Travel Health Alerts

Gastro illnesses soar in NSW kids; Mozzie warnings on repeat

State health authorities in NSW have advised parents to be on the alert for gastrointestinal symptoms after observing a surge in rotavirus infections among children aged under five as well as in the five to 16 years cohort. According to the notice, the increase has seen cases rise to ‘some of their highest levels of the last decade’. Read more

LAST WEEK there were two more reports on the detection of the Murray Valley encephalitis virus in mosquitoes: one in the council areas of Berri Barmera, Mid Murray, Renmark Paringa, Loxton Waikerie and Murray Bridge in South Australia, and the other in Victoria, with the health department warning ‘a high number of detections have been reported from the Mildura area’. No human cases have been reported but the risk of infection is elevated and mosquito bite avoidance measures are advised.

Advice for travellers

While the risk of contracting MVE is low in people taking appropriate 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.

COVID-19 update

Following consideration of data from clinical trials and extensive use in some overseas jurisdictions, and with input from the Advisory Committee on Vaccines, Australia’s TGA this week granted provisional approval for the Pfizer bivalent COVID-19 vaccine (Ancestral and Omicron BA.4/BA.5 strains) to be used as a booster for persons aged over 12 years. According to the regulatory body, ‘The potential use of this vaccine in the national COVID-19 vaccination program is still to be determined’. Read more

The Japanese government is reviewing its pandemic rules, including lowering the classification of COVID-19 to the same level as seasonal influenza. Any changes will be made in a phased manner. Read more. Germany will suspend its mask mandate for passengers on long-distance trains and buses from Feb 2. Read more.

Raw date juice linked to infection

Three deaths from Nipah virus (NiV) infection have been registered this year and two are believed to be linked to drinking raw date juice (the third is under investigation). Confirmed NiV cases have been reported from around half of all Bangladeshi districts since the virus was first isolated in 1999; those with highest case numbers are Faridpur, Lalmonirhat, Naogaon and Rajbari. Read more

Advice for travellers

Fruit bats are the natural hosts of Nipah virus, and females shed the virus when pregnant or lactating. The fruit-eating bats perch on the jars used for collecting juice from palm or date trees, contaminating the juice with infected saliva and droppings.  People are infected when they drink the raw juice, although it is also spread through person-to-person contact. In Bangladesh, Nipah generally occurs between December and April. Read more on Nipah virus

Dengue surges in east

A sharp rise in dengue reports in Santa Cruz department was the focus of a red alert which triggered intensified disease surveillance and the eradication of mosquito breeding grounds in areas including the capital. Of the 508 dengue cases recorded in six of the nine departments this year, more than 300 were in Santa Cruz. 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.

Norovirus spikes in southern state’s beach resorts

Norovirus is believed to be one of the causes of a surge in gastrointestinal illnesses affecting residents and tourists in beach areas of Florianópolis in Santa Catarina state. The outbreak has expanded over the past couple of weeks, spreading into eight other resort towns in the state’s north (Camboriú, Bombinhas, Itapema, Navegantes, Peña, Balneário Picarras, Porto Belo and Itajaí). 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.

Global polio digest

Sixteen circulating vaccine-derived poliovirus type 1 (cVDPV1) cases were reported to the GPEI last week and added to the 2022 total, while the remainder of cases in the DRC (19) and other African nations related to cVDPV2 infections: two cases in Chad (Hadjer Lamis and N'djamena) and one patient each in Cameroon (Extreme Nord province), Nigeria (Sokoto) and Somalia (Banadir). Positive environmental samples were detected in Afghanistan (WPV1 in Nangarhar) and cVDPV2 in Algeria (Tamanghasset) and Zambia (Copperbelt). 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.

Flu overview

The ECDC reported high rates of influenza circulating in the region in its Jan 21 update - 33 of the 40 countries experiencing ‘high or very-high intensity and/or widespread activity’. Three countries had positivity rates exceeding 40 percent (Finland, Poland and Slovenia), while ‘influenza type A and type B viruses were detected with A(H1)pdm09 viruses dominating’. In the US, FluView reported a continuing decline in flu activity in the week to Jan 14, and for the same week, Canada’s FluWatch advised ‘Influenza activity is now at levels typically seen in late spring/early summer’. 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

Measles vax rates fall

Low vaccination uptake during the early days of the pandemic has been blamed on a surge in measles cases last year. Local media report that while childhood immunisation coverage against measles and rubella infections is high in Java and Bali, it sits below 64 percent in other regions. A health ministry official said that this year there have been suspected measles cases in West Nusa Tenggara, West Sumatra, North Maluku and Papua. In other news on measles, South Africa’s outbreak continues with the total of  confirmed cases nearing 400 from the provinces of Limpopo, Mpumalanga, North West, Gauteng and Free State. The NICD has warned that localised outbreaks may occur in under-vaccinated communities now that the school year has started. 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.

Almost 55,000 dengue cases last year

A summary of dengue fever in 2022 released by the country’s EDCD confirmed Bagmati, location of Kathmandu, as the worst-hit province with more than 42,000 of the 54,784 cases recorded nationwide. It was streets ahead of the province with the second highest total – Lumbini, a Buddhist pilgrimage site, with just over 5,000 cases. Chitwan was fifth in terms of districts reporting the highest number of cases. The confirmed national death toll last year was 88. 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.

Diphtheria toll rises to 34; Men. Meningitis response in north; Cholera in SE state

Diphtheria cases have now been confirmed in the states of Kano, Yobe, Lagos and Osun and the death toll is said to be at least 34. The outbreak was first reported late last month and a response is underway from the NCDC. Read more

HEALTH department teams have been sent to the northern state of Jigawa after a reported increase in suspected meningococcal meningitis cases. Precautionary measures which include active case finding have been put in place in the adjacent states of Katsina and Yobe. Read more

GOVERNMENT assistance has been requested to help manage an outbreak of cholera after more than 200 cases and at least 60 deaths were recorded among the Obubura community in the SE state of Cross River. In related news, last week the ECDC published an update on cholera around the globe which included details of new cases recorded in 17 countries since the previous report. 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.

HFMD to be confirmed in Iloilo

The number of suspected hand, foot and mouth disease (HFMD) infections in Iloilo has climbed sharply in the first three weeks of 2023 – up from just two last year to more than 220 in 24 of the province’s towns. Highest case counts have been in Pavia, Barotac Viejo and San Dionisio. Read more

Advice for travellers

HFMD mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication, but good hand hygiene will greatly reduce the risk of infection. Read more about HFMD.

High dengue rates persist into 2023

The NEA advised last week that a ‘sustained high number of dengue cases’ recorded so far this year may signal another large outbreak in 2023 and ‘increases the risk of an early surge in cases in the coming months’. The agency said that the predominant serotype, DENV-3, is one for which many residents have no immunity. 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.

Precautions for typhoid cases

The health department has instituted enhanced protocols at Princess Margaret Hospital on Funafuti atoll after admissions for suspected typhoid fever increased this month. According to a regional report, from Jan 5-18, ‘a total of 81 IgM positive cases and 1 death have been reported’. Read more

Advice for travellers

Typhoid occurs at times in Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters. Read more about typhoid.