Travel Health Alerts

Polio count rises to 36

Another four wild poliovirus1 cases were reported last week (three in KP province and one in Sindh), while Afghanistan's 2020 total has risen to three with one more infection reported (Farah province). Read more. African countries continue to be beset by cVDPV2 infections as this week: Benin reported its first case this year (Borgou province), two cases in the DRC Kwilu province), five cases each in Ethiopia (four in Oromiya province, one in SNNP region), Ghana (Ashanti province had three and one each in Bono and Western North provinces) and Togo (Lomt province had three and two in Savanes province). Collateral damage of the COVID-19 pandemic has been the suspension of vaccination campaigns in countries affected by WPV and cVDPV until later in the year (unfortunately this is also likely for other vital immunisation programmes preventing vaccine-preventable diseases.

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.

Measles hits indigenous communities, global cases

Measles has sickened more than 150 children and killed at least two in the indigenous Chepang community of central Nepal. Immunisation rates are low among these Tibeto-Burman people who live in south-central Nepal, including the affected remote area of Dhading district. Read more. In Africa, measles infections are being reported in two districts of Liberia’s NE - Tappita and Sanniquelliie in Nimba County - and the districts of Cibitoke and Butezi in Burundi. While in Argentina, the 40 local cases recorded to the end of March were mainly among infants and children under 4yo, however ‘the 'number of cases in adults older than 20 years is significant’; and Mexico’s outbreak has expanded with more than 100 cases in Mexico City/state of México (mainly Ecatepec).    

Advice for travellers

Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. While generally benign, infection 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 in NE province

More information this week on dengue fever outbreaks underway in northern provinces - suspected cases in Misiones have exceeded 7,000 and 240 infections have been confirmed so far – three serotypes are circulating. Read more. While in the neighbouring Brazilian state of Paraná, the dengue epidemic continues across 189 municipalities – statewide, cases increased by more than 14,000 in the past week.

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.

Tracking flu and COVID-19

FluTracking, an online health surveillance system used to track influenza in Australia and New Zealand, has expanded its crowdsourcing of flu data to include possible COVID-19 symptoms – more voluntary participation is invited by way of a weekly 10-15 second survey. Australia’s Deputy Chief Medical Officer has encouraged people to sign up and record specific symptoms as ‘health authorities are now looking to it as an early warning system for virus hotspots'. Read more

Outbreak’s end in sight

Suspected cases of Ebola virus disease continue to be reported and promptly investigated, however no new infections have been uncovered since Feb 17. Surveillance and response activities are considered paramount as ‘there is still a high risk of re-emergence of EVD’, according to the WHO.

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.

More yellow fever suspected in Gurage

An update on an investigation into two yellow fever infections confirmed in Gurage zone, SW of Addis Ababa early in March now puts the total at ‘85 cases (2 confirmed cases, 6 presumptive positive cases and 77 suspected cases)’, resulting in at least four deaths. A local reactive vaccination campaign has been underway, to be followed by a more extensive one despite travel restrictions relating to COVID-19, as the onset of the rainy season is expected to add to the risk of mosquito-borne infections such as yellow fever. Read more

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.

SW state’s fever count rises

More than 130 Kyasanur Forest disease (KFD) infections and five related deaths have been registered in Karnataka’s Shimoga district – further cases are likely to be reported through the (dry) peak season which finishes in June. The KFD virus is transmitted to humans through tick bites or contact with an infected monkey, making it a higher risk for people with outdoor activities, such as farmers and hikers in affected areas. Read more

Dengue hits hardest in 2 provinces

Dengue fever hotspots have been declared in East Nusa Tenggara and West Java, as between them they have reported more than 10,000 cases since January. (Bali had recorded 2,173 cases to Apr 4.) Weather conditions are not expected to ease the situation for some time yet.  Read more. Recent updates are also available for Malaysia and Singapore.

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.

COVID-19 news, resources

COVID-19 cases have doubled in the Americas over the past week – more on global cases and new developments in the Apr 7 WHO Situation Report. In the last week, the CDC has amended its advice for residents regarding face masks and now ‘recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission’. The WHO has also updated its guidance on the use of masks to include ‘Advice to decision makers on the use of masks for healthy people in community settings’.  

With a similar format to the weekly flu activity report, FluView, the CDC has established ‘COVIDView’ which will provide updated surveillance and a weekly summary.

More news, articles:

• The MRC Centre for Global Infectious Disease Analysis ‘weekly report presents forecasts of the reported number of deaths in the week ahead and analysis of case reporting trends (case ascertainment) for 42 countries with active transmission.’
• In its Apr 6 Morbidity and Mortality Weekly Report MMWR, the CDC published a preliminary description of paediatric U.S. COVID-19 cases Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020.
• Redefining vulnerability in the era of COVID-19 Read more
• Last week the WHO issued an alert relating to ‘the distribution of falsified medical products: Falsified medical products, including in vitro diagnostics, that claim to prevent, detect, treat or cure COVID-19’.
• Global Health Now offers an understanding of ‘key issues related to the outbreak’ with the COVID-19 Expert Reality Check.
• Controversial drug hydroxychloroquine to be given to coronavirus patients in Australia Read more
• Australian health experts split on 'immunity passport' as new coronavirus test begins development Read more
• We don’t want a new Thalidomide: Why a COVID-19 vaccine is so long coming Read more

Dengue uptick following floods

The country’s under-resourced health system is now coping with increasing numbers of both COVID-19 and dengue fever infections. Recent heavy rains have led to a surge in cases of dengue, with 59 deaths and in excess of 7,400 infections recorded. Read more

Advice for travellers

Common in most tropical or sub-tropical regions of the world, dengue fever is spread by daytime-feeding Aedes mosquitoes. To avoid the risk of dengue 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.