had contracted the infection while working with macaques in a research laboratory. More about Herpes B virus from the US CDC. Read more
COVID-19 update, news
Last week’s WHO epi update announced a 12 percent week-on-week rise in new cases and in this week’s edition, a further eight percent which was mainly due to ‘substantial increases in the Americas and Western Pacific Regions’. Deaths were reported to have climbed sharply last week, up by 21 percent, with SE Asia and Americas contributing the greatest numbers. In our Western Pacific region, new cases have risen each week for the past month and were up by 25 percent last week - Vietnam experienced a 95 percent increase and Malaysia and the Philippines were also in the top three, while Indonesia is facing numerous challenges as it responds to a wave of new cases. The July 27 WHO epi update also contains a section, ‘Special Focus: Evaluations of the effectiveness of COVID-19 vaccines in real-world settings’ which includes a comparison of VE on the Alpha and Delta VoCs among fully vaccinated persons.
In related news:
- Niue has celebrated the success of its vaccination campaign after 97 percent of the eligible population received their second doses earlier this month. Read more
- CIDRAP has published a summary of studies relating to ‘long COVID’ which included findings of ‘203 symptoms involving 10 organ systems, another showing that more than five coronavirus symptoms in the first week of infection portends a long disease course, and one finding few long-haul–like symptoms in children’.
- Last week the US added the UK, Fiji, Indonesia and Zimbabwe to its Level 4: COVID-19 Very High Travel Notices list, and this week also included Spain and Portugal.
- Travel passes are already in use in Europe and hospitality passes are under consideration to allow for more lifting of restrictions, while residents of Chile who are fully vaccinated are now able to travel out of the country by using a ‘mobility pass.
Tick activity increasing
Health officials have alerted residents to be aware of ticks when outdoors and have reinforced messages on avoiding bites and checking their skin and clothing after returning home, with confirmations of Lyme disease on the increase as well as some reports of tick-borne encephalitis cases. Read more
Advice for travellers
A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While most infections are contracted through the bites of infected ticks, food-borne transmission through untreated dairy products is a known mode of transmission. Safe and effective vaccines are available in Europe, but none are licensed in Australia, however the vaccine can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE.
Dengue & kala-azar on the move
The mountainous districts of Kalikot, Okhaldhunga and Myagdi, previously unaffected by kala-azar (visceral leishmaniasis or VL) and dengue, have recorded infections this year and health authorities are warning of the risks of large outbreaks as transport systems get underway again. While dengue is found in around 68 districts, VL is reported from 60 and infections have now been identified at altitudes exceeding 1,400masl. Read more
Advice for travellers
Leishmaniasis is a parasitic disease 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. The former causes skin ulcers and the latter a severe systemic disease that is usually fatal without treatment. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil account for 90% of visceral leishmaniasis, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia and Argentina. Read more on the disease and prevention.
Monkeypox infection imported
Contact tracing has been underway in 27 states after a man who arrived in Atlanta, Georgia from Nigeria and then flew to Texas was later confirmed to have monkeypox – the first such case in the country since 2003. Currently 200 contacts are under surveillance, but the risk of infection is said to be low. In Nigeria, health authorities state they are consolidating monkeypox prevention, detection and control, with an emphasis on the high risk states of Delta, Bayelsa, Rivers and Lagos. 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.
Severe malaria down from 18,000 to 2,500 in 5 years
Some welcome news on the burden of malaria in Rwanda, with a 71 percent decline in cases reported over the past five years due to the effective use of treated bed nets as well as residual insecticide spraying in homes. The measures have been of particularly gain in high burden areas such as Kigali city, Gicumbi, Rulindo, Muhanga, Karongi, Rusizi and Nyamasheke districts. 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.
WNV season alert
Local media are reporting that mosquitoes testing positive for West Nile virus have been detected in Belgrade, as warmer weather brings on the annual transmission season (June to November). Residents have been warned on the need to avoid mosquito bites, particularly around dawn and dusk, and when visiting forested areas or rivers. On a regional level, the ECDC update advises that no WNV infections were logged from July 16-22 and there has only been one human case during the annual reporting period, from La Spezia in Italy. Read more
Advice for travellers
Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions during the peak transmission season should take measures to avoid mosquito bites. Read more on WNV.
Unseasonal norovirus surge
Public Health England has reported an increase in norovirus outbreaks since May. According to the agency, these outbreaks have mostly occurred ‘in educational settings, particularly in nursery and childcare facilities’ and, unusually for the ‘winter vomiting bug’, during warmer weather. Read more
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 after using the toilet and before eating, and practice good hygiene. Read more on norovirus.
Malaria spikes in SW
Around 4,000 suspected and confirmed malaria infections have been recorded this year in the SW governate of Taiz, the site of ongoing conflict in the civil war. As stated by ProMED, ‘malaria is endemic in Yemen especially in the western part along the Red Sea and in pockets on the south coast’. 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.