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 22nd of March 2023
JEV activity in Kimberley region
Western Australia’s Department of Health has issued advice for residents and travellers to the Kimberley region to avoid mosquito bites in view of recent confirmed Japanese encephalitis virus (JEV) activity in chickens and pigs which form part of the surveillance program. While JE infections have been reported in people in NSW, Queensland, South Australia, Victoria and the Northern Territory, none have been detected in Western Australia, however a senior official warned that the situation “represented a significant risk to human health”. Read more
Advice for travellers
A mosquito-borne virus, JEV is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and Papua New Guinea, and now parts of Australia. 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.
Global polio digest
Infection with type 2 circulating poliovirus (cVDPV2) has been confirmed in three children from Bujumbura Rural province – one suffered acute flaccid paralysis – plus five environmental samples in Burundi’s first occurrence of polio virus in more than 30 years. The event is linked to the D R of Congo where six children were paralysed by polio in ‘two separate and new emergences of cVDPV2 linked with nOPV2 that originated in Tanganyika and South Kivu provinces in DRC’. The nOPV2 (novel oral polio vaccine type 2) was developed to reduce the risk of circulating vaccine-derived polioviruses reverting to paralysis-causing forms. With nearly 600 million doses of nOPV2 already administered in 28 countries, these events, although tragic, are not unexpected according to a GPEI statement. A reactive vaccination campaign aimed at Burundian children up to the age of seven years is to commence as part of a declared national public health emergency. In other news on polio, cVDPV2 cases were reported in Chad (one case each in Lac and Logone Occidental provinces) and single infections for both Niger (Tillaberi province) and Benin (Littoral province). 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.
Severe flu complications probe
Health authorities reported serious complications from influenza B infection suffered by a number of healthy young people aged under 18 years. All illnesses occurred in Örebro County region and some required intensive care management for myocarditis and meningo-encephalitis. While complications of influenza infection are recognised, the ages and numbers of those involved are ‘unusual’. In the ECDC flu update for the week to March 12, the agency reported the pre-dominance of influenza B across sentinel and non-sentinel surveillance in the region while also publishing an assessment of the Swedish cases. In our region, Fiji’s Ministry of Health and Medical Services reports an ongoing high level of flu-like and acute respiratory illnesses, largely driven by influenza A (also behind a spike in cases in the Federated States of Micronesia). Read more
Advice for travellers
Seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Vaccination is highly recommended and travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol wipes are a convenient alternative if soap and water is not available.
Measles uptick in 2 states
A measles vaccination campaign has been launched in Madhya Pradesh and another is planned to run next month in Jharkand after cases spiked in both states. Four districts in Madhya Pradesh have fared the worst and will be targeted first (Indore, Narsinghpur, Jabalpur and Burhanpurhave), while Jharkand had nine (Dumka, Pakur, Sahibganj, Godda, Jamtara, Deoghar, Dhanbad, Koderma and Giridih). In other news on measles, this week the WHO published a Disease Outbreak News post on South Africa’s outbreak first declared in Limpopo province in October last year. The agency advised that the risk posed on a national level is high and medium for the region due to the amount of cross-border movement between four of the northern provinces and Zimbabwe, Botswana and Mozambique. 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.
More diphtheria deaths
The death toll from diphtheria in West Java province has risen to nine, however a large scale immunisation drive aimed children who haven’t received all the required vaccine doses is starting to make a positive impact on lowering new case numbers. One of the hardest-hit areas is Pangatikan District, around 55kms SE of the provincial capital of Bandung, which has more areas of under-vaccination (coverage sits at around 70 percent). 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.
Measles spreads among mobile population
Measles has spread from the outbreak first declared in Nepalgunj sub-metropolitan city, Banke district, in January to include seven districts of western Nepal and three in the country’s east, although the WHO recently announced a decline in new cases. The outbreak total has risen to 690 (more than half were unvaccinated) and there has been one associated death. The risk of further spread as assessed by the WHO was high at a national level in view of the highly mobile communities’ low immunity and their frequent cross-border travel’. Read more
Advice for travellers
A highly contagious virus, measles occurs in developing and developed countries. While usually relatively 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.
Warning over rise in leptospirosis infections
Health authorities have issued an advisory over the increase in leptospirosis infections this year – 65 cases to February 28, 56 required hospitalisation and one has died. As was the case in previous reports, the northern province has been most affected with 46 people infected. Residents have been reminded to wear protective gear when in contact with contaminated water and to ensure rodent numbers are controlled in their neighbourhoods. Also in the region, more than 30 leptospirosis infections, one fatal, have been reported in Vanuatu following the passage of two cyclones; most cases occurred on Santo and Efate islands. Read more
Advice for travellers
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.
Rabies death in KZN
Vaccinating pets against rabies in hotspot areas of KwaZulu-Natal has become a priority following the recent death of a 5yo child from rabies. Surveillance undertaken by the Department of Agriculture and Rural Development has found several rabid animals in locations including Pinetown, Mpumalanga Township and Cato Ridge, plus some western areas (Kloof, Hillcrest, Waterfall and Molweni). 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.
More people seek medical help for gastro
More than 165,000 people sought treatment for diarrhoeal illnesses in the week to March 11 amid a general upturn in cases. Most infections registered by the CDC were due to norovirus, however enterovirus was also detected (including two cases of EV71). Elsewhere, UK media have reported sickness due to norovirus continues at elevated levels, with a 50 percent week-on-week increase in news cases in England adding to the strain on the health system. Read more
Advice for travellers
While it is extremely contagious, norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands with soap and water after using the toilet and before eating, and practice good hygiene. Read more on norovirus.
Marburg cases, deaths in NW
Samples taken from several people suffering symptoms including fever, bleeding and renal failure in the country’s NW in Kagera region have been confirmed as Marburg virus disease (MVD) – the first human cases in Tanzania. Five of the MVD cases were fatal and three people remain in hospital, while efforts are ongoing to trace and monitor more than 160 contacts in Bukoba Vijijini district, on the western shores of Lake Victoria. In the other African MVD outbreak declared just last month in Equatorial Guinea, sequencing of viruses have shown similarities to those from fruit bats in Sierra Leone. That death toll remains at 11: only one confirmed as MVD and the remainder were epidemiologically linked. 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
Unseasonal dengue surge
Pre-season rains in the south and central parts of the country have created ideal mosquito breeding conditions, resulting in a surge in dengue fever cases – more than 13,000 have already been recorded even before the peak dengue period commences. In Ho Chi Minh City, it’s not just dengue fever that is spreading, cases of hand, foot and mouth disease (HFMD) have also been increasing. On a separate subject, local media have reported the provision of ‘training courses on avian influenza A(H5N1) prevention’ for medical services. The latest ECDC Communicable Diseases Threats Report (CDTR) provided a comprehensive global dengue fever update for the year to March 9. 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.