Travel Health Alerts

Dengue fever cases surging

Senior officials in the health ministry have warned that this year’s dengue fever outbreak will be greater than the last (in 2020), with viral activity confirmed in the city of Buenos Aires and 13 provinces, and dengue infections likely to be reported for a few more weeks this season. Case numbers for the year to April 1 rose to more than 28,200 – up by more than 27 percent over the previous week. 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.

2 MVE cases in Riverina residents; Second measles case in Sydney’s west

Murray Valley encephalitis (MVE) cases reported this season in NSW have risen to four after two new cases in the Riverina were announced last week by the state health department. One infection was contracted in Leeton LGA, while the other had two possible exposure sites: Federation LGA in the Riverina and Indigo Shire in Victoria. Read more

MULTIPLE retail, medical and entertainment venues are listed as potential places of contact with a measles-infected child in Sydney’s west late last month – there was no history of overseas travel. This follows a confirmed measles case in a returned traveller announced on March 29, also in western Sydney; there are no apparent links between the two infants. With numerous measles outbreaks reported around the globe, parents are reminded to ensure their children receive their routine vaccinations on time, and for travellers born on or after 1966, check two doses of measles-containing vaccines have been received. 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.

Global polio digest

Initial results on the vaccine-derived poliovirus type 1 (VDPV1) infection announced last month in a 14 mo indigenous child with acute flaccid paralysis (AFP) reveal it was a new strain, ‘not genetically related to any other VDPV1 previously sequenced, including those currently circulating in countries with cVDPV1 outbreaks’. Teams have been sent into Manseriche district (Loreto department), with investigators taking specimens for testing from other unvaccinated children, asymptomatic contacts of the first child, as well as another AFP case in the nearby town of Atahualpa. In other news on polio from the GPEI, cVDPV2 infections were reported by Chad (single case from Logone Occidental) and the D R of Congo (nine patients from six different provinces). The DRC also logged 12 cVDPV1 infections (Tanganyika, Haut Lomami and Haut Katanga) and Mozambique recorded one case in Zambezia. 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 outbreak on east coast

Some malaria transmission is known to occur in Huétar Norte Region, near the border with Nicaragua, however health agencies are now monitoring an outbreak affecting the region of Huetar Atlántica, along the eastern coastline. The areas specified are: ‘the canton of Pococí, specifically in Cariari, and in the central canton of Limón, specifically in Moín and in various neighborhoods of the community of La Colina’. 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.

One more fatal MVD case

Another Marburg virus disease (MVD) case was reported in an April 10 Ministry of Health and Social Welfare update; it becomes the 15^th, of which 11 were fatal, and occurred in the coastal district of Bata. Other cases, considered probable, are not listed. Confirmed and probable infections have been dispersed broadly across the country: in coastal, central and eastern border regions. Read more

Advice for travellers

Marburg virus disease (MVD) is a severe viral haemorrhagic fever, related to the Ebola virus, and there is no treatment. Found in the African fruit bat, Marburg typically appears in sporadic outbreaks and laboratory-confirmed cases have occurred in Uganda, Zimbabwe, the Democratic Republic of the Congo, Kenya, Angola, and South Africa. Preventive measures are not well defined, as study in how it is spread continues, but travellers should avoid contact with fruit bats and sick primates in central Africa. Read more on MVD

Dengue incidence rising in all divisions

An April 6 Ministry of Health and Medical Services press release noted ‘a concerning upward trend in the incidence of cases of Dengue throughout all the divisions’, as the outbreak threshold was passed following increases in the Western and Eastern divisions. In addition, typhoid fever rates in the Western division were flagged: ‘the incidence rate is approaching the Outbreak Threshold’. Also in the region, this week’s Pacific Community (SPC) update reported recent upticks in influenza-like illnesses in both Samoa and Tonga. 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.

Tick season alert

The UKHSA published a blog last week reminding local communities and visitors about the risk of tick bites and infections such as Lyme disease and, more rarely, tick-borne encephalitis (TBE). The TBE virus has previously been detected in ticks ‘in the Hampshire and Dorset, and Norfolk and Suffolk border areas’. Then, last year a human TBE case was reported from the Yorkshire area, while Public Health Scotland has announced a probable TBE infection ‘likely’ contracted in Loch Earn (mid-way between Dundee and Oban). The Scottish agency stressed the need to avoid tick bites while also advising that the risk of infection is ‘very low for the general population and at the current time believed to be restricted to this small geographic area in Scotland’. Also on TBE, surveillance of vector ticks in southern Germany has seen tick activity start earlier this year, with ‘one of the highest number of ticks in March collected in this focus since 2009’. 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.

Spring, and high pollen counts, arrive

Widespread, dense forests of Japanese cedar and cypress trees have benefited from pre-seasonal warm weather, causing high levels of pollen dispersal over several weeks from February to May, and a corresponding rise in the incidence of allergic rhinitis (hay fever). A significant portion of the population suffers from seasonal allergic conditions – one news source says as much as 40 percent – and sales of symptom-relieving medications and masks have soared. Read more  

Diarrhoeal outbreak in small children

Local media report a surge in severe diarrhoeal illnesses among infants aged 12 months and under in Mombasa. To date, rotavirus has been confirmed in a small number, however testing is still underway for many more cases. Cholera has been excluded from the diagnosis. Mombasa County officials are mounting a rotavirus vaccination campaign in response to the red alert declared by the governor. Read more

More cholera-affected districts

Cholera has been reported in another province – Nampula - with most cases in the area of Nacala Porto, a large deep-water port that services Malawi by rail. Since the end of last year, eight provinces have recorded more than 24,000 cholera infections – Nampula is the ninth affected in the country’s worst outbreak in more than a decade. In related news, the IFRC published an update on the outbreak in Malawi this week, noting that, generally, ‘the outbreak is increasing over time in terms of magnitude and geographical spread’.  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.

Pertussis deaths prompt investigations

Whooping cough has claimed the lives of three infants this year from a total of 11 cases officially notified. Media report that a public health task force is conducting investigations into whether the infecting strain is more severe or if there are many more cases in the community acquired through undetected chains of transmission. 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.

Rural travel warning

As the weather turns warm, people travelling into rural grassland areas are warned to avoid bites from tiny mites or chiggers potentially infected with scrub typhus-causing bacteria, Orientia tsutsugamushi. The high season for scrub typhus is already underway and will peak towards the middle of the year. 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.

Meningitis outbreak response

A WHO Disease Outbreak News post this week covered ‘the country’s first time dealing with a pneumococcal meningitis outbreak’,  that was declared in mid-February in Oti Sud district in the northern region of Savanes. The agency is assisting with the provision of antibiotics, but considers the risk level at a national level as high due to ‘the security crisis in the Sahel which causes population movements, and suboptimal surveillance capacity’. Read more

Advice for travellers

Pneumococcal meningitis is an infection of the covering of the brain and spinal cord. Symptoms include a stiff neck, fever, headache, pain when looking into bright lights, and confusion. Meningitis is the most severe type of invasive pneumococcal disease. Pneumococcal bacteria spread from person-to-person by direct contact with respiratory secretions, like saliva or mucus. Many people, especially children, have the bacteria in their nose or throat at one time or another without being ill. Infants and the elderly are at most risk of severe outcomes, including death. Read more

Ciguatera sickens 27

According to a health ministry update, 27 people have reported poisoning due to the seafood-toxin illness Ciguatera this year - almost two-thirds of those were from Efate, followed by Maewo and Ambrym (the remainder were in Pentecost, Ambae and Santo). Consumption of unspecified species of reef fish was most commonly reported by those infected with Ciguatera, and to a lesser extent, snapper and grouper. Advice on high-risk fish species and the reef areas where the naturally-occurring ciguatoxins are more prevalent can be sourced from governmental agencies and local authorities. Read more