Health Alerts
  • Brazil: More states added to YF risk area

    Three more southern states (Paraná, Santa Catarina and Rio Grande do Sul) are now included in the designated yellow fever (YF) risk areas after a recent assessment. Further: ‘the World Health Organization (WHO) expects that the yellow fever virus will continue to spread along the Atlantic Forest ecosystem in Sao Paulo State, towards Paraná State and the south of the country in the coming months’. See the report from UK TravelHealthPro. On May 9th, the health ministry updated official YF figures to 1,261 cases and 409 – mostly from south-eastern states.

    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

    Democratic Republic of Congo: Ebola outbreak situation, response

    The case count in the Ebola outbreak affecting Bikoro, Iboko and Wangata health zones in the country’s west is now 44: 3 confirmed cases, 21 suspected infections and a further 20 that are probable. A new development was a recently confirmed death reported over the weekend that took place in an area close the provinicial capital of Mbandaka, home to one million people. Read more.  An unlicensed vaccine that had proved to be effective when used in the late stages of the Guinea outbreak in 2016 is to be employed on a voluntary basis in the remote area, targeting ‘contacts, contacts of contacts, international and local healthcare and frontline response workers in the hot spots, and healthcare and frontline responders in areas at risk’. 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.

    Fiji: Men. meningitis vax campaign kicks off

    A meningococcal meningitis C vaccination campaign began this week in the Central Division (Ra subdivision), the location of 39 of the 65 cases since Jan 1 this year. The May 7 Ministry of Health update notes that of the 65, ‘25 are laboratory confirmed, 7 probable, and 33 suspected ... an average of 3.6 suspected cases per week in the last 4 weeks.’ To date, all those infected have been under 19 years of age. 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 doctor or travel clinic. Read more about Men. meningitis.

    India: Dengue, JE, malaria and more

    Dengue reports this week from Alandi in Maharashtra state, a renowned pilgrimage destination, as well as Kasargod in Kerala. In the NE town of Kushinagar (Uttar Pradesh), up to 10 patients are being admitted on a daily basis for treatment of Japanese encephalitis, well ahead of the peak season for the illness. High temperatures in Ahmedabad (state of Gujarat) early this month are being blamed for a rise in the incidence of food-and water-borne infections such as hepatitis and typhoid, as well as malaria. 

    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 effective mosquito bite avoidance measures is very low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Japan: Measles checks initiated

    As the number of measles cases in Okinawa climbed to over 90, the government took steps to ensure that hospital workers and infants attending nursery school are fully vaccinated i.e. they have received two doses of a measles-containing vaccine. A local news source also revealed that the outbreak has spread beyond Okinawa and Aichi prefectures to Tokyo and Kanagawa prefecture. 

    Advice for travellers: Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, during travel, 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 hits south

    Drinking water contaminated with sewage during flood conditions or damage to infrastructure has caused an outbreak of cholera, with many patients from Nairobi county seeking treatment in adjacent Kiambu county. 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. For general advice on vaccination options for your trip, call Travelvax Australia’s travel health advisory service (1300 360 164).

    Malaysia: Rabies deaths climb to 4

    Just a week after notification of the third rabies death this year, there is news of a fourth, a child in Sandong (13km SW of Kuching CBD, in Sarawak). The child, who was bitten by a stray dog late in April and did not receive the appropriate post-exposure rabies treatment according to a Health Ministry report, is currently in hospital in a critical condition. Read more (translation required).

    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.

    Mexico: Malaria in 5 states: Kissing bug disease rates on Peninsula

    A local news source cites the National Epidemiological Surveillance System in reporting malaria cases from Chiapas, Chihuahua, Tabasco, Campeche, and a new addition, Quintana Roo. Other information disclosed in the article included the potential for malaria in the tourist hotspot Cancun due to the presence of the Anopheles mosquito vector. 
    THE SURVEILLANCE System has also posted an update on Chagas disease (American trypanosomiasis) in the Yucatan – 15 cases for the year. ProMED notes that ‘The Yucatan region has some of the highest levels of Chagas in the country.’

    Advice for travellers: Although widespread in Mexico, Central America, and South America, Chagas disease presents a low risk to Australians travelling to the Americas. Travellers who sleep indoors in air-conditioned or screened hotel rooms are at low risk for exposure to infected triatomine bugs (aka kissing or assassin bugs), which infest poor-quality dwellings and are active mainly at night. However, as has become more common, the disease can also be transmitted through food and freshly pressed juice contaminated with the faeces of insects attracted to ripening fruit. Read more on Chagas disease.

    Nigeria: Lassa fever eases

    Surveillance for further Lassa fever cases continues during the current season, but case numbers have dropped over the past six weeks and so some response activities have been eased. Read more. In Liberia, Margibi became the fourth county to report Lassa fever cases after two deaths were confirmed last week. Many of the previously suspected cases proved negative – 67 of the 81 - after laboratory testing. The death toll now sits at 22. 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: Polio risk persists

    The upshot of a WHO meeting on the global polio situation was commendation for Pakistan on the low disease count this year, however it noted: ‘environmental surveillance continues to detect WPV1 (wild poliovirus 1) transmission in many high risk areas of the country such as Karachi, Peshawar and the Quetta Block.’ There was also a comment on ‘the stagnation in progress in Afghanistan and the ongoing risks to eradication posed by the number of inaccessible and missed children, particularly in the southern and eastern regions’. In conclusion, it was decided to extend the Temporary Recommendations for a further three months as ‘the risk of international spread of poliovirus remains a Public Health Emergency of International Concern’. 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 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 poliomyelitis

    Paraguay: Dengue fever toll now 13

    While there are nearly 3,000 confirmed dengue fever cases, the number of suspected infections is over seven times higher and the death count has risen to 13. Five of the country’s departments are reporting cases. 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.

    Philippines: Luzon’s first JE cases this year; Dengue deaths rise in Eastern Visayas

    The first Japanese encephalitis cases for 2018 have been recorded on Luzon, with two in Benquet, one from Baguio City and five others ‘from outside the Cordillera region’. Read more
    EASTERN Visayas has experienced a sharp rise in dengue fever-related deaths this year – 13 of the 1,066 cases succumbed to the mosquito-borne infection; last year the annual death toll was five. The two provinces that are most affected are Leyte and Northern Samar. Read more

    Reunion Island: Dengue escalates

    Weekly dengue fever case numbers rose to 388, with the year-to-date total now at 2,980. The western districts remain those with most cases. Read more (translation required). Dengue is reported as being widespread in the Seychelles, according to a Russian Foreign Ministry travel warning issued this week. Read more (translation required).

    Sri Lanka: Dengue warning for travellers

    The British Foreign Office has added a link to the local Epidemiology Unit dengue fever update in its advice to travellers. The dengue case count has climbed to over 18,500 for the year to date and the Western Division continues to report most cases. See Smartraveller advice for Australian travellers.

    Ukraine: Vax campaign brings hope for outbreak end

    Rates of measles immunisation (2 doses) plummeted from a high of 95 percent in 2008 down to just over 30 percent in 2016, leading to an extensive outbreak – 12,000+ cases this year with nine fatalities. In a turnaround, a campaign is underway to restore the 95 percent rate by the end of the year. ReliefWeb notes that: ‘Ukraine is facing the largest outbreak in the Region, but high case numbers (100 or more per month) are also being reported by France, Georgia, Greece, Italy, Romania, the Russian Federation and Serbia.’

    Uganda: Measles cases climb

    Measles outbreaks are underway in 26 of 121 districts, with highest numbers in the north and east (Amuru, Kamuli, Mbale & Butebo); the burden of disease is highest in children under five years of age. Read more

    United Kingdom: Measles imports

    Regular travel between Europe and the UK has fanned the spread of measles across England: Up to May 9th, London has recorded 164 of the national total of 440 confirmed cases, followed by the Southeast, West Midlands, Southwest and West Yorkshire. Like the ongoing outbreaks across many parts of Europe, the majority of those infected were unvaccinated, or undervaccinated. Read more

    United States of America: More than half mumps cases over 18yo

    Hawaii’s mumps outbreak continues with a new case on Maui, infected while visiting Oahu. This latest case takes the total to 985 since March last year. The Hawaii Health Dept. website notes that ‘nearly 60% of cases have been in adults aged 18 years and older. There have been 30 reports of complications due to mumps infection (e.g., orchitis, hearing loss).’ Read more

    Advice for travellers: These consequences of mumps infections 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.

    Pacific: Likely dengue export to second island

    A visit from a relative from Wallis is believed to be behind the spread of the mosquito-borne illness to Futuna, after two residents were diagnosed with the infection. Wallis is experiencing a dengue fever outbreak, now in its sixth month. ReliefWeb states that, of the 115 confirmed and suspected cases this year, 11 were imported from New Caledonia and Vanuatu. Read more. In New Caledonia, the dengue outbreak continues – over 1,050 cases this year, mostly from Noumea, Yate and Dumbea. The dengue type 2 virus has caused over 80 percent of infections. Read more (translation required).

  • Argentina: Local dengue reported in NE

    Over 50 confirmed and 26 suspected dengue fever cases have been reported in the NE province of Chaco; most of those infected had no travel history so are deemed to be locally-acquired. The majority of the confirmed cases (42) were in the area of Charata, known for a large meteorite field nearby - Campo del Cielo. Read more. In neighbouring Corrientes province, authorities are monitoring the capital and surrounding areas following notification of 27 dengue fever cases. Read more (translate from Spanish).

    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.

    Belize: Hep A in border town

    Up to 14 suspected and confirmed cases of hepatitis A have been reported in the towns of Benque and Arenal in the central west, near the Guatemalan border. Health authorities are instituting control measures and food hygiene training for schools and food services. Many Guatemalan students cross the border to attend schools in Benque (Benque Viejo del Carmen) in order to receive an English language education. 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.

    Brazil: Another YF case in EU traveller; Seven year malaria lapse ends

    Another European traveller to Brazil has been diagnosed with yellow fever – the eighth such case this year. As with previous cases, the Czech national was not vaccinated against yellow fever prior to travel. According to a European Centre for Disease Control (ECDC) assessment: ‘The outbreak is currently showing a decreasing trend and as the vector activity season in Brazil is coming to an end’. A May 9th Flutrackers update on case numbers can be found here. HEALTH authorities in the southern state of Paraná are awaiting results from malaria testing on up to 90 residents of the city of Foz do Iguacu after having revealed this week that a local farmer was hospitalised in March for treatment of malaria it is believed he contracted while fishing in Porto de Areia, some 75kms to the north-east of the city. The last locally-transmitted malaria cases (3) to be reported in the area were in 2011. The Scottish Fitfortravel website advises that strict mosquito avoidance measures should be taken when visiting the area, site of Iguaçu or Iguazu Falls, the largest waterfalls in the world. 

    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: Fears of dengue peak to come

    The 1,200 dengue fever cases reported in the first quarter of the year represent a rise of more than 200 percent over last year’s, leading health officials to warn that this year could bring a peak in the dengue cycle – the last major outbreak occurred in 2012 causing 400,000 cases and 160 associated deaths. Read more. And in Thailand, the onset of the rainy season brought news that the number of dengue fever infections to date has topped 7,500 (southern districts most affected) already and authorities anticipate higher case numbers this year. Read more

    China: Anthrax warning for central province

    An outbreak of anthrax in central Ningxia Hui Autonomous Region provoked a travel warning in Russia for any of its nationals planning on visiting the area. According to a social media post, there has been further spread from rural areas to Yinchuan City. Read more

    Advice for travellers: The anthrax bacterium is transmitted to people in the form of spores which are can produce disease through consuming contaminated meat, through inhalation or via contact with the wool, hair or hide of infected animals. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about anthrax

    Democratic Republic of Congo: WHO reports on Ebola outbreak

    Testing has confirmed two cases of Ebola virus disease (EVD) near Bikoro, a north-western town that sits on Lake Tumba (Equateur province). The World Health Organization (WHO) report notes: ‘In the past five weeks, there have been 21 suspected viral haemorrhagic fever in and around the iIkoko Iponge, including 17 deaths.’ A comprehensive program is being put in place to control and contain the outbreak, but there are fears of further spread as the affected area is part of a domestic waterway network, providing transport to major cities on the Congo and Ubangi Rivers. Neighbouring countries have been notified of the outbreak; Kenya and Nigeria have started screening arrivals at airports and land borders using thermal guns. 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 travellers visiting infected areas. Read more about Ebola.

    Denmark: Possible hep A ties to Morocco

    European health authorities are investigating a number of hepatitis A cases in from various regions in Denmark, the Netherlands and Germany – two had a history of travel (to Morocco). The ECDC has assessed the situation and noted the possibility of a ‘multi-strain, multi-country foodborne outbreak. The circulation of the strains has been observed in Morocco in the past. The outbreak is possibly ongoing also in Morocco where a number of European travel-related cases may have been recently infected.’ Read more from the ECDC

    Fiji: Men. meningitis, dengue updated

    The Minister of Health and Medical Services presented an update on the meningococcal meningitis outbreak on May 3rd, pronouncing that the success of the recent public awareness campaigns has resulted in no further deaths over the last five weeks. The minister also provided current details: ‘a total of 58 cases from January 1 to April 22 … 24 confirmed cases and 34 suspected or probable…38 from the Central Division, 17 from the West, 2 from the North and 1 from the Eastern Division.’ Most cases were under 19 years of age, ‘close to 40 percent under age 5’ and ‘all deaths this year in the under 5 age group’. A vaccination campaign targeting the 1 to 19 years of age cohort is due to start on May 14th. Dengue outbreak news was also supplied during the conference: case numbers are decreasing in all areas. Of the almost 3,200 dengue infections, the Northern Division reported 1,443 followed by Western (908) and Central (825). Read more

    Advice for travellers: Advice on the prevention of meningococcal infection, as stated on the Fiji Ministry of Health and Childhood 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.

    India: Rise in malaria for SW

    The district of Dakshina Kannada in the state of Karnataka (including the capital Mangaluru) has recorded over two-thirds of the 941 malaria cases recorded this year to the end of March. This represents an increase on last year’s figures and puts in some doubt the plan to eliminate malaria from the state by 2025. Read more

    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. 

    Japan: More measles cases

    In an update on the measles outbreak that started just over a month ago: the case count in Okinawa is now up 91 (most under 50 years of age) and a further 17 in Aichi prefecture. Officials in Okinawa are advising high risk individuals to avoid the area, known for its domestic tourism. 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.

    Kenya: Tandem outbreaks after rain

    Two outbreaks – cholera and chikungunya – underway since the beginning of the year are expected to flare as heavy rains produced flooding and damage to infrastructure. Nearly one-quarter of a million people have been driven out of their homes by the floods and there have been 112 deaths. Active cholera transmission is occurring in five counties, while chikungunya continues in the counties of Mombasa, Lamu and Kilifi. Read more. Floods have affected the local populace in five states of Somalia while in Uganda, authorities are advising the public on clean water and sanitation after an outbreak of cholera was declared in two locations in Kampala City. 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

    Malaysia: New rabies death in Sarawak

    Another human rabies death, the third this year, has been reported in the district of Simunjan, SE of Sarawak’s capital Kuching. It is believed the rabies was transmitted through a dog bite, however this hasn’t been confirmed. 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 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.

    Reunion Island: Dengue count nears 2,600

    A May 7th update from the Indian Ocean Health Agency (L'ARS Océan Indien) on the dengue fever outbreak: in the most recent reporting week there were an additional 356 confirmed cases, taking the total to 2,598 for the year. More areas of the island are now involved, with six new communes recording cases in recent weeks. Western districts remain those most affected. Read more (translate from French).

    Singapore: Three red alert dengue clusters

    The number of dengue fever infections in Jurong West, a residential area in the island’s west, now sits at 70 and includes three associated deaths. This is one of three active high-risk clusters the National Environment Agency (NEA) is monitoring. The national cumulative case count for the year to May 5 is 867, with the peak season approaching. Read more

    South Africa: Diphtheria in NE; Fly larva infections

    Two years after the last reporting of diphtheria in the NW province of KwaZulu-Natal, three cases (2 confirmed, 1 suspected) have occurred since the end of March. The patients were aged from 10 to 20 years; two of them have subsequently died from the infection. Read more from the National Institute for Communicable Diseases (NICD). WET weather has led to the tumbu fly spreading beyond its usual geographical limits. Last week the NICD advised that it was providing guidance on several maggot infestations reported in humans in North West Province and, to a lesser extent, Gauteng. The flies lay their eggs onto clothing; on hatching the larvae burrow into the skin causing itchy sores that enlarge, resembling a painful boil – a condition known as Myiasis. NICD advice on prevention: ‘washing should not be laid on the ground to dry. Ironing of clothes will kill eggs or larvae.’ More on Myiasis from the CDC. Read more

    Spain: Measles in Catalonia

    Health workers comprise seven of the 13 measles cases diagnosed since late March in Tortosa, south of Barcelona, with more suspected cases undergoing testing. Read more (translate from Spanish). 

    Tanzania: Rains boost mozzie numbers

    Heavy rains in Zanzibar have hampered fumigation drives put into place following an outbreak of chikungunya earlier this year in Stone Town and other isles. The mosquito-borne infection has flared again; currently Zanzibar’s main hospital is treating 50 patients for symptoms of chikungunya each day. 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 during daylight hours (and evening, if area is brightly lit) to all exposed skin. Read more about chikungunya and avoiding insect bites.

    United Kingdom: Seasonal insect pest stings; Beverages’ bacterial loads

    The emerging larvae of oak processionary caterpillars in numerous London locales has health officials warning of the detrimental effects the white-haired insect can have on people and animals (and oak trees). The hairs contain a toxic protein that can produce reactions such as skin irritation, vomiting, asthma and conjunctivitis. The advice: Don’t touch! (and report sightings to the Forestry Commission). Read more. THREE cinema chains are responding to a BBC report on the ‘unacceptably high levels of bacteria’, including salmonella, found in drinks and ice sold at some of their branches. Read more

    United States of America: Multi-state food/water-borne infections

    The extensive hepatitis A outbreak is now in its 15th month and the number of cases has exceeded 1,200 across at least six states. While the overwhelming majority of those sickened have been homeless or illicit drug users, a spill-over of infections to people who work as food handlers is now being reported. The hepatitis A vaccine series is included in the routine US immunisation schedule for children aged 1-2 years. Read more. TWENTY-nine states have reported E. coli infections linked to the consumption of contaminated lettuce grown in the Yuma, Arizona. This week the CDC announced that the number of cases had reached 149 - almost half required hospitalisation. Read more

    Vietnam: Rabies in NW, national disease data

    Three people died of rabies last week in the NW province of Lào Cai (location of Sapa), taking the national year-to-date toll to 18. Most cases occur in rural areas where people are unaware of the dangers of the infection and how to prevent and treat at-risk exposures. The health department has warned that the highest incidence of rabies each year is from May to August. Read more. WHILE in other news, data from the health ministry reveals there have been 135 measles infections across the country this year and numbers of hand, foot and mouth disease rose in late April taking the total to 7,000 cases. 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.

  • Brazil: YF update; More mozzie worries for Rio

    In the most recent reporting week (Apr 17-24), another 61 human yellow fever (YF) cases and 22 associated deaths were recorded in the states of Rio de Janeiro (36), Minas Gerais (14) and São Paolo (11). YF outbreaks among non-human primates were also occurring in those states, with 16 of the 18 epizootics in São Paulo. A vaccination campaign aimed at immunising the entire population of 77 million inhabitants continues. Read more. IN THE first quarter of the year, the state of Rio de Janeiro has experienced a three-fold increase in chikungunya cases, almost reaching the 2017 total of 4,305. The city of Rio recorded over 850 cases, mostly from the western districts of Campo Grande, Guaratiba and Santa Cruz. Read more (translation required).

    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

    Chile: Rapa Nui dengue

    Following reports in mid-April of four dengue fever cases on Easter Island, an Apr 27 update announced that number has risen to 14. Health Ministry response has been to declare a health warning which allows for the necessary powers to manage the outbreak and halt it – assembling teams to fumigate the island and distribute mosquito nets and repellents. Up to 80 percent of the population was infected with dengue in 2002, the first major outbreak recorded after the virus was introduced in 2000. 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.

    Europe: Measles woes continue

    Lower than required vaccination rates in many EU countries, compounded by the highly infectious nature of measles, and there is more news on expanding outbreaks: This week, from the Czech Republic, 70 of the more than 100 measles cases notified to authorities this year were in the capital, Prague. A news report stated that the situation has necessitated the closure of the emergency dept. of ‘Prague's largest hospital Motol … until next weekend’. Also updates from Estonia, Ukraine and Portugal.

    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.

    Fiji: Vaccine set-back

    The government has announced there will be a delay in the provision of meningococcal vaccines to all individuals under 19 years of age. The World Health Organization (WHO) and UNICEF had been approached for assistance in procuring the more than 300,000 doses needed. Read more

    France: Chickenpox cases mount in 5 departments; Dengue-transmitting mozzie hits new areas

    The rate of chickenpox infections is more than double the seasonal norm in Burgundy-Franche-Comté (SE of Paris), while increases have also been seen in Brittany, and to a lesser extent in Hauts-de-France, Nouvelle-Aquitaine and Normandy. Around one-third of those infected are under five years of age. Read more (translation required). THE MOSQUITO vector behind the 2017 chikungunya outbreak in Provence-Alpes-Côte d'Azur is now present across 42 of the 96 departments - up from six in 2010 (see map). Warnings have been issued ahead of the warmer months, with real concerns that imported viruses from countries experiencing outbreaks (i.e. dengue in Reunion) could spread to local communities. 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.

    Mexico: Mumps infections intensify in 5 states

    Mumps notifications reached 2,619 by the second week of April with nearly one-third of infections in the 25 to 44 years age group (20 percent were 20-24yo). Most affected states have been: Tamaulipas, Nuevo Leon, Quintana Roo, Jalisco and Chihuahua. Outbreaks have occurred involving university students in Mexico City, Sonora and Chihuahua. Read more (translation required).

    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.

    Nepal: Varicella in valley; Al fresco malaria

    A media release from a Kathmandu hospital states that it is treating three to four children for symptoms of chickenpox every day, and there has been a rise in cases across the valley. Read more. LOCAL health officials in Nawalparasi District - within the Terai and lying to the west/north-west of Chitwan National Park – have attributed at least some of the 21 malaria cases they have recorded to people sleeping outdoors during hot weather. It is hoped through the actions of the National Malaria Control Program to eradicate malaria by 2016. Read more

    Advice for travellers: Travellers visiting this lowland region of Nepal should discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. For details call 1300 360 164. Read more about malaria

    Nigeria: Lower intensity of Men. meningitis season

    Forty-six of the 713 people with suspected meningococcal meningitis have succumbed to the infection in the NW state of Katsina, a significantly lower figure than during last year’s devastating outbreak when there was a ~10 percent death rate from the more than 4,600 cases. The outcome was attributed to an extensive vaccination campaign and prompt antibiotic treatment. 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. Nigeria 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 free travel health advisory service (1300 360 164 - toll-free for landlines) for further advice. Read more about Men. meningitis.

    Pacific: Regional dengue, mumps reports

    The dengue fever outbreak that began late last year in Wallis and Futuna has worsened with a news report stating ‘it has spread to the centre of the island’. The situation has prompted meetings of interest groups including government and local officials. THE MOST recent post from ReliefWeb outlines health issues in regional countries: ongoing outbreaks of dengue fever in New Caledonia, Fiji and Vanuatu; mumps in Vanuatu and two states of Micronesia (Chuuk, Yap) and an Apr 19 update on the meningococcal outbreak in Fiji (see separate post).

    Pakistan: Province's malaria upswing

    An announcement this week from the director of malaria control in the province of Balochistan disclosed that 29 of the districts are reporting malaria and the incidence is increasing. Currently up to 7,000 children are infected with malaria each year. On a national level, annually more than 1.6 million people are infected with the malaria parasite. Read more

    Reunion Island: ‘Unprecedented’ dengue outbreak, over 2,100 cases

    According to the WHO, the risk of exportation of the dengue virus from the current ‘unprecedented’ outbreak to other countries with a competent mosquito vector is ‘heightened’. It also notes that studies established ‘in previous years asymptomatic cases contributed to the transmission cycle and since the proportion of asymptomatic cases was high, the virus has continued to spread unnoticed until now’. While the advice is not to restrict travel, the recommendations include: the use of personal protection measures (effective insect repellents, suitable clothing etc) and ‘Insecticide-treated mosquito nets afford good protection for those who sleep during the day (e.g. infants, the bedridden and night-shift workers), but also during the night to prevent mosquito bites, if the lights are kept on.' As of Apr 29, there have been 2,119 cases across the island, with western districts hardest hit. Read more

    Singapore: HFMD for month tops 12,000

    More than 3,800 cases of hand, foot and mouth disease (HFMD) have been notified to authorities over the last four weeks, taking the cumulative yearly total to 12,309. Case numbers started to climb in early March. Read more. Reports of HFMD in China show a drop from last year’s figures for the same period – nearly 142,000 cases and six associated deaths to Apr 20. Read more. And in Taiwan, HFMD infections climbed by 20 percent last week taking the yearly total to more than 5,000 cases - not classified as an epidemic as yet however. Read more. Thailand had recorded over 10,000 HFMD cases to Apr 30. 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.

    Thailand: Measles update

    Bureau of Epidemiology data on measles cases across the kingdom this year: over 700 cases with the majority in the central, NE, north and southern provinces. One-quarter of cases were aged 15 to 24 years of age, followed by 25-34 years cohort. Last week the health department in Victoria (Australia) advised of an imported case of measles originating in Thailand (mirroring the outbreaks underway in Okinawa & Aichi Prefectures, Japan, and in Taiwan).

    United States of America: Spring increase in rabies reports

    With the warming of the weather people spend more time outdoors, wild animals become more active and so the rabies risk increases. This week, ProMED posted details of four separate incidents of human exposure to rabid animals that took place over the last seven days in the states of Alabama, Massachusetts, New York and South Carolina.

    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 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.

    Venezuela: Measles, malaria among the multiple health troubles

    A paediatric hospital in the capital Caracas is treating between five and seven children for measles infections every day; in total over 450 since the end of last year. Lack of isolation facilities has led to children who are in-patients becoming infected with measles during their stay. The outbreak has spread beyond the Capital District to seven other states. Read more (translation required). And measles is not the only health issue hammering the country, malaria cases increased by almost 70 percent in 2017 – the greatest increase of any country. Read more