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 7th of December 2022
2022 dengue cases up nearly 5-fold
The number of dengue fever cases recorded to Nov 26 this year is almost five times higher than 2021 figures, with a cumulative total of more than 325,000 - 78,000 of those were added in the past four weeks. Brazil and India round out the top three reporting countries, according to ECDC global outbreak monitoring. 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.
High intensity spread of flu
The WHO global flu update, using data in the week to Nov 13, advised that ‘activity increased and where subtyped, influenza A(H3N2) viruses predominated’. In Europe, flu activity was described as high intensity with local spread in Malta and widespread in both Germany and Portugal. In temperate South America, the report advised that in Chile, ‘influenza A(H3N2) predominated and percent positivity and ILI rates reached extraordinary levels’. In the USA, hospitalisation rates at this stage of the season are the highest since 2010-11 according to FluView (CDC); they doubled from the third to the fourth week of November. 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
Global polio digest
The GPEI last week announced a single circulating vaccine-derived poliovirus type 1 (cDVPV1) case in the D R of Congo (Haut Lomami province), while Yemen reported four cVDPV2 cases (Ibb, Dhamar and Hajjah governates). Meanwhile, Indonesian health authorities will broaden the polio vaccination drives underway after the recent detection of the cVDPV2 acute flaccid paralysis case and three asymptomatic infections in Aceh. They will now aim to reach children living in four high risk provinces. And in the USA, the CDC is planning wastewater testing for poliovirus ‘in certain counties with potentially low polio vaccination coverage, or counties with possible connections to the at-risk New York communities that are linked to a single case of paralytic polio in Rockland County, New York’. The program is expected to continue for at least four months and will start in Michigan and Philadelphia. 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.
Cholera vaccines arrive onsite
Vaccination campaigns are now underway as local and international agencies, including the WHO and UNICEF, work to control cholera outbreaks in all regions. The WHO reports that there have been ‘tens of thousands of suspected acute watery diarrhoea (AWD) cases’ but the highest caseload has been in the governates of Aleppo, Ar-Raqqa Al–Hassakeh and Deir ez-Zor. While in neighbouring Lebanon, the death toll in the cholera outbreak has risen to 22 from more than 4,800 suspected and confirmed cases in 19 localities. Elsewhere, more than 13,000 suspected cholera cases had been reported to Dec 3 in Haiti; the hardest-hit age group is from one to four years. 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, chikungunya cases rising
A senior health official has asked residents to remove all rainwater-collecting containers that could harbour mosquito larvae after dengue and chikungunya infections surged following recent heavy rainfall. Many of the confirmed dengue cases were in Alto Paraguay and Boquerón, while chikungunya was reported in Asunción and the departments of Central and in Alto Paraná. 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.
Dengue activity continuing
There are concerns the slightly elevated level of dengue fever infections being reported in this low season could mean another major outbreak next year. The peak of weekly cases this year occurred in May (1,568) but they have dropped by 80 percent to just over 240. The less common serotype of DENV-3 was circulating in the 14 high-risk clusters this week. 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.
3rd province reporting measles cases
Three confirmed measles cases and another that was “equivocal” were reported late last week in the province of North West. The health department is tracing contacts in Signal Hill, Ngaka Modiri Molema District, advising parents to ensure their children’s routine vaccinations are current. According to the statement, North West Province’s 2-dose measles vaccination coverage is 82.3 percent. To Nov 30, the NICD updated the case total for the measles outbreaks in the provinces of Limpopo and Mpumalanga to 77 and 22, respectively. 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.
Strategy to end rabies by 2025
A program to speed up the elimination of rabies in the kingdom is planning to start with animal vaccinations and public awareness campaigns. It’s reported that the main reservoir of rabies in Thailand are dogs, accounting for 92 percent of human cases, followed by bats and cats (7 percent and 1 percent respectively). 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. Read more on rabies.
Elevated risk of resistant infections
The ECDC reported on an increase in multi-drug resistant Shigella sonnei infections, with at least 120 cases and one death among residents of several regions since July. The agency also outlined details on S. sonnei cases with resistance markers identified in travellers returning from Tunisia (but also Egypt, Pakistan, Afghanistan among others) from the Czech Republic, France, the Netherlands and Norway. It concluded that the ‘genetic variation of S. sonnei strains from returning travellers in the EU/EEA indicate multiple sources of infection and circulation of different strains in Tunisia’ and more cases ‘are likely to be detected’. Read more
Advice for travellers
Caused by Shigella bacteria, shigellosis can result in diarrhoea, fever, and stomach cramps starting a day or two after exposure, which is usually through contaminated food. Persons with mild infections usually recover quickly, but antibiotic treatment is recommended for patients with more severe symptoms. Read more
No new Ebola cases logged
The last person hospitalised with Sudan ebolavirus infection in Mubende district was discharged last week, however heightened surveillance will continue. Five districts are into the second half of their 42-day countdown without a case and no further spread reported (Mubende, Jinja, Wakiso, Masaka and Kyegegwa), while Kassanda and Kampala are in the first incubation period cycle. The outbreak total remains at 142 confirmed cases and 56 deaths. In related news, Science reports on ‘Uganda’s disappearing Ebola outbreak challenges vaccine testing’. Read more
Advice for travellers
Ebola Virus disease is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola virus disease.
Parents on alert for group A strep symptoms
Health authorities have asked parents to monitor their children for the appearance of symptoms typical of scarlet fever, including: ‘sore throat, headache, and fever, along with a fine, pinkish or red body rash with a sandpapery feel’. Cases in the week ending Nov 19 were more than four times higher than for the same period in previous years (851 cf. 186), probably as a result of ‘high amounts of circulating bacteria and social mixing’. In children under 10 years, there’s also been an increase in cases of iGAS, a rare complication of group A streptococcal infection, as well as lower respiratory tract Group A strep infections. More on group A strep from healthdirect. Read more