Health Alerts
  • Brazil: Hopes winter will ease YF

    From the most recent yellow fever update provided by the European Centre for Disease Control (ECDC), the states of Rio de Janeiro and Minas Gerais had recorded five more human cases and six deaths. Cooler weather from the southern winter is expected to bring some respite as mosquito activity drops. 

    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

    Brunei Darussalam: Dengue upswing in ‘water village’

    The three to four year cycle of dengue fever infections is expected to peak this coming season - the last (and largest) peak occurred in 2014. Half of all cases to date this year have been in Kampong Ayer – a chain of villages built on stilts over the banks of the Brunei River. 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.

    Cambodia: Dengue report card

    As reported in the May 24 WHO Western Pacific Region update, the incidence of dengue fever climbed in the first two weeks of May, rising above the epidemic threshold. There had been 694 cases to mid-May. Read all regional countries’ reports here

    Chile: Mumps in lake district; Dengue vector menace on Easter Island

    A large mumps outbreak is ongoing in the Los Lagos region, including the regional capital Puerto Montt. Nearly 1,400 cases have been recorded to date with 100 more every week. The area known for its lakes, volcanoes and picturesque countryside. Read more 
    IN VIEW of the recent dengue fever outbreak on Easter Island, the Chilean Health Ministry will administer yellow fever vaccinations to all residents of the island, starting with infants 18 months of age and then extending to the adult population. No cases of yellow fever have ever been reported on the island, however health authorities are concerned about the number of visitors and permanent arrivals from endemic regions. On the date of the press release (8 May) the number of dengue fever cases in the outbreak reported in April had increased to 16. 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.

    China: Hong Kong’s HFMD spike

    In the week to May 24, the number of kindegartens, child care centres and primary schools reporting hand, foot and mouth disease outbreaks had risen to 15. Each year, May to July are the peak months for the spread of the infection. 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.

    Democratic Republic of Congo: Local, international response to Ebola outbreak

    Efforts to tackle the Ebola virus disease (EVD) outbreak in Equateur Province are ongoing: vaccination of ring contacts in the major centre of Mbandaka and, this week, also in the outlying areas of Bikoro and Iboko; surveillance, contact tracing and public information campaigns. Latest disease data from a Médecins Sans Frontières report: ‘54 people who presented symptoms of haemorrhagic fever, including 35 confirmed Ebola cases, and 25 deaths (of whom 12 were confirmed as Ebola’. It is noted that previous EVD outbreaks in the DRC have been mostly in remote areas and there have now been four confirmed cases in Mbandaka, a city of over one million people, but ‘the epidemic has not spread widely within the city’. 

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

    French Polynesia: Dengue, influenza counts

    Health department figures show a rise in inflluenza A (H1N1)pdm 09 cases in Tahiti, reaching epidemic threshold by mid-May. In the two weeks from May 6, there were 13 confirmed dengue fever cases from Tahiti, Bora Bora and Raiatea, Moorea – of the 13, six were tourists. Read more (translation required).

    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 recommendsinfluenza vaccination, if available, for all travellers over 6 months of age. 

    India: Nipah virus update; Dengue, chikungunya, JE reports

    The death toll in the Nipah virus (NiV) disease outbreak in Kerala has risen to 13 from a total of 25 suspected infections. Testing for the virus is being carried out on a soldier who died after travelling from Kerala to Kolkata in West Bengal and another case, hospitalised in Goa, has proved negative.
    DENGUE fever reports are coming from the states of Kerala and Karnataka, which is also seeing a spike in chikungunya cases - 4,879, followed by Gujarat (1357) and Maharashtra (966). 
    Five districts in the NE state of Assam are the focus of a campaign to reduce the burden of Japanese encephalitis (JE) infections. JE constituted over 16 percent of the state’s death toll last year. Read more. There have also been reported JE cases in Kerala this week. 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 very low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Kazakhstan: Men. meningitis cases rise above 60

    A local news source claims 30 people in the largest city of Almaty have been diagnosed with meningococcal meningitis infections – no mention of the serogroups is provided however. Medical advice includes ‘restrict visiting any mass cultural events being held in closed area, sports events and pools’. The national case count for the year to date is 62 from Almaty region, Astana as well as Eastern and southern regions of the country. 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 travel doctor. Read more about Men. meningitis.

    Maldives: Flu, dengue prevalent

    Following last week’s report on the rise in flu cases, the last seven days have seen up to 7,000 people report influenza and ‘viral’ fever symptoms and over two-thirds of those tested for flu were confirmed to have type A. The Health Protection agency stated that daily family gatherings for Ramadan ‘could contribute to the spread of diseases’. Dengue fever cases are also likely to rise from the 96 reported last week due to recent rains. Read more

    Mauritius: More school measles

    Measles cases in local schools have shot up from 48 last week to 120 as of Monday. The country’s Senior Community Physician has voiced his concerns about the increase and advised that all students’ vaccination cards are being checked for the two vaccine doses. Read more (translation required).

    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.

    Namibia: Viral hepatitis spreads to north

    People attending a cultural festival in the northern region of Omusati last weekend were advised to maintain strict personal hygiene after 11 hepatitis E infections were confirmed in the districts of Tsandi, Okahao, Outapi and Oshikuku; one death was recorded earlier this month and a further 47 people are being monitored for symptoms. A large outbreak of the viral illness has been underway in informal townships of the capital Windhoek, with 14 deaths from nearly 500 cases recorded. Read more 

    Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. The virus is found worldwide, mainly in communities with low levels of sanitation and hygiene. There is no vaccine licensed outside China. More than 60% of all hepatitis E infections and 65% of deaths occur in East and South Asia, with up 1-in-4 people in some age groups having been exposed to the virus. Read more about the virus and how to prevent it.

    Netherlands: Upward trend in W meningococcal strain

    The number of meningococcal meningitis infections (type W) recorded has been rising – an average of four cases (& no deaths) per year up to 2015 and, for the first four months of 2017, it was 27 and this year, 57 with 11 deaths (the total number of deaths for 2017). A vaccine which protects against the W strain is being introduced into the immunisation program for children at ages 14 months and 14 years. Read more 

    Nigeria: Cholera in NE kills 13

    The death toll in the cholera outbreak occurring in the NE state of Adamawa is now 13 from 434 cases. Mubi is the epicentre of the outbreak and contaminated water sold by water vendors is believed to be the cause. 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

    Pakistan: Punjab’s steep measles toll

    More than 5,000 children in the state of Punjab are believed to have been infected with measles this year – 735 in the past week - and the death toll has risen to 31. According to a local news report, the cities with most cases are Lahore, Rawalpindi and Gujranwala, although most areas are reporting infections. Read more 

    Paraguay: Mozzie-borne infections rise

    There has been a surge in chikungunya cases in Pedro Juan Caballero, a city on the Brazilian border, and a further 745 suspected cases nation-wide are yet to be confirmed. Dengue fever has hit the Central department hardest, in several districts of the capital, Asunción, and the neighbouring towns of San Lorenzo, Capiatá and Ñemby. Read more.  Elsewhere in South America, Colombia has recorded nearly 1,000 dengue fever cases and 49 dengue-related deaths from 10 departments. Read more (translation required).

    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.

    Reunion Island: Dengue, leptospirosis hit west, south

    A May 29 update on the dengue fever situation gives the running total of cases this year as 3,756 with 79 requiring hospitalisation. Western and southern districts are those most affected by dengue, but also by leptospirosis. Outbreaks of this bacterial infection occur annually following rains and flooding as activities such as swimming and gardening bring people into contact with waters contaminated with the urine of infected rodents. 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.

    Russia: Vax reminder for sports fans

    The WHO has issued a reminder to those soccer (football) fans heading to Russia for the World Cup in June – make sure routine vaccinations up to date, with an emphasis placed on the MMR (measles-mumps-rubella) vaccine in view of the ongoing large outbreaks across Europe. ‘Of the 32 countries that will participate in the World Cup, 28 have reported cases of measles this year.’ Further, ‘The increase in international travel and the mass movement of people during events such as the World Cup increases the risk of transmission of diseases. It also increases the likelihood of travelers returning to their countries with diseases such as measles, which is highly contagious and can have grave consequences on the health of unvaccinated populations.’ More information on smartraveller.

    Taiwan: SW city’s JE cluster

    Seven pig farms situated near a reported cluster of Japanese encephalitis infections in residents of the SW city of Kaohsiung are being investigated by public health authorities. Pigs are important amplifiers of the virus which is then transmitted to humans through bites from infected mosquitoes. Two JE cases have been confirmed and a third is under investigation. The local population has been advised to avoid mosquito bites and to get the JE vaccine. Read more 

    Tanzania: Cholera worsening on mainland

    Five districts (Sumbawanga, Ngorongoro, and to a lesser extent, Longido, Monduli and Songwe) are experiencing cholera outbreaks which have ramped up over the most recent reporting week – reporting five times the number of cases over the previous week. ReliefWeb notes that ‘to 20 May 2018, a cumulative of 2,105 suspected cholera cases, including 44 deaths have been reported in Tanzania Mainland. Three out of 26 regions currently have active transmission, namely Arusha, Rukwa and Songwe and the situation is deteriorating’. 

    United Arab Emirates: MERS in west

    A farmer from the western town of Ghayathi is the Emirates’ first MERS case this year. The 78-year-old man, who has other medical conditions, visited his camel farm regularly and had also been in Saudi Arabia recently - all are considered risk factors in acquiring MERS. He remains in hospital. Read more 

  • Brazil: Pará state, rabies and kala-azar; Measles in Amazon hub

    There are reports of up to 14 suspected rabies cases and eight deaths on the river island of Marajó, near the mouth of the Amazon River in Pará state. The last recorded cases in the state occurred 13 years ago and were due to bites from infected blood-feeding (haematophagous) bats. Read more. Also in Pará, leishmaniasis infections – cutaneous and visceral - have been detected in residents of the eastern districts of Canaã dos Carajás (22)  and Parauapebas (36), situated near to the world’s largest iron ore project. AUTHORITIES in Manaus (Amazonas state) have advised there were an additional 62 suspected measles cases in the week to May 15, taking the total for the year to 457. 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.

    China: HFMD cases soar in SE

    Peak season for hand, foot and mouth disease (HFMD) has arrived in Guangdong after the province experienced a 73 percent rise in cases in the most recent week, up to over 12,400 in the 7-day period. This is however a decrease on last year’s figures for the same period. Read more. And in neighbouring Jiangxi province, health officials are anticipating a peak in the cycle of HFMD in the capital Nanchang this year. Read more (translation required).

    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.

    Democratic Republic of Congo: More Ebola cases, response progressing

    Targeted vaccinations in Ebola-affected health zones, ‘strengthening of surveillance and contract tracing, laboratory capacity, infection prevention and control’ are just some of the priorities outlined by the World Health Organization (WHO) in its response to the outbreak in Equateur province. A May 22 health ministry press release tabled the current situation: 58 cases of which 30 are confirmed, 14 probable and 14 suspected. There have been 27 deaths. While the WHO has not recommended travel or trade restrictions, it does advise surveillance and preparedness in neighbouring countries and stresses the importance of ‘exit screening, including at airports and ports on the Congo river’. Read more

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

    Europe: Hep A outbreak developments

    Investigations are ongoing in a hepatitis A (HAV) outbreak affecting six EU countries, with infections related to virus strains from Morocco (intermediate HAV endemicity). Only three of the cases had travelled and it is believed the remaining 39 acquired the infection locally, ‘either through food handling or through direct person-to-person transmission’. Read the ECDC report

    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 some types of 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.

    India: Deadly bat virus in south

    Nipah virus (NiV) has killed 10 people (4 more are probable) of 13 confirmed cases (and 16 suspected), according to the latest update from the Kerala Directorate of Health Services; two further cases are under investigation in Karnataka. The patients, most of whom are from Kozhikode and Mallapuram districts (Kerala), are community contacts. It’s the first time the virus has been found in the country’s south. One news source asserts that the outbreak originated from a drinking well that was infested with bats. Transmitted by infectious fruit bats, including through consumption of raw date palm sap tainted by excretions from infected bats, Nipah virus can infect people and animals (mainly pigs). There is no preventive vaccine for this viral infection which has fatality rates of 40-70 percent. NiV is a Henipavirus, of the same genus as Hendra virus. Read more. Read more about Nipah virus from the US CDC and WHO.

    Japan: No relief from measles

    The city of Fukuoka (Kyushu) is now reporting measles cases as a rise in domestic travel seen during Spring adds to the transmission rates. Earlier this week, health authorities announced that the case count had risen to more than 170 from the four currently affected areas. 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.

    Kenya: Cholera cases climb

    Together with Somalia (Banadir, Lower Jubba), the number of cholera infections is rising in Kenya, with the counties of Garissa, Nairobi and Isiolo most affected in recent weeks. Read more in a UNICEF regional update.

    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

    Maldives: Flu ramping up

    Both government and privately run hospitals are experiencing a surge in influenza cases – one facility is treating one hundred patients a day. A health official has advised people ‘to avoid public areas as much as possible to curb the flu spread.’ Read more

    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 for all travellers over 6 months of age.

    Mauritius: Capital focus for measles vax

    Measles cases have started to rise in the island – from 17 just under two weeks ago, to 48 as of Monday. A vaccination campaign is underway in the capital district of Port Louis to ensure children and adults have received the two doses of MMR vaccine. Read more

    Mexico: Southern state’s dengue spike

    Dengue fever cases have risen sharply in the southern state of Chiapas, bordering Guatemala. While dengue infections have dropped on a national level, Chiapas’ case count is twice last year’s for the same period and two deaths have been recorded. Read more. While in Honduras, dengue fever and Zika virus infections climbed in the most recent reporting week. Read more (translation required). 

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

    New Caledonia: Second dengue death reported

    The dengue outbreak has claimed its second victim this year, a six-month-old baby died of associated causes on Saturday. Read more. Of the 1,156 year-to-date cases, 768 have been dengue type 2 and just under one-third of all cases have been in the capital, Noumea. Over the past three weeks, infections have decreased in number and plateaued. Read more (translation required).

    New Zealand: Mumps, north and south

    Auckland’s mumps case numbers climbed to 1,269 this week and the South Island has also been facing an increase in notifications over the past 16 months. Most are associated with travel and are centred around Dunedin, Oamaru and Queenstown. 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.

    Peru: Viral infection likely from jungle stay

    Canadian health authorities have reported on a case of Mayaro virus, an emerging mosquito-borne virus that is present in northern South America, from a traveller who, among other activities, followed a typical tourist route through Puerto Maldonado in the Amazon jungle before returning to Canada in March. Read more. Mayaro virus is of the alphavirus family of viruses which includes chikungunya and Ross River virus. It presents very similar symptoms to dengue fever and chikungunya: fever, fatigue and joint pains. Read more about Mayaro virus

    Saudi Arabia: Pilgrims, workers preventive health needs

    The Ministry of Health has released the Hajj and Umrah health requirements (and recommendations) for this year’s pilgrimages and for those people working in the areas or residing in the holy cities. They include proof of vaccination against meningococcal meningitis, plus, for those travellers arriving from designated risk areas, yellow fever and poliomyelitis. Additionally, routine immunisations should be up to date, adhere to personal and food hygiene measures, pay attention to heat exposure, and, in reference to MERS Co-V, avoid contact with camels. Read more 

    Sri Lanka: Impending dengue season

    The monsoon season is looming, but rains have already caused flooding and landslides across many areas. Pooling of water makes ideal mosquito breeding grounds and so dengue fever cases are likely to spiral, adding to the over 19,000 suspected cases recorded this year. Read more

    Taiwan: South’s first JE case

    Confirmation this week of the first Japanese encephalitis (JE) infection in 2018, a farmer from Pingtung County in the country’s far south. The peak JE season extends from May to October; in 2017, there were 25 recorded JE cases. According to the Centers for Disease Control (CDC), ‘All cities and counties have reported sporadic cases and people of all age are at risk of contracting the disease. The majority of the confirmed cases are adults aged 40 and above.’ Read more

    Advice for travellers: On average, 24 cases are recorded each year in Taiwan, mainly in the south from May to October, but peaking in June and July. Cases typically occur in rural, rice-growing areas where people live near the host animals, pigs and wading birds. While it is a low risk for most travellers staying in urban areas, expats and travellers spending extended periods in agricultural areas of Asia should consult their travel doctor about recommendations for vaccination. Read more about JE.

    Thailand: Dengue count rising

    As with other regional countries, the upcoming rainy season will bring a rise in the incidence of dengue fever – there have already been more than 10,000 cases and 15 associated deaths, but health officials expect the annual figure to be in excess of 74,000. Read more. Children and young adults have borne the bulk of the burden to date, with highest rates in those ‘aged between 15 and 24, followed by those aged 10-14’. Top morbidity rates were in Phuket and Krabi. Read more 

    Vietnam: Varicella strikes scores of adults

    One large hospital in Hanoi is reporting ‘hundreds’ of adults suffering from chickenpox (or varicella), many with complications of the viral infection. 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.

    Pacific: Situation update for regional dengue

    Wallis and Futuna: There have been no further dengue fever cases reported since Monday this week and the case count currently sits at 127 suspected or confirmed cases; the 114 locally transmitted cases on Wallis have been from the districts Mua (71), Hahake (33) and Hihifo (10). Futuna has had two cases to date – only one was locally acquired. Read more (translation required). From a regional weekly bulletin issued through ReliefWeb up to May 13, dengue fever outbreaks are also underway in Kiribati, Vanuatu and Fiji (also see New Caledonia post).

  • Brazil: More states added to YF risk area

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

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

    Democratic Republic of Congo: Ebola outbreak situation, response

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

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

    Fiji: Men. meningitis vax campaign kicks off

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

    Advice for travellers: Advice on the prevention of meningococcal infection, as stated on the Fiji Ministry of Health and Medical Services website, includes: Practicing good hygiene such as covering mouth and nose when coughing or sneezing and washing hands; don’t share utensils, cups/glasses, drinks at social gatherings, cigarettes, or kava bowls. If planning travel to Fiji, discuss whether vaccination against meningococcal meningitis would be appropriate for your itinerary with your doctor or travel clinic. Read more about Men. meningitis.

    India: Dengue, JE, malaria and more

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

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

    Japan: Measles checks initiated

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

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

    Kenya: Cholera hits south

    Drinking water contaminated with sewage during flood conditions or damage to infrastructure has caused an outbreak of cholera, with many patients from Nairobi county seeking treatment in adjacent Kiambu county. Read more

    Advice for travellers: Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. For general advice on vaccination options for your trip, call Travelvax Australia’s travel health advisory service (1300 360 164).

    Malaysia: Rabies deaths climb to 4

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

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

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

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

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

    Nigeria: Lassa fever eases

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

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

    Pakistan: Polio risk persists

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

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

    Paraguay: Dengue fever toll now 13

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

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

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

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

    Reunion Island: Dengue escalates

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

    Sri Lanka: Dengue warning for travellers

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

    Ukraine: Vax campaign brings hope for outbreak end

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

    Uganda: Measles cases climb

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

    United Kingdom: Measles imports

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

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

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

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

    Pacific: Likely dengue export to second island

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