Travel Health Alerts

Pork products linked to several outbreaks

More than 580 suspected and confirmed cases of trichinellosis in six separate outbreaks have been recorded this year in Buenos Aires province. The largest, involving 12 or more towns, ‘has been linked to contaminated commercially available products’, while the others were through domestic butchering of infected animals. Two other outbreaks have been reported from the province of Córdoba and in one instance, commercially prepared meats could be implicated.

Hep A alert as cases top 1,430

More than 1,400 hepatitis A infections recorded up to September this year have prompted an alert from health authorities and advice on prevention. Most of the cases have been in the province of San José (960 cases), followed by Alajuela and Heredia. Read more

Advice for travellers

Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through consuming contaminated food and water, by handling everyday items and through some types of sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and offers long term protection.

Global polio update

Four circulating vaccine-derived poliovirus type 1 (cVDPV1) cases were recorded in Ihorombe, Boeni, Sofia and Haute Matsiatra, while the DR of Congo also reported two patients with type 1 in Haut Lomami and Haut Katanga, plus eight cVDPV2 patients in four provinces. Other countries notifying the GPEI of cVDPV2 cases were Côte d’Ivoire (Tchologo) and Mali (two in Gao). Lastly, cVDPV2 positive environmental samples were collected in Egypt (North Sinai) and Mbeya, Tanzania. A Sept 10 WHO regional report on the situation in Tanzania noted that ‘the presence of low population immunity against type 2 poliovirus and the ongoing population movement could potentially increase the public health risk’. 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.

Dengue case numbers rising

The rainy season is still to begin but the dengue virus is already circulating widely in Manabí, Santo Domingo de los Tsachilas and Esmeraldas, while case numbers are higher than usual in La Mana, Cotopaxi province. Across the nation, dengue infections are up 40 percent on 2022 figures.

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, 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 oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

Bedbugs bite in Paris; Local dengue in Drôme

Infestations of bedbugs have been reported from numerous sites across Paris, including lodgings, public transport and cinemas. Local government officials have asked for disinfection measures against the scourge for the sake of locals, tourists and the upcoming Olympic Games. Read more

TWO CONFIRMED and one suspected locally-acquired dengue fever cases have been reported from the Auvergne-Rhône-Alpes region. Investigators working in Bourg-lès-Valence in Drôme department will carry out door-to-door survey of residents, together with mosquito fumigation to control Aedes albopictus populations in the neighbourhood. 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.

West Nile toll climbs to 17; Indigenous dengue count rises

West Nile virus (WNV) season continues and infections and the death toll are mounting – now 283 cases and 17 deaths – although the virus is circulating in 52 provinces on 10 regions (Piedmont, Lombardy, Veneto, Friuli Venezia Giulia, Liguria, Emilia Romagna, Puglia, Basilicata, Sicily, and Sardinia). The fatalities occurred in Piedmont, Lombardy and Emilia Romagna up to Sept 27. Italian health authorities also announced the detection of five Usutu virus cases: four asymptomatic and one with neuro-invasive complications (from Piedmont and Lombardy). On a regional level, the weekly ECDC update advised that the following areas have reported locally-acquired WNV cases for the first time: ‘Ioannina in Greece; Cáceres in Spain; Charente, Gard and Vaucluse in France; and Taranto and Lecce in Italy’. Read more

A FURTHER update on locally-acquired dengue fever cases advised that 36 infections in three unlinked transmission events had been reported to Sept 25: 25 cases in Lodi, two in Latina, and nine in Rome, ‘with exposures in different parts of the metropolitan city of Rome for which investigations are underway to verify any epidemiological links’. Read more

Advice for travellers

West Nile virus is endemic in Eastern Europe and the Mediterranean basin, with epidemics regularly reported in summer and autumn since the 1950s. 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 reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites. Europe’s outbreaks are not as severe or widespread as in other regions where the virus occurs, notably North America. Read more on WNV.

Dengue across the Antilles

Local media report that new suspected dengue case numbers have stabilised at around 800 per week with the highest incidence of infections in Vieux-Habitants, Basse-Terre and Capesterre-Belle-Eau. While in Martinique, the weekly count of presumed dengue cases was higher over the last reporting week (1,020) with only DENV-2 circulating. All areas of the island are affected, however Anses-d’Arlets, Le Carbet, Le Diamant, Saint-Pierre and Trois-Ilets have seen most cases. Slight increases in new cases were also registered in Saint Martin and Saint Barthélemy. 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.

Post-monsoon dengue surges; Nipah virus update

Media have reported a spike in dengue fever outbreaks post-monsoon with most cases in the states of Delhi, West Bengal, Chattisgharh, Bihar, Uttar Pradesh, Northeastern States, Telangana, Maharashtra, Punjab, Karnataka and Gujarat. Guidelines and funding have been provided to all states and territories to reduce the disease burden and mortality rates. Read more

THIS WEEK the WHO issued a Disease Outbreak News post on the Nipah virus outbreak in Kerala’s Kozhikode district, noting that the source for the index case has not been identified as yet and ‘no environmental/animal samples (including bats) have tested positive for Nipah virus’. The five other confirmed cases were family members or healthcare contacts and the death toll remains at two. Response measures instituted include containment zones, mask-wearing and social distancing in the area around nine Kozhikode district villages. Read more

Advice for travellers

Avoid drinking unprocessed palm juice. Fruit bats (flying foxes) are the natural hosts of Nipah virus, and females shed the virus when pregnant or lactating. The bats perch on the jars used for collecting juice from palm or date trees, leaving contaminated saliva and droppings in the jars.  People are infected when they drink the raw juice, although it is also spread through person-to-person contact. Nipah generally occurs between December and April. Read more about Nipah virus.

No end yet to malaria transmission

Malaria elimination by 2025 is still the target while authorities investigate seven locally-acquired malaria infections this year and pending confirmation on the areas of transmission for a total of 432 cases from 39 districts. The extended range of the parasite due to global warming is a concern, now moving into previously non-endemic areas such as the mountainous districts of Mugu, Bajura and Humla. Elsewhere, zoonotic transmission of malaria continues in Malaysia, with authorities advising that the 2022 total of Plasmodium knowlesi cases (404) has already been passed this year. By June, Sabah had recorded almost 850 cases, followed by Kelantan with 215 and Terengganu with 26. In welcome news on malaria, a second malaria vaccine for children, R21/Matrix-M, has been recommended by the WHO. In announcing the news this week, the WHO director-general said “in areas with seasonal transmission, it reduced symptomatic cases of malaria by 75% in the 12 months following a three-dose series of the vaccine. A fourth dose, given a year after the third, was shown to maintain protection.” Read more

Advice for travellers

Travellers visiting malarious regions should discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. Read more about malaria.

Isolated imported typhoid spread

An imported case of typhoid fever has spread the infection among five other workmates in a rural site in the NE area of Tairāwhiti. Those affected have been treated and containment measures put in place. 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.

Diphtheria spikes in 3 locations

A total of 865 diphtheria cases and 37 deaths have been reported in Zinder and Tillaberi regions, and in the capital, Niamey. Meanwhile, according to the latest report from UNICEF, Nigeria is now dealing with ‘the most severe diphtheria outbreak in recent global history’. There have been more than 11,500 suspected cases and 7,000 confirmed cases, with 453 deaths, mostly in unvaccinated children aged between four and 15 years. Read more

Advice for travellers

Spread by coughing and sneezing or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more on diphtheria.

Pink eye uptick post-typhoon

Conjunctivitis has spread among communities in several areas of Abra province following a recent typhoon and the gathering of residents in evacuation centres in the provincial capital of Bangued. The first reports of a surge in the eye infections emerged in Santa Rosa, Cabaluan, and San Antonio, however more barangays and towns are now implicated. Read more

6 Zika cases confirmed in Honiara

Enhanced testing carried out in advance of the Pacific Games (being held in Honiara between Nov 19 and December 2 this year) detected six confirmed Zika virus cases in the capital as of Sept 30. A Ministry of Health & Medical Services Facebook post urged residents to clear mosquito breeding sites. The government has also published Health Advice for Travellers to the 17^th Pacific Games. Read more

Advice for travellers

Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read more about Zika virus through healthdirect.

Dengue surge in south

The more than 2,500 dengue fever cases recorded last week has taken this year’s national total to an 8-year high. To date, there have been 13,036 local dengue fever cases and 20 deaths. Most of the cases reported last week were in Tainan City. 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.

‘significant epidemiological event’

The Ministry of Health has reported that more than 750 people have reported symptoms of influenza-like illnesses including fever, cough, sore throat, body aches and fatigue since Sept 18. Samples have been sent to Australia for testing, but to date COVID-19 RATs, dengue and typhoid serology have been negative. Read more

Cholera cases in Harare

An outbreak of cholera continues in Buhera district, Manicaland province, and Harare health officials have now confirmed five cases in the capital, only three of which may have been acquired in Buhera. The Harare cases are from five locations: Hopely Zone 5, Stoneridge, Southlands, Granary and Adbernie Mbare. In response, the health ministry has suspended public gatherings and open markets. 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. For those at higher risk, an oral cholera vaccine is available. Read more about cholera.