Travel Health Alerts

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 3rd of April 2019

Dengue cases, national and Falls area

Seven of the country’s 17 departments have recorded a total of 965 dengue fever cases this year; the highest incidence was in Alto Paraná which is located in the country’s east and shares borders with Argentina and Brazil near Iguazu Falls. A news report cites the health minister from Argentina’s Misiones province warning residents of the risk of contracting severe dengue infections if they travel to the neighbouring regions of Paraguay and Brazil due to the presence of the DENV-4 virus, a different strain to the one that has been circulating locally (DENV-1). For those people who must travel to these areas, suitable mosquito bite avoidance precautions are strongly advised during the hours of peak Aedes mosquito activity. Read more  

Advice for travellers

Dengue is spread by two types of Aedes mosquitoes which breed in shady areas close homes and other accommodation. Both 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.

Meningococcal vaccine for teenagers

April 1 was the first day of a 4-year federal government funded campaign to immunise children aged 14 to 19 years against the A, C, W & Y strains of invasive meningococcal bacteria. As advised in the Minister of Health’s Sept 2018 media release, students aged 14 to 16 will receive the vaccine through a school-based program, while ‘adolescents aged 15 to 19 years of age, who have not already received the vaccine in school, will be able to receive the vaccine through an ongoing GP based catch up program.’ From July 1, 2018, the National Immunisation Program introduced a dose of ACWY vaccine for infants at 12 months of age.

Advice for travellers

Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions, extended contact with local people in crowded places and travel to North Africa’s ‘meningitis belt’ where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). Read more about Men. meningitis.

20-year psittacosis peak; Regional flu update

The ECDC’s Week 13 Communicable Disease Threats Report (CDTR) comments on a recent increase in human psittacosis infections reported over this last winter period in Sweden - the 60 cases notified between November and March amount to a 20-year high as yearly averages had ranged between 20 and 25 from 2013-17. The CDTR notes that ‘the majority of cases were infected through contact with wild birds and bird tables’ and ‘healthcare providers should be aware of the increased risk of infection in people keeping or handling birds and their environments’.

INFLUENZA data for the EU region on Flu News Europe website reveals low activity in most countries (‘influenza type A virus detections dominated with more A(H3N2) than A(H1N1)pdm09 viruses’), with the exception of Finland, Romania, Kosovo and Bosnia and Herzegovina which report medium levels. Additionally, ‘circulating viruses in the European Region remain susceptible to neuraminidase inhibitors supporting use of antiviral treatment according to national guidelines’.

Advice for travellers

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

Santa Catarina YF death

Local news sources are reporting the death of a man due to yellow fever infection in Santa Catarina, the first such death in the southern state for more than 50 years. He is believed to have contracted the infection in a rural district of Joinville in the state’s north. Only nine percent of at-risk municipalities in Santa Catarina attained necessary vaccination coverage during last year’s national campaign according to a Feb 2019 WHO update. Read more

Advice for travellers

Yellow fever virus is a mosquito-borne disease found in tropical and subtropical areas in Central/South America and Africa. While it can be severe, yellow fever infection is a very rare in Australian travellers. However, under the International Health Regulations (IHR), proof of vaccination may be required of any traveller entering or leaving an area at risk of yellow fever transmission. Read more about yellow fever.

Measles sparks extreme measure

In a drastic measure aimed at limiting further spread of measles in the local community, authorities in the county of Rockland, NY State, declared a state of emergency: ‘Effective at the stroke of midnight, Wednesday, March 27, anyone who is under 18 years of age and unvaccinated against the measles will be barred from public places until this declaration expires in 30 days or until they receive the MMR vaccination’. According to the health dept., as of Apr 2, 158 measles infections had been recorded, over 82 percent of which were in unvaccinated individuals. Across the US, there have been more measles cases in the first three months of the year than in the full 12 months last year. CDC updates on the six ongoing measles outbreaks in the US can be found here. Elsewhere, separate updates on measles are available for Switzerland, Lithuania, Israel, Ukraine, Macau, New Zealand (Canterbury & Auckland), Canada and the African continent. And health authorities in Hong Kong have advised that the second routine MMR vaccine which has been given to children at six years of age is to be administered at 18 months starting next year. This forms part of the response to the recent spike in cases, with vaccinations continuing at the international airport after more cases were identified there during the past week. Read more

Advice for travellers

A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.

24 dengue cases since February

The number of dengue fever cases reported since mid-February has now risen to 24 ‘(18 confirmed, six probable) and infections have spread from Aroa and KiiKii to Pokoinu, Tepuka, Tupapa, Matavera and Inave. A single serotype has been identified to date - DENV-1. Read more. Elsewhere in the Pacific region, the dengue outbreak continues in Palau (with 135 cases since December) and authorities in Tuvalu are reporting dengue-like illnesses.

Advice for travellers

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. 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 PMD when outdoors to all exposed skin. Read more about dengue fever.

Cholera, monkeypox updates; March saw peak Ebola transmission in NE

THE SE province of Haut Katanga and North Kivu in the east have reported almost two-thirds of the country’s cholera infections, with details provided in a week 11 ReliefWeb update - more than 6,600 suspected cases and 177 deaths were recorded overall. Some improvement in the situation has been noted in the SE (with the exception of Kapemba, Katuba and Kenya health districts), however North Kivu case numbers are increasing. Three provinces have recorded confirmed monkeypox cases this year - Ecuador, North Ubangi and South Ubangi which are all situated in the NW. The current total sits at 824 cases and 12 deaths.

THE MOST recent WHO update on the Ebola virus disease outbreak comments on ‘a notable increase in the number of Ebola virus disease cases’ while the agency and partners ‘remain concerned by these recent developments and are continuing to adapt strategies to strengthen the response to limit the further spread of EVD’. Latest case counts from the Apr 2 Ministry of Health newsletter: 1,092 confirmed and probable cases, 291 suspect cases under investigation and 683 deaths.

Advice for travellers

Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox.

Typhoid spikes in dry season

The annual dry season usually brings about an increase in typhoid fever infections, however this year’s 517 cases is over 40 percent higher than for the same 12-week period in 2018. The west central department of San Salvador is most affected and the upsurge is attributed to ‘scarcity of water’ and poor hygiene measures. There has also been a rise in the reporting of dengue fever, chikungunya and Zika virus infections, none of which are in epidemic phase however. 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.

Dengue in all Mombasa’s sub-counties

Dengue infections are being reported in all six districts of Mombasa county (Kisauni, Jomvu, Nyali, Likoni, Changamwe and Mvita sub-counties) and the 660 cases notified to the WHO are considered to be a substantial under-reporting of the true situation. 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, 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.

Human rabies cases in 2 provinces; Report on Zambian trypanosomiasis

According to the March Communicable Diseases Communiqué issued by the NICD, there have been two confirmed and two probable rabies cases this year due to dog bites – from the provinces of Eastern Cape (confirmed cases) and Limpopo (probable), resulting in three deaths. 

THE REPORT also contains details of an East African trypanosomiasis (EAT) infection contracted by a game hunter near Zambia’s South Luangwa Game Reserve - he received treatment in South Africa. Two other cases had been managed by the same facility in Johannesburg (one from Malawi and the other, ‘a game management area close to the Lower Zambezi National Park’). As advised in the March communiqué, ‘People travelling and working in game reserves in northern Zimbabwe, Zambia and Malawi should be aware of the risk of EAT, which carries the potential for serious and fatal disease if infection is not diagnosed and treated promptly. While tsetse flies are common in these endemic areas, and are aggressive daytime biters, only a small percentage of bites are infective. Pale-coloured clothing and insect repellents assist in reducing exposure, but if fever and malaria-like symptoms occur within a few days to three weeks after travel in tsetse-infested areas, the possibility of EAT must be considered’.

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. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is normally recommended for longer stays, especially travellers planning to live in, or travel extensively through, rural areas and also for children; however the final recommendation is itinerary-specific. Read more on rabies.

Dengue cases continue to climb

No sign of a let-up in notifications of new chikungunya and dengue fever cases this year, with year-to-date totals at 421 and 1,303 cases respectively. A local news source states that (of dengue), ‘909 of the cases were reported from the outer lying atolls, with most cases reported from Haa Alifu, Raa, Alifu Dhaalu, Laamu and Gaafu Dhaalu atolls’ and national totals are at a 3-year high. Read more  

Advice for travellers

Avoid mosquito bites and you won’t get 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.

Cholera strikes post-Idai

The outbreak of cholera reported following Cyclone Idai has grown and is now affecting Nhamatanda, 100kms NW of where it first emerged, in Beira City, Sofala province. Further to the more than 1,400 cholera cases and two deaths (as of April 2), reports of acute watery diarrhoea and malaria infections have started to emerge from Beira City and Nhamatanda as well as Dondo, a town located between the two. A cholera vaccination campaign is due to commence in Beira today (Apr 3). 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.

Fake meningitis vaccines warning

Authorities in Nigeria are on the alert for two formulations of counterfeit meningococcal vaccines which it is feared may be imported from Niger. The fake ACWY and ACW polysaccharide vaccines were detected in some Niamey pharmacies during scheduled inspections performed as part of a vaccination campaign in the Republic of Niger aimed at protecting children from serotype A infection. Read more

Advice for travellers

Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. If planning to travel to any region experiencing an outbreak, discuss whether vaccination against meningococcal meningitis would be appropriate for your itinerary with your doctor. Read more about Men. meningitis.

Wild poliovirus cases in two provinces

The weekly country update published by the GPEI notes two more wild poliovirus cases – one from Khyber District (Tribal District (KPTD)) and the other in Layari, a constituent town of Karachi (Sindh province). Positive environmental samples were also obtained from four separate provinces including Sindh, Khyber Pakhtunkhwa, Punjab and Balochistan. Read all polio updates, including news of two more (cVDPV2) cases in Nigeria (Borno & Kwara states) here.

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 polio.

Measles risk high locally, moderate for region

Data on the extensive measles outbreak is currently unavailable through the NDRRMC website, however a UNICEF-WHO report published on Apr 2 provides the following Risk Assessment: ‘WHO is assessing the overall risk of the current outbreak as high at the national level due to the large number of cases reported, chronic low routine immunisation coverage, and persistent vaccination hesitancy. Regional risk is moderate although an increasing number of neighbouring countries are reporting measles cases with a travel history to the Philippines (Australia, Cambodia, China, Hong Kong SAR (China), Japan, the Lao People’s Democratic Republic, New Zealand, the Republic of Korea, Singapore and Viet Nam).’

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.

Dengue news - cases top 2,200, 3rd death

The number of dengue fever cases reported this year rose to 2,224 this week and the Ministry of Health announced the third dengue-related death, an elderly lady from Ang Mo Kio, a residential town in the NE. Of the 26 active clusters, three are categorised as a ‘high-risk area with 10 or more cases’. There have also been four Zika virus cases this year - two were imported. Read more

Advice for travellers

Dengue is spread by two types of Aedes mosquitoes which breed in shady areas close homes and other accommodation. Both 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.