Travel Health Alerts

Flu activity continues, vaccine composition decided

The European flu season continues and activity is still reported to be widespread. For the week ending Feb 19, testing positivity at rates above 40 percent in sentinel primary care were registered by Armenia, Denmark, France, Hungary,Netherlands, Romania and Slovenia. In the Southern Pacific, surges in flu-like illnesses have been reported in Tonga (influenza B predominates) and Wallis and Futuna (influenza A). Lastly, the recommended compositions of the vaccines for the 2023-2024 northern hemisphere influenza season have been published by the WHO. The major difference over the 2023 southern hemisphere season’s vaccines is a change in the H1N1 component for both egg-based and cell culture- or recombinant-based vaccines. Read more

Advice for travellers

In most years, 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. Read more

Japanese encephalitis vaccines for more Victorians; Syphilis back with a vengeance

ABC News reports that eligible people residing or working in a further seven Victorian local government areas are now able to access the Japanese encephalitis virus (JEV) vaccine - Greater Bendigo, Northern Grampians, Hindmarsh, Horsham, Buloke, Yarriambiack and West Wimmera. While no mosquitoes carrying JEV have been detected this season, state health authorities say they know the virus is circulating. In related news, a human Murray Valley encephalitis infection has been confirmed in NSW for the first time in 11 years – a man who was infected in January while in the Temora, Edward River or Murrumbidgee local government districts. Read more  

SEXUAL HEALTH experts in Victoria are calling for expanded testing for syphilis following last year’s 30-year record number of cases. Tragically, foetal deaths from congenital syphilis have been reported in recent years as more women are becoming infected. Clusters of syphilis cases are more common in Melbourne’s SE and outer west, with concern over higher transmission rates in the LGAs of Casey, Wyndham, Melton, Maribyrnong and Merri-bek. This mirrors increases in infections also being observed in parts of the USA and Canada (British Columbia). 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, and now parts of Australia. In Asia, 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.

Bird flu death in north

A young girl from Sithor Kandal district in the far north of Prey Veng province has died from highly pathogenic avian influenza (HPAIV) A(H5N1). The girl’s father also tested positive and has been treated with antivirals in hospital, while another 29 contacts have returned negative results. The infecting H5N1 strain has been endemic in the SE Asian region since 2014, resulting in sporadic human infections and is different to the 2.3.4.4b clade that first emerged in 2020 and is circulating in wild bird populations around the globe, with cross-species transmission to several mammal populations (bears, foxes, racoon, skunk, mink, cat, dolphin, seals and whales). A senior Cambodian health official stressed the need for ‘regularly washing hands with soap and water, not to touch or stay away from sick or dead poultry, eat well cooked foods’. More details in the Feb 26 WHO update. Globally, 21 different countries have recorded a total of 870 human HPAIV A(H5N1) cases with 458 deaths since 2004, all without sustained human-to-human transmission. Read more

Advice for travellers

While bird flu is often fatal in humans, there has been no sustained person-to-person transmission. Infection occurs after contact with the saliva, mucous or faeces of infected birds or surfaces contaminated with them, which makes the disease a low risk for most travellers. Australians travelling to a region where the disease is present or an outbreak is occurring should avoid contact with birds or poultry in marketplaces, wash their hands before and after preparing food, and observe strict personal hygiene. Read more on bird flu and how to avoid it.

Polio case in northern city, global polio digest

Health authorities have announced a probable case of poliomyelitis in an 8yo unvaccinated child living near the northern city of Safed. The child is symptomatic with limb weakness. Initial tests were positive for the virus and all contacts are being followed up. According to the health ministry, approximately 150,000 children are unvaccinated, ‘and there is evidence of the continued existence of polio in the sewers in many communities’. In other news on polio, the GPEI announced circulating vaccine-derived poliovirus type 2 (cVDPV2) cases in the D R of Congo (four patients in Haut Lomami province) and Yemen (one in Alhudaidah), while cVDPV1 infections were recorded by both Mozambique (two cases in Zambezia) and Madagascar (one in Sava). 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 poliomyelitis.

Marburg outbreak situation

Two more suspected Marburg virus deaths take the total to 11 in the Kié-Ntem province outbreak that was first announced on Feb 9. The province is in Río Muni Region and shares borders with Gabon’s Woleu-Ntem Province and South Region in Cameroon. Of the 48 contacts, three are receiving care in isolation in hospital and have mild symptoms, while the other symptomatic individual remains in the community. In an earlier update, the WHO expressed concern that there could be unidentified transmission chains, so the risk of spread within Equatorial Guinea is high and, due to the high flow of people across the borders, the regional risk is deemed to be moderate. 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

Lassa fever confirmed in capital residents

Two residents of Accra, who were known to each other, have contracted Lassa fever and one has succumbed to the infection. More than 50 contacts have been identified and are being followed up. Lassa fever was first reported in Ghana 12 years ago. Read more

Advice for travellers

Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

Cholera outbreak set to deteriorate

More rains in the early days of February are expected to exacerbate the cholera outbreak that had already surged into new districts since December. A WHO Disease Outbreak News post assessed the risk of spread both nationally and across the region as very high due to ‘the frequency of cross-border movement and the history of cross-border spread of cholera during this outbreak’. To the north, Malawi has charted more than 45,000 cholera cases and nearly 1,500 deaths in its worst outbreak on record. A full run-down of global cholera outbreaks was listed in the ECDC Communicable Disease Threats Report of Feb 24, and a focus on the situation in the African continent is provided by the regional WHO office’s Feb 12 weekly bulletin. 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.

Dengue uptick on peninsula

Local media in the Yucatán peninsula are reporting dengue hotspots in Yobaín and Santa Elena, but at least two other municipalities are also being impacted by the mosquito-borne disease (Temozón and Umán). A single dengue case was registered last year, so the 157 announced in the Epidemiological Panorama of Dengue weekly report last week represented a dramatic increase. Read more

Advice for travellers

Dengue is spread by Aedes mosquitoes which breed in shady areas close to habitations and 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 an effective 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.

Leptospirosis cases rise

Heavy rainfall over the summer, compounded by recent cyclones, has increased the risk of leptospirosis in the territory. The DASS reported 56 infections to mid-February, many of which were in the northern province. 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

Mosquitoes and climate disruption

Across the Pacific, nations are experiencing changes in disease patterns and severity caused by climate disruption, and outbreaks of diseases such as dengue fever and chikungunya are expected to become larger and more frequent. Conditions that are favourable to mosquito proliferation have already led to a rise in malaria cases in the Solomon Islands, up by 40 percent from 2015- 2021, and more malaria-related deaths over the same period in Papua New Guinea (25 percent increase). Read more

Advice for travellers

Travellers visiting malarious regions should discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. Read more about malaria.

Health alert in Negros Occidental city

The mayor of San Carlos City on the NE coast of the island of Negros (Western Visayas region) has declared a health emergency in response to a surge in cases of amoebiasis, a parasitic bowel infection contracted through the consumption of contaminated food or water. The announcement has alerted residents to the surge in cases (now 230) and will spark public information drives on how to prevent infection. An increase in gastrointestinal infections and cholera cases have been observed in Negros Occidental since October last year. Read more

Cholera cases in Gauteng

Two cholera infections have recently been reported in Gauteng: one in a man from Alexandra township in Johannesburg and the other, a fatal case in a young man from an informal settlement about 25 kms away, near Wattville. There was no relevant travel history in either individual. Investigations are underway into the sources of infection. Three other cholera cases confirmed early in February were associated with travel to Malawi. 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.

Zika in foreign tourists; Norovirus strikes students

Hungarian health authorities announced two imported cases of Zika virus disease in travellers who had been to Thailand. No details were provided on where in Thailand the people had visited and it was noted that the individuals had experienced mild infections. Read more

AN OUTBREAK of norovirus in the NE province of Chaiyaphum has hit hundreds of students at four schools in Mueang district. Parents have been advised to take extra precautions in food preparation and selection for their children and to prevent further spread of the highly infectious virus. Read more

Advice for travellers

Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on Zika virus through healthdirect.  

Rainy season, more diarrhoeal disease

The surge in diarrhoeal illnesses, including those caused by rotavirus, has carried over into this year, prolonged by a lack of access to safe drinking water and effective sanitation infrastructure. Young children have been most affected, particularly in the provinces of Mashonaland Central and Mashonaland East, however cases have been reported from across the country and are now nearing 34,000. The capital Harare has not been spared, with notifications including 125 confirmed or suspected typhoid cases. Increased surveillance for cholera has been established in view of extensive outbreaks within the region. 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 usually 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.