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

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

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

    Advice for travellers: Yellow fever virus is a mosquito-borne disease found in tropical and subtropical areas in Central/South America and Africa. While it can be severe, yellow fever infection is a very rare in Australian travellers. However, under the International Health Regulations (IHR), proof of vaccination may be required of any traveller entering or leaving an area at risk of yellow fever transmission. Read more about yellow fever. 

    Cambodia: Mondulkiri malaria

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

    Democratic Republic of Congo: Danger of cholera spread persists

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

    Advice for travellers: Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera

    Europe: Flu still peaking

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

    Advice for travellers: Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends influenza vaccination against influenza for all travellers over 6 months of age.

    Fiji: Dengue cases top 1,000

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

    Advice for travellers: Dengue is spread by two types of Aedes mosquitoes. Both breed close to dwellings, are found in shady areas and bite mainly during the daylight hours, making them difficult to avoid outdoors. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply repellent containing an active ingredient, such as DEET, Picaridin, or PMD when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    French Polynesia: Lepto risk raised

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

    Advice for travellers: Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.

    India: Unseasonal dengue for Jaipur

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

    Advice for travellers: Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

    Ireland: Mid-West measles warning

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

    Advice for travellers: Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure. Read more about measles.

    Malawi: Local and regional cholera outbreaks

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

    Mozambique: Fatal consequences of vax shortage

    Insufficient funds for buying the necessary vaccines is one reason given for the human rabies toll – 72 people died from the infection last year. Of the 11,000 notified rabies exposures last year, most were children and were from Cabo Delgado, Nampula, Zambezia and Inhambane. Read more

    Advice for travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals – especially dogs, the main source of infection. If bitten, urgent post-exposure treatment is required. Vaccination is normally recommended for those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.

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

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

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

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

    Pakistan: Measles toll climbs to 8

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

    Samoa: Dengue situation updated

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

    South Africa: Listeria sources identified; 3rd rabies death

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

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

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

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

    HEPATITIS A outbreaks continue in the states of Kentucky, Utah and Michigan. Due to the fact that most infected people are homeless or illicit drug users with higher rates of associated medical conditions, many have required hospitalisation. Read more

    Advice for travellers: Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

  • Australia: Listeria infections from melons

    Rockmelons supplied by a regional NSW grower have been implicated in a listeria outbreak that has claimed the lives of two people and sickened 10 others across three states. Immunocompromised people and those aged over 65 years who are at a greater risk from listeria infections are advised to monitor their health if they consumed melons prior to the recall. Read more. More on the largest ever outbreak of listeriosis which continues in South Africa with a total of 945 cases (202 this year) and 176 deaths. A source has not been discovered as yet, however authorities now advise: ‘processed, ready-to-eat meat products, soft cheeses, and unpasteurised milk and dairy products should be avoided by persons who are at risk of listeriosis.’ Read more from the National Institute for Communicable Diseases (NICD). 

    Brazil: More YF in tourists

    The World Health Organization (WHO) yellow fever update of Feb 27th notes that, ‘Unlike the previous seasonal period, the current seasonal period has been characterized by more cases reported in São Paulo and Rio de Janeiro states along with the occurrence of cases in areas near large cities.’ Both states, together with Minas Gerais have experienced a surge in YF cases this year. In addition to the 2 cases in tourists who had travelled to Ilha Grande (a Chilean man who subsequently died and an Argentinian man), as outlined in last week’s post, news this week of YF infections in two more Chilean nationals who had also visited Ilha Grande, and another in an Argentinian (woman) following visits to Ilha Grande and Isla Bella. A Brazilian news source disclosed that French authorities have confirmed a recent case in a woman who had travelled through Minas Gerais. All the foreign nationals who contracted YF were reported to be unvaccinated. WHO advice: ‘Vaccination is the single most important measure for preventing yellow fever. The vaccine has been used for many decades and is safe and affordable, providing effective immunity against yellow fever within 10 days for more than 90% of people vaccinated and within 30 days for 99% of people vaccinated. A single dose provides lifelong protection.’ Read more from flutrackers

    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: 2017 malaria report card; Dengue cases climb

    A report on the nation’s malaria burden in 2017 has shown that malaria cases almost doubled over the previous year – from 23,627 cases to 45,991. A health official suggested the dramatic increase could have been caused by the lengthy wet season and the expiration of insecticide used in impregnated mosquito nets distributed three years ago. Read more

    FOLLOWING an upturn in the cycle of mosquito breeding, this year’s dengue case count has doubled last year’s figures for the first 6 weeks – 600 cases and the infection has claimed one life. 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.

    Cayman Islands: Out-of-season HFMD

    Hand, foot and mouth disease (HFMD) cases have hit a 10-year high and are continuing to climb ahead of the usual peak season in summer. Sixty infections have been diagnosed to date with children under 10 years of age making up the majority of cases. 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.

    Iraq: Leishmania infections in east

    More than 500 residents of Al-Udhaim in Diyala Governate returning to their homes following years of occupation by ISIL have been infected with cutaneous leishmaniasis. Known locally as Baghdad Boil, the parasitic infection is transmitted through sand fly bites. Read more

    Advice for travellers: Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention.

    Jamaica: Dengue rising in SE

    There has been an outbreak of dengue fever in the parish of St Catherine, adjacent to the capital Kingston, with up to 30 cases identified this year. Portmore and Spanish Town have reported large numbers of mosquitoes following heavy rainfall. Read more

    Kenya: Warning of chikungunya spread

    The WHO has warned that there is a possibility that the chikungunya outbreak could spread further in the country’s second largest city, Mombasa. Six sub-counties of the city and one in the district of Kilifi have reported suspected cases but highest numbers are in Likoni and Mvita. Since the outbreak began in mid-December, there have been more than 450 suspected cases. 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/PMD when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

    Malaysia: Marine Park dengue

    A dengue clean-up campaign is underway on Gaya Island, part of Tunku Abdul Rahman National Park and adjacent to Kota Kinabalu. More than a dozen dengue infections have been reported, mostly in schoolchildren, from three villages on the island. Read more

    New Caledonia: Dengue type 2 return alarms

    An epidemic alarm has been triggered by local health authorities after more than 100 cases of dengue fever were reported in the first few weeks of the year. Most were found to be Dengue virus type 2 which hasn’t circulated in the territory for two decades, so immunity levels in the local population are likely to be low. Affected areas include the capital Nouméa and the east coast towns of Yaté, and Poindimié. Read more (translate from French).

    New Zealand: STI rise reported

    Cases of syphilis in women have increased 5-fold in the past four years, but the figure may well be higher as an early sign of infection, an ulcer or chancre, may go unnoticed. Read more 

    Advice for travellers: Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an antibiotic like penicillin. Read more about syphilis and other STIs.

    Nigeria: Lassa’s growing burden

    The Lassa fever outbreak continues to expand with 54 more cases and 10 deaths from eight states in the most recent reporting week – over two-thirds of cases were in the states of Edo and Ondo. Measures introduced by the Nigerian Centre for Disease Control in response include the launch of a Lassa fever information website and directing disease surveillance teams to 4 states that border Benin - Kebbi, Kwara, Niger and Oyo. Read more. South Africa has instituted enhanced screening at border posts for arrivals from Lassa-affected West African countries, but health authorities there maintain that the risk on a country level is very low. 

    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.

    Reunion Island: Dengue alert for west/south

    A sharp increase in the number of dengue cases recorded last week has prompted authorities to increase anti-mosquito measures, particularly in those areas reporting cases: Saint-Paul, Saint-Gilles-Les-bains and Le Port in the west; and Saint Pierre and Tampon in the south. Read more (translate from French).

    Taiwan: New Year celebration gastro spike

    A surge in diarrhoea cases, mainly due to norovirus, is most likely associated with Lunar New Year feasts and should subside quickly, according to the CDC Deputy Director-General. More than 160,000 people sought treatment for diarrhoeal symptoms from Feb 18-24. Strict personal hygiene measures have been encouraged. Read more

    Advice for travellers: While it is extremely contagious, norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands thoroughly after using the toilet and before eating, and practice good hygiene. Read more on norovirus.

    Thailand: Dog rabies uptick

    Control teams have been sent to areas with high rates of rabies in dogs to sterilise the animals and administer vaccines. The strategy follows the release of figures of over 270 dogs diagnosed with rabies this year, compared with 250 for all of 2014. The Lower North Eastern Region has reported most cases. Read more. Since the beginning of the year, rabies has claimed the lives of two people in Thailand. 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.

    Uganda: Cholera in western district

    The district of Hoima, which takes in part of Lake Albert’s eastern shore, is the site of a cholera outbreak that has killed 29 people and hospitalised 962 more. Cholera infections first broke out in camp for Congolese refugees and then spread to local villages. 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.

    Ukraine: Marginal measles burden improvement

    It may have been a 5 percent decrease on the previous week’s measles rates, but there were still 800 new cases from Feb 19-25. The national toll for the year now sits at 7 deaths from 5,839 cases (around 4,000 people required hospitalisation). 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.

    United States of America: Parasite prompts warning

    Hawaii State health authorities are advising residents to thoroughly inspect, ‘wash and store produce in sealed containers, regardless of whether it came from a local retailer, farmer’s market, or backyard garden and to wash ‘all fruits and vegetables under running water, especially leafy greens, to remove any tiny slugs or snails’ as details of the year’s first case of rat lung worm were released, a resident of West Hawaii. The parasite is passed to snails and slugs when they eat the faeces of an infected rodent, usually a rat – the definitive host. Read more

    Yemen: Resurgence in cholera forecast

    The lull in cholera cases is likely to end with the arrival of annual rains, adding to the 1 million plus cases and over 2,000 deaths. The WHO will be conducting vaccination campaigns in the near future to tackle the country’s cholera and diphtheria outbreaks. Read more

  • Angola: Spike in coastal province’s malaria

    Preventive health measures are needed to tackle a sudden spike in malaria cases in the coastal province of Benguela. Upwards of 8,000 malaria cases and 50 deaths were recorded in the province in a recent 10-day period. Read more (translate from Portuguese). The province of Luanda carries the highest malaria burden however, with over 75,000 of the nearly 308,000 cases this year. 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: Yellow fever cases climb again

    Two states have recorded an increase in human yellow fever (YF) cases, with many of those residing in areas near major urban centres. The Feb 16th Pan American Health Organization (PAHO) Epidemiological Update reports that in ‘São Paulo, 57% of the confirmed cases had the probable place of infection in a rural area of the municipality of Mairiporã, located 15 kms from the northern area of São Paulo city. In Rio de Janeiro, 45% of the confirmed cases are residents of the municipalities of Valença and Teresópolis, the latter located 96 kms from the city of Rio de Janeiro.’ The toll in the current outbreak sits at 545 cases and 164 deaths. Additionally, a rise in the number of epizootics (disease outbreaks in animals – non-human primates in this case) prompted the agency to warn of the risk of a repeat of the situation in 2008 when YF spread beyond Brazil’s borders to Argentina and Paraguay. Also this week, news of the death of a Chilean man from YF he contracted while staying on Ilha Grande, an island off the coast of Rio de Janeiro state. He had not sought vaccination before his trip. His is the second YF death in foreign tourists to Brazil this year – the first was an unvaccinated Dutch traveller to São Paulo state, as reported in ProMED on Jan 15th. Read more (translate from Spanish). Translated from a local news site, an unvaccinated Argentinian man who had travelled to Brazil’s Ilha Grande and the archipelago of Ilhabela in the first two weeks of February has been diagnosed with YF on his return to Buenos Aires. 

    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

    Cote D'ivoire: Parasitic infection spreads

    A government report on tropical diseases states that almost two-thirds of all health districts have been affected by cases of lymphatic filariasis, a parasitic infection transmitted by mosquitoes, and over 83 percent of the population is at risk. Read more (translate from French). 

    Democratic Republic of Congo: Rabies rife in NE

    Bites from rabies-infected dogs have killed up to 11 people in the NE province of North Kivu, bordering Uganda and Rwanda. While vaccines for dogs are available locally, there are no vaccines for the treatment of humans. 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.

    Fiji: Dengue strikes in Western Division

    Residents of Central and Western Divisions were warned in a news report on Sunday that the ‘high levels’ of mosquito breeding identified in traps in Suva, Lami, Nasinu, Nadi and Lautoka could mean a rise in the incidence of dengue fever. By Wednesday, it was revealed that Nadi and Ba, an inland town 60kms to its north-west, are reporting outbreaks of the viral illness. Most of the 312 confirmed cases this year have been from the two centres in the Western Division (from a national total of 860). Read more. And in Vanuatu, Pacific Public Health Surveillance Network (PPHSN) emerging disease alerts indicate increasing numbers of dengue fever and mumps cases. 

    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.

    Greece: Measles outbreak persists

    Mandatory vaccination against measles is an option that authorities are hoping not to take as the country continues to battle the outbreak that has so far produced over 1,500 cases and caused three deaths. Southern regions have been hardest hit. Read more. While in the Republic of Georgia, a measles outbreak is also underway, with two-thirds of the 278 cases in the SW region of Adjara and a rising number in the country’s capital Tbilisi. A Ministry of Health official said women aged 20 to 40 years make up the highest number of infections to date. Read more (translate from Russian).

    Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps 6 weeks before departure.

    India: Dry season disease cycles

    Kerala’s capital, Thiruvananthapuram is experiencing a spike in chicken pox and conjunctivitis cases among the ‘summer diseases’ more commonly seen at this time of year. Others include hepatitis A, typhoid, diarrhoea and mumps. 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.

    Nigeria: Record outbreak

    The regional WHO office weekly update describes the ongoing Lassa fever outbreak as ‘unprecedented’ as it moves into states not typically involved in the cycle of endemicity. As many as 17 states are now affected, however three-quarters of all cases were in Edo and Ondo. The WHO assessment includes ‘strengthening cross-border surveillance and collaboration with neighbouring countries is paramount to mitigate the risk of trans-boundary transmission’. (More from the Nigerian Centre for Disease Control.) Other issues of note in the weekly update include cholera outbreaks in Tanzania (of concern) and Malawi (insidious and increasing). More on the outbreaks in Malawi, Zambia and Uganda (suspected). 

    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: Testing reveals resistance to multiple antibiotics

    Disturbing news from the analysis of Salmonella bacteria responsible for the ongoing outbreak of typhoid fever in Sindh has shown the infecting H58 strain to have mutated further - ‘harboring a promiscuous plasmid’ - and it is now extensively drug resistant (to 5 classes of antibiotics). Read more. The study was published this week in the journal mBio

    Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination against typhoid fever is itinerary specific, but is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices.

    Paraguay: Two regions report dengue

    Almost 2,500 dengue fever cases have been recorded in the year up to Feb 3rd, with the majority from Central department and the capital, Asunción. Read more (translate from Spanish).

    Saudi Arabia: MERS cases total 2,160

    Two more MERS-CoV cases (from Riyadh and Taif) have been added to the February total (now 4) by the Ministry of Health, while a WHO update for the month of January identified 25 cases and 8 deaths and included an outbreak in a hospital in the NE region of Hafr Albatin. 

    South Africa: Two rabies deaths in east

    Already this month two children have died of rabies in eastern provinces (Eastern Cape and KwaZulu-Natal) following dog bites. Neither had received timely and effective post-exposure treatment. Calls have been made for public awareness campaigns on rabies and the need for vaccination of domestic dogs. 

    Thailand: Rallies planned for capital

    Rolling protests will be held by pro-democracy activists in Bangkok over the next three months as the anniversary of the 2014 coup approaches. The first will be held next Saturday, followed by two in March, and they are planned to increase in frequency throughout May. Read more

    Advice for travellers: Advice from smartraveller.gov.au for visitors to Thailand includes: Avoid demonstrations, political events, rallies, processions and large-scale public gatherings; Monitor the media and other sources for possible unrest and avoid affected areas; and Take official warnings seriously and follow the advice of local authorities.

    Tonga: Dengue risk rises post-cyclone

    The news is not unexpected: there is likely to be a surge in dengue fever cases following Cyclone Gita as pooling water forms ideal mosquito breeding sites. More than 50 dengue cases had been identified on the main island of Tongatapu prior to the cyclone. Read more 

    United States of America: Hep A in Kentucky’s largest city; Mumps spike in Alaska

    A rise in hepatitis A cases in Kentucky (most in Louisville) is being partly attributed to a spread from outbreaks in other states. The Department for Public Health notes that transmission of the virus is predominantly through person-to-person contact rather than food-borne and most cases are being diagnosed among the homeless or users of illicit drugs. Read more

    PROMED reports on the rising numbers of mumps infections in Alaska’s capital, Juneau, and its most populous city, Anchorage. Almost 250 confirmed and suspected cases have been reported in Anchorage, a near-100 percent increase on 2012 figures, and while the four infections (one confirmed, three suspected) in Juneau might seem low by comparison, they are the first the city has recorded in over 20 years. The Hawaii health department advisory on the mumps outbreak there notes that as of Feb 15th, there have been 879 cases - 702 of those in Honolulu.  

    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.