Health Alerts
  • Algeria: Five districts hit by cholera

    Cholera infections have been confirmed in 59 people and killed two in five health districts - Blida, Bouira, Tipaza, Medea and Ain Defla; the deaths occurred in residents of Boufarik (30kms SW of Algiers). Up to 172 suspected cases have been hospitalised. 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). Read more about cholera.

    Brazil: Amazon measles outbreak persists

    Confirmed measles infections continue to occur in the Amazonas capital Manaus, with 90 more recorded in the past week and the number of suspected cases now over 5,700. (The US CDC has issued a travel advisory relating to the outbreak.) While children under five make up almost half of the confirmed cases, of the suspected infections, over half are teenagers and adults – 15 to 29yo. Read more. A country-wide measles vaccination campaign is drawing to a close, whereas in the neighbouring country of Venezuela, international agencies are trying to reduce the enormous burden of measles: over 3,500 infections this year and 62 deaths. Read more. Other regional countries are on the alert for infectious illnesses, including measles, carried by people fleeing Venezuela (Colombia, Ecuador and Peru).

    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.

    China: Dengue fever count now at 27

    In what had already been considered a peak in locally acquired dengue fever cases in Hong Kong, a total of 27 people have now contracted the mosquito-borne infection since Aug 14th. Almost one-third of cases appear to have been infected on the popular tourist island of Cheung Chau, and this has resulted in a drop in visitor numbers; others had been to Lion Rock Park and nearby Wong Tai Sin – the park is currently closed. A month long operation is underway to employ insecticide fogging near the homes of those people infected with dengue. More information is available on the Centre for Health Protection website

    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.

    Republic of the Congo: Two southern districts with suspected YF cases

    Two adjacent departments near the southern border with Angola have reporting suspected yellow fever infections. Seventy cases are under investigation in Kouilou and Pointe-noire but there have been no deaths to date. Read more (translate from French).  Another news source puts the case count for the year at 186. 

    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: Race to contain Ebola

    Government and aid agencies are ramping up their efforts to contain the Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces as they attempt to keep the affected areas within ‘within 20-30 km of the epicenter. Next 7 to 10 days critical to turn the outbreak around while still confined to relatively accessible security zones’, according to the WHO Deputy Director-General for Emergency Preparedness and Response, Dr Peter Salama. At the latest count, there have been 115 haemorrhagic fever cases - 85 confirmed as EVD, 29 probable and the death toll stands at 77. 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.

    India: Monsoon season reaching its peak

    The incidence of malaria has spiked in eastern divisions of Maharashtra state, with more than 2,000 cases of malaria in Gadchiroli district (and a further 188 of dengue fever in Nagpur). This rise has occurred roughly one month ahead of the expected increase. Read more. Haryana is also experiencing a surge in malaria and dengue, but authorities say case numbers are lower than last year. he current reporting of Japanese encephalitis (JE) infections in Bhopal (Madhya Pradesh) has authorities planning the vaccination of the susceptible population and monitoring of the disease vectors and hosts – mosquitoes and pigs. Since the end of last month dengue fever cases in the city of Bhilai Nagar (Chhattisgarh) have shot up, with more than 2,700 recorded and at least 27 deaths.  Up to 28 districts of Odisha have been hard hit by dengue infections which have sickened more than 1,800 people and caused the deaths of three – a significant rise on 2017 notifications. Doctors in Rajasthan have identified three separate vector-borne infections occurring simultaneously in two people from neighbouring districts in Rajasthan. The patients from Jaipur and Dausa have been diagnosed with dengue, chikungunya and scrub typhus infections. Read more. Elsewhere in Rajasthan, scrub typhus has caused the deaths of six people in Kota. Read more

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

    Japan: Rubella spikes in capital region

    Up to 110 people have contracted German measles (rubella) this year in Tokyo and Chiba prefecture on the eastern side of Tokyo Bay, echoing a rise in infections across the country. A combined measles, rubella vaccine is given as part of the immunisation schedule in Japan at the ages of one and five years. 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 in Australia 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.

    Kiribati: Dengue case numbers dwindle

    The seven month-long dengue outbreak is waning. Since February, nearly 1,800 people have been infected and two children have died of dengue-related complications. Read more 

    Malaysia: HFMD cases top 55,000

    Hand, foot and mouth disease (HFMD) cases have more than doubled this year compared to 2017 figures for the same period, climbing to 55,860 up to Aug 27th. Nearly 90 percent of cases were in children under seven and there have been two deaths (in Sarawak and Penang). 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.

    Myanmar: Malaria rates reported

    A national report on malaria incidence has highlighted a rise in the number of drug resistant cases even while overall numbers have dropped. The states with highest figures are Kachin, Rakhine and Sagaing, but more than 31 million people remain at risk of malaria infection. Read more. As stated in the UK’s Fit for Travel website  , ‘Malaria risk is present throughout the year in all areas except the major cities Mandalay and Yangon. Risk is highest in Chin, Kachin, Kayah, Rakhine, Sagaing and Tanintharyi states.’

    Advice for travellers: 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

    Papua New Guinea: Polio count hits 6

    The number of polio cases affecting children under five has climbed to six with confirmation this week of two more cases – from Madang and the Eastern Highlands. A reactive vaccination campaign continues countrywide. 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 poliomyelitis

    Taiwan: Dengue cases rise to 53

    More locally-acquired dengue fever cases being identified, with the majority in Taichung (25) and the district of Sinjhuang in New Taipei City (22). Other affected areas are Taipei, Chaiyi County, Taoyuan and Kaohsiung. Read more

    Tanzania: Cholera persists near northern border

    The reporting of cholera continues with an average of 60 new cases each week. The majority of cases during the week ending Aug 18th were from Arusha region (Ngorongoro District) – a pattern repeated over the past month (> 80 percent of cases were from this district, one of three with active transmission). Read more

    United Kingdom: MERS import; Measles targets capital

    A person infected with the MERS coronavirus has travelled from the Middle East to the UK, where the diagnosis was confirmed. Public health agencies are on the alert, particularly as this has occurred as millions of pilgrims return home from Saudi Arabia after performing the Hajj. Read more. Public Health England has issued advice for those ‘travelling from the Middle East to be aware of the symptoms of MERS’. 
    ONE important consideration for those travellers planning a trip to England and its capital – over one-third of all confirmed measles cases in England this year have occurred in London. The message from health authorities – it’s never too late for unvaccinated children and adults to have the 2-dose MMR vaccine. Read more

    United States of America: WNV season peaks

    The height of summer in August brings an increased risk of transmission of the mosquito-borne West Nile virus, as monitored by the CDC.  While around 80 percent of infections are mild or not apparent (and therefore not likely to be reported in official figures), the complications of WNV that affect the central nervous system (neuroinvasive) occur in around one in 150 cases. Read more. Latest news reports can be found on the Flutrackers website. Five European countries have recorded a total of 39 deaths from WNV this year – Serbia (15), Greece (11), Italy (6), Romania (6) and Kosovo (1); Hungary, France and Croatia have also reported confirmed cases. Read more

    Zimbabwe: Concerns over Midland’s typhoid outbreak

    The WHO regional report on typhoid in the Midlands (Gweru) gives the number of cases as of Aug 26th as: ‘a total of 1,657 suspected typhoid fever cases, including eight deaths’. Despite the introduction of control measures, the agency remains cautious about the outcome in view of ‘only two antibiotics remaining for treatment. In this regard, there is an urgent need to ensure rational use of antibiotics, including dissuading the public from self-medication, as part of efforts to prevent antibiotic resistance.’ Over 160kms to the north, authorities in Kadoma are investigating an undisclosed number of suspected typhoid cases. 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 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.

  • Brazil: Kissing bug strikes

    In the northern state of Pará, a cluster of Chagas disease cases is being blamed on the consumption of tainted acai berries – this occurs when the berries are contaminated with the faeces of infected triatomine, or ‘kissing’ bugs. Eighteen people have been sickened and one death recorded in Acará, near the capital, Belém. Read more (translate from Portuguese).

    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.

    China: More local dengue cases surface

    A park in the New Territories has been closed for several weeks after it was found that the majority of the recent dengue fever cases had visited the area. A total of 18 cases have now been identified - two were from the island of Cheung Chau - but authorities are checking each patient’s movements during the incubation period to determine where they were infected. Measurements of mosquito density focusing on a dengue vector, Aedes albopictus, have shown 15 areas over the alert level of 20 percent – highest incidence was recorded in Yau Tong, Wo Che and Tseung Kwan O North. 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.

    Democratic Republic of Congo: Ebola death toll passes 60

    Updated information from the Ministry of Health since our last post on Aug 16, there have been 76 confirmed Ebola Virus disease (EVD) cases and 27 more are considered probable. New cases have occurred in Mabalako, Beni and Oicha; of the 61 recorded deaths, 34 were among confirmed cases – all from either Mabalako or Beni. In other news on the outbreak: Efforts to treat the sick are being hampered by conflict and militia bands in the area; and five treatments that fall under Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) are to be used ‘depending on clinical criteria, complexity of administration and monitoring capacities’. 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.

    Europe: 6 month measles tally soars; WNV update

    From the World Health Organization’s (WHO) European agency report on the 2018 measles situation: There have been more than 41,000 cases (adults and children) this year, including 37 deaths, noting ‘The total number for this period far exceeds the 12-month totals reported for every other year this decade.’ In addition, ‘Seven countries in the Region have seen over 1000 infections in children and adults this year (France, Georgia, Greece, Italy, the Russian Federation, Serbia and Ukraine). Ukraine has been the hardest hit, with over 23 000 people affected; this accounts for over half of the regional total. Measles-related deaths have been reported in all of these countries, with Serbia reporting the highest number of 14.’ The WHO is promoting vaccination coverage of at least 95 percent and the introduction of ‘enhanced routine and supplemental immunization as well as heightened surveillance to quickly detect cases.  
    DETAILS from the Aug 17 European Centre for Disease Control (ECDC) update on West Nile virus (WNV) infections in the region: ‘EU Member States reported 273 human cases: Italy (123), Greece (75), Hungary (39), Romania (31), France (3) and Croatia (2). EU neighbouring countries reported 128 human cases: Serbia (126) and Kosovo* (2). To date, a total of 20 deaths due to West Nile fever have been reported by Serbia (11), Greece (4), Italy (3), Kosovo* and Romania (1 each).’ Read more on WNV in the Veneto region of Italy here

    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.

    Honduras: Sand fly infections in south

    The two departments with coastlines on the Gulf of Fonseca have been placed on alert following news of the seventh leishmaniasis case this year. There are suggestions that warmer temperatures experienced in Choluteca and Valle have aided in the proliferation in the sand fly vector. Read more (translate from Spanish). Montes Claros, a city in the northern state of Minas Gerais, Brazil has also experienced a rise in the incidence of leishmaniasis, both cutaneous and visceral forms. Up to 15 percent of dogs (a reservoir of the leishmania parasite) in the municipality have been found to be infected. Read more

    Advice for travellers: Leishmaniasis is generally a low risk for travellers. The parasitic disease is 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. 

    India: Mozzies, floods prevail

    In Mumbai, malaria cases have halved in the first half of this month compared to the same period in 2017 with 415 recorded in the city, while monsoon rains have added to the number of leptospirosis cases. Local doctors are warning that an expected drop in rainfall will lead to more mosquitoes, soon followed by a rise in related infections such as dengue fever and chikungunya. Read more. Maharashtra state is second only to Karnataka in the number of chikungunya cases recorded this year (17,311 nationwide to Aug 10) - Gujarat is named as third highest. Read more. Children’s wards in Visakhapatnam (Andhra Pradesh) are severely overcrowded as a result of a sharp rise in dengue fever cases in and around the port city; local news sources in the central state of Chhattisgarh are also commenting on an alarming spread in dengue fever infections. The effort to limit the burden of dengue on residents of Patiala in Punjab includes fines for failing to clear standing water from around their premises. 
    THE ANNUAL hike in Japanese encephalitis (JE) cases that begins in late August and then escalates over the next two months has authorities in Bihar and Assam.
    GOVERNMENT support is available for the flood-affected state of Kerala with health advisories issued by the National Centre for Disease Control (NCDC) ahead of an anticipated rise in the incidence of ‘water borne, vector borne and viral hepatitis diseases’ – there have already been early reports of suspected hepatitis A infections from the district of Kozhikode
    Elsewhere in the region (Thailand, Vietnam, Laos), annual rains have caused flooding, as outlined by ReliefWeb

    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

    Myanmar: Dengue cases, deaths climb

    Dengue fever case numbers have risen as expected during the current rainy season with reports coming from Mon state and the region of Mandalay where children have been hardest hit. Read more

    Papua New Guinea: Polio vax campaign underway

    Children under five years of age from six provinces are to receive their first polio vaccinations next week as part of the response to the four confirmed and 60+ suspected polio cases reported recently. Second doses are being distributed in the provinces of Morobe, Madang and Eastern Highlands over the current fortnight. 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

    Reunion Island: Dengue tally nears 6,500

    There were only 32 new dengue fever cases from Aug 6 – 12, but the fact that they continue to be reported during the cooler months has authorities concerned that the outbreak could ramp up again in summer. The year-to-date total of dengue infections is now 6,476. Door-to-door visits to more than 40,000 houses have been conducted by vector control teams since the beginning of the year as part of the effort to stem the outbreak. Read more (translate from French).

    Russia: Tick activity increases

    Warmer weather has brought the risk of tick bites and tick-borne illnesses to the residents of St Petersburg. Reports of tick bites are on the rise as the number of tick-borne encephalitis infections (TBE) reached 50 for the season, with a further 113 people infected with borreliosis (Lyme disease). Read more

    Advice for travellers: A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. VACCINE: While safe and effective vaccines are available in Europe, none are licensed in Australia; however, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE

    South Africa: Whooping cough alert; More rabies cases reported

    Health authorities have issued an alert relating to an increased incidence in whooping cough (pertussis). Western Cape was first to report a rise in the number of cases at the end of last year, but the increase is now also being felt by Gauteng, Mpumalanga, North West and KwaZulu-Natal, with infants under 3 months of age making up over half of the infections from May to July. Read more 
    THE death toll from rabies infections has risen to 11 this year, with two more suspected. The deaths were recorded in the provinces of KwaZulu-Natal and Eastern Cape at a time when they are also experiencing outbreaks of rabies in dogs. 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.

    Sri Lanka: Dengue dips this year

    Dengue fever infections are down by more than three times last year’s epidemic tally. To date the country has recorded over 35,000 cases, almost 7,000 from Colombo and surrounding districts. Read more

    United States of America: Hep A lingers in multiple states

    The hepatitis A outbreak continues, affecting mainly homeless people and illicit drug users across several states including Michigan, Tennessee, Utah, Kentucky and Indiana.

    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 protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Zimbabwe: Midland’s typhoid count mounting

    Treatment options are limited for the resistant strain of typhoid responsible for the Midland’s outbreak. Read more. Eight deaths and 1,500 suspected cases have been recorded to date from all areas of Gweru. Read more. As Gweru lies between the two largest cities – Harare and Bulawayo - there are concerns the outbreak could expand to these highly populous centres. 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 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. Read more about typhoid fever.

  • Brazil: States battle mosquito-borne illnesses

    Mosquito-borne infections have maintained a strong presence in the state of Minas Gerais. Chikungunya case numbers have now topped 10,000 and suspected dengue fever infections have risen even further, to 23,265 with at least seven deaths attributed to the illness; another nine under investigation. Read more. And in the central-western state of Mato Grosso, chikungunya infections have surged by more than 200 percent over last year’s figures - Várzea Grande, a city adjacent to the capital Cuiabá recorded almost 10,000 cases this year. Read more 

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

    Canada: Measles alert for cruise passengers

    Passengers on board a ship that cruised from Vancouver to Seward in Alaska, departing on August 6th, have been advised to be alert for measles symptoms. A teenager who was infected with measles was promptly isolated after boarding in Vancouver, so the risk of infection to others was said to be low. 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.

    China: Local dengue investigated

    Hong Kong health authorities reported the first four locally acquired dengue fever cases this week. As investigations continue into the locations where each person was infected, the Centre for Health Protection has issued a map of the sites of distribution and information on each case. 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.

    Democratic Republic of Congo: NE region Ebola update

    The World Health Organization (WHO) has declared the public health risk to other countries in the region presented by the Ebola Virus disease (EVD) outbreak in the highly populous North Kivu area to be high. Enhanced screening is planned for entry points on a local level, but also in the neighbouring countries of Burundi, Central African Republic, Rwanda, South Sudan, Zambia and Uganda. To August 14, there have been 73 cases of haemorrhagic fever of which 46 are confirmed as EVD. A further 27 are considered probable and 40 others are undergoing testing. Several new cases were diagnosed at Mabalako; all are contacts of previously identified cases. Of the 43 deaths recorded, 16 were confirmed EVD. Read more. An experimental treatment for EVD using monoclonal antibodies, still in early clinical trials, is to be employed in the area. Read the FAQs.

    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.

    El Salvador: Towns in 4 departments on dengue alert

    Six towns have been placed under a yellow (moderate) alert for dengue fever while authorities have also announced an increase in severe dengue fever cases. The towns on alert are in four regions (departments): Santa Ana, Chalatenango, La Libertad and San Salvador. Read more (translate from Spanish).

    India: Monsoon season outbreaks

    Monsoon-associated illnesses including dengue fever, leptospirosis and gastro intestinal infections are surging in Mumbai. Dengue fever is also a mounting concern elsewhere in Maharashtra state (Kolhapur, Nashik and Pune), while in Odisha, there’s been a jump in cases in a commercial district of the capital Bhubaneswar, and villages in the district of Kalahandi. Other locations reporting dengue outbreaks this week: Durg (Chhattisgarh),  Hyderabad (Telangana), Parmanoo (Himachal Pradesh) and Andhra Pradesh. In the SW state of Karnataka, malaria case numbers are climbing in the district of Dakshina Kannada that includes the commercial port city of Mangaluru. In Assam, the death toll caused by the Japanese encephalitis virus (JEV) this year has reached 66 among more than 320 confirmed infections. The latest death occurred in Dibrugarh, a city surrounded by tea estates. JE is endemic in Assam and is considered a major public health issue. Four JE cases have been reported in Bhopal (Madhya Pradesh); the infection was identified in the city for the first time last year. Contaminated drinking water has sickened more than 900 people in two villages of Kupwara district in the state of Jammu and Kashmir. A local news source cites a government report which claims that ‘74 percent of drinking water samples tested from Kashmir have been found contaminated’. Read more

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

    Libya: Measles on the march

    ProMED reports on the increase in measles cases occurring in many Libyan cities, noting that the outbreak is spreading fast. Read more

    Malaysia: KL's dengue uptick

    There has been a recent surge in dengue fever cases in Kuala Lumpur, with the greatest impact felt in three northern districts – Batu, Kepong and Segambut. Read more

    New Caledonia: Hep A cases linked to Vanuatu

    Health authorities reported on seven hepatitis A cases that occurred in travellers returning from Vanuatu. The infections were acquired during an 18-day visit dating from June 10th. 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.

    New Zealand: Mumps outbreak slows, but not over

    Auckland’s mumps outbreak is finally slowing, down from the peak of the epidemic in October 2017. In the 18 months to the end of June, almost 1,300 mumps cases were recorded in the city’s health region – the highest incidence has been among children and adults aged 10 to 29 years. Read more

    Advice for travellers: These outbreaks of mumps highlight the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to any destination – be it a developed or developing country. Read more about mumps.

    Pakistan: Resistant typhoid cases mounting

    During a local news interview, an Assoc. Professor of Pathology and Consultant Microbiologist in Islamabad has put the number of extensively drug-resistant typhoid fever cases recorded during the first half of this year at ‘around 2,000’. The US Centers for Disease Control and Prevention (CDC) issued a travel advisory for Pakistan in early July. 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 is itinerary specific, but is generally 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. Read more about typhoid fever.

    Papua New Guinea: Another polio case confirmed

    The Eastern Highlands province is the latest to report a case of polio, the fourth in the country since late July. The WHO considers the risk of further spread is high. Immunisation campaigns are underway and are being offered to all children under five years of age. Surveillance of reported acute flaccid paralysis continues – 65 cases are under investigation. 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

    Philippines: Monsoon-related illnesses spike in highlands

    A spike in cases of dengue fever and leptospirosis cases has been reported in the Cordillera region of northern Luzon - the provinces of Benguet, Kalinga and Apayao have reported most of the dengue cases. The cooler weather of the highlands means the area is a popular destination during summer. Read more

    Advice for travellers: The Philippines averages almost 7000 leptospirosis cases and 40 fatalities a year, with the seasonal peak occurring during the rainy months from July to October. 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.

    Serbia: Measles cases soar to over 5,700

    While Slovakia’s spate of measles is waning, the epidemic in Serbia continues with the case count for confirmed and suspected infections now over 5,700 (and 15 associated deaths) for the past 10 months. Read more. The latest report on the extensive outbreaks across many EU countries can be found here

    Singapore: HFMD incidence on the rise

    There has been a surge in cases of hand, foot and mouth disease (HFMD), with nearly 1,250 for the week to Aug 4th. While there have been more reports than usual of the EV71 strain, it is not the predominant cause. Two Malaysian children have died this year from complications of infection with EV71. 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.

    Sweden: E Coli flare up

    Investigations are being carried out to determine the origin of an outbreak of E Coli infections that has spread countrywide. According to a Xinhuanet news article, two cities have been hardest hit – Uppsala and Gotaland. Read more 

    Switzerland: Tick season in full swing

    In an update on the current tick-borne encephalitis (TBE) season, there are new record highs – a slight increase in cases, more serious infections – almost four times the 2015 rate - and more doctor’s visits for tick bites and bacterial infections. Vaccination is recommended for at-risk areas in Switzerland and may be extended to cover most of the country next year. Read more. In the Czech Republic, the SE region of South Moravia is reporting a three-fold increase in new TBE cases when compared to the last two years. While the TBE vaccine is recommended for Czech nationals, it is not funded by the government and so uptake is low, around 25 percent. Read more

    Advice for travellers: A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia; however, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE

    Taiwan: More dengue for New Taipei City

    Several more dengue fever cases have been added to the cluster in an inner district of New Taipei City, with authorities urging the use mosquito bite avoidance measures and the removal of insect breeding sites in the immediate area. Of the 14 locally acquired cases this year, 10 have been from Xinzhuang district. Read more

    Zimbabwe: Typhoid in Midlands

    A national youth sporting competition which was to take place this week in the midlands capital of Gweru has been deferred due to an outbreak of typhoid fever. According to reports, there have been up to 350 confirmed cases and five resulting deaths; most areas of the city are affected. As contaminated drinking water is believed to be the cause of the outbreak, the government is to provide water tankers and water purification tablets. Read more