Health Alerts
  • Australia: RRV advice for south-west

    Warnings on Ross River virus have been issued by WA’s health department this week to ‘residents and travellers in the south-west region of Western Australia, including the Perth metropolitan area, to take precautions to avoid mosquito bites over coming weeks’. Numbers are currently low, however the upcoming holiday season will bring an influx of tourists to the area and appropriate personal protection measures are advised. Read more

    Advice for travellers: Cases of Ross River occur throughout Australia, including more temperate southern states. Travellers visiting areas of Australia affected by recent flooding or continuing rain should take measures to prevent mosquito bites. Use a personal effective insect effective ingredient such as DEET, Picaridin,or PMD when outdoors and wear long, loose-fitting, light coloured clothing – especially at dawn and dusk, the times of day when RRV-carrying insects are most active.

    Bangladesh: Dengue peaks

    Dengue fever cases in and around the capital Dhaka have reached an 18-year high, with over 9,500 to date. The rates of new infections have started to decline, however doctors are reporting more complications among those presenting with fever at hospitals in the city. 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. 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.

    China: Second rat Hep E case

    Several local news sources in Hong Kong are reporting a second case of hepatitis E transmitted from rats to a human. Both cases were from nearby housing estates in Kowloon’s Wong Tai Sin District and were likely contracted through consuming food contaminated by rats. Read more. The US CDC’s Emerging Infectious Diseases journal  (Volume 24, Number 12—December 2018) contains an article on the initial case: ‘Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant’. Read more

    Costa Rica: Rabies death from untreated bat bite

    A biologist who was bitten by a bat while visiting a cave in Copey de Dota in August has succumbed to rabies infection. The man had not sought medical treatment following the bite and had onset of rabies symptoms approximately eight weeks later (‘numbness and paralysis of movements, difficulties swallowing and behavioral disorders). Read more

    Advice for travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is normally recommended for longer stays, especially travellers planning to live in, or travel extensively through, rural areas and also for children; however the final recommendation is itinerary-specific. Read more on rabies

    Democratic Republic of Congo: Update on NE’s Ebola outbreak; Cholera uptick

    The World Health Organization's (WHO) latest assessment of the Ebola outbreak in North Kivu and Ituri provinces notes that it ‘remains dangerous and unpredictable’ due to ‘escalating insecurity’ with fresh concerns, reported by CIDRAP, that it ‘could last at least another 6 months’. Latest data from the health ministry’s dashboard: 373 confirmed or probable cases, 71 under investigation and 217 deaths (170 confirmed as Ebola Virus disease).
    THE WHO has also reported that cholera case numbers have started to rise again after a lull in early October, with the provinces of Tanganyika, Haut Katanga, Sankuru and Kasai-Oriental most affected. Cameroon’s Far North region is experiencing a flare up in its cholera outbreak and a high case fatality ratio has been registered for both the North and Far North regions. Read more

    Advice for travellers: Ebola Virus disease is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola virus disease.

    Guadeloupe: Dengue resurfaces

    Mosquito bite avoidance measures are advised following the confirmation of a small number of local dengue fever cases (in Abymes, Pointe à Pitre, Goyave and Petit Bourg), the first in over two years. Read more 

    India: Zika cases in MP climbs to 127; Punjab’s dengue lingers

    Zika virus disease cases have now been reported in the regions of Vidisha, Bhopal, Sehore, Hoshangabad, Raisen and Sagar in Madhya Pradesh – a total of 127 to date. Read more. DENGUE fever rates remain high in the state of Punjab with reports this week from Amritsar, Patiala and Muktsar.

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT). 

    Israel: Travel notice for measles outbreak

    Last week the US CDC issued a level 1 Travel Notice - Practice Usual Precaution – due to the ongoing measles outbreak with similar notices also added for Colombia, New Zealand and Moldova. While in France, there has been a recent spike in measles cases in Seine-Saint-Denis, in the NE of Greater Paris, with 11 requiring hospitalisation. Read more. The health ministry in Algeria reports that more than four million children are not vaccinated against measles due to hesitancy or parental refusal. This year there have already been 23,000 cases and 16 related deaths. 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.

    Japan: Rubella count nears 1,900

    The nearly four month-long outbreak of rubella continues with the latest count approaching 1,900 cases. Twenty-six prefectures are now reporting cases; one local news source states there has been a recent increase in cases in the Kansai region, which takes in the cities of Nara, Kyoto and Osaka. Sub-optimal vaccination rates among adults (particularly men) aged 30-plus are fuelling the outbreak. Read more

    Advice for travellers: Rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine, one of the routine immunisations which should be current for prior to overseas travel. Travellers should also check their immunisation status for tetanus, diphtheria, and whooping cough. Read more about rubella.

    Madagascar: Measles in 25 districts

    Of the 114 districts, 25 - including the capital Antananarivo - are now reporting measles infections. Since the outbreak began in early October, nearly 2,600 cases have been recorded. Read more

    Namibia: Anthrax sickens 7

    In the Kunene and Kavango regions, anthrax infections have spread from buffaloes to livestock and now to humans, with seven cases recently reported in Siesfontein. 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

    Papua New Guinea: Polio case count rises to 22

    East Sepik is the latest province to report a case of vaccine-derived poliovirus, taking the total since June to 22. There are no other details of this last case other than it was in Angoram district, SE of Wewak, and had onset of paralysis on Sept 26. 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, however vaccination is recommended for travel to affected regions and is a requirement for travel to/from some countries. If at risk, adults should have a booster to the childhood series. More on polio and vaccine-derived polio

    Philippines: Double hit in CAR

    In Luzon’s far northern districts, cases of dengue fever and leptospirosis rose sharply this year. Dengue infections in the Cordillera Administrative Region have doubled compared to 2017 data, and the number of deaths attributable to leptospirosis trebled, from two to six. 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.

    Spain: Catalonia records dengue case

    A sixth case of locally acquired dengue fever has been reported in a resident of Barcelona. The man who had no history of travel was diagnosed earlier this month. The five previous cases identified this year are believed to have been infected while staying in the SE region of Murcia. Read more

    United States of America: Contaminated lettuce alert; Florida’s local dengue case

    Until a source of contamination has been determined in a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7, the CDC is advising ‘U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any’. Cases have emerged in 11 US states (California, Connecticut, Illinois, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio and Wisconsin) as well as the Canadian provinces of Ontario and Quebec. (In Australia, the lettuce variety is known as Cos) Read more
    WHILE fewer than 50 dengue fever infections have been diagnosed in travellers returning to Florida from overseas in 2018, this week the Department of Health in Miami-Dade County announced a single locally acquired case of dengue. Local authorities have initiated their ‘response protocol to eliminate breeding and adult mosquito activity in the area of the confirmed case’. Read more

  • Brazil: YF risk rises; Kala Azar in NE; Dengue total nears 220,000

    The Ministry of Health has warned residents of metropolitan areas of Rio de Janeiro, Minas Gerias and São Paulo to ensure they are vaccinated against yellow fever (YF) as the peak YF transmission season starts. The emphasis is on the three south-eastern and southern regions as they are ‘recently affected’ and have large populations. Circulation of the YF virus has been seen in the cooler months this year; the ministry reported ‘the first death from yellow fever in the second half of this year. The case was registered in São Paulo, with probable infection in the city of Caraguatatuba’. Read more
    AUTHORITIES in Sergipe have called for more measures to tackle visceral leishmaniasis, an endemic infection in the NE state. ‘Intense’ transmission is reported in three towns - Aracaju, Nossa Senhora do Socorro and São Cristóvão – while state-wide this year there have been nine deaths from 55 cases. Read more
    ON A national level, circulation of all four dengue serotypes is being reported. The total number of dengue fever cases to week 42, according to regional data provided by PAHO, rose to nearly 220,000 cases, almost half of which were laboratory confirmed. 

    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

    China: HKG’s Hep A spike

    Late last week Hong Kong’s Centre for Health Protection  issued an ‘appeal for vigilance against hepatitis A’ following hospitalisation of 14 people with hep A since October 1 – average monthly notifications this year had been from one to five cases. Five of the cases were confirmed to have been imported (from Pakistan or Bangladesh). A common source of infection for the remainder is yet to be identified. 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 highly effective and long term protection. Travellers should also follow these guidelines for safe food and water.

    Democratic Republic of Congo: Ebola outbreak now largest recorded in DRC

    On Nov 9, with 319 cases that were either confirmed or probable, the Health Ministry admitted that the current Ebola virus disease (EVD) outbreak is the largest to date. In the latest report (Nov 12), the ministry announced that ‘the cumulative number of cases is 339, of which 301 confirmed and 38 probable. In total, there were 212 deaths (174 confirmed and 38 probable).’ More information from CIDRAP.  

    Advice for travellers: Ebola Virus disease is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola virus disease.

    Honduras: Dengue follows rains

    Dengue fever cases have risen sharply in the last month, with many of those reported in the category of severe dengue. Six departments have been hardest hit - Cortés, Tegucigalpa, Yoro, Atlántida, Olancho and Comayagua – following recent rains. 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. 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.

    India: More Zika in MP; Assam’s JE; Punjab’s dengue now also rural

    The Zika count in the state of Madhya Pradesh has risen to 109 with cases in the cities of Bhopal (44 cases), Vidisha (39) and Sehore (20). Seven districts are now involved in the outbreak; two new areas identified this week are Raisen and Narsinghpur. A ‘containment area’ has been established around Bhopal, Sehore, Vidisha and Sagar. Read more
    DELHI’S air pollution is currently ranging from unhealthy to hazardous, following the annual trend that sees the smog persist into next month. Read more
    LOW vaccination rates among adults in several districts of Assam are blamed for the NE state having the country’s highest rates of Japanese encephalitis - by week 43 (Oct 26) there had been 488 cases and 94 deaths. 
    IT’S peak dengue season in the state of Punjab with reports that the infection is becoming more common in rural communities – around one-third of all cases this year have been in villages well outside major centres such as Chandigarh. Read more

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT). 

    Indonesia: Update on JE in Bali

    Japanese encephalitis vaccines given to Balinese children as part of their routine immunisations in April this year appear to be behind several media reports of an outbreak of the infection on the island. On the weekend, however, the Head of the Bali Provincial Health Office refuted the existence of an outbreak, stating that ‘there was only one case of JE in January and it was cured, there was no death’. The island houses large numbers of pigs, the basis of the famous local dish ‘babi guling’ but also an amplifier of the Japanese encephalitis virus. With a heightened risk of transmission, authorities have aimed to vaccinate all children from the age of nine months to 15 years against JE. Read more (computer translated). Advice from DFAT’s smartraveller site includes: ‘Japanese encephalitis is an ongoing risk in Indonesia, including Bali. But the risk of infection remains low. Avoid mosquito bites. Talk to your doctor about vaccinations before you go.’

    Advice for travellers: A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Mexico: Mosquito-borne infections simmer

    Low levels of Zika virus infections are circulating in over half of all states (18 of 32), while chikungunya is reported, with confirmed cases in very low numbers, in nine. The top four states for Zika virus, according to a local news report, are Jalisco (64), Sinaloa (21), State of Mexico (15), Baja California Sur and Nayarit (both 11). 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.

    Nepal: Tackling Pokhara’s dengue

    In response to the 185 dengue fever infections recorded over the past six weeks in Pokhara district (and valley), local authorities have mounted a public awareness campaign and initiated the clean-up of potential mosquito breeding sites. Read more

    New Zealand: Meningococcal rates on the rise

    Cases (and related deaths) of invasive meningococcal disease (IMD) due to serotype W have doubled since 2017 – over one-quarter of those were in the Northland region – and ‘cases due to all serogroups has been increasing steadily since 2014’. As a result, the Institute of Environmental Science and Research (ESR) has increased the frequency of its IMD surveillance reporting to weekly. Read more

    Advice for travellers: Meningococcal meningitis is an acute bacterial disease transmitted from person-to-person through close (kissing, sharing eating utensils) or extended contact. Risk factors include extensive travel in crowded conditions or extended contact with local people in crowded places. If planning to travel to any region experiencing an outbreak, discuss whether vaccination against meningococcal meningitis would be appropriate for your itinerary with your doctor. Read more about Men. meningitis.

    Senegal: Dengue prompts travel notice

    With over 2,000 suspected dengue fever cases reported in six regions (Fatick, Diourbel, Saint Louis, Louga, Dakar and Thiès), the US CDC has issued a travel notice – Level 1, Practice usual precautions - for travellers to Senegal. Read more. It is hoped the imminent dry season will limit the spread of dengue in Senegal and also in its northerly neighbour Mauritania where an outbreak has been ongoing since May. Dengue virus serotype 2 has been circulating in six regions, with most cases in the capital Nouakchott. Read more 

    Pacific: Dengue fatality

    The year-long dengue fever outbreak in Wallis and Futuna has produced 461 suspected cases to date and its first death, which was recorded this week – a young girl who had been transported to New Caledonia for treatment. Also in the region, dengue infections continue to emerge from another lengthy outbreak, this one in American Samoa – there have been almost 2,000 cases to date. Read more

    United Kingdom: Rabies ex-Morocco

    Public Health England has reminded the travelling public to avoid animals in rabies risk countries and to seek medical assistance in case of exposures such as bites, scratches or licks from animals. The warning comes after a UK citizen died from rabies transmitted through a bite from a rabid cat in Morocco. Read more

    Advice for travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals. If bitten or scratched, urgent post-exposure treatment is required. Vaccination is normally recommended for longer stays, especially travellers planning to live in, or travel extensively through, rural areas and also for children; however the final recommendation is itinerary-specific. Read more on rabies

    Vietnam: HCMC’s dengue upsurge

    Pooling water in the many new building projects underway in Ho Chi Minh City’s peripheral districts is driving a rise in dengue fever cases in the municipality, however all areas of the city are reporting cases. Last month’s dengue count was 125 percent higher than the same period in 2017 with the intense transmission season now in progress. Read more

  • Botswana: Diarrhoeal illness kills 38 children

    Rotavirus is believed to be responsible for a large outbreak of diarrhoeal illness among children that started in September. To date 38 children have died and 30,000 cases recorded. A senior health official stated that the peak of the outbreak was in mid to late September and only three of the 28 affected districts continue to report cases - Jwaneng, Gaborone and Chobe. Read more. More about rotavirus infection from healthdirect.gov.au

    Chad: Alert on measles epidemics

    A measles outbreak occurring in 11 provinces is now into its ninth month and has killed 79 people from over 3,000 suspected infections; epidemics have been declared in 41 health districts. Read more 

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

    Democratic Republic of Congo: New hot zone in Ebola outbreak, Uganda vaccinates frontline HCWs

    Ebola virus disease (EVD) cases in a new health zone and another chain of transmission to follow are two more barriers in the control of the outbreak in North Kivu and Ituri provinces. The US CDC Director has warned that this outbreak may not be contained, leading to EVD becoming endemic in the region. The current situation can be found in the DRC Ministry of Health report here. Ebola vaccines are to be supplied to Ugandan healthcare workers, particularly those that would be in a front line position in the event of a local EVD case arising from the outbreak in the neighbouring DRC. Read more

    Advice for travellers: Ebola Virus disease is a severe viral haemorrhagic fever found in humans and other primates (such as monkeys, gorillas, and chimpanzees). It spreads through families and friends in close contact with blood and infectious secretions of people with obvious symptoms and, as such, presents a low risk to tourists to the affected countries. Read more about Ebola virus disease.

    Ethiopia: Yellow fever in SW

    A yellow fever (YF) vaccination campaign has been carried out in the districts of Gamo Gofa and Wolaita in the SW Southern Nations, Nationalities, and Peoples region following the reporting of 35 suspected YF cases and 10 deaths since late August. The WHO regional office situation assessment notes that the ‘outbreak is of concern since the population of Ethiopia is highly susceptible to yellow fever due to absence of recent exposure and lack of large-scale immunization’. Inclusion of the YF vaccine in the routine immunisation schedule is not planned until 2020. 

    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

    Egypt: Clean-up campaign for Red Sea resort hotels

    Hotels in the popular diving resort town of Hurghada on the Red Sea are to have their hygiene standards assessed in the wake of the deaths of two tourists from the UK. According to Egyptian authorities, the couple died from E.coli infections in August while staying at a local hotel. Read more

    India: Zika cases identified in third state; Delhi’s toxic air; Dengue in Punjab

    The number of Zika virus cases in Rajasthan has risen to 159 and surveillance activities continue, however the focus is now on the state of Madhya Pradesh where eight Zika cases have been found, including in the capital Bhopal and two nearby districts, Sehore and Sironj. Madhya Pradesh lies in central India and is adjacent to the two states also reporting Zika – it is SE of Rajasthan and east of Gujarat. Read more
    THIS WEEK Delhi’s air pollution has peaked at 20 times recommended levels (as dictated by the WHO) and are set to worsen during the upcoming festival of Diwali. In the past, the firecrackers that are set off during the Hindu celebration exacerbate pollution levels, so this year authorities are limiting the times of use for the fireworks. Read more. See Delhi’s real time Air Quality Index here.
    CHILDREN have been hardest hit in a large outbreak of what is suspected to be dengue fever in the NW state of Punjab. The sudden increase to more than 5,000 cases has occurred in the city of Kotkapura. Read more

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).

    Israel: Measles count exceeds 1,300

    The 2018 national measles case count has now exceeded 1,300 with over half in Jerusalem’s ultra-Orthodox communities, known to have low immunisation rates. The country’s first measles-related death in 15 years occurred last week in an unvaccinated young child from Jerusalem. Read more. An outbreak of measles in New York State, USA is believed to have stemmed from infected (unvaccinated) travellers returning to the US from Israel (and the Ukraine). Read more

    Japan: Rubella outbreak nears 1,700 cases

    The German measles (rubella) outbreak continues with 100 or more new cases per week reported over the past two months and there are now concerns that cases could continue to emerge during large upcoming sporting events, such as next year’s Rugby World Cup. In the most recent reporting week (week 43), a total of 170 cases were reported from Tokyo (60), Kanagawa (24), Chiba (19), Osaka (7) and Fukuoka (6). The National Institute of Infectious Diseases (NIID) is urging women planning pregnancy and their close contacts to ensure they are vaccinated; this advice is reflected in a US CDC travel notice for anyone heading to Japan. Read more

    Advice for travellers: Rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine, one of the routine immunisations which should be current for prior to overseas travel. Travellers should also check their immunisation status for tetanus, diphtheria, and whooping cough. Read more about rubella.

    Madagascar: Measles in capital region

    Measles vaccinations are to be carried out in the capital Antananarivo as well as in the neighbouring districts of Avaradrano, Atsimondrano and Ambohidratrimo after a large number of suspected measles cases were reported – over 1,000 in one location alone. Read more. While in Mauritius the case count has now risen to 1,226 and many of those infected are aged 20 to 49 years, followed by young children under four. New cases appear every day and so a vaccination campaign is planned targeting the adult cohort. Read more

    Malawi: Suspected typhoid in north

    Typhoid fever is assumed to be the cause of ‘some’ hospital admissions and related deaths in Mzuzu in the country’s north - the source of the illnesses is still unknown. The city is described as the gateway to Lake Malawi. Read more

    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 usually recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters and for travel to areas reporting drug-resistant typhoid. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices.

    Papua New Guinea: Added measures to tackle polio

    As reported by the GPEI, new polio cases in the provinces of Jiwaka, Gulf and Southern Highlands take the total number of cases of vaccine-derived poliovirus to 21. A fourth round of polio vaccinations is planned as part of the response to the outbreak, with completion due early next month. All details of the response are outlined in an ifrc.org update. In other polio news this week (from a local news source), four children aged from five to eight years from the district of Mastung in NW Balochistan province, Pakistan, have become the country’s latest cases for 2018, taking the total to 10. 

    Advice for travellers: Polio is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low, however vaccination is recommended for travel to affected regions and is a requirement for travel to/from some countries. If at risk, adults should have a booster to the childhood series. More on poliomyelitis and vaccine-derived polio

    Peru: Mosquito-borne virus alert; Measles in south

    With conditions considered ideal for the transmission of viral illnesses transmitted by the Aedes aegypti mosquito (i.e. dengue fever, Zika virus and chikungunya), a health emergency has been declared in the SW province of Madre de Dios. The initiative will allow the government to employ measures ‘to provide the necessary health services and protect public health’. Read more
    OVER 70 suspected measles cases have been reported in the neighbouring province of Cusco; the national health agency (MINSA) is planning a vaccination campaign in response. 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. 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.

    Spain: Local dengue cases updated

    Updated information on the locally-acquired dengue fever infections reported last month brings news that two other cases with identical sequencing have since been recorded in Murcia and the region is now considered to be the origin of all five infections. Read more

    Sri Lanka: Dengue risk rising

    Recent rains are likely to boost the number of dengue fever-carrying mosquitoes with the health ministry warning that ‘the density of mosquito larvae has significantly risen in the Western, Wayamba, Nothern and Eastern provinces’. The year-to-date total of dengue fever cases is 41,000 and 45 deaths. Read more

    United Kingdom: Hep A spike among homeless, drug users

    Bearing similarities to the hepatitis outbreak occurring in several US states since last year, the Middlesex-London Health Unit has advised that 15 non-travel related hepatitis A cases have been reported since the start of October ‘mostly among under-housed or homeless Londoners, and those who inject drugs’. On average, the unit reports ‘about three cases of hepatitis A per year, most of them travel-related’. Read more

    Advice for travellers: Vaccine-preventable Hepatitis A (HAV) is one of the most common infections affecting travellers. It is a significant risk in most developing countries where sanitation and hygiene are lacking, with an estimated 1.4 million cases occurring worldwide each year. The virus is transmitted by the oral-faecal route, such as through contaminated food and water, and with some sexual practices. A course of hepatitis A vaccine offers immunity that’s 99%-plus effective and long lasting (20-30 years). It is also important to follow safe food and water guidelines.

    Zimbabwe: Cholera situation easing

    New cholera cases have dropped by almost 70 percent in the most recent reporting week, part of the 6-week ‘downward trend’ - 59 more infections were reported in Harare for the last full week of October. In the same UNICEF report on cholera in Eastern and Southern Africa, in Tanzania an ‘increase in the epidemic trend has been noted… All new cases emerged from Ngorongoro district in Arusha region’.

    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).