Travel Health Alerts

Another MV encephalitis case in NSW; Imported Hep A in Qld

A second case of Murray Valley encephalitis infection has been confirmed in NSW, in a resident of Hilltops local government area, north of Yass. The individual had travelled to other areas of the state during the potential exposure timeframe in January/February so the infection may not have been acquired in Hilltops (where it has not been identified previously), according to NSW Health. More on mosquito surveillance in NSW dated March 25. Read more

THE SUNSHINE Coast Hospital and Health Service Public Health Unit in Qld issued a public health alert last week after confirming a family cluster of hepatitis A infections. According to the alert, “The original exposure occurred at Gympie Hospital with the hospitalisation of a person returning from overseas in January 2023”. Advice and information has been provided to local schools where infected family members may have attended. Read more

Advice for travellers

Vaccine-preventable Hepatitis A (HAV) is a vaccine-preventable viral disease that is transmitted by the oral-faecal route, such as through contaminated food and water, and some types of sexual contact. A course of hepatitis A vaccine offers immunity that’s highly effective and long lasting. It is also important to follow safe food and water guidelines.

Measles outbreak expands

The health department has announced the total of suspected measles cases has risen to 145 (75 confirmed) from across the country since the beginning of the year, as the number of Kazakhstanis opting out of vaccination quadrupled compared to the same period in 2022. Also on measles, notifications are now declining in Austria, with Styria recording the only new cases in the past three weeks – another 23, taking its total to 87 of the national count of 96, while South Africa’s outbreak was the subject of a WHO update which assessed the overall risk of measles as high. Lastly, a spike in measles and rubella cases has been reported in the Philippines with cases up 5-fold compared to Jan-Feb 2022. A vaccination campaign for more than 2 million susceptible children is planned for May. 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.

Chikungunya, dengue situation across the region

A comprehensive WHO Disease Outbreak News post on the increasing trend of dengue and chikungunya transmission across the Americas gauged the risk across the region as high. It noted a ‘geographical expansion’ of the affected areas, anticipated surges in the months to come, as well as ‘a high incidence of meningoencephalitis possibly associated to chikungunya reported by Paraguay’. For dengue fever rates in the year to March 4, the highest cumulative incidence was reported by Bolivia, Nicaragua and Belize, and for chikungunya, Paraguay, Brazil and Belize. Read more

Advice for travellers

Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is currently no approved vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent when outdoors to all exposed skin. Read more about chikungunya.

Global polio digest

A young girl from Purwakarta Regency in West Java has been diagnosed with vaccine-derived polio type 2 (VDPV2) after suffering acute flaccid paralysis late last month. She was unvaccinated according to news sources which also reported the April launch of a vaccination campaign aimed at protecting around 3.9 million children in the region. In other news on polio, a VDPV1 infection has been detected in a small boy from an indigenous community in Loreto department, Peru, who presented with paralysis in the lower limbs in late December. He was unvaccinated and had not travelled out of the area. Vaccination rates for a third polio dose were under 44 percent in Loreto last year and in the affected district (Manseriche district, Datem del Marañón province), nine Guillain Barré Syndrome cases have been recorded among adults since the beginning of 2022. More information in the March 23 PAHO Epidemiological Update Poliomyelitis in the Region of the Americas. Elsewhere, a single wastewater detection of a type 2 poliovirus in New York’s Rockland County last month has health authorities stressing the need for polio vaccination or boosters for people in the counties of Rockland, Orange and Sullivan who will be travelling overseas, in particular to other polio-affected countries including Israel and the UK.  And from the GPEI last week, Pakistan’s first WPV1 case for the year was reported from Bannu in Khyber Pakhtunkhwa province, while the D R of Congo logged two cVDPV1 infections (Haut Lomami and Tanganyika) and three cVDPV2 cases (Mongala and Tanganyika), all dating from 2022. 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.

Cholera, local and global

Cholera has claimed 34 lives in Nairobi since October last year, the highest count in Kenya, followed by a combined total of 31 from the counties of Tana River, Garissa and Wajir. Nation-wide there have been in excess of 500 cases. Last week the WHO issued a cholera update, noting that 24 countries are now experiencing outbreaks and assessing the global risk to be very high. More regions may be impacted by the disease as they move out of current ‘low or interepidemic transmission periods’. Response to the outbreaks is being hampered by shortages in cholera vaccines and other medical supplies, and severely strained health systems ‘dealing with multiple disease outbreaks and other health emergencies at the same time’. It is feared the situation in SE Africa could deteriorate further after intense cyclone Freddy remained active in the region for five weeks, heaping devastation on Madagascar, Mozambique and Malawi. The update provides a focus on six countries up to March 20: Malawi, Mozambique, D R of Congo, Haiti, Lebanon and NW Syria. 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.

Spring is strep season

In its latest weekly update, the ECDC advised that increased levels of group A strep (GAS) infections and iGAS cases were ongoing in Denmark, Ireland, the Netherlands and the UK, with the usual peak season in Spring still to settle in. The age groups that have been most affected to date are children under 10 years and adults aged over 65 years. Read more

Advice for travellers

Scarlet fever is a low risk for most travellers. A mild bacterial infection, it generally causes strep throat or, less commonly, streptococcal skin infections. It affects people of any age, but is most common among children. The classic symptom is a sandpaper-like red rash. Scarlet fever is treatable with antibiotics which helps clear up symptoms faster, reduces spread to other people and prevents rare but serious long-term health problems. Read more on group A streptococcal infections, including the severe, life-threatening invasive group A streptococcal disease (iGAS) infection.

Marburg virus index case, more developments

Details about the origin of the Marburg virus disease (MVD) outbreak in Kagera region have emerged: the index case had been to Goziba island in Lake Victoria and became unwell on return home to his village in Bukoba. Several of his family members became infected also. The outbreak remains at eight cases (two were healthcare workers), five were fatal. There are concerns over the location of the outbreak, occurring near porous borders shared with Uganda, Rwanda, and Burundi. Tanzania is the fourth country to report its first MVD cases since 2021, along with Guinea, Ghana and, more recently, Equatorial Guinea. An update on the current situation in Equatorial Guinea reveals new chains of transmission, taking the virus into two new provinces which sit around 150 kms apart – Centre- Sur and Litoral. Confirmed infections have now been detected in the large port city of Bata in Litoral, while reports have emerged of cases in the capital of Centre-Sur, Evinayong. The outbreak total has risen to nine cases, seven were fatal and another 20 (also fatal) probable cases. 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

Flu case numbers rise

Influenza surveillance has shown rates of GP visits for acute respiratory infections have increased to more than one in 10 patients. Both influenza A and B strains have been detected. And in Fiji, the health department has confirmed influenza B /Victoria is circulating and is probably behind a second peak in influenza-like illnesses observed during the current January-May/June flu season. 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.

Dengue surge continues

There are reports of increasing numbers of dengue fever cases in Khartoum state and official figures are unlikely to represent the situation accurately due to insufficient pathology services needed to confirm infections. Shortages in medical supplies are also said to be hampering the treatment of those suffering from dengue fever. 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.

Pathogen behind Savanes outbreak identified

The cause of a meningitis outbreak responsible for 123 suspected cases and 12 deaths in Oti Sud district in the northern region of Savanes has been confirmed as Streptococcus pneumoniae. The weekly WHO bulletin noted that ‘Children under five are less affected because they are covered by the routine PCV13 vaccine, which has 100% coverage in the region for the third dose’. Around 58 percent of cases have been in the 10 to 24 years of age cohort - those who missed out on the later introduction of the PCV13 vaccination into the immunisation schedule. Read more

Testing finds more dengue

After a single case of dengue was confirmed by the Ministry of Health, Social Welfare and Gender Affairs in late January, further testing had identified another 25 infections by March 13. 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.

Varicella spikes in capital

Eighteen of Hanoi’s 30 districts have reported chickenpox infections, with cases now totalling 548 for the year (cf. four for the same months last year). Notifications from Ho Chi Minh City indicate case numbers have not risen above usual levels, however the typical peak season generally lasts until June. Read more

Advice for travellers

Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.