Health Alerts
  • Angola: Malaria escalation in south

    In the province of Cunene, malaria cases reported from May to August have exceeded the total for 2016 (33,100 cases & 91 deaths). ProMED reports that, despite the fact that Angola is highly endemic for malaria, the southern province ‘is not usually regarded as a malaria high risk area. However, there has been several reports of increased malaria risk over the past few months from Botswana and South Africa.’ Read more.

    Advice for travellers: For most 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

    Brazil: NE state records rise in chikungunya

    The incidence of dengue fever and Zika virus may have dropped in the NE state of Piauí, but chikungunya has increased its presence - 2,779 cases have been recorded this year state-wide. The towns and cities with higher numbers of suspected cases are Teresina, São Raimundo Nonato, Parnaíba, Luís Correia and Floriano. Read more (translate from Portuguese). 

    Democratic Republic of Congo: Cholera strikes 20 provinces

    Cholera has struck in 20 of the 26 provinces, causing 1,500 infections each week and killing over 500 people across the capital, Kinshasa, and 9 other town/cities. 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

    Grenada: ‘Pink eye’ increase

    An outbreak of viral conjunctivitis or ‘pink eye’ which had caused intermittent cases in the region throughout the year has spiked this month producing as many as 40 cases in one district in the first week alone. Read more.

    India: Monsoon, measles & flu

    Mosquito larvae-eating Gambusia fish are just part of the arsenal being used by authorities in their battle against the vectors of dengue fever and chikungunya in New Delhi. Read more. Dengue cases have surged this month in Mumbai, with one hospital-based doctor saying that one-in-5 of cases admitted are related to dengue infection.Other published dengue reports have come from the states of Orissa,Telangana and Karnataka
    It has been a bad year for influenza with some figures showing up to 1,530 deaths resulting from infections with the influenza A (H1N1) strain. Read more. Some better news on the measles front after the World Health Organization (WHO) announced that India’s cases almost halved over the 2014-16 period, however the country still reports 60 per cent of all cases in SE Asia. Read more.

    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.

    Italy: Chikungunya reaches Anzio

    News this week of 3 locally-acquired cases of chikungunya in the coastal town of Anzio, south of Rome. As a precaution a pause in blood donations has been ordered for the Anzio area and may also apply to Rome. The mosquito-borne infection is rare in Italy – the last occurrence was ten years ago when 217 confirmed cases were identified in Emilia Romagna. In that outbreak, the index case was thought to be a resident who had returned from India; local mosquitoes then transmitted the virus to other residents. 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 repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

    Malaysia: More rabies sites in Sarawak

    Over 35,000 animals have been vaccinated against rabies but Sarawak state authorities this week gave an update, advising of the 24th area affected by the virus. Testing showed up positive samples for rabies in animals from a housing area of Kuching and also near Serian town (approx. 60km south of Kuching). 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.

    Nepal: Kathmandu hosts insect-borne infections

    ProMED reported this week on the increased incidence of scrub typhus in the capital, Kathmandu. Up to 140 cases have been identified; suspected dengue and chikungunya infections have also surfaced recently. (See 10 Sep 2017, Vector borne diseases – Nepal)

    Advice for travellers: Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases.

    Romania: Measles now widespread

    A local news report has now put the death toll in the measles outbreak at 34 (from 9,100 cases), with another 122 cases recorded last week. The outbreak is widespread and only one of the 41 counties has a clean sheet – Tulcea, a coastal area on the Black Sea. The European Centre for Disease Control report of Sept 3-9 outlines other EU countries reporting cases in 2017 (including Italy - 4,444 cases, Germany – 866 & Czech Republic - 136) and elsewhere on the site posts an update on West Nile Virus fever cases in the region. Read more

    Advice for travellers: West Nile virus is endemic and epidemic in Eastern Europe and the Mediterranean basin, with epidemics regularly reported in summer and autumn since the 1950s. Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive disease. The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites. Europe’s outbreaks are not as severe or widespread as in other regions where the virus occurs, notable North America.

    South Africa: NE measles outbreak

    Measles cases (23 to date) have been identified in 4 of the 11 provinces in KwaZulu-Natal – Ethekwini (14), Umgungundlovu (6), ILembe (2) and Uthukela (1). Local health authorities have planned vaccination campaigns and are attempting to address the concerns of some community members who are ‘hesitant to accept vaccination for religious reasons.’ Read more.

    Sri Lanka: Programs to curb dengue

    Dengue control programs are to continue during the upcoming inter-monsoon season and extend into the NE monsoons starting in December. New cases are the decline now, with 1,500 cases per week instead of 10,000 as was the case earlier in the year. The danger of dengue persists in many districts, including Colombo, Gampaha, Kalutara and Kurunegala and Kandy. Read more.

    Advice for travellers: Dengue is spread by some types of Aedes mosquitoes. They 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.

    Zimbabwe: Adult malaria burden, severe flu season

    Over 227,000 influenza cases have been recorded this year – nearly 8,000 of those in one week in late August. In that same week the malaria case count topped 2,444 - mostly adult infections. Read more. Across the border in southern Zambia, malaria cases are surging in the districts of Luangwa and Kafue. Read more.

    Advice for travellers: The 2017 flu season is well underway in the southern hemisphere and Travelvax Australia recommends vaccination for all travellers over 6 months. Seasonal flu is the most common vaccine-preventable travel-related illness, posing a risk aboard aircraft, in crowded airport terminals, and at your destination. Travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Hand sanitiser is a convenient alternative if soap and water is not available.

  • Australia: Hep A increase in NSW; Flu lingers; NW chickenpox spike

    A sharp increase in hepatitis A infections has been reported in the Sydney region, 12 in the past 5 weeks. There is some urgency to determine a local source of the infections as 10 of the people infected had not travelled overseas within the incubation period. Most cases notified in NSW are related to travel to endemic countries. Three of the patients required admission to hospital. Read more
    THE record flu season continues here, while the peak appears to have passed in other temperate regions of the Southern Hemisphere according to the World Health Organization (WHO) global flu update. Activity has decreased in South Africa, South America and New Zealand, however cases continue to rise in New Caledonia. Read the full report with details of increased flu detections in tropical regions of Asia. 
    LOCAL health authorities in West Australia’s Pilbara region have warned parents to be on the alert for symptoms of chickenpox following an outbreak affecting schools in Hedland and Karratha. Read more.

    Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with the faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and with 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.

    Brazil: YF outbreak over; Sand fly infection strikes north

    After a total of 777 yellow fever infections and 261 related deaths, this week the Health Ministry confirmed the end of the 9 month outbreak. Over 36 million yellow fever vaccines have been distributed in the affected states ‘both for routine vaccination and for boosters’, while next year the vaccine will be provided to children from 9 months of age in their routine schedule. Read more (translate from Portuguese) 
    FIFTY suspected cases of kala-azar (or visceral leishmaniasis) have been recorded this year in the town of Tocantinópolis, near the NE state borders of Tocantins and Maranhão. Dogs and humans are among the reservoirs of the parasite which is transmitted by over 90 species of sand flies. Read more (translate from Portuguese).

    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

    Cape Verde: Travel warning issued

    The unprecedented malaria outbreak affecting the capital Praia is behind a travel advisory issued by the Portuguese government. The health department has recommended that pregnant women in particular delay their travel to Praia and for other travellers to ensure they use repellent and take malaria chemoprophylaxis. Read more.  More on malaria

    India: Diphtheria in Karnataka’s east; Monsoon-related diseases surge

    Testing is underway on 33 people suspected of having diphtheria, with 11 confirmed infections to date in the district of Raichur in NE Karnataka state. Contacts of the patients are being given prophylactic antibiotics and vaccinations are to be offered in the local community. Read more
    A common health threat during the monsoons, dengue fever is on the rise: reports from Delhi, Kolkata, Lucknow, Hyderabad and Chandigarh, while in Mumbai authorities have issued alerts due to the heightened risk of water-borne infections such as diarrhoea, hepatitis and leptospirosis.  The regional flooding has already caused disease outbreaks in Bangladesh, Nepal and the adjacent Indian state of Bihar, with reports of dengue, malaria and diarrhoeal illnesses on the rise. 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.

    Italy: Malaria mystery in north

    Doctors in the northern region of Trentino are urgently investigating the death of a 4yo girl following confirmation the cause was cerebral malaria. She had not travelled out of the country but had been admitted (for unrelated issues) to a hospital where 2 other children were being treated for malaria contracted in Africa (Burkina Faso). As Italy is free of the malaria vector, Anopheles mosquitoes, there is one reasoning that some insects may have been transported to the local area with air passenger arrivals from Africa. Read more.

    Advice for travellers: For most 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. http://www.travelvax.com.au/resource_files/Malaria-2016.pdf

    Japan: Mumps complications outlined

    A study conducted into the rate of mumps complications has shown that for the last 2 years a total of 261 individuals – 154 of them aged between 5 & 10 years – have suffered severe hearing loss as a consequence of the viral infection. Routine vaccinations to protect against mumps were ceased in Japan in the early 1990s and now, with the release of this study, specialist ENT doctors are calling for its reintroduction into the childhood immunisation schedule. Read more.

    Advice for travellers: These consequences of mumps outbreaks 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.

    Myanmar: JE vax to be routine

    News this week that over 14 million children will be vaccinated against Japanese encephalitis (JE), starting in December. This year there have been over 200 JE cases across the country. According to the WHO factsheet, the JE virus ‘is the most important cause of viral encephalitis in Asia’ and it primarily affects children. 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 can occur in or near cities. The risk to short-stay travellers and those who confine their travel to urban centres is very low. The recommendations for vaccination are itinerary-specific. Read more on JE

    New Zealand: Mumps in Auckland, Dunedin

    Young adults of Pacific Island origin make up almost two-thirds of the 300 mumps cases recorded in Auckland this year, with a further spread to Dunedin in the South Island also reported. The spike in cases in Auckland means that this year cases have exceeded the sum total of the previous 16 years. Many of those infected were unvaccinated and the wider community is being urged to ensure they have received 2 doses of the MMR vaccine (provided free by the government). Read more.

    Pakistan: Fourth polio case

    A total of four polio cases have now been recorded across the nation this year, with news this week of the first in 20 months for its most populous city, Karachi. The latest casualty, a young child of Afghan refugees, had an incomplete polio vaccination course after his parents refused more vaccine doses. Read more.

    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. Vaccination is advised for travel to affected regions, while some countries have temporary vaccination recommendations as outlined by the WHO. If at risk, adults should have a booster to the childhood series. More on poliomyelitis.

    Philippines: JE in Luzon 'rice granary'

    Central Luzon has reported the nation’s highest figures for Japanese encephalitis (JE) infections this year, followed by Pangasinan and Laguna. While there have been 133 JE cases nationwide, over 50 were from Central Luzon, the main rice-growing region which is located north of Metro Manila. The death toll from JE this year is currently at 9. Calls have been made for the vaccine to be provided in the expanded immunisation program however, currently, all efforts are being made towards removing mosquito breeding grounds. Read more.

    Sierra Leone: Cholera vaccination drive

    Major flooding and the ensuing landslides near the capital of Freetown have caused hundreds of deaths and put the lives of countless others in danger as contaminated water supplies bring the risk of cholera. Local and international health agencies are planning cholera vaccinations for later this month in the 25 affected regions. 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

    South Africa: East Rand hit with measles

    Over 20 measles cases have been recorded in the last 8 weeks in Johannesburg’s east (Benoni in East Rand), prompting health authorities to urge parents to ensure their children are fully vaccinated – 17 infections were diagnosed in the last month alone. This follows another measles outbreak earlier this year, also in Gauteng province. 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.

    Sudan: SW cholera trials

    Central and southern regions of Darfur in the country’s west are suffering outbreaks of cholera, or ‘watery diarrhoea’ as the government is naming it. Wet weather has hit areas where camps for displaced people are located, further exacerbating the situation. There are fears in the South Darfur capital of Nyala that the outbreak there is spiralling out of control. Read more.

    United States of America: Hawaii mumps tops 300

    Oahu has recorded the highest numbers of mumps cases in the ongoing outbreak, 277 of the 312 from across the state up to Aug 31. Other islands reporting cases are Kauai (26), Hawaii (8) and Maui (1). Read more.

    Zimbabwe: Malaria in north

    Rates of malaria in Mashonaland Central, located in the country’s north, are the highest in the country, with over one-third of the 2,035 cases reported in the week of Aug 20. The year-to-date total is 346,211 malaria cases and 421 associated deaths. Read more.

  • Democratic Republic of Congo: Cholera strikes in east

    International aid agencies are on the ground in the eastern province of South Kivu as local health resources struggle to manage the cholera outbreak that has been ongoing since July. Médecins Sans Frontières/Doctors Without Borders (MSF) is assisting with treatment of the patients, while admitting that the situation could easily worsen. 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

    France: More chikungunya cases in SE

    The latest World Health Organization (WHO) update on the chikungunya cases reported in the SE it notes that ‘All 13 patients (4 confirmed, 1 probable and 8 suspected) ... are inhabitants of the same district of the commune of Cannet des Maures in Var department.’ It went on to state that, ‘chikungunya is an emerging disease in southern Europe, and an outbreak is considered unexpected. The vector Aedes albopictus is establishing itself in large part of the Mediterranean basin and beyond.’ 

    Advice for travellers: The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.

    India: Monsoon rains fuel vector-borne infections

    The tally of mosquito-borne infections affecting cities and states is mounting as the monsoon season progresses – malaria, dengue and chikungunya and Japanese encephalitis cases are continuing to rise, with various reports coming in from Pune in Maharashtra state, Tamil Nadu, Gujarat, Kerala, Karnataka and the National Capital Territory (Delhi).

    Advice for travellers: Malaria is widespread in India and occurs year-round in both rural and urban areas, including major cities. Travellers visiting India should discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. Read more on malaria in India

    Myanmar: Severe dengue season

    Like other countries in the region, dengue fever is rampant but this year there’s been a 4-fold increase in cases over 2016. Most affected have been the regions of Yangon, Ayeyawady and Rakhine State. The national death toll has now topped 131 for the year. 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.

    Nepal: Floods carry multiple disease threats

    Disease outbreaks in the wake of the floods are starting to appear in the Terai region. Local reporting gives details of diarrhoea, dengue and viral fever cases ‘overwhelming’ the hospitals. Read more. A concerning report from a doctor in Kathmandu that cases of scrub typhus are appearing in parts of the city, away from the sites more commonly associated with the tick-borne infection. Read more. In the far-western district of Bajura, malaria is being reported for the first time. The region, which has been considered too high to have the risk of malaria is now seeing warmer temperatures, leading to the presence of the malaria vector. Read more.

    Advice for travellers: Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases.

    Pakistan: NW dengue surge

    In the NW border province of Khyber Pakhtunkhwa dengue fever has struck, infecting over 3,000 people. In the capital Peshawar epidemic zones have appeared where the water lying in used tyres has become dengue-transmitting mosquito breeding grounds. Read more.

    Sri Lanka: Dengue battle continues

    A concerted campaign to tackle the dengue epidemic is drawing to a close this week, with a final push in the Western Division. The year to date count of dengue cases is now in excess of 145,000 with 360 deaths – between them, the cities of Colombo, Gampaha and Kandy have recorded over 66,000 cases. Read more.

    United States of America: Hep A rise

    An increase in hepatitis A cases seen in the state of Colorado is thought to be linked to the rise in cases earlier this year in New York and in Europe – in the wider community, but more specifically in the risk group, men who have sex with men (MSM). Read more.

    Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans by faecally contaminated food and water, or by handling everyday items. 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.

    Vietnam: Dengue & HFMD spike

    Health departments across the country are struggling to cope with the influx of dengue fever cases and now, hand, foot and mouth disease (HFMD). Ho Chi Minh City has the lion’s share of the 51,000 cases recorded, however Hanoi is reporting more dengue cases – 20,000 of the national total of 100,000, with more expected during the current peak season. The US CDC has issued a travel advisory referring to the dengue fever outbreak. 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.

    Yemen: Hope cholera outbreak stabilising

    There had been recent improvement in the cholera situation with numbers on the decline, however in the most recent reporting week there has been a rise in cases again. The total case count in the 4 months of the outbreak is now over 580,000 with 2,028 associated deaths. Read more.