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 30th of January 2019

Hantavirus advice and warnings

More on the hantavirus situation from a WHO Disease Outbreak News post on Jan 23 which included the following information: ‘As of 17 January 2019, a total of 98 asymptomatic contacts have been identified and are being monitored for the potential development of symptoms. In Argentina, four endemic regions have been identified: North (Salta, Jujuy), Centro (Buenos Aires, Santa Fe, and Entre Ríos), Northeast (Misiones) and Sur (Neuquén, Río Negro, and Chubut). Between 2013 and 2018, an average of 100 confirmed cases were registered annually, with the provinces of Buenos Aires, Salta, and Jujuy having the highest numbers of cases.’ Advice provided includes, ‘Most usual tourism activities pose little or no risk of exposure of travelers to rodents or their excreta. However, people who engage in outdoor activities such as camping or hiking, should take precautions to reduce possible exposure to potentially infectious materials.’

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.

Peak transmission time for YF, PAHO update

The Pan-American Health Organization’s yellow fever update issued on Jan 25 notes ‘Human cases reported during the current 2018-2019 seasonal period in four municipalities in São Paulo State, as well as the confirmation of epizootics in the state of Paraná, mark the beginning of what could be a third cycle and a progression of the outbreak towards the Southeast and South regions of the country’. Peru’s total of 20 suspected and confirmed yellow fever cases during 2018 (from the forested departments of Loreto, San Martín, Ucayali, and Madre de Dios) was an increase on notifications during the previous year.

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.

Ebola virus death toll exceeds 460

The case count in the NE’s Ebola virus disease outbreak has climbed to 743 with 461 deaths and there are 174 cases under investigation. Nearly 70,000 vaccines have been administered, including more than 7,800 in the latest hotspot, Katwa. Read more in the health ministry’s Jan 29 newsletter.

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.

 

Bacterial infection kills four; 6 towns report 'pink eye'

This week the health ministry announced the reporting of 69 cases of leptospirosis in the Central Division since the beginning of the year and four deaths resulting – most cases were in the 1- 29 years of age group. Read more.  On Jan 21 the department also advised an increased incidence of conjunctivitis or ‘pink eye’, mainly affecting Suva, Sigatoka, Nadi, Ba, Lautoka, and Savusavu. The Ministry of Health and Medical Services’ website has listed a number of ways to help prevent infection ‘by following some simple good hygiene steps’. Read more on conjunctivitis from healthdirect.

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

Measles updates

There are reports of a measles outbreak in Vladimir Oblast, east of Moscow, with over 50 cases identified to date. A news source claims the first infected case arrived from Azerbaijan and the virus then spread in the local Roma community. Read more Meanwhile, Georgia could be heading into a large measles outbreak with 580 infections reported already this year. The majority of cases were from Tbilisi, Samegrelo (Western Georgia) and Kakheti (Eastern Georgia) regions). Read more. Kazakhstan’s 741 measles cases reported in January (the basis of a current CDC travel notice) exceeds the number of notifications for all of 2018. Over 550 of the cases were in the capital Astana.

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.

Regional diphtheria reporting

Haiti’s climbing diphtheria rates over the past four years have been attributed to better surveillance systems - in 2018 there were 373 probable cases (and 14 deaths), more than 16 times the 2014 total. Data from Venezuela reveals the scale of that outbreak, with 1,102 suspected diphtheria infections last year (with 270 deaths) and a further 46 to date in 2019 – all age groups were affected. Read the PAHO report here.

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.

Tainted temple food offering

For the second time in two months, contaminated food offered at temples in Karnataka have led to sickness and even death. The two episodes occurred in Chintamani town and in Mysore. Two women died in the most recent poisoning (Chintamani) but last month, in the Mysore incident, 11 people perished. Investigations are underway into the causes of the poisoning. Read more

Capital’s 4-fold rise in dengue

More on the dengue fever spike with one news source in Jakarta stating the city experienced ‘about 430 cases in the first three weeks of 2019, nearly four times the 111 cases recorded in the same period last year’. By Sunday that figure had risen to 613. Highest infection rates have been in Jagakarsa (South Jakarta), Kalideres (West Jakarta), Kebayoran Baru (South Jakarta), Pasar Rebo and Cipayung (East Jakarta). 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.

HFMD upsurge in Sarawak

There’s been a more than five-fold increase in the incidence of hand, foot and mouth disease (HFMD) in Sarawak during the first 19 days of the year (615 compared with 112 in 2018). The divisions of Miri, Kuching and Sibu were hardest hit, each recording in excess of 100 cases. 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.

 

Lassa fever toll mounts

In the most recent reporting week (to Jan 20), 74 more confirmed Lassa fever infections were announced by the NCDC - in the states of Edo, Ondo, Bauchi, Ebonyi, Plateau,Taraba and Adamawa. More than 30 people have succumbed to Lassa fever this year. See the NCDC’s update map here. Read more

Advice for travellers

Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings and it’s then passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. While Lassa fever is mild or has no observable symptoms in about 80% of people infected with the virus, the remaining 20% have a severe multisystem disease. Read more on Lassa fever.

 

MERS in south and Oman

The year-to-date total of MERS cases has climbed to 15 after an infection was notified from the southern town Wadi Aldwasir and Oman’s health ministry announced they had four cases in the Sultanate. The Saudi case had confirmed contact with camels, a risk factor in MERS transmission, but no details were provided by authorities on the cases in Oman. Read more

WNV observed in blood donors

Researchers working in the province of Punjab have stressed the need for national surveillance after they identified active West Nile virus (WNV) circulation in over 1,000 asymptomatic blood donors. Limited testing carried out in the province did not find evidence of WNV in mosquitoes. Read more

Advice for travellers

Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites. Read more on WNV.

ECDC: Flu activity situation, dengue report card

The ECDC’s Communicable Disease Threats Report (Jan 20-26) notes increasing influenza activity following seasonal patterns with both A(H1N1)pdm09 and A(H3N2) viruses circulating widely. From Flu News Europe, countries reporting high levels of flu activity in January are Romania, Turkey and Montenegro. The Report also provides an epidemiological summary of dengue fever for countries with ‘an increasing trend compared with 2017’. They include Thailand (up 50%), Taiwan (10-fold), Bangladesh (11-fold), Cambodia (4-fold), the Philippines (10-fold) and Singapore.

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.

Early dengue count nears 5,000

With the peak dengue fever season still a few months away, there have already been more than 4,800 cases with over one-third recorded in the capital Colombo and nearby Gampaha. 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.

NW measles outbreak spreading

It’s now been over a week since a local public health emergency was declared in Washington State in response to measles cases occurring in a region known for low vaccination rates. Thirty-seven cases have now been confirmed, all but one in Clark County (King County reported the other case). 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. 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.