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 14th of November 2018

Dengue fatality

The year-long dengue fever outbreak in Wallis and Futuna has produced 461 suspected cases to date and its first death, which was recorded this week – a young girl who had been transported to New Caledonia for treatment. Also in the region, dengue infections continue to emerge from another lengthy outbreak, this one in American Samoa – there have been almost 2,000 cases to date. Read more

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.

YF risk rises; Kala Azar in NE; Dengue total nears 220,000

The Ministry of Health has warned residents of metropolitan areas of Rio de Janeiro, Minas Gerias and São Paulo to ensure they are vaccinated against yellow fever (YF) as the peak YF transmission season starts. The emphasis is on the three south-eastern and southern regions as they are 'recently affected' and have large populations. Circulation of the YF virus has been seen in the cooler months this year; the ministry reported 'the first death from yellow fever in the second half of this year. The case was registered in São Paulo, with probable infection in the city of Caraguatatuba'. Read more

AUTHOTITIES in Sergipe have called for more measures to tackle visceral leishmaniasis, an endemic infection in the NE state. 'Intense' transmission is reported in three towns - Aracaju, Nossa Senhora do Socorro and São Cristóvão – while state-wide this year there have been nine deaths from 55 cases.

ON A national level, circulation of all four dengue serotypes is being reported. The total number of dengue fever cases to week 42, according to regional data provided by PAHO, rose to nearly 220,000 cases, almost half of which were laboratory confirmed.

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 outbreak now largest recorded in DRC

On Nov 9, with 319 cases that were either confirmed or probable, the Health Ministry admitted that the current Ebola virus disease (EVD) outbreak is the largest to date.  In the latest report (Nov 12), the ministry announced that 'the cumulative number of cases is 339, of which 301 confirmed and 38 probable. In total, there were 212 deaths (174 confirmed and 38 probable).' More information from CIDRAP. A clinical trial will begin this month comparing four treatments used during this Ebola outbreak.

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.

Dengue follows rains

Dengue fever cases have risen sharply in the last month, with many of those reported in the category of severe dengue. Six departments have been hardest hit - Cortés, Tegucigalpa, Yoro, Atlántida, Olancho and Comayagua – following recent rains. Read more

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.

Hep A spike

Late last week Hong Kong’s Centre for Health Protection issued an 'appeal for vigilance against hepatitis A' following hospitalisation of 14 people with hep A since October 1 – average monthly notifications this year had been from one to five cases. Five of the cases were confirmed to have been imported (from Pakistan or Bangladesh). A common source of infection for the remainder is yet to be identified. Read more

Advice for travellers

Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is highly effective and offers long term protection.

Zika in MP; Assam’s JE; Punjab’s dengue now also rural

The Zika count in the state of Madhya Pradesh has risen to 109 with cases in the cities of Bhopal (44 cases), Vidisha (39) and Sehore (20). Seven districts are now involved in the outbreak; two new areas identified this week are Raisen and Narsinghpur. A 'containment area' has been established around Bhopal, Sehore, Vidisha and Sagar. Read more

DELHI'S air pollution is currently ranging from unhealthy to hazardous, following the annual trend that sees the smog persist into next month.

LOW vaccination rates among adults in several districts of Assam are blamed for the NE state having the country's highest rates of Japanese encephalitis - by week 43 (Oct 26) there had been 488 cases and 94 deaths.

IT'S peak dengue season in the state of Punjab with reports that the infection is becoming more common in rural communities – around one-third of all cases this year have been in villages well outside major centres such as Chandigarh.

Advice for travellers

Zika's symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts.& Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).

Update on JE in Bali news

Japanese encephalitis vaccines given to Balinese children as part of their routine immunisations in April this year appear to be behind several media reports of an outbreak of the infection on the island. On the weekend, however, the Head of the Bali Provincial Health Office refuted the existence of an outbreak, stating that ‘there was only one case of JE in January and it was cured, there was no death’. The island houses large numbers of pigs, the basis of the famous local dish 'babi guling' but also an amplifier of the Japanese encephalitis virus. With a heightened risk of transmission, authorities have aimed to vaccinate all children from the age of nine months to 15 years against JE. Read more

Advice for travellers

A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE.

Dengue prompts travel notice

With over 2,000 suspected dengue fever cases reported in six regions (Fatick, Diourbel, Saint Louis, Louga, Dakar and Thiès), the US CDC has issued a travel notice – Level 1, Practice usual precautions - for travellers to Senegal. It is hoped the pending dry season will limit the spread of dengue in Senegal and also in its northerly neighbour Mauritania where an outbreak has been ongoing since May. Dengue virus serotype 2 has been circulating in six regions, with most cases in the capital Nouakchott. Read more

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.

Mosquito-borne infections simmer

Low levels of Zika virus infections are circulating in over half of all states (18 of 32), while chikungunya is reported, with confirmed cases in very low numbers, in nine. The top four states for Zika virus, according to a local news report, are Jalisco (64), Sinaloa (21), State of Mexico (15), Baja California Sur and Nayarit (both 11). Read more

Advice for travellers

Zika's symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).

Rabies ex-Morocco

Public Health England has reminded the travelling public to avoid animals in rabies risk countries and to seek medical assistance in case of exposures such as bites, scratches or licks from animals. The warning comes after a UK citizen died from rabies transmitted through a bite from a rabid cat in Morocco.

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.

Tackling Pokhara’s dengue

In response to the 185 dengue fever infections recorded over the past six weeks in Pokhara district (and valley) local authorities have mounted a public awareness campaign and initiated the clean-up of potential mosquito breeding sites. Read more

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.

Meningococcal disease rates rise

Cases (and related deaths) of invasive meningococcal disease (IMD) due to serotype W have doubled since 2017 – over one-quarter of those were in the Northland region – and 'cases due to all serogroups has been increasing steadily since 2014'. As a result, the Institute of Environmental Science and Research (ESR) has increased the frequency of its IMD surveillance reporting to weekly. 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 Meningococcal meningitis.

HCMC’s dengue upsurge

Pooling water in the many new building projects underway in Ho Chi Minh City's peripheral districts is driving a rise in dengue fever cases in the municipality, however all areas of the city are reporting cases. Last month's dengue count was 125 percent higher than the same period in 2017 with the intense transmission season now in progress. Read more

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.