Travel Health Alerts

2 imported measles cases in NSW

Another report on returning travellers diagnosed with measles – this time two family members, who were infectious at the time, visited numerous locations in Sydney after arriving on a flight from Doha on July 14. The sites are listed on the NSW Health Department alert dated July 21 and the public is reminded to monitor for symptoms up to 18 days after a potential exposure to the viral illness. 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. 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.

Dire dengue warnings

The Save the Children organisation has warned that heatwave and rainy conditions threaten the health of millions of children in SE Asia through worsening outbreaks of dengue fever. Thailand’s children make up many of the 4-fold increase in dengue cases this year, while Bangladesh, Malaysia and Cambodia have also experienced sharp rises in incidence that have disproportionately affected younger age groups. 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.

High risk dengue season

A WHO Disease Outbreak News post issued this week covered dengue fever in the Americas, describing ‘outbreaks of significant magnitude’ and almost three million cases across the region. The agency assessed the risk of dengue as high due to several factors, including the prevalence of the vector mosquito ‘and the expansion out of historical areas of transmission, where all the population, including risk groups and healthcare workers, may not be aware of warning signs’. The report also contains updates of dengue fever in 10 selected countries. 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.

Whooping cough spikes in eastern capital

All but 40 of the 469 pertussis (whooping cough) cases recorded nationwide this year have been in Santa Cruz department, and half of those were in the capital, Santa Cruz de la Sierra. Parents have been reminded to ensure their children received their routine vaccinations on time. Read more

Advice for travellers

Travelvax Australia recommends that all travellers ensure they are current for whooping cough (pertussis) and all childhood vaccinations, including, diphtheria, measles, chickenpox and tetanus for travel to any destination – be it a developed or developing country. Read more about pertussis.

Global polio digest

A vaccine-derived poliovirus type 2 (cVDPV2) case, the first in Tanzania, has been detected in the western region of Rukwa. Onset of paralysis was in late May. Surveillance has been stepped up, while immunisation drives continue as part of the regional response to outbreaks in SE Africa. The strain collected in Rukwa has been linked to a virus isolated in Burundi. Other cVDPV2 reports over the week came in from Chad (five patients across Mayo Kebbi Est, Logone Oriental, Ouaddai and Lac) and the DR of Congo (16 cases, plus eight cVDPV1). 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.

Malaria uptick in 5 departments

The departments of Antioquia, Chocó, Risaralda, Cauca and Quindío are named in a malaria alert over concerns of impending outbreaks, while another four are said to be at risk. In the year to the second week of July, more than 45,000 malaria cases were recorded, mostly due to the Plasmodium vivax parasite. P. falciparum was confirmed in another 33 percent and 10 percent were mixed infections. Read more

Advice for travellers

Travelvax recommends that travellers visiting malarious regions discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. More on malaria.

Measles infection rates rise

According to health ministry data, at least 730 measles cases (and two deaths) were recorded for the year to mid-June, a substantial rise on 2022 figures. While highest case numbers were reported in Central Luzon, Central Visayas and Zamboanga Peninsula, the biggest incremental rises were in Central Luzon, Eastern Visayas and Soccsksargen. In other news on measles, an immunisation drive is planned for southern districts of Khyber Pakhtunkhwa in Pakistan after 4,000 cases were reported (mostly from Tank, Bannu, Lakki Marwat, Dera Ismail Khan, and North and South Waziristan), while several health zones in the DRC’s Ituri province are experiencing measles epidemics. Lastly, South Africa’s prolonged measles outbreak is all but over after the NICD recorded more than 1,100 cases from eight provinces. Sporadic cases are still being detected in Gauteng and Limpopo. 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.

Probable odyssean malaria case

Twelve months after the last reporting of ‘airport malaria’ at Frankfurt, another case is suspected in a passenger agent working an airbridge between aircraft and the terminal. The worker, with no relevant travel history, was diagnosed with P. falciparum malaria on July 22, leading local doctors to suggest his was a locally-acquired infection. Read more

Seasonal disease reports

The SW monsoon has covered all areas of the country since early July and in this past week, related disease reports have emerged: scrub typhus in Himachal Pradesh (Shimla district) and conjunctivitis affecting school students in Uttar Pradesh (Kanpur and Jhansi districts) and Arunachal Pradesh (Longding district), while measles and mumps is spreading in ‘small clusters’ of children across Kashmir. Read more

Advice for travellers

Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases.

Update on cholera

The cholera outbreak is now into its 11^th month and cases have been declining in recent weeks from the peak in late March. According to the WHO weekly bulletin, ‘the outbreak epicentre has shifted and is now largely concentrated in three districts (Nampula City, Meconta, and Erati) in Nampula Province and two districts (Macomia and Mueda) in Cabo Delgado. The provinces are known to have cholera hotspots. 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.

WHO assesses GBS risk

The WHO has published a Disease Outbreak News post on the ‘unusual increase in Guillain-Barré Syndrome (GBS) cases in different regions of the country’. Investigations are continuing into the cause of the 231 suspected cases currently reported, more than half of which were recorded in the five weeks to July 15. During that period, the WHO stated that ‘22 samples were collected of which 14 (63%) were positive for Campylobacter jejuni (one of the most common risk factors for GBS)’. Peru’s GBS outbreak of 2019 was eventually linked to Campylobacter infections. Read more

Shigella, and now cholera in Niari

Further investigations into the shigellosis reports last week in Dolisie City, Niari Department have also uncovered a number of cholera cases. Combined case numbers to July 16 climbed to 1,365 with 12 deaths. The health ministry has declared a cholera outbreak. Read more

Advice for travellers

Caused by Shigella bacteria, shigellosis can result in diarrhoea, fever, and stomach cramps starting a day or two after exposure via the faecal-oral route, including through contaminated food or sexual contact. Persons with mild infections usually recover quickly, but antibiotic treatment is recommended for patients with more severe symptoms. Read more.

Gastro woes for holidaymakers

UK health authorities have reported a spike in gastrointestinal infections caused by Salmonella bacteria and the majority occurred in travellers returning from the coastal region of Antalya in the country’s SW. Just over 240 cases in five clusters were recorded in the first six months of this year, the most recent on July 19. The afflicted travellers stayed in all-inclusive hotel resorts and ate ‘a wide variety of different foods’. Read more

Advice for travellers

Salmonella is a bacterium typically found in food, such as poultry, that causes diarrhoea, fever, and abdominal cramps between 12 and 72 hours after infection. Illness usually lasts 4 to 7 days, and most people recover without treatment, although diarrhoea may be so severe as to require hospital treatment. Young children and the elderly are at highest risk of severe illness. As there is no vaccine to prevent salmonellosis, it is best to avoid raw or undercooked eggs, poultry, or meat. Read more

MERS case in border city

The WHO this week announced the confirmation of a MERS-CoV case from early June in Al Ain city, on the border with Oman. The man, in his late 20s, has no underlying illnesses and there was no history of travel, or of ‘direct or indirect contact with dromedaries, goats, or sheep’. He has received supportive treatment for respiratory failure in an ICU and all of his contacts have cleared the period of monitoring without issue. Read more

Rabies round-up

ProMED has summarised recent human rabies exposures in seven states that involved confirmed or potential contact with infected animals (cat, fox, bat and dogs). One of the posts described an attack on a young girl swimming in Georgia’s Lake Lanier by a beaver that was later found to have rabies. Signs alerting the public to the incident have been displayed in the area. Read more

Advice for travellers

Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals – especially dogs, the main source of infection. If bitten, urgent post-exposure treatment is required. Vaccination recommendations are itinerary-specific but include those travellers planning to live in, or travel extensively or repeatedly through, endemic countries and also for children. Read more on rabies.

‘Sandworm disease’ in beachgoers

Thirteen people from Cuidad Guyana (Bolivar state) reported they were infected with animal hookworm larvae while playing tennis in a public area at a local beach. The infection, cutaneous larva migrans or creeping eruption, resulted after contact between the skin on their feet and the sand which was contaminated with the excreta of infected dogs or cats. There have been calls for authorities to clean up the affected areas. Read more