Health Alerts
  • Angola: Malaria spirals in 3 provinces

    Malaria is the biggest killer in Angola and even so, the outlook for this year is predicted to be severe - the provinces of Cuanza Norte, Bengo and Huambo are already experiencing malaria epidemics. The national toll rose to 3,835 deaths from over 1.5 million cases for the year. Read more (translation required).

    Advice for travellers: For many travellers, Africa presents a significant malaria risk. Travellers can discuss their itinerary and the need for anti-malaria medication with a trained travel health professional at their nearest Travelvax clinic. For details call 1300 360 164. Read more about malaria

    Argentina: Late dengue surge

    Authorities are hoping for cooler weather which would reduce the activity of dengue virus-carrying mosquitoes. A local news source puts the number of cases in the province of Misiones as 63 confirmed, 18 probable – nine cases have been diagnosed in Puerto Iguazú, situated near the Falls, and 169 in the capital city of Buenos Aires. Read more (translation required). 

    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.

    Cameroon: Viral disease spreads in 5 regions

    Five health districts, located across different compass points, have reported either confirmed or suspected Monkeypox infections - Njikwa, Akwaya, Biyem-Assi, Bertoua and Fotokol health districts. The most recent World Health Organization (WHO) update states there have been 16 cases, an increase of nine from the last report. The latest assessment judges that the risk of spread from the remote areas is limited. WHO factsheet on Monkeypox.

    Advice for travellers: Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. Read more on monkeypox from the CDC. 

    Chad: Measles toll climbs

    An epidemic of measles is unfolding in the districts of Bokoro, Gama, Ati, Am dam and Goz Beida – the death toll sits at 18 from 474 infections. International aid agencies are working in the area, vaccinating up to 75 percent of children who are currently unimmunised. 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.

    Democratic Republic of Congo: More Ebola, but progress made

    As reported by the health ministry in an update on the Ebola virus disease (EVD) outbreak, up to June 5th there have 60 cases of haemorrhagic fever (37 confirmed, 14 probable, 9 suspected). An additional six suspected cases have been identified (from Bikoro, Iboko & Wangata), three of whom were contacts of previous cases. Over 1,500 people have received the vaccine and a number of local traditional healers were invited to participate in an awareness campaign to learn of the need for strict hygiene measures.  According to a senior WHO official, Dr Peter Salama, ‘115 points of entry have been listed and mapped and 30 prioritized for implementing Ebola prevention, detection and control measures.’

    Advice for travellers: Ebola 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.

    Fiji: Men C death toll rises

    This year’s death toll from meningococcal meningitis has risen to five this week following the death of a 22yo woman in Labasa; she was a nursing student. Read more. Vaccination of all children from one to 19 years of age is still underway – by the end of May up to 45,000 Meningococcal C vaccines had been administered. Read more 

    Advice for travellers: Advice on the prevention of meningococcal infection, as stated on the Fiji Ministry of Health and Medical Services website, includes: Practicing good hygiene such as covering mouth and nose when coughing or sneezing and washing hands; don’t share utensils, cups/glasses, drinks at social gatherings, cigarettes, or kava bowls. If planning travel to Fiji, discuss whether vaccination against meningococcal meningitis would be appropriate for your itinerary with your travel doctor. Read more about Men. meningitis.

    Grenada: Dengue, diarrhoea upsurge

    Dengue fever and diarrhoeal disease have struck the Spice Island. To date this year there have been 140 dengue infections (PAHO data), and health authorities have advised there is currently an increase in gastrointestinal illness being observed, particularly in the large eastern parish of St Andrews. Read more

    Honduras: Dengue fever cases top 3,600; Zika rating changes in region

    The health minister announced that there had been no dengue-related deaths this year, but over 3,600 infections have been confirmed with as many as 122 of those classified as severe. The northern department of Colón has been affected, together with the capital, Tegucigalpa, and the urban centres of San Pedro Sula, Puerto Cortes, Olancho and El Progreso. Read more (translation required).The UK government travel health site Travelhealthpro has advised this week that Nicaragua is now categorised as high risk for Zika infections, while the Netherlands Caribbean islands is now moderate risk as ‘previously some islands in this group were classified as high risk’. 

    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).

    India: Nipah, dengue, JE updates

    Measures to contain the Nipah virus disease outbreak now include home detention for over 2,000 people who have had contact with sick individuals in the Malabar district. The latest figures from the state Directorate of Health Services: 18 confirmed cases (10 suspected) and 16 confirmed deaths (one suspected). Read more. The monsoon season is intensifying and along with it, the incidence of mosquito-borne infections. Reports this week from Pune (Maharashtra state), Mangaluru (Karnataka), Solan (Himachal Pradesh) and Kozhikode (Kerala).

    Advice for travellers: Fruit bats (flying foxes) are the natural hosts of Nipah virus, and females shed the virus when pregnant or lactating. The fruit-eating bats perch on the jars used for collecting juice from palm or date trees, contaminating the juice with infected saliva and droppings. People are infected when they drink the raw juice, although it is also spread through person-to-person contact. In Bangladesh, Nipah generally occurs between December and April. More on Nipah virus

    Malaysia: Sarawak’s 10th rabies death; HFMD outbreaks; Dengue cases top 26,000

    Five districts of Sarawak are under a rabies alert this week as another rabies-related death was recorded in Serian. The young woman was bitten by a dog late in April but had not received the appropriate follow up treatment and vaccines. Hers is the 10th death in the state since July last year. Read more
    SABAH’S capital, Kota Kinabalu, is top of the list of HFMD cases in the state, one of eight municipalities reporting outbreaks. This year has seen increased case numbers across a wider area than for the same period in 2017. Read more
    OF THE 26,209 dengue cases recorded for the year, Selangor has fared worst (14, 525 cases), followed by Johor (2,315) and the Federal Territory of Kuala Lumpur (2,015). 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. 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

    Mauritius: Measles count nears 200

    Measles case numbers had climbed to 192 by Tuesday in areas including Port-Louis, Roche-Bois, Baie-du-Tombeau and Pointe-aux-Sables. Vaccination campaigns have been carried out in government schools and will follow in private institutions. Read more (translation required). 

    Pacific: Regional dengue data

    Wallis has now reported 139 locally-acquired cases of dengue from the districts of Mua, Hahake and Hihifo, while Futuna has had one only. The cumulative total sits at 151 as it includes imported cases from New Caledonia and Vanuatu. Read more (translation required). In other regional dengue reports as published by ReliefWeb: Kiribati, for the two months to May 25, 472 dengue-like illnesses. Ongoing dengue outbreaks in Fiji and Vanuatu. Elsewhere - of the 1,412 cases recorded in New Caledonia to the 4th of June, 436 were from the capital Noumea.  A late wet season in Australia’s tropical north (Qld) is thought to be one of the reasons behind a single case of dengue identified in Mareeba, situated in the hinterlands near Cairns. This is the area’s first dengue case in over a year. Read more 

    Slovakia: Measles in east

    It is believed that measles imported from the UK is the source of the 22 suspected and confirmed infections that have spread in the district of Michalovce, on the shores of Lake Sirava in the country’s east. Read more

    Taiwan: JE peak brings 2 more cases

    The number of Japanese encephalitis (JE) cases recorded has increased to five, with two more cases from Kaohsiung City and Chiayi County. According to the Centers for Disease Control, ‘All 5 cases live in a high risk environment where there are vector breeding sites nearby.’ The peak of the JE season each year is June to July, however the infections can occur from May to October. Read more

    Advice for travellers: On average, 24 cases are recorded each year in Taiwan, mainly in the south from May to October, but peaking in June and July. Cases typically occur in rural, rice-growing areas where people live near the host animals, pigs and wading birds. While it is a low risk for most travellers staying in urban areas, expats and travellers spending extended periods in agricultural areas of Asia should consult their travel doctor about recommendations for vaccination. Read more about JE.

    Tanzania: Disease hike following floods

    Contaminated water and the local community’s lack of attention to hygiene are behind the cholera outbreak in the western district of Sumbawanga that has sickened nearly 400 people and killed 15. Read more

    Advice for travellers: While the risk of infection with cholera is low for short-stay travellers, Australians travelling to regions where an outbreak is occurring should adhere to strict personal hygiene and choose food and beverages with care. For further advice, call Travelvax Australia’s travel health advisory service (1300 360 164).

    Thailand: Dengue rates rise

    A relatively sparsely populated area of the capital is the site of the first dengue fatality this year - Nong Chok in the city’s east. Overall Bangkok has recorded almost 2,500 dengue fever cases this year. Five other districts are being monitored for dengue infections, including inner city locations. Read more. Country-wide, there have been over 5,600 dengue fever cases and four related deaths. Phuket has the highest infection rates per capita. In neighbouring Myanmar, over 2,300 dengue fever cases were recorded in the first five months of the year. Advice from a recent assembly of local experts in the Yangon region is that the mosquito-borne infection is now year-round. Read more

  • Brazil: Hopes winter will ease YF

    From the most recent yellow fever update provided by the European Centre for Disease Control (ECDC), the states of Rio de Janeiro and Minas Gerais had recorded five more human cases and six deaths. Cooler weather from the southern winter is expected to bring some respite as mosquito activity drops. 

    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

    Brunei Darussalam: Dengue upswing in ‘water village’

    The three to four year cycle of dengue fever infections is expected to peak this coming season - the last (and largest) peak occurred in 2014. Half of all cases to date this year have been in Kampong Ayer – a chain of villages built on stilts over the banks of the Brunei River. 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.

    Cambodia: Dengue report card

    As reported in the May 24 WHO Western Pacific Region update, the incidence of dengue fever climbed in the first two weeks of May, rising above the epidemic threshold. There had been 694 cases to mid-May. Read all regional countries’ reports here

    Chile: Mumps in lake district; Dengue vector menace on Easter Island

    A large mumps outbreak is ongoing in the Los Lagos region, including the regional capital Puerto Montt. Nearly 1,400 cases have been recorded to date with 100 more every week. The area known for its lakes, volcanoes and picturesque countryside. Read more 
    IN VIEW of the recent dengue fever outbreak on Easter Island, the Chilean Health Ministry will administer yellow fever vaccinations to all residents of the island, starting with infants 18 months of age and then extending to the adult population. No cases of yellow fever have ever been reported on the island, however health authorities are concerned about the number of visitors and permanent arrivals from endemic regions. On the date of the press release (8 May) the number of dengue fever cases in the outbreak reported in April had increased to 16. Read more 

    Advice for travellers: These outbreaks of mumps highlight 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.

    China: Hong Kong’s HFMD spike

    In the week to May 24, the number of kindegartens, child care centres and primary schools reporting hand, foot and mouth disease outbreaks had risen to 15. Each year, May to July are the peak months for the spread of the infection. 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.

    Democratic Republic of Congo: Local, international response to Ebola outbreak

    Efforts to tackle the Ebola virus disease (EVD) outbreak in Equateur Province are ongoing: vaccination of ring contacts in the major centre of Mbandaka and, this week, also in the outlying areas of Bikoro and Iboko; surveillance, contact tracing and public information campaigns. Latest disease data from a Médecins Sans Frontières report: ‘54 people who presented symptoms of haemorrhagic fever, including 35 confirmed Ebola cases, and 25 deaths (of whom 12 were confirmed as Ebola’. It is noted that previous EVD outbreaks in the DRC have been mostly in remote areas and there have now been four confirmed cases in Mbandaka, a city of over one million people, but ‘the epidemic has not spread widely within the city’. 

    Advice for travellers: Ebola 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.

    French Polynesia: Dengue, influenza counts

    Health department figures show a rise in inflluenza A (H1N1)pdm 09 cases in Tahiti, reaching epidemic threshold by mid-May. In the two weeks from May 6, there were 13 confirmed dengue fever cases from Tahiti, Bora Bora and Raiatea, Moorea – of the 13, six were tourists. Read more (translation required).

    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 recommendsinfluenza vaccination, if available, for all travellers over 6 months of age. 

    India: Nipah virus update; Dengue, chikungunya, JE reports

    The death toll in the Nipah virus (NiV) disease outbreak in Kerala has risen to 13 from a total of 25 suspected infections. Testing for the virus is being carried out on a soldier who died after travelling from Kerala to Kolkata in West Bengal and another case, hospitalised in Goa, has proved negative.
    DENGUE fever reports are coming from the states of Kerala and Karnataka, which is also seeing a spike in chikungunya cases - 4,879, followed by Gujarat (1357) and Maharashtra (966). 
    Five districts in the NE state of Assam are the focus of a campaign to reduce the burden of Japanese encephalitis (JE) infections. JE constituted over 16 percent of the state’s death toll last year. Read more. There have also been reported JE cases in Kerala this week. 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 very low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Kazakhstan: Men. meningitis cases rise above 60

    A local news source claims 30 people in the largest city of Almaty have been diagnosed with meningococcal meningitis infections – no mention of the serogroups is provided however. Medical advice includes ‘restrict visiting any mass cultural events being held in closed area, sports events and pools’. The national case count for the year to date is 62 from Almaty region, Astana as well as Eastern and southern regions of the country. 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 travel doctor. Read more about Men. meningitis.

    Maldives: Flu, dengue prevalent

    Following last week’s report on the rise in flu cases, the last seven days have seen up to 7,000 people report influenza and ‘viral’ fever symptoms and over two-thirds of those tested for flu were confirmed to have type A. The Health Protection agency stated that daily family gatherings for Ramadan ‘could contribute to the spread of diseases’. Dengue fever cases are also likely to rise from the 96 reported last week due to recent rains. Read more

    Mauritius: More school measles

    Measles cases in local schools have shot up from 48 last week to 120 as of Monday. The country’s Senior Community Physician has voiced his concerns about the increase and advised that all students’ vaccination cards are being checked for the two vaccine doses. Read more (translation required).

    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.

    Namibia: Viral hepatitis spreads to north

    People attending a cultural festival in the northern region of Omusati last weekend were advised to maintain strict personal hygiene after 11 hepatitis E infections were confirmed in the districts of Tsandi, Okahao, Outapi and Oshikuku; one death was recorded earlier this month and a further 47 people are being monitored for symptoms. A large outbreak of the viral illness has been underway in informal townships of the capital Windhoek, with 14 deaths from nearly 500 cases recorded. Read more 

    Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. The virus is found worldwide, mainly in communities with low levels of sanitation and hygiene. There is no vaccine licensed outside China. More than 60% of all hepatitis E infections and 65% of deaths occur in East and South Asia, with up 1-in-4 people in some age groups having been exposed to the virus. Read more about the virus and how to prevent it.

    Netherlands: Upward trend in W meningococcal strain

    The number of meningococcal meningitis infections (type W) recorded has been rising – an average of four cases (& no deaths) per year up to 2015 and, for the first four months of 2017, it was 27 and this year, 57 with 11 deaths (the total number of deaths for 2017). A vaccine which protects against the W strain is being introduced into the immunisation program for children at ages 14 months and 14 years. Read more 

    Nigeria: Cholera in NE kills 13

    The death toll in the cholera outbreak occurring in the NE state of Adamawa is now 13 from 434 cases. Mubi is the epicentre of the outbreak and contaminated water sold by water vendors is believed to be the cause. 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

    Pakistan: Punjab’s steep measles toll

    More than 5,000 children in the state of Punjab are believed to have been infected with measles this year – 735 in the past week - and the death toll has risen to 31. According to a local news report, the cities with most cases are Lahore, Rawalpindi and Gujranwala, although most areas are reporting infections. Read more 

    Paraguay: Mozzie-borne infections rise

    There has been a surge in chikungunya cases in Pedro Juan Caballero, a city on the Brazilian border, and a further 745 suspected cases nation-wide are yet to be confirmed. Dengue fever has hit the Central department hardest, in several districts of the capital, Asunción, and the neighbouring towns of San Lorenzo, Capiatá and Ñemby. Read more.  Elsewhere in South America, Colombia has recorded nearly 1,000 dengue fever cases and 49 dengue-related deaths from 10 departments. Read more (translation required).

    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.

    Reunion Island: Dengue, leptospirosis hit west, south

    A May 29 update on the dengue fever situation gives the running total of cases this year as 3,756 with 79 requiring hospitalisation. Western and southern districts are those most affected by dengue, but also by leptospirosis. Outbreaks of this bacterial infection occur annually following rains and flooding as activities such as swimming and gardening bring people into contact with waters contaminated with the urine of infected rodents. Read more 

    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.

    Russia: Vax reminder for sports fans

    The WHO has issued a reminder to those soccer (football) fans heading to Russia for the World Cup in June – make sure routine vaccinations up to date, with an emphasis placed on the MMR (measles-mumps-rubella) vaccine in view of the ongoing large outbreaks across Europe. ‘Of the 32 countries that will participate in the World Cup, 28 have reported cases of measles this year.’ Further, ‘The increase in international travel and the mass movement of people during events such as the World Cup increases the risk of transmission of diseases. It also increases the likelihood of travelers returning to their countries with diseases such as measles, which is highly contagious and can have grave consequences on the health of unvaccinated populations.’ More information on smartraveller.

    Taiwan: SW city’s JE cluster

    Seven pig farms situated near a reported cluster of Japanese encephalitis infections in residents of the SW city of Kaohsiung are being investigated by public health authorities. Pigs are important amplifiers of the virus which is then transmitted to humans through bites from infected mosquitoes. Two JE cases have been confirmed and a third is under investigation. The local population has been advised to avoid mosquito bites and to get the JE vaccine. Read more 

    Tanzania: Cholera worsening on mainland

    Five districts (Sumbawanga, Ngorongoro, and to a lesser extent, Longido, Monduli and Songwe) are experiencing cholera outbreaks which have ramped up over the most recent reporting week – reporting five times the number of cases over the previous week. ReliefWeb notes that ‘to 20 May 2018, a cumulative of 2,105 suspected cholera cases, including 44 deaths have been reported in Tanzania Mainland. Three out of 26 regions currently have active transmission, namely Arusha, Rukwa and Songwe and the situation is deteriorating’. 

    United Arab Emirates: MERS in west

    A farmer from the western town of Ghayathi is the Emirates’ first MERS case this year. The 78-year-old man, who has other medical conditions, visited his camel farm regularly and had also been in Saudi Arabia recently - all are considered risk factors in acquiring MERS. He remains in hospital. Read more 

  • Brazil: Pará state, rabies and kala-azar; Measles in Amazon hub

    There are reports of up to 14 suspected rabies cases and eight deaths on the river island of Marajó, near the mouth of the Amazon River in Pará state. The last recorded cases in the state occurred 13 years ago and were due to bites from infected blood-feeding (haematophagous) bats. Read more. Also in Pará, leishmaniasis infections – cutaneous and visceral - have been detected in residents of the eastern districts of Canaã dos Carajás (22)  and Parauapebas (36), situated near to the world’s largest iron ore project. AUTHORITIES in Manaus (Amazonas state) have advised there were an additional 62 suspected measles cases in the week to May 15, taking the total for the year to 457. 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. 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.

    China: HFMD cases soar in SE

    Peak season for hand, foot and mouth disease (HFMD) has arrived in Guangdong after the province experienced a 73 percent rise in cases in the most recent week, up to over 12,400 in the 7-day period. This is however a decrease on last year’s figures for the same period. Read more. And in neighbouring Jiangxi province, health officials are anticipating a peak in the cycle of HFMD in the capital Nanchang this year. Read more (translation required).

    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.

    Democratic Republic of Congo: More Ebola cases, response progressing

    Targeted vaccinations in Ebola-affected health zones, ‘strengthening of surveillance and contract tracing, laboratory capacity, infection prevention and control’ are just some of the priorities outlined by the World Health Organization (WHO) in its response to the outbreak in Equateur province. A May 22 health ministry press release tabled the current situation: 58 cases of which 30 are confirmed, 14 probable and 14 suspected. There have been 27 deaths. While the WHO has not recommended travel or trade restrictions, it does advise surveillance and preparedness in neighbouring countries and stresses the importance of ‘exit screening, including at airports and ports on the Congo river’. Read more

    Advice for travellers: Ebola 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.

    Europe: Hep A outbreak developments

    Investigations are ongoing in a hepatitis A (HAV) outbreak affecting six EU countries, with infections related to virus strains from Morocco (intermediate HAV endemicity). Only three of the cases had travelled and it is believed the remaining 39 acquired the infection locally, ‘either through food handling or through direct person-to-person transmission’. Read the ECDC report

    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 some types of 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.

    India: Deadly bat virus in south

    Nipah virus (NiV) has killed 10 people (4 more are probable) of 13 confirmed cases (and 16 suspected), according to the latest update from the Kerala Directorate of Health Services; two further cases are under investigation in Karnataka. The patients, most of whom are from Kozhikode and Mallapuram districts (Kerala), are community contacts. It’s the first time the virus has been found in the country’s south. One news source asserts that the outbreak originated from a drinking well that was infested with bats. Transmitted by infectious fruit bats, including through consumption of raw date palm sap tainted by excretions from infected bats, Nipah virus can infect people and animals (mainly pigs). There is no preventive vaccine for this viral infection which has fatality rates of 40-70 percent. NiV is a Henipavirus, of the same genus as Hendra virus. Read more. Read more about Nipah virus from the US CDC and WHO.

    Japan: No relief from measles

    The city of Fukuoka (Kyushu) is now reporting measles cases as a rise in domestic travel seen during Spring adds to the transmission rates. Earlier this week, health authorities announced that the case count had risen to more than 170 from the four currently affected areas. 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.

    Kenya: Cholera cases climb

    Together with Somalia (Banadir, Lower Jubba), the number of cholera infections is rising in Kenya, with the counties of Garissa, Nairobi and Isiolo most affected in recent weeks. Read more in a UNICEF regional update.

    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

    Maldives: Flu ramping up

    Both government and privately run hospitals are experiencing a surge in influenza cases – one facility is treating one hundred patients a day. A health official has advised people ‘to avoid public areas as much as possible to curb the flu spread.’ Read more

    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 for all travellers over 6 months of age.

    Mauritius: Capital focus for measles vax

    Measles cases have started to rise in the island – from 17 just under two weeks ago, to 48 as of Monday. A vaccination campaign is underway in the capital district of Port Louis to ensure children and adults have received the two doses of MMR vaccine. Read more

    Mexico: Southern state’s dengue spike

    Dengue fever cases have risen sharply in the southern state of Chiapas, bordering Guatemala. While dengue infections have dropped on a national level, Chiapas’ case count is twice last year’s for the same period and two deaths have been recorded. Read more. While in Honduras, dengue fever and Zika virus infections climbed in the most recent reporting week. Read more (translation required). 

    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.

    New Caledonia: Second dengue death reported

    The dengue outbreak has claimed its second victim this year, a six-month-old baby died of associated causes on Saturday. Read more. Of the 1,156 year-to-date cases, 768 have been dengue type 2 and just under one-third of all cases have been in the capital, Noumea. Over the past three weeks, infections have decreased in number and plateaued. Read more (translation required).

    New Zealand: Mumps, north and south

    Auckland’s mumps case numbers climbed to 1,269 this week and the South Island has also been facing an increase in notifications over the past 16 months. Most are associated with travel and are centred around Dunedin, Oamaru and Queenstown. Read more

    Advice for travellers: These outbreaks of mumps highlight 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.

    Peru: Viral infection likely from jungle stay

    Canadian health authorities have reported on a case of Mayaro virus, an emerging mosquito-borne virus that is present in northern South America, from a traveller who, among other activities, followed a typical tourist route through Puerto Maldonado in the Amazon jungle before returning to Canada in March. Read more. Mayaro virus is of the alphavirus family of viruses which includes chikungunya and Ross River virus. It presents very similar symptoms to dengue fever and chikungunya: fever, fatigue and joint pains. Read more about Mayaro virus

    Saudi Arabia: Pilgrims, workers preventive health needs

    The Ministry of Health has released the Hajj and Umrah health requirements (and recommendations) for this year’s pilgrimages and for those people working in the areas or residing in the holy cities. They include proof of vaccination against meningococcal meningitis, plus, for those travellers arriving from designated risk areas, yellow fever and poliomyelitis. Additionally, routine immunisations should be up to date, adhere to personal and food hygiene measures, pay attention to heat exposure, and, in reference to MERS Co-V, avoid contact with camels. Read more 

    Sri Lanka: Impending dengue season

    The monsoon season is looming, but rains have already caused flooding and landslides across many areas. Pooling of water makes ideal mosquito breeding grounds and so dengue fever cases are likely to spiral, adding to the over 19,000 suspected cases recorded this year. Read more

    Taiwan: South’s first JE case

    Confirmation this week of the first Japanese encephalitis (JE) infection in 2018, a farmer from Pingtung County in the country’s far south. The peak JE season extends from May to October; in 2017, there were 25 recorded JE cases. According to the Centers for Disease Control (CDC), ‘All cities and counties have reported sporadic cases and people of all age are at risk of contracting the disease. The majority of the confirmed cases are adults aged 40 and above.’ Read more

    Advice for travellers: On average, 24 cases are recorded each year in Taiwan, mainly in the south from May to October, but peaking in June and July. Cases typically occur in rural, rice-growing areas where people live near the host animals, pigs and wading birds. While it is a low risk for most travellers staying in urban areas, expats and travellers spending extended periods in agricultural areas of Asia should consult their travel doctor about recommendations for vaccination. Read more about JE.

    Thailand: Dengue count rising

    As with other regional countries, the upcoming rainy season will bring a rise in the incidence of dengue fever – there have already been more than 10,000 cases and 15 associated deaths, but health officials expect the annual figure to be in excess of 74,000. Read more. Children and young adults have borne the bulk of the burden to date, with highest rates in those ‘aged between 15 and 24, followed by those aged 10-14’. Top morbidity rates were in Phuket and Krabi. Read more 

    Vietnam: Varicella strikes scores of adults

    One large hospital in Hanoi is reporting ‘hundreds’ of adults suffering from chickenpox (or varicella), many with complications of the viral infection. Read more

    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.

    Pacific: Situation update for regional dengue

    Wallis and Futuna: There have been no further dengue fever cases reported since Monday this week and the case count currently sits at 127 suspected or confirmed cases; the 114 locally transmitted cases on Wallis have been from the districts Mua (71), Hahake (33) and Hihifo (10). Futuna has had two cases to date – only one was locally acquired. Read more (translation required). From a regional weekly bulletin issued through ReliefWeb up to May 13, dengue fever outbreaks are also underway in Kiribati, Vanuatu and Fiji (also see New Caledonia post).