Travel Health Alerts

Hopes winter will ease YF

From the most recent yellow fever update provided by the European Centre for Disease Control (ECDC), the states of Rio de Janeiro and Minas Gerais had recorded five more human cases and six deaths. Cooler weather from the southern winter is expected to bring some respite as mosquito activity drops. 

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 upswing in ‘water village’

The three to four year cycle of dengue fever infections is expected to peak this coming season - the last (and largest) peak occurred in 2014. Half of all cases to date this year have been in Kampong Ayer – a chain of villages built on stilts over the banks of the Brunei River. Read more

Advice for travellers

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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

Dengue report card

As reported in the May 24 WHO Western Pacific Region update, the incidence of dengue fever climbed in the first two weeks of May, rising above the epidemic threshold. There had been 694 cases to mid-May. Read all regional countries’ reports here. 

Mumps in lake district; Dengue vector menace on Easter Island

A large mumps outbreak is ongoing in the Los Lagos region, including the regional capital Puerto Montt. Nearly 1,400 cases have been recorded to date with 100 more every week. The area known for its lakes, volcanoes and picturesque countryside. Read more 
IN VIEW of the recent dengue fever outbreak on Easter Island, the Chilean Health Ministry will administer yellow fever vaccinations to all residents of the island, starting with infants 18 months of age and then extending to the adult population. No cases of yellow fever have ever been reported on the island, however health authorities are concerned about the number of visitors and permanent arrivals from endemic regions. On the date of the press release (8 May) the number of dengue fever cases in the outbreak reported in April had increased to 16. Read more 

Advice for travellers

These outbreaks of mumps highlight the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to any destination – be it a developed or developing country. Read more about mumps.

Hong Kong’s HFMD spike

In the week to May 24, the number of kindegartens, child care centres and primary schools reporting hand, foot and mouth disease outbreaks had risen to 15. Each year, May to July are the peak months for the spread of the infection. Read more

Advice for travellers

HFMD mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection. Read more about HFMD.

Local, international response to Ebola outbreak

Efforts to tackle the Ebola virus disease (EVD) outbreak in Equateur Province are ongoing: vaccination of ring contacts in the major centre of Mbandaka and, this week, also in the outlying areas of Bikoro and Iboko; surveillance, contact tracing and public information campaigns. Latest disease data from a Médecins Sans Frontières report: ‘54 people who presented symptoms of haemorrhagic fever, including 35 confirmed Ebola cases, and 25 deaths (of whom 12 were confirmed as Ebola’. It is noted that previous EVD outbreaks in the DRC have been mostly in remote areas and there have now been four confirmed cases in Mbandaka, a city of over one million people, but ‘the epidemic has not spread widely within the city’. 

Advice for travellers

 Ebola 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.

Dengue, influenza counts

Health department figures show a rise in inflluenza A (H1N1)pdm 09 cases in Tahiti, reaching epidemic threshold by mid-May. In the two weeks from May 6, there were 13 confirmed dengue fever cases from Tahiti, Bora Bora and Raiatea, Moorea – of the 13, six were tourists. Read more (translation required).

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 recommendsinfluenza vaccination, if available, for all travellers over 6 months of age. 

Nipah virus update; Dengue, chikungunya, JE reports

The death toll in the Nipah virus (NiV) disease outbreak in Kerala has risen to 13 from a total of 25 suspected infections. Testing for the virus is being carried out on a soldier who died after travelling from Kerala to Kolkata in West Bengal and another case, hospitalised in Goa, has proved negative.
DENGUE fever reports are coming from the states of Kerala and Karnataka, which is also seeing a spike in chikungunya cases - 4,879, followed by Gujarat (1357) and Maharashtra (966). 
Five districts in the NE state of Assam are the focus of a campaign to reduce the burden of Japanese encephalitis (JE) infections. JE constituted over 16 percent of the state’s death toll last year. Read more. There have also been reported JE cases in Kerala this week. Read more  

Advice for travellers

A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is very low. The recommendations for vaccination are itinerary-specific. Read more on JE. 

Men. meningitis cases rise above 60

A local news source claims 30 people in the largest city of Almaty have been diagnosed with meningococcal meningitis infections – no mention of the serogroups is provided however. Medical advice includes ‘restrict visiting any mass cultural events being held in closed area, sports events and pools’. The national case count for the year to date is 62 from Almaty region, Astana as well as Eastern and southern regions of the country. Read more

Advice for travellers

Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. If planning to travel to any region experiencing an outbreak, discuss whether vaccination against meningococcal meningitis would be appropriate for your itinerary with your travel doctor. Read more about Men. meningitis.

Flu, dengue prevalent

Following last week’s report on the rise in flu cases, the last seven days have seen up to 7,000 people report influenza and ‘viral’ fever symptoms and over two-thirds of those tested for flu were confirmed to have type A. The Health Protection agency stated that daily family gatherings for Ramadan ‘could contribute to the spread of diseases’. Dengue fever cases are also likely to rise from the 96 reported last week due to recent rains. Read more

More school measles

Measles cases in local schools have shot up from 48 last week to 120 as of Monday. The country’s Senior Community Physician has voiced his concerns about the increase and advised that all students’ vaccination cards are being checked for the two vaccine doses. Read more (translation required).

Advice for travellers

A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.

Viral hepatitis spreads to north

People attending a cultural festival in the northern region of Omusati last weekend were advised to maintain strict personal hygiene after 11 hepatitis E infections were confirmed in the districts of Tsandi, Okahao, Outapi and Oshikuku; one death was recorded earlier this month and a further 47 people are being monitored for symptoms. A large outbreak of the viral illness has been underway in informal townships of the capital Windhoek, with 14 deaths from nearly 500 cases recorded. Read more 

Advice for travellers

The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. The virus is found worldwide, mainly in communities with low levels of sanitation and hygiene. There is no vaccine licensed outside China. More than 60% of all hepatitis E infections and 65% of deaths occur in East and South Asia, with up 1-in-4 people in some age groups having been exposed to the virus. Read more about the virus and how to prevent it.

Upward trend in W meningococcal strain

The number of meningococcal meningitis infections (type W) recorded has been rising – an average of four cases (& no deaths) per year up to 2015 and, for the first four months of 2017, it was 27 and this year, 57 with 11 deaths (the total number of deaths for 2017). A vaccine which protects against the W strain is being introduced into the immunisation program for children at ages 14 months and 14 years. Read more 

Cholera in NE kills 13

The death toll in the cholera outbreak occurring in the NE state of Adamawa is now 13 from 434 cases. Mubi is the epicentre of the outbreak and contaminated water sold by water vendors is believed to be the cause. Read more

Advice for travellers

Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera. 

Punjab’s steep measles toll

More than 5,000 children in the state of Punjab are believed to have been infected with measles this year – 735 in the past week - and the death toll has risen to 31. According to a local news report, the cities with most cases are Lahore, Rawalpindi and Gujranwala, although most areas are reporting infections. Read more 

Mozzie-borne infections rise

There has been a surge in chikungunya cases in Pedro Juan Caballero, a city on the Brazilian border, and a further 745 suspected cases nation-wide are yet to be confirmed. Dengue fever has hit the Central department hardest, in several districts of the capital, Asunción, and the neighbouring towns of San Lorenzo, Capiatá and Ñemby. Read more.  Elsewhere in South America, Colombia has recorded nearly 1,000 dengue fever cases and 49 dengue-related deaths from 10 departments. Read more (translation required).

Advice for travellers

Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellentwhen outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

Dengue, leptospirosis hit west, south

A May 29 update on the dengue fever situation gives the running total of cases this year as 3,756 with 79 requiring hospitalisation. Western and southern districts are those most affected by dengue, but also by leptospirosis. Outbreaks of this bacterial infection occur annually following rains and flooding as activities such as swimming and gardening bring people into contact with waters contaminated with the urine of infected rodents. Read more 

Advice for travellers

Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.

Vax reminder for sports fans

The WHO has issued a reminder to those soccer (football) fans heading to Russia for the World Cup in June – make sure routine vaccinations up to date, with an emphasis placed on the MMR (measles-mumps-rubella) vaccine in view of the ongoing large outbreaks across Europe. ‘Of the 32 countries that will participate in the World Cup, 28 have reported cases of measles this year.’ Further, ‘The increase in international travel and the mass movement of people during events such as the World Cup increases the risk of transmission of diseases. It also increases the likelihood of travelers returning to their countries with diseases such as measles, which is highly contagious and can have grave consequences on the health of unvaccinated populations.’ More information on smartraveller.

SW city’s JE cluster

Seven pig farms situated near a reported cluster of Japanese encephalitis infections in residents of the SW city of Kaohsiung are being investigated by public health authorities. Pigs are important amplifiers of the virus which is then transmitted to humans through bites from infected mosquitoes. Two JE cases have been confirmed and a third is under investigation. The local population has been advised to avoid mosquito bites and to get the JE vaccine. Read more 

Cholera worsening on mainland

Five districts (Sumbawanga, Ngorongoro, and to a lesser extent, Longido, Monduli and Songwe) are experiencing cholera outbreaks which have ramped up over the most recent reporting week – reporting five times the number of cases over the previous week. ReliefWeb notes that ‘to 20 May 2018, a cumulative of 2,105 suspected cholera cases, including 44 deaths have been reported in Tanzania Mainland. Three out of 26 regions currently have active transmission, namely Arusha, Rukwa and Songwe and the situation is deteriorating’. 

MERS in west

A farmer from the western town of Ghayathi is the Emirates’ first MERS case this year. The 78-year-old man, who has other medical conditions, visited his camel farm regularly and had also been in Saudi Arabia recently - all are considered risk factors in acquiring MERS. He remains in hospital. Read more