Health Alerts
  • Brazil: Hope cooler months will ease outbreak

    This season’s yellow fever outbreak has proved to be larger than for 2016/17. The Pan American Health Organization (PAHO) has declared the situation relating to both human cases and outbreaks in primate hosts (epizootics) across the Americas as ‘the highest observed in decades’. Case counts by state in descending order are: Minas Gerais (415 cases, 130 deaths), São Paulo (376, 120), Rio de Janeiro (123, 49), Espirito Santo (5, 0) and in the Federal District (1 death). The infection continues to spread through epizootics of infected non-human primates, particularly in the state of São Paulo, leading to concerns of a repeat of the SW movement seen in an earlier outbreak with Argentina and Paraguay impacted once again. It is hoped the onset of cooler weather will prevent this outcome. Read more

    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

    Cambodia: Hike in dengue rates

    Dengue fever rates are more than 2 times higher this year than for the same period in 2017 and authorities are concerned there could be a large outbreak during the July/August peak summer season. Cycles of epidemics run every 5 to 6 years, the last being in 2012 when up to 40,000 cases and 160 deaths were reported. Read more. A study carried out in Taiwan and published earlier this month in the Canadian Medical Association Journal revealed that in the two months following dengue fever infection, the risk of stroke is increased by up to 2.49 times.

    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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Canada: Cholera from fish eggs

    In an event that has surprised heath authorities, herring eggs found off the east coast of Vancouver Island have been found to be the source of cholera infections in four First Nations people. Measures, including closure of the affected area, have been instituted to check further infections. 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

    China: Air pollution warnings

    For the third time this year, Beijing has been hit by an ‘orange’ smog alert - the second highest degree after red. Some industries in the region of Beijing-Tianjin-Hebei are required to reduce production, and therefore emissions, during these alerts. Read more

    France: Measles infections top 1,000

    Currently 64 of the 94 metropolitan departments have recorded measles cases, with in excess of 1,000 infections from early November last year to March 19th. According to French public health authorities, 87 percent of cases were either unvaccinated or under-vaccinated. The highest incidence has been in infants under 12 months of age and Nouvelle-Aquitaine has reported 47 percent of all cases. Vaccination buses have been sent to university campuses amid warnings that one infected individual can transmit the infection to 15-20 others who are non-immune. Read more (translate from French).

    Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.

    India: Blood-borne viruses surge in southern state

    Lack of infection control during dental and endoscopic procedures, together with inadequate testing of donated blood are suspected to be the cause of a spike in the incidence of hepatitis B and C in the southern state of Telangana. Two cities situated in the SW of the state have Hep B rates of 15 percent, compared with the national rate of 3.5 percent. Read more

    Advice for travellers: The hepatitis B virus is transmitted mainly through the body fluids of an infected individual. The infection can become chronic, increasing the risk of cirrhosis and cancer of the liver. The global burden of hepatitis B is high, particularly in the Western Pacific and in Africa, followed by the eastern Mediterranean region and SE Asia. The virus remains viable outside the body for ≥7 days and so remains a risk for unvaccinated individuals. A course of hepatitis B vaccinations offers high rates of protection for the long term. Read more about hepatitis B and hepatitis C.

    Namibia: Zambezi’s malaria cases climb

    Over 1,100 malaria cases (and three deaths) have been reported in the Zambezi region – the pan-handle area to the north of Botswana. The capital, Katima Mulilo (200kms west of Victoria Falls) has been hardest hit, followed by Sangwali, Sesheke, Choi, Sibbinda and Mosokotwani. Read more

    Advice for travellers: Malaria is endemic in many areas of southern Africa. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.

    Nepal: Security alert for Valley

    Warnings have been issued to US government personnel in the region of Kathmandu Valley following threats made to public security in the area, particularly Chandragiri Hills Cable Car in Thankot, but including the whole Valley. The alert extends to the end of this month (March). Read more

    Nigeria: Largest Lassa outbreak; Cholera in NW

    A Mar 26 World Health Organization (WHO) statement announced that ‘the spread of Lassa fever in Nigeria is beginning to slow but the epidemic is far from contained,’ after several weeks of reducing case numbers. The likelihood of more infections is high due to the seasonal nature of the disease. While there has been no mutation of the virus leading to the large outbreak, disease levels remain above the norm for this time of year. Read more

    THE NE state of Bauchi has recorded as many as nine cholera deaths from more than 320 cases. Read more

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

    Reunion Island: Rainy season infections rise

    A dengue fever outbreak (588 cases in western and southern districts) is not the only threat arising from heavy rains, there has also been an increase in leptospirosis cases centred mainly on the south of the island. The incidence of leptospirosis increases each year from January to May, however the current case count (42, one death) is higher than previous years. Read more (translate from French).

    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.

    Singapore: HFMD peaks

    Parents have been asked to be vigilant for the symptoms of hand, foot and mouth disease (HFMD) in their children after a rise in cases – the highest in almost two years. Advice is to use strict hygiene measures and exclude the children from school and crowded places if they display symptoms of the infection. Read more

    Advice for travellers: Parents of young children should be aware of that seasonal epidemics of HFMD occur throughout Asia. The virus 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.

    South Africa: Water supply disconnect revised; Fourth rabies death in KZN; Malaria set to increase

    Cape Town’s water supply cut-off, which was forecast for August, may not happen until next year if ‘good rains and consumers continued to stick to 50 litres a day.’ Some reports put the reasons for the later date as due to a substantial drop in water usage across the city and a marked reduction in inbound tourism. Read more

    THERE has been another death from rabies in the province of KwaZulu-Natal – this time in the northern town of Vryheid. The man did not seek medical follow up and rabies post-exposure treatment after being bitten by his own dog. The Rabies Project Manager with the Department of Agriculture and Rural Development doesn’t name Vryheid as the current area of concern, instead it is the “coastal area from Richards Bay to Port Edward and all the towns 100km inward from there.” The national rabies toll for the year is now 7. Read more

    A NOTE of caution from the National Institute for Communicable Diseases (NICD) this week that recent rains are likely to cause more malaria in endemic areas after the Easter break. The Institute advises that the affected regions include: ‘north-eastern parts, covering Mopani and Vhembe districts of Limpopo Province, and the western parts of the Waterberg district (Thabazimbi and Lephalale areas)… Other areas of high transmission risk include the lowveld of Mpumalanga Province, including the Kruger National Park and surrounds, and the northern KwaZulu-Natal Province-Mozambique border.’ 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 or scratched, urgent post-exposure treatment is required. Vaccination is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.

    South Sudan: Aid to tackle 3 outbreaks

    A trio of infectious diseases has struck the central, north and NW regions of the war-ravaged country – Rift Valley fever, measles and meningococcal meningitis. 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. South Sudan 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). If you plan to visit this region, call Travelvax Australia’s travel health advisory service (1300 360 164 - toll-free for landlines) for further advice. Read more about Men. meningitis.

    Tanzania: Dengue in largest city

    Insect control measures established following a large dengue fever outbreak in 2014 are to be introduced again in Dar es Salaam after several dengue fever cases were reported recently. Read more

    Thailand: Beach safety concerns for resort area

    A news source in Phuket has reported on the local conditions hazardous to swimmers at popular beaches in the resort area and made more dangerous by the absence of lifeguards. More information on beach safety in Thailand is offered through DFAT's smartraveller.gov.au.

    Ukraine: Measles cases escalate

    Far from waning, the current measles outbreak is intensifying with over 700 new cases reported last week, taking the total since the beginning of the year to 8,434 cases and seven deaths. The hardest-hit regions are Ivano-Frankivsk, Zakarpattia, Odesa, Chernivtsi and Lviv. Read more. In the United Kingdom (Wales & Surrey) and Ireland (Limerick), alerts have been issued as measles infections continue to circulate.

    Vanuatu: Mumps, dengue cases emerge

    Reports issued through ReliefWeb advise there are dengue fever and mumps outbreaks in Vanuatu; mumps in Chuuk state (Micronesia); dengue fever in Fiji, New Caledonia, Samoa, Tonga, as well as Vanuatu; and the Fiji Ministry of Health has declared an outbreak of meningococcal meningitis C after 18 cases were recorded for the year to Feb 21.

    Advice for travellers: This outbreak of mumps highlights the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to any destination – be it a developed or developing country. Read more about mumps.

    Venezuela: Regional diphtheria

    More diphtheria infections have been reported since the beginning of the year, adding 36 additional cases to the 933 recorded over the course of the outbreak that started in July 2016. Two cases were also ‘exported’ to Brazil and Colombia, as notified in the PAHO report issued at the end of February. The same report notes that the long-running outbreak in Haiti has produced two to five suspected cases each week this year. Elsewhere, outbreaks of both diphtheria and cholera continue to assail Yemen, although the cholera situation has stablised somewhat in most regions (except Al Mahweet). The case count for cholera now sits at 1,080,422 with 2,266 associated deaths since April 2017; diphtheria 1,368 probable cases and 76 related deaths. Read more 

    Advice for travellers: Spread by coughing and sneezing or 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 about diphtheria.

  • Australia: Measles jets in

    The Victorian health department has issued a second measles alert in under a week, referring to an incident on March 7th when an air traveller arrived into Melbourne from Kuala Lumpur while highly infectious with measles. People who were on the flight and in the terminal at the same time are asked to monitor their health for measles symptoms. The other recent case, a backpacker who is believed to have contracted measles in Indonesia, visited various tourist sites in the south of the state while infectious.

    Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.

    American Samoa: Post-cyclone dengue risk

    There have been more government warnings on the continuing presence of dengue fever in the post-cyclone period; the infection is still spreading and effective mosquito bite avoidance measures should be employed. Read more. Also in the region affected by Cyclone Gita, Tonga has reported 70+ suspected dengue fever cases. Mosquito breeding sites are being targeted in a clean-up campaign, concentrating on the central district. 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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Brazil: YF cases rise again

    With the yellow fever virus continuing its spread into new areas, health authorities have been struggling to vaccinate those people who live in regions now considered an infection risk. The World Health Organization (WHO) has released details of three more foreign tourists (from Switzerland, Romania and Argentina) infected with YF during the current season – they take the total to 10. ‘Probable site of infection for these cases are under investigation and are likely: Mairiporã/Atibaia (one case), Ilha Grande, municipality of Angra do Reis (eight cases), Brumadinho, Minas Gerais (one case).’ Further, ‘WHO encourage Member States to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination.’ Read more

    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

    Europe: Measles cases, deaths continue

    The protracted measles epidemic that started in 2016 continues to produce new cases, with four regional countries reporting seven deaths between them this year among significant numbers of infections: Greece (1,008 cases), Romania (757), France (429) and Italy (164). A European Centre for Disease Control (ECDC) report notes that: ‘the highest incidence of cases was reported in infants below one year of age, being those most at risk of severe complications and deaths … are best protected by herd immunity.’ The report also refers to outbreaks in the wider region: Belarus, Georgia, the former Yugoslav Republic of Macedonia, Moldova, Serbia and Ukraine. Read more

    India: Infections tracked to dental lapses

    A doctor’s group in Kashmir has blamed the lack of infection control by dentists for the high rates of the blood-borne infections hepatitis B & C and HIV in the district. Read more

    Advice for travellers: The hepatitis B virus is transmitted mainly through the body fluids of an infected individual. The infection can become chronic, increasing the risk of cirrhosis and cancer of the liver. The global burden of hepatitis B is high, particularly in the Western Pacific and in Africa, followed by the eastern Mediterranean region and SE Asia. The virus remains viable outside the body for ≥7 days and so remains a risk for unvaccinated individuals. A course of hepatitis B vaccinations offers high rates of protection for the long term. Read more about hepatitis B.

    Kenya: Cholera outbreaks linger

    In the eastern county of Tana River, more cholera cases are appearing while the search for the source of the infection continues. The case count now sits at 242. Read more. Cholera infections persist in Uíge and capital city of Cabinda province in Angola, while there has been some improvement in the situation in Hoima, Uganda, with fewer new cases being reported. Of concern, daily arrivals of more refugees from Democratic Republic of Congo add to the risk of an upsurge in infections.

    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

    Mexico: Safety concerns on Yucatan

    Parts of the resort town of Playa del Carmen on the Yucatan Peninsula are off limits to US govt. personnel in the wake of ‘an ongoing security threat’ and, as an added measure, the local US embassy was closed from Mar 7-12. Other zones of the town, as well as resorts on the Riviera Maya are not affected. In another matter, a warning is in place for all US citizens to avoid using the Cozumel to Playa del Carmen ferry following an explosion onboard one vessel and the discovery of suspect material on another in late Feb. Read more

    Myanmar: UK ups Zika rating

    This week UK travel health authorities upgraded the Zika virus alert for Myanmar to moderate, advising those who are pregnant or planning pregnancy that, ‘The greatest likelihood of acquiring Zika virus infection is in a country with high or moderate risk, however the individual risk of infection is likely to be lower especially if mosquito bite avoidance measures are followed.’ 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, the Zika virus 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). 

    New Caledonia: Uptick in dengue

    The incidence of dengue fever is on the rise, with an increase from 43 to 78 cases in the two most recent reporting weeks. According to the Direction des Affaires Sanitaires et Sociales, over three-quarters of cases are type 2 dengue virus. Yate, Noumea and Dumbea have recorded most cases. Read more

    Nigeria: Fever outbreak widens

    The first few weeks of the year have seen more Lassa fever cases than in the previous 12 months and it’s likely the situation is more serious due to under-reporting. The Mar 13 update from the Nigeria Centre for Disease Control (NCDC) announced another state, Kaduna, has confirmed a Lassa fever infection; it becomes the 19th reporting the viral infection. Other relevant news from the NCDC released on Mar 12: ‘The most likely route of transmission continues to be spill over of viruses from the rodent reservoir to humans rather than extensive human-to-human transmission.’ Read more. Three Lassa fever cases (and deaths) have also been recorded in Liberia recently– two in the county of Montserrado (60kms NW of Monrovia) and one in Nimba (300kms to the east of the capital). They take the year’s case count to 28 (suspected) cases and 12 deaths. 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.

    Philippines: Dengue in Cavite; Measles spikes on southern island

    There has been a year-on-year rise in the number of dengue fever cases in the province of Cavite (southern shores of Manila Bay, Luzon) but it isn’t classified as an epidemic as yet. The cities with the highest burden of dengue are General Trias, Bacoor, Imus, Dasmariñas and Trece Martires. Read more 

    MEASLES cases soared in the first few weeks of the year to almost three times last year’s figures, according to a government report. Twelve deaths were reported and there were 877 suspected measles infections in the period Jan 1 to Feb 3, with the majority on the island of Mindanao. Read more. A measles outbreak has been declared in Central Visayas – Dumaguete City, capital of Negros Oriental province, has most cases. Read more

    Reunion Island: Push against dengue

    Public awareness campaigns and the destruction of mosquito breeding sites have been given priority in the wake of recent heavy rains and isolated outbreaks of dengue fever. The range of dengue has been spreading in districts of the west and south (Saint-Paul, Saint-Gilles-les-Bains, La Possession, Le Port, Saint-Leu and Saint-Pierre). Read more (translate from French).

    Saudi Arabia: Peak season for MERS

    Information on the MERS outbreak has been limited of late, but this week news sources cited the Undersecretary of the Ministry of Health speaking on the current increase in community cases which he attributed to the season of peak virus transmission. Precautionary advice should be followed if in proximity to camels, markets and slaughterhouses. Read more from afludiary

    South Africa: Malaria in tourists

    From a report received through the GeoSentinel global surveillance system, two UK children have acquired malaria while staying at an advertised ‘malaria-free’ game park near Vaalwater in Limpopo province. Travellers should seek advice from their travel health practitioner about the best methods of avoiding mosquito bites and whether malaria prophylaxis is recommended for their particular circumstances.

    Advice for travellers: Malaria is endemic in many areas of southern Africa. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria.

    South Sudan: Risk of fever spread

    An epidemic of Rift Valley fever (RVF) has been declared after positive test results were obtained from livestock in the central district of Yirol. There have been a number of confirmed cases in humans already, but the presence of the disease in cattle indicates the potential for further spread. Read more

    Advice for travellers: Rift Valley fever (RVF) is an acute viral disease that typically infects domesticated herd animals. It is generally found in eastern and southern Africa where sheep and cattle are raised, as well as in West Africa, Madagascar, and more recently Saudi Arabia and Yemen. People are infected after exposure to blood, body fluids, or the tissue of RVF-infected animals, or from the bite of an infected mosquito. The virus presents a low risk to travellers, but is another reason to use personal insect repellent and take other steps to minimise insect bites in places where it occurs. Read more about RVF.

    Taiwan: Spiked snails

    Five foreign workers have become infected with the parasitic nematode Angiostrongylus after eating raw apple snails they had found near their work place in the country’s south. The men are undergoing treatment in hospital after reporting severe symptoms produced by the roundworm infection, Angiostrongyliasis. More information and advice from the Centers for Disease Control, Taiwan.

    Uganda: Saving kids from measles

    Children aged between five months and five years are the focus of a measles vaccination campaign in the eastern disticts of Mbale and Butebo after more than 40 cases were confirmed recently. Read more

    Vietnam: Chickenpox upsurge

    The incidence of chickenpox has risen sharply in both the north and south of the country. The peak season for varicella notifications, according to a senior paediatrician in Ho Chi Minh City, is from February to June.

    Advice for travellers: Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.

  • Brazil: YF risk nears cities; Dengue cases triple in SP

    A Mar 7th Health Ministry report outlines this season’s marked increase in the incidence of yellow fever cases and deaths over the previous season (2016-7), also noting that infections are now being found in areas close to major population centres. Substantial numbers of the at-risk population in the states of Rio de Janeiro, Bahia and São Paulo are yet to be vaccinated in the current campaign. Read more

    DENGUE fever rates climbed in São Paulo in the first few weeks of the year to triple last year’s figures for the same period. Smaller increases were also seen in Paraná, Santa Catarina and Rio Grande do Sul. Read more. The national dengue burden to date sits at 22,580 cases. Read more from the Pan American Health Organization (PAHO).

    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. 

    Cambodia: Mondulkiri malaria

    An Australian woman is undergoing treatment for malaria which she contracted while doing short-term volunteer work at an elephant sanctuary in the eastern province of Mondulkiri. Read more. More information on malaria in Cambodia from the US Centers for Disease Control and Prevention (CDC).

    Democratic Republic of Congo: Danger of cholera spread persists

    The incidence of cholera is declining in Kinshasa province, down from 100 cases a week reported two months ago, however the WHO describes the situation as remaining ‘alarming’. This is attributed to new cases ‘in areas along the Congo River and the arrival of the second rainy season which will last from March to June pose a risk for the resurgence of cases in Kinshasa’. The risk of spread in the region is also considered high. 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

    Europe: Flu still peaking

    Influenza season is still underway, with most countries in the region (particularly Denmark, Estonia, Norway, Sweden, and Russia) reporting high amounts of activity, according to the European Centre for Disease Control (ECDC) weekly update, and while both A and B virus strains are circulating, influenza B virus is currently causing more illness. World Health Organization (WHO) surveillance also shows high levels of influenza-like illness in the USA, Canada, parts of North Africa and Hong Kong. Read full report here.

    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 influenza vaccination against influenza for all travellers over 6 months of age.

    Fiji: Dengue cases top 1,000

    The island nation is currently recording an average of 61 new dengue fever cases every week. The Health Minister announced the figures at the end of last week and advised that the infection is now present year-round. Almost 400 cases have been reported in the Western Division and a further 638 in the Central and Northern Divisions (to Feb 23). 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 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 PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    French Polynesia: Lepto risk raised

    Each year leptospirosis infections spike during the November to March wet season as people are exposed to the bacteria in floodwaters and soil that are contaminated with the urine of infected animals. Last year, the region experienced a 11-year peak in cases, with most in the eastern and western parts of the Society Islands (Windward and Leeward Islands). High risk behaviour included exposure through freshwater bathing and recreational activities and walking through puddles and mud. Read more (translate from French).

    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.

    India: Unseasonal dengue for Jaipur

    Insecticide fogging is already being carried out in parts of Rajasthan after an early rise in dengue fever and chikungunya cases, most of which were in the capital, Jaipur. 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 and avoiding insect bites.

    Ireland: Mid-West measles warning

    The city of Limerick is at the centre of a measles outbreak with 22 cases already recorded this year. Health authorities are advising adults under 40 years of age to ensure they have received the full course of 2 MMR vaccines. Read more. Six people who were in the city centre of Cardiff in SE Wales on the same day have contracted measles from one source – ‘an unknown highly infectious case’. Read more Canadian travel health advisories have been updated this week with the addition of Latvia, Macedonia, Montenegro, and Norway on the list of countries with measles risk. 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.

    Malawi: Local and regional cholera outbreaks

    Almost half of the country’s 28 districts have now reported cholera infections. A further 172 cases over the past month have taken the total to 718 and 19 deaths. The capital, Lilongue, and the district of Karonga have been hardest hit. Read more. Quarantine officials at Egypt’s Cairo International Airport are to begin screening passengers arriving from Malawi, Mozambique and Namibia for symptoms of cholera. The measure is in response to ongoing outbreaks in Eastern and Southern Africa (see UNICEF bulletin). Read more

    Mozambique: Fatal consequences of vax shortage

    Insufficient funds for buying the necessary vaccines is one reason given for the human rabies toll – 72 people died from the infection last year. Of the 11,000 notified rabies exposures last year, most were children and were from Cabo Delgado, Nampula, Zambezia and Inhambane. 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 is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.

    Nigeria: WHO: largest outbreak of Lassa fever: YF vax campaign in NW

    The WHO has assessed the degree of risk imposed by ‘the largest outbreak of Lassa fever ever reported in Nigeria’ as moderate on a regional level, as the toll climbed to 90 deaths from over 1,000 suspected cases in 18 states for the year to Feb 25. Read more. And surveillance has been heightened in Ghana following the death of a man infected with Lassa fever last week in Tema, Greater Accra region. Read more.

    YELLOW fever vaccinations will be administered to over 1.5 million people in the NW state of Kebbi following 36 cases of the infection in eight districts (Bagudo, Fakai, Koko/Besse, Maiyama, Ngaski, Shango, Suru and Yauri). 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.

    Pakistan: Measles toll climbs to 8

    Measles has killed at least eight of the 100 children infected this year in the province of Sindh – the deaths occurred in Hyderabad and the city of Badin to the south. Read more

    Samoa: Dengue situation updated

    The dengue fever outbreak is finally abating, however health officials are still recommending the population employs precautions against mosquito bites. From the latest Ministry of Health report (taking in information up to January 28), there have been over 3,000 dengue infections on two islands, Upolu and Savaii - the highest incidence was reported in a SE district of the capital, Apia. Read more

    South Africa: Listeria sources identified; 3rd rabies death

    Local food outlets and countries in the region are recalling a variety of processed meat products (polony, viennas/sausages, other cold meats) after it was revealed that they were the cause of what had become the largest outbreak of listeriosis. Up to 30 percent of environmental samples taken from a factory in Polokwane were positive for listeria bacteria. Other food production facilities are undergoing testing. The outbreak, ongoing since January last year, has caused 948 infections and had a reported 27 percent fatality rate. Read more

    SADLY another child has died from rabies infection in KwaZulu-Natal, the third this year. The boy had reportedly been scratched by a cat at a beach near KwaDukuza (Stanger). Read more

    United States of America: STIs spike; Hep A persists in 3 states

    HIV and syphilis rates have surged in Wisconsin’s largest city, Milwaukee. Authorities have announced a cluster of 125 people, some high school students, with one or both infections. A local news source stated that the ‘Milwaukee area ranked first in the nation in gonorrhea rates; fourth in chlamydia’. Read more

    HEPATITIS A outbreaks continue in the states of Kentucky, Utah and Michigan. Due to the fact that most infected people are homeless or illicit drug users with higher rates of associated medical conditions, many have required hospitalisation. 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 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.