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 15th of April 2020
COVID-19 – ‘the way down is much slower than the way up’
Gradual improvement in COVID-19 case numbers and deaths in some European countries has prompted the WHO director-general to warn that, while the disease ‘accelerates very fast, it decelerates much more slowly’. There have now been almost 1 million COVID-19 cases in the region, according to the WHO dashboard, with outbreaks declining in some countries, but accelerating in others, such as the UK and Turkey. Most of the confirmed cases being reported around the world now are from Europe and the US – more information in the Apr 14 WHO Sitrep.
More data on Australian cases and a summary of global figures.
More news:
Australian researchers 'a few weeks' from clinical trial results for coronavirus treatment Read more
In an Apr 12 WHO Scientific brief on the BCG vaccine, the agency advised that results from two clinical trials are pending, however there is currently no evidence that the vaccine will protect against infection from SARS-CoV-2. Three pre-print studies found that the countries where infants routinely received the BCG vaccine had lower rates of COVID-19 disease, but in the brief the agency acknowledged that ‘Such ecological studies are prone to significant bias from many confounders…’.
How much of the coronavirus does it take to make you sick? The science, explained Read more
CIDRAP reports on studies of the effectiveness of different concentrations of two WHO-recommended and two modified hand sanitiser formulations used over the recommended 30 second time frame.
Coronavirus fuels a surge in fake medicines Read more
How do SARS and MERS compare with COVID-19? Read more
Various resources:
- Children’s story book released to help children and young people cope with COVID-19 Read more
- Updated WHO advice for the public - Mythbusters: Read more
- Should we all be wearing face masks to prevent Covid-19 spread? Read more
- Kits, reagents and viruses Read more
- WHO and EU Commission publish coronavirus food safety advice Read more
Polio update, temporary recommendations to continue
In the latest reporting week a single WPV1 case was detected in Sindh province, taking the YTD total to 37; while in the African region, two cVDPV2 infections were reported in Burkina Faso (Centre-Est region) and one each in both the Central African Republic (RS2 province) and Côte d’Ivoire (Gbokle–Nawa-San Pedro province). Read more. In other polio news, at the 24th Executive Committee meeting on the international spread of poliovirus on Mar 26, concern was expressed at the global rise in WPV1 and the multiple outbreaks of circulating VDPV across four WHO regions (African, Eastern Mediterranean, South-east Asian and Western Pacific). Spread of cVDPV has now become common in the African region, however it is hoped the introduction of the novel OPV2 vaccine in mid-2020 will substantially lessen the risk of seeding of further outbreaks. (Burkina Faso has been added to the list of States infected with cVDPV2, with potential or demonstrated risk of international spread). While the existing temporary recommendations are to continue for three more months, ‘some if not many international borders are closed to prevent international spread of COVID-19, State Parties may not currently be able to enforce the Temporary Recommendations in all places’. The committee expressed extreme concern that the COVID-19 pandemic could lead to more polio transmission with ‘the potential for international spread and significant reversal of polio eradication and outbreak response campaigns.
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.
Local, regional measles updates
In the NE state of Adamawa, measles has claimed the lives of seven children in Fufore district, adjacent to the state capital Yola. Outbreaks have been scattered across five local districts for the past two months. Also within the African region, the measles epidemic in the Central African Republic is finally showing some signs of improvement, while in Cameroon up to 15 districts continue to report cases, Chad reports epidemic phases in 14 districts and infections are spreading in the district of Citiboke in Burundi. According to the WHO, measles vaccination campaigns planned for 24 countries have been delayed or postponed, putting more than 117 million children at risk of infection. 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.
Dengue count tops 40,000
Last year’s dengue fever outbreak was described as one of the worst in recent history, affecting over half the country. This year, there have already been more than 40,000 infections and 82 deaths (a further 40 are under investigation), with four municipalities recording more than 1,000 cases - Cali (>7,000 cases), Palmira, Ibagué and Tuluá. 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.
Update on dengue outbreak
The steepest uptick in dengue fever infections since the outbreak was first declared in Feb last year came about in March (2020). Overall the vast majority of cases have been in Rarotonga, however Aitutaki has also recorded five infections (none in the Outer Islands). There have been a further 115 confirmed and suspected dengue fever cases reported for the year to Apr 5. Read more
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.
New Ebola cases ‘not completely unexpected’
In not unexpected news, less than a week before the Ebola outbreak was to be declared over, there has been a flare-up: three new cases (two fatal), all of whom had visited a clinic in a previous hotspot, Beni. The sources of infection are being investigated. As a result of the new cases and in anticipation of more small outbreaks, the WHO advised this week that the current situation ‘continues to constitute a Public Health Emergency of International Concern’. Read more
Advice for travellers
Ebola Virus disease is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola virus disease.
Malaria on the rise
Malaria is advancing through the provinces of Matabeleland South and Mashonaland East, infecting more than 580 people over the past fortnight. An adverse impact of the lockdown imposed to limit the spread of COVID-19 has been restriction of access to healthcare services in the affected districts. While in neighbouring Namibia, the adjoining Kavango West and East regions have experienced a four-fold increase in malaria cases this year compared to early 2019 figures. 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.
Rains lift dengue count in 3 provinces
Recent rainfall has boosted Aedes mosquito populations in parts of Ang Thong, Rayong and Phichit provinces, leading to an uptick in dengue fever cases. More than 8,000 infections have been recorded over a recent 12-week period, resulting in four deaths. Read more
Advice for travellers
Dengue fever is spread by daytime-feeding Aedes mosquitoes and travellers should apply an insect repellent containing an effective active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus/PMD to exposed skin during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, when the mosquitoes are most active.
Hep C testing should widen
Based on data from 2009-2018 showing 3-fold increases in rates of acute hepatitis C among young adults, the CDC has updated its recommendations for testing to all adults, pregnant women and those with risk factors. Read more
Advice for travellers
Hepatitis C is a viral infection of the liver which is most commonly contracted through intravenous drug use, but transmission has also has been reported infrequently through modes such as unsafe MSM sex with an HCV-infected person (a higher risk if that person is also HIV-infected), sharing personal care items (i.e. razors) contaminated with blood and unregulated tattooing. For up to 30% of infections, it is a short-term illness and the individual may not have symptoms; but for the majority it can become a chronic infection which can produce long-term health issues and potentially lead to death. Antiviral medications have been developed which have been shown to successfully treat the majority of Hep C infections. Read more on hepatitis C from the WHO.
Vector-borne infections spike in SW region
A trio of mosquito-borne infections are impacting the SW governate of Lahij – malaria, dengue fever and chikungunya. As reported by ProMED, the persistence of these endemic diseases is ‘due to lack of basic vector control measures and the presence of swamps’. Read more
Advice for travellers
The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.