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 27th of March 2019

Measles on both islands

Canterbury district’s measles count increased by one to 35 this week after an infectious passenger arrived in Christchurch on a flight from Melbourne on Mar 19. Read more. Auckland’s case count has risen to nine with four of the five most recent measles infections considered close contacts of an earlier case. In Australia, the state of Victoria has reported another measles case in the past week, an infection stemming from an outbreak in the Northern Territory. There are separate alerts for both NSW and QLD, while in Western Australia, the state government announced a program providing free measles vaccines for residents born in or after 1966 who are not fully vaccinated against measles’. The media release noted that ‘while the vaccine is free, there may be a fee for the consultation’.

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.

BRAZIL: Southern state’s YF uptick

Yellow fever cases reported this year in the southern state of Paraná have risen to 12 with a local news source stating there have been 224 notifications overall and 61 cases are under investigation. Confirmed cases were in the municipalities of Antonina, Morretes, Adrianopolis, Campina Grande do Sul, Curitiba, Piraquara and São Jose dos Pinhais (this last town is the site of a new YF epizootic, together with Paranagua). Vaccination campaigns are being carried out across the 22 health zones of the state. 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.

Dengue surges across 11 departments

New dengue fever cases are currently presenting at a rate of around 2,000 per week with highest rates occurring in the departments of Putumayo, Amazonas, Meta, Norte de Santander, Guaviare, Boyacá, Huila, Cesar, Tolima, Magdalena and Córdoba. Read more. A PAHO dengue summary shows the cumulative total in Colombia nearing 20,000 (to week 11). Other substantial data from the summary: Brazil (185,934 cases to week 10), Nicaragua (11,574 to week 8) and Mexico (7,131 to week 10).

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.

Regional dengue reports

The Mar 14 WHO Dengue Situation Update notes that ‘dengue activity has increased since week 7, and is higher compared to the same period in previous five years’ with the latest count at 978 cases and four deaths. Elsewhere in the Western Pacific region, Cambodia’s weekly total remains above the threshold, while year-on-year increases have been experienced in Singapore, Malaysia, the Philippines, Thailand, China and Vietnam.

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.

Ebola outbreak – 9 months, 1022 cases, 639 deaths

The Ministry of Health newsletter (Mar 26) announced the latest figures in this challenging outbreak – there are 161 cases under investigation, more cases in Katwa, Mandima and Vuhovi and news that four high-risk community deaths had occurred in Katwa and Mandima. 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.

Local dengue 2 infection detected

Last month a level two health alert was instituted after an imported DENV-2 infection was diagnosed in a new arrival from New Caledonia; the reason being that over 80 percent of the local population has never been exposed to this strain. The alert remains in operation and will continue to do so after authorities confirmed a locally acquired DENV-2 infection in the area of Patuto'a, near the port and main shopping precinct. Read more. And in Palau it is DENV-3 that is the newcomer, with advice from the Ministry of Health that ‘the whole population is potentially vulnerable to infection’. Eight new infections were diagnosed in the most recent reporting week, taking the total since early December to 124. The majority of the cases have been in the southern states of Koror and Airai.

Advice for travellers

Dengue fever is common in most tropical or sub-tropical regions of the world. The virus is spread by daytime-feeding Aedes mosquitoes and to avoid it and other insect-borne diseases, travellers should apply an insect repellent containing an effective active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin when outdoors during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, as well as other times when the mosquitoes are active.

Update on polio in Papua

From the GPEI weekly report on the current situation in Papua province: ‘In total, three genetically-linked circulating vaccine-derived poliovirus type 1 (cVDPV1) isolates were detected from Papua province. In addition to the above-listed isolate, cVDPV1 was isolated from an acute flaccid paralysis (AFP) case, with onset of paralysis on 27 November 2018, and from a sample of a healthy community contact, collected on 24 January 2019.  This outbreak is not linked to the cVDPV1 currently affecting neighbouring Papua New Guinea.’ Investigations into the occurrence and the necessary response measures are continuing. In the same report, more on Nigeria’s situation: ‘One case of circulating vaccine-derived poliovirus type 2 has been reported this week in Kaiama LGA, Kwara State. This is third case in Kwara State and the second in 2019 in Nigeria.’

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 polio.

Cyclone lifts disease risk

Following damage to water infrastructure and health facilities caused by Cyclone Idai, response measures planned by aid agencies will tackle the anticipated rise in cases of acute watery diarrhoea, cholera, typhoid and malaria infections across the affected central regions, but centred on the port city of Beira in Sofala province. Authorities in Zimbabwe and Malawi, which were also severely impacted by the cyclone, are also on alert for the emergence of these same flood-related issues. The CDC has issued a level 3 alert – avoid non-essential travel – to the three affected countries while DFAT’s smartraveller also has current warnings for the region.

Clampdown on medication compounds

Authorities are cracking down on the practice by some pharmacies of pulverising medications (including analgesics, cough suppressants, steroids and antibiotics) and combining them in one sachet. The drugs involved may not even be registered or have passed their expiry dates. Of the many concerns over this practice, such as antibiotic resistance, there is a heightened risk of interactions and of side effects being intensified. A local news source claims the sachets are being sold at low cost in ‘convenient shops and beauty stores’. Read more