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 2nd of December 2020
13% fall in Europe's COVID-19 cases
Mitigation measures implemented across several European countries to stem COVID-19 case surges are behind the biggest weekly decline in global infection rates since September, but on Nov 30 the WHO director-general expressed extreme caution warning that any gains are easily lost. Read more. Increases in new case reporting have been seen in other regions: the US, parts of Brazil, Mexico and Colombia in the Americas; Iran, Jordan and Morocco in the Eastern Mediterranean; Indonesia in SE Asia; and South Korea in the Western Pacific region. In Africa, the WHO regional office is reporting a spike in cases in Uganda which is centred in and around the capital Kampala, however national spread is said to be significant which is likely due to non-adherence to physical distancing and mask wearing. Across the continent, the top five countries recording most cases in November were South Africa, Kenya, Algeria, Ethiopia and Uganda. More in the Dec 1 WHO epi update.
In related news:
-COVID-19 vaccines FAQs answered by the National Centre for Immunisation Research and Surveillance (NCIRS).
-Plane, ferry and train travellers from countries not in the UK’s travel corridors (which include both Australia and New Zealand) will soon have the option to pre-book a COVID-19 test which they will take five days into their period of self-isolation (to potentially reduce the quarantine time) – part of a ‘Test to release for international travel’ strategy. Read more
- From Imperial College, a global analysis of the different social settings where SARS-CoV-2 transmission takes place found that among indoor settings, ‘households show the highest transmission rates’, with secondary attack rates estimated to be just over 20 percent. Other findings included: the chance of an asymptomatic infected person infecting a close contact was approx. one quarter of the chance for a symptomatic infected person infecting his or her close contact. Read more
16 more cVDPV2 cases, global digest
Six African countries reported cVDPV2 cases to the GPEI: 16 of the weekly total of 32 were logged by Côte d’Ivoire, the remainder by Burkina Faso, Niger, South Sudan, Sudan and Somalia. Yemen registered two cVDPV1 cases in Sanaa City and Saadah, while Afghanistan reported two WPV1 cases and 24 cVDPV2 cases and Pakistan’s tally for the week was 21 cVDPV2 cases. In other news, an Interim guidance document has been published by the WHO, offering context and policy guidance on the use of the Novel Oral Polio Vaccine type 2 (nOPV2) during the Initial Use Period.
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.
Warnings over mosquito-borne infection risks
Reports have emerged from three states on the increased risk of mosquito-borne infections such as Ross River fever and Murray Valley encephalitis. Health authorities in South Australia caution that the transmission risk is now the highest since 2010 and the Murray River system gets a special mention. In Victoria, Ross River virus was recently detected in mosquitoes in the area around the Gippsland Lakes, while in Queensland, Ross River fever cases have doubled from 1,650 in 2019 to more than 3,300 this year. According to data published by the National Notifiable Diseases Surveillance System (NNDSS), Ross River fever cases have also risen this year in NSW - up from 589 in 2019 to 1,941.
Advice for travellers
Cases of Ross River fever occur throughout Australia, including more temperate southern states. Travellers visiting areas of Australia affected by recent flooding or continuing rain should take measures to prevent mosquito bites. Use a personal effective insect effective ingredient such as DEET, Picaridin or oil of lemon eucalyptus (PMD) when outdoors and wear long, loose-fitting, light coloured clothing – especially at dawn and dusk, the times of day when RRV-carrying insects are most active. More on Ross River virus from NSW Health.
Measles cases surface in tropical lowlands
More signs of the disruptions to routine immunisation services caused by the pandemic with the reappearance of measles cases in Bolivia after 20 years of control. Authorities in the lowland department of Santa Cruz have reported the country’s third measles infection this year and a further three infections are suspected. Global measles vaccination rates had already stalled at around 85 percent prior to the onset of the of SARS-CoV-2 pandemic. 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.
Low flu activity at season's start
With the peak of the flu season still to come, so far influenza activity in Europe is at record low levels. In Spain, flu transmission is reported to be 99 percent lower than the 5-year average and more people are receiving the annual flu vaccine. The latest WHO global update notes that predominately influenza A(H3N2) continued to be reported in Laos, Thailand and Vietnam while some flu activity was reported in Burkina Faso, Côte d’Ivoire and Togo. Read more
Advice for travellers
Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination for all travellers over 6 months of age. Read more about influenza.
Hep E confirmed in Sanmatenga province
While only a limited number of hepatitis E cases have been laboratory-confirmed, a total of 450 suspected infections have been reported since early September in Barsalogho, in north-central Sanmatenga Province. Of the 16 recorded deaths to Nov 23, 15 were women who were either pregnant or postpartum. 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.
Malaria update, global report published
WHO Western Pacific region data from the 2020 World Malaria Report signalled that about 80 percent of cases in 2019 were reported by Papua New Guinea. Without PNG’s burden of disease, the region is almost on track to meet the malaria morbidity and mortality milestones set in the WHO Global Technical Strategy for Malaria 2016–2030. Six countries recorded a 90 percent reduction in malaria cases between 2000-2019 - Cambodia, China’s Yunnan Province, Laos, Myanmar, Thailand and Vietnam. In the report, a warning was delivered that ‘progress against malaria continues to plateau, particularly in high burden countries in Africa’ while the pandemic is certain to cause disruptions to prevention and treatment services. Africa carries more than 90 percent of the overall global burden, but just six countries account for half of all malaria cases: Nigeria, the Democratic Republic of the Congo, Tanzania, Niger, Mozambique and Burkina Faso. Global malaria statistics have more or less plateaued since 2015: last year there were 229 million cases and the death toll was slightly lower than in 2018 (409,000 cf. 411,000).
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.
STI hike in western province
The increase in syphilis cases reported in the prairie province of Saskatchewan mirrors the situation seen across many parts of North America over the past three years. Public health officials note with some concern that outbreaks among MSM continue but new cases are also occurring in women of childbearing age and pregnant women. Read more
Advice for travellers
Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an effective antibiotic. Read more about syphilis and other STIs.
YF reported in NW prefecture
Local news sources are reporting 13 deaths from among nearly 30 yellow fever cases since October in the prefecture of Koundara in the country’s far NW. The first cases, all in children aged under 15 years, were thought to be suffering from severe malaria, however tests taken after haemorrhagic symptoms manifested have since returned positive for yellow fever. Read more. And more on Nigeria’s YF outbreak with news that Enugu’s death toll has risen to 133 - mosquito fumigation activities have begun and a reactive immunisation campaign is already underway for residents of the disease hotspots – Enugu’s YF vaccine coverage for children aged between 12 and 23 months was measured at only 32 percent in 2018. More from the IFRC.
Advice for travellers
Yellow fever virus is a mosquito-borne disease found in tropical and subtropical areas in Central/South America and Africa. While it can be severe, yellow fever infection is a very rare in Australian travellers. However, under the International Health Regulations (IHR), proof of vaccination may be required of any traveller entering or leaving an area at risk of yellow fever transmission. Read more about yellow fever.
Dengue infections jump in east
The arrival of the year’s second inter-monsoonal season has brought with it an uptick in dengue fever cases in the Eastern province, with an increase recently reported in the coastal city of Batticloa. January was the peak month for dengue cases across the country this year - more than 11,000 cases in the month (1,693 in Colombo). Read more. Elsewhere, Vientiane and the provinces of Bolikhamxay, Bokeo and Savannakhet in Laos have recorded most dengue cases in 2020 as the YTD total nears 8,000.
Advice for travellers
Avoid mosquito bites to protect against dengue fever. To avoid biting insects, apply repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) to all exposed skin when outdoors. Dengue is spread by two types of aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid outdoors. Travellers should also cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active.
Rabies rates up among Sibu’s dogs
A surge in the population of stray dogs and the incidence of dog bites in Sarawak’s central Sibu district has alarmed authorities, occurring at the same time that random sampling detected a nearly 50 percent rate of positive tests for canine rabies. After three human rabies deaths were recorded this year, there are more calls for public rabies awareness campaigns to educate residents on the risk of rabies. 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.
Peak dengue season hits
Visitors are reminded that the dengue season is now in full swing and it had a jump-start this year from elevated case numbers over the winter season (due to interruptions in mosquito control programs). Extra caution is urged in areas with high annual dengue virus circulation: Loreto, Ica, Ucayali, San Martín, Junín, and Madre de Dios. Read more
Advice for travellers
Dengue is spread by Aedes mosquitoes which breed in shady areas close homes and other accommodation. They bite mainly during the daylight hours and can be found indoors, making them difficult to avoid. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.