Travel Health Alerts

Shifting disease patterns and outbreaks affect the recommendations and information we provide to travellers during a pre-travel consultation. Each week Travelvax updates the current travel health alerts to reflect those issues which could affect travellers heading to a particular region or country. We do this by scanning the websites of health agencies such as the World Health Organization and the European and US Centers for Disease Control, as well as international news media. Simply click on the point on the map of your area of interest for more details on the current health alert. We also include Advice for Travellers which gives background information and tips. If you have any further questions, of course you can give our Travelvax infoline a call during business hours on 1300 360 164.

World travel health alerts for 16th of August 2018

States battle mosquito-borne illnesses

Mosquito-borne infections have maintained a strong presence in the state of Minas Gerais. Chikungunya case numbers have now topped 10,000 and suspected dengue fever infections have risen even further, to 23,265 with at least seven deaths attributed to the illness; another nine under investigation. Read more. And in the central-western state of Mato Grosso, chikungunya infections have surged by more than 200 percent over last year’s figures - Várzea Grande, a city adjacent to the capital Cuiabá recorded almost 10,000 cases this year. Read more 

Advice for travellers

The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.

Measles alert for cruise passengers

Passengers on board a ship that cruised from Vancouver to Seward in Alaska, departing on August 6th, have been advised to be alert for measles symptoms. A teenager who was infected with measles was promptly isolated after boarding in Vancouver, so the risk of infection to others was said to be low. 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.

Local dengue investigated

Hong Kong health authorities reported the first four locally acquired dengue fever cases this week. As investigations continue into the locations where each person was infected, the Centre for Health Protection has issued a map of the sites of distribution and information on each case. 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 and preventing insect bites.

NE region Ebola update

The World Health Organization (WHO) has declared the public health risk to other countries in the region presented by the Ebola Virus disease (EVD) outbreak in the highly populous North Kivu area to be high. Enhanced screening is planned for entry points on a local level, but also in the neighbouring countries of Burundi, Central African Republic, Rwanda, South Sudan, Zambia and Uganda. To August 14, there have been 73 cases of haemorrhagic fever of which 46 are confirmed as EVD. A further 27 are considered probable and 40 others are undergoing testing. Several new cases were diagnosed at Mabalako; all are contacts of previously identified cases. Of the 43 deaths recorded, 16 were confirmed EVD. Read more. An experimental treatment for EVD using monoclonal antibodies, still in early clinical trials, is to be employed in the area. Read the FAQs.

Advice for travellers

Ebola Virus disease 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.

Towns in 4 departments on dengue alert

Six towns have been placed under a yellow (moderate) alert for dengue fever while authorities have also announced an increase in severe dengue fever cases. The towns on alert are in four regions (departments): Santa Ana, Chalatenango, La Libertad and San Salvador. Read more (translate from Spanish).

Monsoon season outbreaks

Monsoon-associated illnesses including dengue fever, leptospirosis and gastro intestinal infections are surging in Mumbai. Dengue fever is also a mounting concern elsewhere in Maharashtra state (Kolhapur, Nashik and Pune), while in Odisha, there’s been a jump in cases in a commercial district of the capital Bhubaneswar, and villages in the district of Kalahandi. Other locations reporting dengue outbreaks this week: Durg (Chhattisgarh),  Hyderabad (Telangana), Parmanoo (Himachal Pradesh) and Andhra Pradesh. In the SW state of Karnataka, malaria case numbers are climbing in the district of Dakshina Kannada that includes the commercial port city of Mangaluru. In Assam, the death toll caused by the Japanese encephalitis virus (JEV) this year has reached 66 among more than 320 confirmed infections. The latest death occurred in Dibrugarh, a city surrounded by tea estates. JE is endemic in Assam and is considered a major public health issue. Four JE cases have been reported in Bhopal (Madhya Pradesh); the infection was identified in the city for the first time last year. Contaminated drinking water has sickened more than 900 people in two villages of Kupwara district in the state of Jammu and Kashmir. A local news source cites a government report which claims that ‘74 percent of drinking water samples tested from Kashmir have been found contaminated’. 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 low. The recommendations for vaccination are itinerary-specific. Read more on JE

Measles on the march

ProMED reports on the increase in measles cases occurring in many Libyan cities, noting that the outbreak is spreading fast. Read more

KL's dengue uptick

There has been a recent surge in dengue fever cases in Kuala Lumpur, with the greatest impact felt in three northern districts – Batu, Kepong and Segambut. Read more

Hep A cases linked to Vanuatu

Health authorities reported on seven hepatitis A cases that occurred in travellers returning from Vanuatu. The infections were acquired during an 18-day visit dating from June 10th. 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 contaminated food and water, by handling everyday items and 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 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

Mumps outbreak slows, but not over

Auckland’s mumps outbreak is finally slowing, down from the peak of the epidemic in October 2017. In the 18 months to the end of June, almost 1,300 mumps cases were recorded in the city’s health region – the highest incidence has been among children and adults aged 10 to 29 years. 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.

Resistant typhoid cases mounting

During a local news interview, an Assoc. Professor of Pathology and Consultant Microbiologist in Islamabad has put the number of extensively drug-resistant typhoid fever cases recorded during the first half of this year at ‘around 2,000’. The US Centers for Disease Control and Prevention (CDC) issued a travel advisory for Pakistan in early July. Read more

Advice for travellers

Typhoid 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 generally 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.

Another polio case confirmed

The Eastern Highlands province is the latest to report a case of polio, the fourth in the country since late July. The WHO considers the risk of further spread is high. Immunisation campaigns are underway and are being offered to all children under five years of age. Surveillance of reported acute flaccid paralysis continues – 65 cases are under investigation. Read more

Advice for travellers

Polio 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

Monsoon-related illnesses spike in highlands

A spike in cases of dengue fever and leptospirosis cases has been reported in the Cordillera region of northern Luzon - the provinces of Benguet, Kalinga and Apayao have reported most of the dengue cases. The cooler weather of the highlands means the area is a popular destination during summer. Read more

Advice for travellers

The Philippines averages almost 7000 leptospirosis cases and 40 fatalities a year, with the seasonal peak occurring during the rainy months from July to October. 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.

Measles cases soar to over 5,700

While Slovakia’s spate of measles is waning, the epidemic in Serbia continues with the case count for confirmed and suspected infections now over 5,700 (and 15 associated deaths) for the past 10 months. Read more. The latest report on the extensive outbreaks across many EU countries can be found here

HFMD incidence on the rise

There has been a surge in cases of hand, foot and mouth disease (HFMD), with nearly 1,250 for the week to Aug 4th. While there have been more reports than usual of the EV71 strain, it is not the predominant cause. Two Malaysian children have died this year from complications of infection with EV71. Read more

Advice for travellers

Parents of young children should be aware of that seasonal epidemics of HFMD occur throughout Asia. The virus 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.

E Coli flare up

Investigations are being carried out to determine the origin of an outbreak of E Coli infections that has spread countrywide. According to a Xinhuanet news article, two cities have been hardest hit – Uppsala and Gotaland. Read more 

Tick season in full swing

In an update on the current tick-borne encephalitis (TBE) season, there are new record highs – a slight increase in cases, more serious infections – almost four times the 2015 rate - and more doctor’s visits for tick bites and bacterial infections. Vaccination is recommended for at-risk areas in Switzerland and may be extended to cover most of the country next year. Read more. In the Czech Republic, the SE region of South Moravia is reporting a three-fold increase in new TBE cases when compared to the last two years. While the TBE vaccine is recommended for Czech nationals, it is not funded by the government and so uptake is low, around 25 percent. Read more

Advice for travellers

A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia; however, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE

More dengue for New Taipei City

Several more dengue fever cases have been added to the cluster in an inner district of New Taipei City, with authorities urging the use mosquito bite avoidance measures and the removal of insect breeding sites in the immediate area. Of the 14 locally acquired cases this year, 10 have been from Xinzhuang district. Read more

Typhoid in Midlands

A national youth sporting competition which was to take place this week in the midlands capital of Gweru has been deferred due to an outbreak of typhoid fever. According to reports, there have been up to 350 confirmed cases and five resulting deaths; most areas of the city are affected. As contaminated drinking water is believed to be the cause of the outbreak, the government is to provide water tankers and water purification tablets. Read more