Travel Health Alerts

MenB vax for Qld kids; Measles alert for northern NSW

The Qld government announced last week that from 2024 it will fund meningococcal meningitis B (MenB) vaccines for infants aged two years and under, and adolescents from 15 to 19 years of age. The vaccinations will be administered through the routine childhood and school immunisation programs. According to the government media statement, ‘Queensland has recorded 20 cases of MenB so far this year, following 10 cases to the same time last year, with a total of 26 cases in 2022.’ Read more

A MEASLES alert has been issued for northern NSW and the state’s mid-north coast after a person who was believed to have been infected while on holidays in Bali visited locations including AFL games in Coffs Harbour and Woolgoolga on July 30 and a site in Minnie Water the following day. The Mid-North Coast Local Health District advised that a high number of measles cases have been reported from Bali ‘in recent months’. 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 death toll passes 300

Dengue fever cases usually peak in September following the progress of the monsoon season, but the current death toll of at least 303 is already higher than the 2022 total. Just over half of the 63,000+ cases recorded by August 5 have been from Dhaka and the city’s hospitals are said to be overwhelmed with dengue fever patients. In neighbouring India, monsoon-associated health events reported over the week included a surge in dengue fever cases in Jammu division (Jammu and Kashmir), dengue and cholera in Mohali (Chandigarh), scrub typhus in Raiganj (West Bengal), Japanese encephalitis in Assam, and malaria in Mumbai (Maharashtra). 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.

Leishmaniasis risk regions listed

According to the Sichuan CDC, there are only a few remaining leishmaniasis-endemic regions in China, however those that are still active are Shanxi, Gansu, Shaanxi, Xinjiang, Sichuan and Henan 6 provinces (autonomous regions). The agency has called for vigilance against bites from the parasite’s sand fly vector. Read more

Advice for travellers

Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. The former causes skin ulcers and the latter a severe systemic disease that is usually fatal without treatment. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil account for 90% of visceral leishmaniasis, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia and Argentina. Read more on the disease and prevention.

Global polio digest

Local media have reported a second wild poliovirus type 1 (WPV1) case this year - a young girl with acute flaccid paralysis from a NW district of Khyber Pakhtunkhwa province. In other news on polio from the weekly GPEI update, the D R of Congo recorded 10 circulating vaccine-derived poliovirus type 1 (cVDPV1) infections (mostly from Tanganyika province) and four cVDPV2 patients from the provinces of Haut Lomami and Lualaba. A single cVDPV2 case was also reported from Nigeria’s Kebbi province. 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.

First WNV cases in south-west; Locally acquired dengue near Marseille

Last week the ECDC reported the first locally-acquired human cases of West Nile virus (WNV) fever in the SW region of Gironde-Nouvelle Aquitaine. In August 2022, positive WNV results were obtained from horses in Gironde, while human WNV cases have been reported in France in the past, but in the SE. A separate ProMED report noted that the Gironde infections (three asymptomatic, two with West Nile fever and two with neuro-invasive disease) were probably contracted in an area that includes the city of Bordeaux. Other WNV reports from the region were tabled by Italy (25 cases, one death) and Greece (eight cases, two deaths). Read more

TWO RESIDENTS of the town of Gardanne near Marseille in the Bouches-du-Rhone region, without a relevant travel history, have tested positive for dengue fever, becoming the first indigenous cases this summer in France. Health authorities have carried out insecticide fumigation in the immediate area. 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 hotspots in 7 departments

Epidemic dengue fever conditions are rife in seven departments (Comayagua, La Paz, Yoro, Atlantida, Olancho, Copan and Ocotepeque), while alerts have been issued for eight more. The incidence of dengue has been increasing each week since mid-April, sustained by wet weather and plenty of mosquito breeding sites in uncovered water storage containers. By July 22, more than 3,500 cases had been recorded in Francisco Morazán department’s Central District (location of the capital, Tegucigalpa) and 922 in Comayagua. Read more

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.

Contaminated medicine alert

A sixth medical product alert has been issued by the WHO since October last year, relating to contaminated liquid medications used in the management of symptoms of respiratory tract infections or allergies. The syrups which were found to be contaminated with unacceptable levels of diethylene glycol and/or ethylene glycol were manufactured in various facilities in India and have so far been detected in eight countries - Iraq, Gambia, Indonesia, Uzbekistan, Cambodia, Marshall Islands, Micronesia and Cameroon. Read more

JE virus activity in southern island

The results of testing performed on sentinel pigs in an arbovirus surveillance program in Kumamoto prefecture have led to a Japanese encephalitis (JE) warning after one animal was found to have antibodies to JEV. With evidence of recent viral circulation, residents of the central Kyushu prefecture have been advised to take measures to avoid mosquito bites. 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, and now parts of Australia. 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 low. The recommendations for vaccination are itinerary-specific. Read more on JE.

Capital, 2 provinces with highest dengue counts

Dengue fever cases are reporting to be surging, with highest numbers to date in the provinces of Oudomxay, and the capital Vientiane. Almost 17,500 cases have been logged so far this year and there have been 12 fatalities. 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.

Brucellosis uptick in central state

Heath authorities in the state of Guanajuato have confirmed the detection of Brucella bacteria in unpasteurised artisanal cheeses sold in Pénjamo after hygiene and food safety checks were carried out on outlets selling dairy and meat products. Ninety-six brucellosis cases were registered in the municipality in the year to July 8, a substantial increase on the 34 infections diagnosed during the same period last year. Read more

Men. meningitis outbreak in Zinder

More than 1,600 suspected and confirmed cases of bacterial meningitis and 99 deaths have been reported from the SE region of Zinder. Testing of symptomatic infections were positive for Neisseria meningitis serotype C. The Africa CDC said in a weekly surveillance report that response measures already enacted included immunisation drives and public awareness initiatives. The affected area is near the Nigerian border and lies in the Africa’s Meningitis Belt. 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, extended contact with local people in crowded places and travel to North Africa’s ‘meningitis belt’ where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). Read more about Men. meningitis.

Fatal CCHF infection from tick bite

An agricultural worker from a remote area near the eastern city of Štip has died of Crimean-Congo haemorrhagic fever (CCHF) just over a week after finding a tick on his abdomen. The CCHF diagnosis was confirmed post-mortem, while a second, fatal case has been reported in a healthcare worker in contact with the patient at the treating hospital in Skopje. The CCHF virus was first detected in North Macedonia in 1971 and the tick vector is now established in all regions. According to the ECDC, sporadic CCHF cases ‘have also been reported in the neighbouring countries of Albania, Bulgaria, Greece and Kosovo’. 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.

Gastrointestinal diseases spread from Dolisie

While the initial reports of gastrointestinal illnesses stemmed from Dolisie in Niari department, the latest updates reveal the spread of shigellosis, cholera and typhoid fever from the epicentre to Pointe-Noire, Bouenza, Kouilou and Brazzaville departments. The concurrent outbreaks have hit children aged five to 14 years the hardest and the WHO reports a ‘high number of cases with intestinal perforation’ from severe typhoid fever infections. 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.

Worst dengue season in 10 years

Dengue fever case numbers are now their highest in a decade and the threat of infection will continue during the current typhoon season. Public health experts have called for more preventive measures aimed at dengue hotspots in the south and for the benefit of domestic tourists. Read more

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.

Harare’s mumps surge

Health authorities have announced an increase in mumps cases diagnosed at Harare’s schools and health centres. Sub-optimal vaccination rates over the past year have contributed to the spread of mumps, or mahumunya, during its annual winter peak season. 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.