Travel Health Alerts

Kabul province tops list with CCHF

Almost half of all fatal Crimean-Congo haemorrhagic fever (CCHF) cases this year have been in the province of Kabul from a national total of 949 suspected infections across 14 provinces. A senior doctor with the health ministry’s zoonosis department has reminded residents to avoid tick bites and for those working with potentially infected meat products, to employ protective clothing and hygiene measures. Read more

Advice for travellers

CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about the virus.

Dengue cases surge

More than 5,000 new dengue fever cases have been registered since early August, with highest incidence in the northern province of Oudomxay (rounding out the top five provinces were Khammouane, Vientiane Capital, Luang Prabang and Savannakhet). The peak rainy season runs until mid-October. Elsewhere in the region, in Vietnam more than 1,100 dengue cases were recorded in Hanoi over the week to Aug 31, while Tainan has had over 87 percent of Taiwan’s dengue cases this year as another 1,300 cases were logged last week across the country, and the national dengue case total in Bangladesh has risen to nearly 136,000 with 657 deaths.  More regional information on dengue fever can be found in the Update on the Dengue situation in the WHO Western Pacific Region of August 17. 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.

Global polio digest

The country’s first case of circulating vaccine-derived polio type 2 (cVDPV2) this year has been reported to the GPEI, from the Red Sea port of Al-Hudaydah, while the two other nations with cVDPV2 infections were Chad (four cases in the regions of Lac, Logone Oriental and Logone Occidental) and the DR of Congo (16 cases, with 11 from Kasai Oriental). The DRC also logged six cVDPV1 patients (five from Haut Katanga). Read more

Advice for travellers

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.

Severe dengue season

With 22 dengue fever fatalities recorded this year and case numbers passing 12,250, a 3-month national emergency was declared last week to direct more resources towards vector control and patient care. Also in the region, suspected dengue fever cases are on the rise in Nicaragua, adding to the 75,000 reported to the PAHO by early August. Nicaragua has recorded the highest cumulative incidence, followed by Belize, Panama and Honduras. 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. 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.

Diphtheria kills 9 in southern region

Following on from the news of a diphtheria outbreak in four districts of Guinea’s northern Kankan region (now with 117 suspected cases, 37 deaths), the African CDC reported on a surge in cases in southern Niger. More than 270 diphtheria cases and nine deaths have been confirmed in Matamaye health district, Zinder region. 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.

Conjunctivitis spreading in Karachi

An outbreak of viral conjunctivitis has hit the port city of Karachi (Sindh), with ‘significant numbers’ of people suffering from the infection reaching out to hospitals and clinics for treatment each day. A surge in conjunctivitis cases was also reported in several Indian states earlier in the monsoon season and more recently in Himachal Pradesh. Read more

Zika case reporting

A news source has reported new Zika virus infections in 24 provinces over the past month, with highest case numbers in Chanthaburi in the SE (37 cases) and 23 in Phetchabun in the central north. A July 27 news article from another outlet said at that time that the case total for the year to mid-July was 110 Zika cases from 20 Thai provinces. In related news, further testing is being sought to reconfirm Zika virus infections in three people from Ichalkaranji in the Indian state of Maharashtra. One of the individuals had a recent history of travel to Ratnagiri and Ganpatipule, while local media today reported a second confirmed Zika infection in Mumbai. 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.  

Measles count rises in 77, global update

As the number of young children from West Aceh district who have caught measles this year climbed to 77, the health office urged parents to ensure their infants are vaccinated in the first year of life. In other reports on measles: a second non-travel related measles case confirmed in Texas (USA) this year was the subject of an Aug 29 health department news alert; a Sept 1 report on measles and rubella in Kyrgyzstan noted that the epidemiological situation has deteriorated as infections spread from Bishkek city, Osh city to seven regions in all; and last week, UN News reported 34,000 suspected cases of measles and rubella and 413 deaths in Yemen in the year to July as funding gaps narrow the age groups of children targeted in vaccination drives. Read more  

Advice for travellers

A highly contagious virus, measles occurs in developing and developed countries. While usually relatively 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.

Weeks more of dengue transmission

Dengue fever transmission is expected to continue until mid-October and the national tally has already passed the 23,000-mark with 14 deaths. Highest case numbers have been in the SE district of Sunsari (most of those in Dharan), recording more than five times the next most affected districts, Morang and Dhading. 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.

August increase in Hep E

Investigations are underway into a spate of hepatitis E cases in August – 11 infections have been confirmed. Advice from the government particularly directly at people who are immunocompromised, pregnant or with liver disease is to avoid consuming raw pork, venison, fish and unwashed vegetables. Read more

Advice for travellers

Hepatitis E is a liver disease caused by the hepatitis E virus (HEV). Although rare in developed countries, hepatitis E is widespread in the developing world. In the vast majority of people, HEV infection results in a self-limited, acute illness. However, acute infection can be fatal during pregnancy or become chronic in rare cases, primarily in people who have received solid-organ transplants.

MERS-CoV update

On August 29 WHO Disease Outbreak News post updating data on MERS cases since mid-September last year advised that three more infections - two fatal - have been recorded (in Riyadh, Asser and Makkah Al Mukarramah regions). All had comorbidities and known direct contact with camels or consumed raw camel milk in the previous fortnight, however there was no evidence of onward transmission of the virus to their contacts. Over 90 percent of global MERS infections have been in Saudi Arabia, and 84 percent of related deaths. The WHO report suggested that the recent decline in new MERS cases was probably influenced by ‘epidemiological surveillance activities for COVID-19 being prioritized and the similar clinical picture of both diseases, resulting in reduced testing and detection’. Read more

Advice for travellers

Middle East respiratory syndrome (MERS) is a rare but severe respiratory illness that originated in Middle Eastern countries. It is spread through close contact with camels, camel products, or an infected person.

Cholera outbreak in south

Cholera has spread among communities in the south central district of Kayunga and on the Sigulu Islands in Namayingo district since late June; most cases and all fatalities to date have been in Kayunga. In related news, a cholera outbreak in Zambia’s far north Nsama district has killed four people and there have been at least 103 suspected and confirmed cases. 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.

Meningococcal in mid-Atlantic state

On August 30, health authorities in the state of Virginia announced that since a meningococcal meningitis outbreak was first confirmed in the east in September 2022, case numbers have risen to three times the average and infectioins have now also been detected in the SW and central regions. According to the press release, ‘Most case-patients are Black or African American adults between 30-60 years of age’. The outbreak total sits at 27 Neisseria meningitidis serogroup Y cases and five deaths; no common risk factor has been determined as yet, however specimens were ‘highly genetically related’.  Read more   

Advice for travellers

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 doctor. Read more about Men. meningitis.