Travel Health Alerts

Diphtheria clusters in south

Last week, 11 confirmed diphtheria infections were reported from the southern towns of Tamanrasset and Tin Zaouatine (on the Algerian side of the border shared with Mali). The cases, plus more that are suspected, were found among foreign children who do not attend local schools. According to the news report, large families from Mali and Niger arrive in the area each year to escape harsh summer weather. 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.

Infectious measles case in Brisbane’s north

Another imported measles infection has led to a QLD health department alert for Brisbane and Redcliffe. The man who was infectious with measles had flown from Jakarta to Brisbane via Melbourne, arriving on July 3. The numerous locations he visited are listed in a Metro North Public Health release and they include lengthy waits at a hospital emergency department on both July 13 and 14. All those who may have been in the potential exposure sites are asked to monitor for symptoms for 18 days. 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.

Influenza activity update

An update on flu activity across the globe during a 14-day period in mid-June noted increased levels of both influenza and RSV infections in Australia (and RSV in Fiji, the Marshall Islands and Palau). Also in the report: Costa Rica had ‘extraordinary levels’ of flu activity, high levels in Honduras and in Mexico, activity was higher than usual for this period (influenza B predominately). Read more

Advice for travellers

Seasonal flu is the most common vaccine-preventable travel-related illness in most years because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination for all travellers over 6 months of age. Read more about influenza

Global polio digest

The first detections of circulating vaccine-derived poliovirus type 2 (cVDPV2) for 2023 were reported to the GPEI last week. Two acute flaccid paralysis (AFP) cases with onset of paralysis in late May, plus an asymptomatic community contact from a camp for displaced persons, were recorded in Fafi district in the province of Garissa. The infections have been linked to virus strains collected in Banadir, Somalia. Other cVDPV2 reports were issued by Benin (two cases from Borgou and Littoral), the Central African Republic (three cases from RS4, RS6 and RS7 regions), and Niger (single case in Maradi). 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.

More oral transmission of Chagas

Açaí and sugarcane juice (garapa) contaminated with the Trypanosoma cruzi parasite are now the source of around 70 percent of Chagas disease cases in endemic areas. The infection is transmitted through the bite of the triatomine or kissing bug or when it, or its faeces, are crushed in the juicing process. Large producers will process the juice to remove the contaminants, but this is not the case for many local vendors. Read more

Advice for travellers

Although widespread in Mexico, Central America, and South America, Chagas disease presents a low risk to Australians travelling to the Americas. Travellers who sleep indoors in air-conditioned or screened hotel rooms are at low risk for exposure to infected triatomine bugs (aka kissing or assassin bugs), which infest poor-quality dwellings and are active mainly at night. However, as has become more common, the disease can also be transmitted through food and freshly pressed juice contaminated with the faeces of insects attracted to ripening fruit. Read more on Chagas disease.

Gastro cases spike

Doctors report increasing numbers of people seeking treatment for gastroenteritis: viral infections have recently spread among children and now temperatures in the high 30s and 40s each day have led to a spike in food poisoning diagnoses. Some cases have also been seen in Cypriots who had travelled to SE Asian destinations on holiday. Record high temperatures are being recorded across many areas in the Northern Hemisphere – heat stress warnings are current for widespread regions of Europe. Read more

Dengue in Nile city; E.coli alert for Red Sea resort area

More than 250 residents of the village of Al-Aliqat, Qena Governorate have been diagnosed with dengue fever, according to local media. Response teams are being sent to the area, which is to the north of Luxor on the banks of the Nile. The last dengue outbreak in Egypt occurred six years ago in Qusseir city, Red Sea governorate. Read more

HEALTH AUTHORITIES in Germany say they have seen an uptick in E. coli infections and associated haemolytic uraemic syndrome in returning travellers from Egypt. While many had stayed in the Red Sea resort city of Hurghada, the sources of infection have not been identified as yet. In 2019, the same area was the subject of travel advice from Public Health England due to a spike in E. coli infections among UK travellers. 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.

Cholera outbreaks increasing, longer-lasting

Climate-related factors and conflict in the Horn of Africa have contributed to more frequent and lengthier cholera outbreaks. “Current cholera outbreaks in the Horn of Africa are among the longest outbreaks ever recorded in the region and there are multiple outbreaks happening at the same time,” says Samreen Hussain, MSF’s medical coordinator in Ethiopia. “While we are putting an end to one outbreak in one location, a new outbreak starts elsewhere.” 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. Read more about cholera.

TBE activity spreads

A public health update on the incidence of tick-borne encephalitis (TBE) since 2021 revealed a further spread in the range of the virus and a lengthier risk season. In those two years, highest TBE case numbers were in Haute-Savoie, with a recent uptick in Alsace, while virus activity was greatest in the mountains of Auvergne-Rhône-Alpes and in the south of Ardèche. 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 doctors through a Special Access Scheme.

Dengue clusters spark warning

The gradual rise in dengue fever reports which has accelerated in recent weeks has provoked some concern with the regional health authority that an epidemic may be brewing. Over the past month, clusters of dengue infections have been detected in 13 towns, and the summer’s season of cyclones and popular festivals may be all that is needed to trigger the rapid spread of the dengue virus. To the south, Panama’s health ministry, MINSA, released its latest epidemiology report on vector-borne infections, noting that 2,700 dengue infections have been recorded this year, with highest case numbers in Bocas del Toro, Columbus and Panama Metro.  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.

Measles immunity gap

Despite 10 percent of school age children having no measles vaccinations and 104 locally-acquired cases recorded in the first six months of the year, a governmental risk assessment reported that, based on several factors, ‘the risk of widespread transmission of measles, leading to a measles epidemic across the UK is considered low’. There is however ‘a high risk of imported cases leading to outbreaks in specific population groups’, particularly those with low vaccination rates and in high density districts such as in London and other inner-city areas. Without an improvement in measles vaccination rates there is the potential for ‘an outbreak of between 40,000 and 160,000 cases’ in London. In related news, a vaccination drive is underway in Kenya’s Mombasa County in response to an outbreak in Mvita and Likoni sub-counties. And at least 700 children aged between five and 10 years who arrived in South Sudan after fleeing the conflict in Sudan are receiving treatment for measles infections in Bentui, 31 have died. 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.

Shigella cases in 3 departments

The highly infectious gastro-intestinal illness shigellosis has sickened at least 1,200 people and caused the deaths of five in Dolisie, in the western province of Niari. A health ministry update advised that the infection had also been detected in the coastal city of Pointe-Noire, with six cases and one fatality recorded, as well as in the department of Bouenza. The government has asked residents to employ enhanced personal hygiene measures to avoid faecal-oral transmission of la maladie des mains sales, ‘dirty hands disease’. In other news on shigella, the ECDC released an epidemiological update this week covering the ‘Spread of multidrug-resistant Shigella in EU/EEA among gay, bisexual and other men who have sex with men‘, reporting that more than 300 cases have been diagnosed in the EU and USA since April. 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.

Heat, rains escalate malaria risk

Higher temperatures and increased rainfall has allowed malaria mosquito populations to boom, which has in turn caused a rise in cases this year. The Korea Disease Control and Prevention Agency (KDCA) has advised that malaria infections (P. vivax) recorded so far this year in Incheon and the provinces of northern Gyeonggi and Gangwon are nearly 2.5 times higher than the same period in 2022. 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.

Cholera trends remain worrying

The cholera outbreak has taken a concerning turn, with Harare province now appearing to be the epicentre after a 35 percent rise in new cases over the week. Deaths also rose 5-fold and were all from Manicaland province - one of the three other provinces reporting new cases (also Mashonaland South and Mashonaland East). The regional WHO weekly bulletin noted that ‘the spread to new hotspot areas and deaths already having surpassed those reported in the last major outbreak’ in 2018-19. Elsewhere, it an ECDC update, the suspected cholera case in Sardinia reported last week has now been revised to an infection with Vibrio cholerae non-O1 and non-O139, ‘and therefore not classified as a cholera’. The source of infection was suggested as consumption of raw mussels. 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.