Travel Health Alerts

Influenza activity high in 13 countries

Flu activity is declining overall in the region, however in the week ending Jan 8 circulation levels remain high in Armenia, Belgium, Bulgaria, Finland, Israel, Lithuania, Moldova, the Netherlands, Poland, Slovenia, Slovakia, Switzerland and Northern Ireland, according to the ECDC weekly report. Both influenza A and B viruses were reported in sentinel surveillance systems. 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

Floodwaters and disease risks; WorldPride health advice

Residents and visitors in the northern Victorian local government areas of Loddon, Indigo and Mildura have been warned of the risk of Murray Valley encephalitis (MVE) after the virus was detected during mosquito surveillance in those districts. Local media report that there had also been a recent MVE virus activity in Bendigo and Mildura for the first time in a decade. And in NSW, mosquito monitoring has seen MVEV detected in Menindee and Griffith this month. ABC News wrote last week that NSW’s last locally acquired MVE cases were in 2011 and 1974 in Victoria. More in a Jan 17 The Conversation article by A/Prof Cameron Webb. Read more  

SYDNEY WorldPride 2023 kicks off on Feb 17 and discussions on potential health risks to attendees are likely to include vaccination against Mpox. While anyone can contract the virus, most cases in Australia and overseas have occurred in gay, bisexual and other men who have sex with men (GBMSM), a key risk group as designated by ATAGI. Uptake of the smallpox vaccines in use has been very good in Australia but that may not be the case in some rural and overseas jurisdictions, making it even more important for those attending to seek vaccination in advance. Read more  

Advice for travellers

While the risk of contracting MVE is low in people taking anti-insect measures, the virus can cause severe illness, even death in very rare cases. The vector mosquitoes are active at dawn and dusk, particularly in the first two hours after dark. They pass on the virus to humans after feeding on infected birds attracted to flooded wetlands. Travellers to wetland areas of Australia should take all measures to prevent bites. Apply an insect repellent containing DEET, picaridin or oil of lemon eucalyptus (PMD) to exposed skin when outdoors. Read more on MVE.

Preparing for peak dengue season

Health authorities have started preparations in anticipation of a peak year in the dengue fever transmission cycle. Repellents and larvicides have been stockpiled, plans are in place for clean-up campaigns, and requests issued to healthcare workers to escalate management of severe dengue cases to larger hospitals. 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.

Bird flu and the Americas

A young girl from the province of Bolivar has become the seventh human case of H5N1 avian influenza in the world since January 2022 and the first for Ecuador and the region. No further transmission has occurred in the Ecuador case following 15 days of contact monitoring. In a Jan 11 update, the PAHO advised ‘strengthening surveillance of respiratory disease in animal and human populations, thorough investigation of all zoonotic infections, and pandemic influenza preparedness planning’. Other countries reporting human H5N1 cases in the past year, all through exposure to infected poultry, were China, Vietnam, UK, Spain and USA. In related news, China has reported three more human cases of H9N2 bird flu from late last year - in the provinces of Hunan, Gansu and Anhui. Read more

Advice for travellers

While bird flu can be fatal in humans, there has been no sustained person-to-person transmission. Infection occurs after contact with infected birds, which makes the disease a low risk for 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.

Global polio digest

Another 32 circulating vaccine-derived poliovirus (cVDPV) cases, comprising types 1 and 2, were reported by the DRC to the GPEI last week, all dating from 2022. Haut Lomami province registered a total of 22 of those cases – 15 cVDPV1 and seven cVDPV2. Niger’s single cVDPV2 infection was in Tahoua, while 12 cVDPV2 positive environmental samples were collected in New York, USA. 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.

STI peaks at just under 13,000 cases

After 7,983 syphilis cases were confirmed in 2021, a preliminary figure of nearly 13,000 was proposed for last year – a record number since data was first collected 22 years ago. ProMED reports that in ‘recent years, about 70% of the total cases of syphilis each year in Japan were cases of primary and secondary (P&S) syphilis, the most contagious stages of syphilis’. Read more

Advice for travellers

Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an effective antibiotic. Read more about syphilis and other STIs.

Measles outbreak in Terai city

A large measles outbreak has hit both child and adult populations in Banke district in the Terai, spreading to more than half of Nepalgunj’s 23 city wards. Authorities say that many of the cases are members of marginalised groups who adhere to vaccine misinformation or are unaware of the importance of routine vaccination. The SE Asian WHO office is calling for concerted vaccination and surveillance effort by governments to prevent more outbreaks of measles and rubella, noting that the target for their elimination within the region by 2023 is ‘off track’. Currently nine million children lack any measles vaccines and more than five million others are under-vaccinated. 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.

Meningitis strikes southern border region

A meningitis outbreak in Zinder region is the subject of a post by the WHO regional office which highlighted the location near the Nigerian border (in Dungass district) and the high fatality rate among those infected. Health districts adjacent to Dungass are now reporting cases but the major concern is how to mount reactive vaccination campaigns while the country is also dealing with outbreaks of measles, yellow fever and COVID-19. 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. Niger lies in 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.

Lassa fever cases in 27 states

A year’s-end NCDC summary on Lassa fever summarised in an editorial provided an updated case count for 2022: just over 1,000 confirmed cases, 8,200 suspected infections and around 190 deaths were registered across 27 states. Almost three-quarters of Lassa fever cases were in just three states - Ondo, Edo and Bauchi. 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.

New hantavirus case in southern province

The province of Los Santos has reported its first Hantavirus case in 2023 – a man from the coastal district of Tonosí. Last year the province recorded 39 infections of which 22 were hantavirus cardiopulmonary syndrome (HCPS). Tonosí had the highest burden of hantavirus cases of the six affected districts (also Los Santos, Las Tablas, Macaracas and Guararé). Read more

Advice for travellers

Hantavirus is passed on to humans through contact with hantavirus-infected rodents or their urine and droppings. Eliminating rats in and around living quarters is the main way of preventing hantavirus infection. Cases have been documented in Argentina, Brazil, Canada, Chile, Panama, Paraguay, and Uruguay, making HPS a pan-hemispheric disease. Read more about hantavirus.

Chikungunya outpaces dengue

Sixteen people have been admitted to hospital for treatment of chikungunya and health officials have announced the first death caused by the infection, that of a 73yo woman. Locations with most cases to date have been Metropolitan, Asunción and Central areas, while neighbouring regions of Argentina (Fracrán County in Misiones province) and Brazil are said to be on alert. Fewer dengue fever infections have been recorded in Paraguay in recent weeks as higher levels of chikungunya virus circulated. Read more

Advice for travellers

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

3 regions with high dengue count in 2022

A summary of dengue fever cases reported last year reveals a national total of more than 220,000 infections, nearly double the 2021 case count. The most affected regions were Central Luzon, the National Capital Region and Calabarzon. Read more

Advice for travellers

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 Aedes mosquitoes that 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. Read more about dengue fever.

Gastro illnesses surge

A norovirus outbreak is causing concern to public health authorities, coming just before the busy travel season around the Lunar New Year. The CDC said there had been nearly 140,000 presentations at clinics and hospitals last week for diarrhoea treatment and has stressed the need for enhanced personal hygiene and food safety to prevent infection. 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 after using the toilet and before eating, and practice good hygiene. Read more on norovirus.

Outbreak over, challenges remain

Last week the WHO confirmed the health ministry’s declaration of the end of the Sudan ebolavirus outbreak in nine districts. The final total: ‘164 cases (142 confirmed, 22 probable) with 77 deaths (55 among confirmed cases and 22 among probable cases) and 87 recovered patients’. Follow-up activities including surveillance, support of survivors and vaccine trials continue. Read more

Alert over tainted medication

More medication alerts have been issued by the WHO; the latest relate to contaminated children’s cough syrup supplied in Uzbekistan, with two formulations found to be sub-standard. This incident comes in the wake of other tainted cough syrups and paracetamol preparations reported since October 2022 in the Gambia and Indonesia. Read more