Health Alerts
  • Australia: Tainted fish suspected; Alerts for Cairns, South Burnett

    Yellowfin tuna recently sold at a fish market in the coastal town of Mooloolaba, QLD, is thought to have contained histamine (caused by bacterial contamination of the flesh) after the local public health unit was contacted by several people who were suffering symptoms typical of scombroid poisoning – these are similar to an allergic reaction and include flushing of the skin, itchiness, fast heart rate and headache. Read more. More on scombroid poisoning.
    ALSO in Queensland, news sources are reporting on two outbreaks of vaccine-preventable disease – in the Cairns region  37 whooping cough have been reported, and in South Burnett, at least 16 mumps infections were identified in Murgon, Wondai and Cherbourg.

    Advice for travellers: Travelvax recommends Australians travelling overseas check their immunisation status for childhood diseases such as whooping cough, diphtheria, measles and mumps at least 6 weeks before departure. Read more about whooping cough.

    China: New bird flu strain detected in humans

    Yet another avian (bird) flu strain has been detected in humans – a single case of influenza A (H7N4) in the city of Liyang, Jiangsu Province. The patient, a woman who has since recovered, had contact with poultry prior to developing the infection in late December. Her close contacts were monitored but remained well. In a news release, Hong Kong’s Centre for Health Protection (CHP) has ‘reminded the public to maintain strict personal, food and environmental hygiene both locally and during travel’. More on avian influenza and prevention measures from the CHP.

    Denmark: Dates recalled

    Up to 17 people have been infected with hepatitis A since December last year (16 required hospitalisation), and the most likely culprit is contaminated dates bought at a national supermarket chain. Following the identification of the source, all dates have been withdrawn from sale by the vendor. 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.

    France: Measles death in SW, 2017 summary

    The measles epidemic in Nouvelle-Aquitaine has caused its first fatality, an unvaccinated 32yo woman who succumbed to the infection this week in Poitiers. Latest outbreak figures from the French health ministry reveal 387 cases, with 83 requiring hospitalisation and 6 of those treated in intensive care. Read more (translate from French). Europe reported a more than 3-fold increase in measles cases in 2017 compared to 2016, and the outbreak continues in many countries (France, UK and Sweden), according to a European Centre for Disease Prevention (ECDC) report. Among the details: ‘45% of measles cases with known age were aged 15 years or older’ and ‘of all measles cases reported during 2017 with known vaccination status, 87% were in unvaccinated individuals’. Further, this week health authorities in Ireland have confirmed that a measles outbreak previously confined to Limerick has now spread to Dublin – 11 cases in total have been reported but others in Munster and Dublin are under investigation. 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.

    India: Cholera warning issued

    Cholera has been reported in 4 districts of Kerala state. Actual numbers are not specified by the health authorities who have advised strict personal hygiene measures for residents to avoid infection. 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.

    Japan: High flu rates countrywide

    The health ministry reports that the age group hardest hit in this flu season is children from 5 to 9 years while overall cases have reached new peaks for 3 consecutive weeks. While all prefectures have reported ‘alert levels of influenza’, those with the highest burden are Oita, Fukuoka, Saitama and Kochi. 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 vaccination, if available, for all travellers over 6 months.

    Malawi: No respite from cholera

    The cholera outbreak that began in November continues despite aid agencies’ and government efforts – the latest tally is 434 cases and 6 deaths. The most recent cases are from the districts of Lilongwe, the capital and Karonga, on the shores of Lake Nyasa. Read more

    Malaysia: New Year dengue advice

    As family members travel for the Chinese New Year holiday break, a message from the government, which is trying to limit the spread of dengue fever during this time, is to avoid mosquito bites and stay away from dengue hotspots. 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.

    Micronesia: Gastro cases climbing

    The health department has issued a warning that cases of diarrhoea have ‘exceeded the threshold’ on the island of Yap. The advice is to maintain personal hygiene, including thorough and frequent hand washing. Read more 

    New Zealand: Dengue imports alarm authorities

    A local news source has reported on the recent rise in dengue fever cases confirmed in travellers returning from Pacific Island countries –103 infections in the past month alone. Information is only available for some of those cases; travel had been to Samoa (12 cases), Tonga (5) and Fiji (2). Read more

    Nigeria: Aid intervention planned

    The higher than expected burden of Lassa fever cases is concerning the WHO which is currently responding to the outbreak by ramping up its containment efforts. Efforts have been concentrated on the hardest hit southern states of Edo, Ondo and Ebonyi. For the year up to Feb 4th, there have been 450 suspected cases and 43 deaths. Read more. While in Guinea, a woman who died last month was confirmed to have had Lassa fever – hers was the first case in over 20 years and she succumbed to the infection while in Liberia. Read more

    Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

    Philippines: Measles in southern island; Dengue on Luzon

    In Zamboanga City, on Mindanao’s western tip, a measles outbreak has been declared after more than 100 suspected cases were notified in the first 4 weeks of the year. As most of those infected were unvaccinated, primary and catch up immunisation programs have been put in place. Read more

    DENGUE fever cases in the province of Pangasinan, south of Baguio on the island of Luzon, have risen sharply this year with 200 in the last week alone. Nine municipalities are considered hot spots. Read more

    South Africa: Hope for end of outbreak

    Following advice from WHO specialists, there is a ‘strong lead’ as to the cause of the listeriosis outbreak that has now caused 852 cases and 107 deaths. Read more

    Thailand: Island fire upshot

    One news report on a large fire that consumed several buildings on the island of Koh Phi Phi, injuring residents and foreign tourists, quotes a provincial administrator saying the island ‘lacks tap water and fire extinguishing systems’, however contingency plans for any future events will be made. Read more

    United States of America: Nine year flu peak

    The Centers for Disease Control & Prevention’s weekly seasonal flu update warns that the rate of influenza-like illness (ILI) notifications is high – reaching levels last faced during the 2009 pandemic. Widespread ILI activity is now underway across 43 states and also New York City, the District of Columbia and Puerto Rico. Read more

  • Brazil: Carnival warnings

    Visitors to the annual Carnival in Rio de Janeiro face a ‘nearly zero’ chance of contracting yellow fever (YF) if they stay in ‘touristic’ parts of the city and the beaches, according to the state’s Health Secretary, but they are strongly advised to keep away from areas where the risk of infection is higher – forests and waterfalls. Read more. An update from authorities in the state of Minas Gerais revealed a further 25 YF-related deaths from Jan 30 to Feb 6, with 3 from the capital Belo Horizonte and 15 from neighbouring districts. There have been 164 cases confirmed, but another 300 are under investigation. Read more.CIDRAP reports on the national YF statistics and the ongoing vaccination campaigns across 5 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

    Cambodia: Dengue peak predicted

    This year is expected to bring a peak in the 5 to 6-year dengue fever cycles – the first 3 weeks have already produced a sharp rise in cases (316 and one death compared with last year, 138 cases and 0 deaths). Fears of an epidemic have increased as this escalation is happening well ahead of the rainy season, when dengue rates typically climb. A spokesman for the Ministry of Health said that all 4 strains of dengue virus had been detected during one recent survey of mosquito vectors (no Zika virus however). 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.

    Europe: Flu update

    The latest World Health Organization (WHO) global flu update of Feb 5 reveals high rates of influenza ‘in Northern and Southwestern Europe, and peaked in few countries but started to increase in Eastern Europe’ – the B virus strain predominating. While in North America, ‘overall influenza activity remained high, with detections of predominantly influenza A(H3N2) viruses’. Read the full update here. In Hong Kong, a meeting of public health officials and medical experts was held on Feb 7 to address an increase in flu cases and vaccine shortages. As a result, the Lunar Year school break (for kindergartens & primary and special needs schools) will start early, from Feb 8th. This year’s Lunar New Year celebrations take place from Feb 16-19. Read more from the Centre for Health Protection. 

    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 vaccination, if available, for all travellers over 6 months.

    India: Monkey fever in 2 western states

    Visitors to the southern Sindburgh distict of Maharashtra state have been warned of the dangers of tick bites after a resurgence in cases of Kyasanur Forest Disease (KFD). Over 200 cases have been confirmed in the past 2 years. The infection can be contracted through tick bites or contact with diseased animals such as monkeys. Read more . Across the state border in Goa, 12 KFD cases have been reported at Satari. Read more. More on KFD from the US Centers for Disease Control & Prevention (CDC).

    Kazakhstan: Hep A in east

    Measures such as washing vegetables before eating them and observing good personal hygiene have been advised for residents of Karagandy (Qaraghandy), SW of the capital Astana, after more than 50 hepatitis A infections were reported in the city – over two-thirds of cases are children. A senior health official said that contaminated vegetables (beets and radishes) were suspected as being the source. Read more (translate from Russian).

    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.

    Malaysia: JE in Sarawak; Dengue tops 5,700

    In Sarawak, 2 cases of Japanese encephalitis have been identified since the beginning of the year. One, a man from a district some 30kms south of Kuching has succumbed to the infection – another JE case was notified from an area west of Kuching in December. Mosquito control measures have been put in place and vaccination campaigns are planned for the affected areas. Read more.

    OF THE 5,702 dengue fever cases reported Dec 31- Feb 6, over half were in the state of Selangor, followed by Johor (671) and the Federal Territory of Kuala Lumpur (408). 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 can occur in or near cities. The risk to short-stay travellers and those who confine their travel to urban centres is very low. The recommendations for vaccination are itinerary-specific. Read more on JE

    Nigeria: Fever outbreak draws WHO advice

    The WHO has called for cooperation between Nigeria and Benin as the neighbouring countries respond to Lassa fever outbreaks. A weekly bulletin issued on Feb 2 notes that for the first 4 weeks of the year Nigeria had ‘a total of 297 suspected cases and 22 deaths … from 13 active states’. A more recent French language news update puts the death rate at 31 from 15 states. Benin’s 21 confirmed and suspected cases (& 8 deaths) reported since the first case was identified on Jan 8 came from 4 departments (Alibori, Atacora, Borgou & Collines). Read more.

    Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

    South Africa: Water crisis disease risk

    Disease outbreaks are just one of the contingencies that authorities are having to anticipate as the forecast May 11th Day Zero cut-off nears for the water supply to 75 percent of homes in Cape Town. It is hoped that measures currently being used and others in the planning will defer the shut-off until the end of June, after the start of the wet season. Read more.

    South Korea: Public health issues for Olympics

    In view of several large ongoing outbreaks of vaccine-preventable diseases across the globe, and the heightened risk of respiratory and gastrointestinal infections during large public gatherings, the WHO and South Korean health officials have jointly issued health recommendations for athletes, support teams and visitors to the XXIII Olympic and Paralympic Winter Games. The advice includes ensuring routine vaccines are current (such as measles, diphtheria, mumps & influenza), precautions relating to exposure to cold temperatures, sexually transmitted diseases and food and water-borne infections. This last warning is apt given the highly infectious norovirus outbreak affecting up to 86 workers at the Olympic village, forcing quarantine conditions on a further 1,200 people. Read more.

    Sri Lanka: Dengue cases set to rise

    The New Year’s dengue fever toll has already topped 6,200 cases (with 5 deaths) and it’s expected to climb following recent rains. Over 40 percent of cases have been in the Western province that includes the capital Colombo and 2 other large cities, Gampaha and Kalutara. One news report asserts that: ‘2018 has been identified as a dengue epidemic year.’ Read more.

    United Kingdom: Peak forecast for fever cases

    Scarlet fever rates have risen over 130 percent since September last year compared to same period in 2016. The annual cycle of infections caused by the Group A Streptococcus started earlier this year and, to date, the season is at a 4-year peak. Public Health England has alerted parents to the tell-tale symptoms: ‘sore throat, headache and fever with a characteristic fine, pinkish or red rash with a sandpapery feel.’ Read more.

    Zambia: Slow improvement in capital’s cholera

    Good news for residents of the capital Lusaka, with new cholera cases slowing, down to 12 in a recent 24-hour period. Nearly 4,000 cases and 83 deaths have been reported since October. Read more. And in neighbouring Zimbabwe, the case count from the cholera outbreak that originated in Chegutu have reached 94, one reported recently from a town only 40kms from the capital, Harare. 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.

  • Australia: Diphtheria in FNQ; Rains hike infection risk

    A man from northern Qld, with no recent history of overseas travel, is under treatment at a hospital in Brisbane after being diagnosed with diphtheria. News reports state that he had not been vaccinated against the infectious bacterial illness, one that is routinely covered in the standard childhood immunisation schedule. Currently there are large outbreaks of diphtheria in Indonesia and among the Rohingya refugees in Bangladesh, however infections are a rare occurrence in Australia. Read more

    A RECENT increase in the number of melioidosis infections recorded in the Northern Territory serves to reinforce the seasonal messages issued by the health department. Heavy rains at this time of year move the bacteria from deep underground to the muddy surface where they infect people through open wounds, or even by breathing them in. With fatality rates of 10 to 15 percent, symptoms to watch out for include fever, cough, difficulty in breathing and skin ulcers. People with lowered immune defences are more at risk of infection. Read more. More on melioidosis

    Brazil: Malaria in NE

    The US Centers for Disease Control & Prevention (CDC) has issued a level 2 alert - Practice Enhanced Precautions – for the town of Wenceslau Guimarães in Bahia state following the confirmation of 7 malaria cases and one death. Health authorities are deeming it a localised outbreak which was possibly started with a traveller arriving from the state of Pará, a malaria endemic location. Read more (translate from Portuguese). 

    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

    Fiji: Second dengue focus

    There have been 11 confirmed dengue fever cases and more are suspected in a second province - Cakaudrove - on the island of Vanua Levu. Cakaudrove neighbours Macuata, where a recent outbreak was recorded. Read more. While some 800kms to the SW of Fiji, on Tonga’s main island of Tonga'tapu, 19 dengue cases have been confirmed and a girl who was visiting the kingdom from New Zealand succumbed to the infection last week. Read more. The NZ Minister for Pacific Peoples is calling for signage and information to be displayed at regional airports to advise arriving passengers of the potential for mosquito-borne infections such as dengue fever and Zika. 

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

    Greece: Measles top 1,260

    As expected, there has been further spread of the measles outbreak, with many of the new cases reported in the south. A Department of Epidemiological Surveillance and Intervention update on January 25th notes that more cases are likely to be confirmed, adding to the 1,262 notified since the outbreak began. According to the report, ‘It concerns people of Greek nationality (mainly young Roma children, as well as Greek adults mainly aged 25-44 years old) susceptible to measles’. There have been 2 associated deaths.  

    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.

    Madagascar: Typhoid fears in capital

    Doctors in the capital Antananarivo have alerted the local population to several suspected cases of typhoid fever and have recommended stronger food-related hygiene measures. Read more (translate from French).

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

    Mozambique: Cholera in NE

    Cholera has struck the NE city of Pemba in the province of Cabo Delgado. Authorities are tackling the lack of adequate sanitation in areas such as the colourful fishing village of Paquitequete in an attempt to bring the outbreak to an end. At least 75 cholera cases have been recorded in Pemba to date. Read more (translate from Portuguese).

    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.

    Nigeria: January’s fever cases near 300

    The NCDC situation report on the ongoing Lassa fever outbreak provides the latest data: 15 new confirmed infections and 2 deaths from Jan 22 to 28, and nearly 300 suspected cases and 22 deaths since the beginning of the month. The new cases were recorded across 5 states: Edo (6), Ondo (4), Taraba (3) and one each from Delta & Imo. Read more from the Nigeria Centre for Disease Control (week 4). 

    Advice for travellers: Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.

    Pakistan: Hyderabad tackling resistant typhoid

    In the 12 months to November/December last year, more than 100 children died from typhoid infections that were due to antibiotic resistant strains of the bacterium. Children between 2 and 10 years of age in two areas of Hyderabad (Latifabad & Qasimabad) have been hardest hit and deaths continue to occur daily. Around one quarter of a million children will be vaccinated using a new conjugate typhoid vaccine – Typbar – that was recently pre-qualified by the WHO. Read more.

    Papua New Guinea: Dengue flares after rains

    At least 7 suspected and confirmed dengue fever infections have been recorded in Port Moresby with a local doctor warning of the increased risk of the mosquito-borne infection following heavy rains. Read more.

    South Africa: Listeria cases mount

    From the most recent NICD update (Jan 25th) on the listeriosis outbreak: the source of the bacterial contamination remains unknown and up to Jan 23rd (from 1/1/17), there have been 820 laboratory-confirmed cases and 82 deaths with highest numbers recorded in the provinces of Gauteng (486), Western Cape (105) and KwaZuluNatal (59). While the search for the source of this outbreak continues, advice is to follow the WHO’s Five Keys to Safer Foods

    Spain: Hep A in Balearic Is.

    Over 30 people who had eaten at a restaurant in the city of Palma, Mallorca, in mid-December have been diagnosed with hepatitis A. Health officials traced the infection to one of the workers at the establishment. While it is hoped that there won’t be any further cases, the extended incubation period of the viral illness (up to 50 days) means that it's still a possibility. Read more (translate from Spanish).

    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.

    United States of America: Measures to halt Michigan’s Hep A

    The hepatitis A outbreak in Michigan is now into its 7th month with 715 cases reported to Jan 24. While most cases have been in the Detroit urban area, as many as 12 new cases have been identified in other counties. Food handlers in Detroit are now being encouraged to take up the offer of Hep A vaccinations. Read more.

    Vanuatu: Mumps cases persist

    The Pacific Public Health Surveillance Network disease alert map reveals increasing numbers of mumps cases in Vanuatu. The outbreak was first announced in late September last year, when a number of schoolchildren in Port Vila were diagnosed with mumps. At the time, news reports suggested the initial case was a traveller arriving from New Zealand. 

    Advice for travellers: This lingering outbreak of mumps highlights 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.

    Zimbabwe: Outbreaks slowing

    From the peak of the typhoid outbreak in November, there has been further reduction in the number of cases in the most affected areas of the capital Harare - Kuwadzana in the west and Mbare in the south. According to a WHO regional report, the attack rate has dropped from 15:100,000 to 5:100,000. Addressing sanitation issues is paramount – ‘The key drivers of this outbreak are the lack of safe drinking water, inadequate sanitation, and unhygienic conditions in the affected areas…’. Meanwhile, up to Jan 26th the cholera outbreak has led to ‘a total of 81 cases (4 confirmed, 3 probable, 74 suspected) and four deaths.’ The improvement has been slower in Zambia and cases continue to be reported, bringing the total case count as of Jan 23rd to 3,635 with 78 deaths – 94 percent of cases are from the capital, Lusaka.