Shifting disease patterns and outbreaks affect the recommendations and information we provide to travellers during a pre-travel consultation. Each week Travelvax updates the current travel health alerts to reflect those issues which could affect travellers heading to a particular region or country. We do this by scanning the websites of health agencies such as the World Health Organization and the European and US Centers for Disease Control, as well as international news media. Simply click on the point on the map of your area of interest for more details on the current health alert. We also include Advice for Travellers which gives background information and tips. If you have any further questions, of course you can give our Travelvax infoline a call during business hours on 1300 360 164.
World travel health alerts for 10th of May 2018
Local dengue reported in NE
Over 50 confirmed and 26 suspected dengue fever cases have been reported in the NE province of Chaco; most of those infected had no travel history so are deemed to be locally-acquired. The majority of the confirmed cases (42) were in the area of Charata, known for a large meteorite field nearby - Campo del Cielo. Read more. In neighbouring Corrientes province, authorities are monitoring the capital and surrounding areas following notification of 27 dengue fever cases. Read more (translate from Spanish).
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.
Hep A in border town
Up to 14 suspected and confirmed cases of hepatitis A have been reported in the towns of Benque and Arenal in the central west, near the Guatemalan border. Health authorities are instituting control measures and food hygiene training for schools and food services. Many Guatemalan students cross the border to attend schools in Benque (Benque Viejo del Carmen) in order to receive an English language education. 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.
Another YF case in EU traveller; Seven year malaria lapse ends
Another European traveller to Brazil has been diagnosed with yellow fever – the eighth such case this year. As with previous cases, the Czech national was not vaccinated against yellow fever prior to travel. According to a European Centre for Disease Control (ECDC) assessment: ‘The outbreak is currently showing a decreasing trend and as the vector activity season in Brazil is coming to an end’. A May 9th Flutrackers update on case numbers can be found here. HEALTH authorities in the southern state of Paraná are awaiting results from malaria testing on up to 90 residents of the city of Foz do Iguacu after having revealed this week that a local farmer was hospitalised in March for treatment of malaria it is believed he contracted while fishing in Porto de Areia, some 75kms to the north-east of the city. The last locally-transmitted malaria cases (3) to be reported in the area were in 2011. The Scottish Fitfortravel website advises that strict mosquito avoidance measures should be taken when visiting the area, site of Iguaçu or Iguazu Falls, the largest waterfalls in the world.
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.
Fears of dengue peak to come
The 1,200 dengue fever cases reported in the first quarter of the year represent a rise of more than 200 percent over last year’s, leading health officials to warn that this year could bring a peak in the dengue cycle – the last major outbreak occurred in 2012 causing 400,000 cases and 160 associated deaths. Read more. And in Thailand, the onset of the rainy season brought news that the number of dengue fever infections to date has topped 7,500 (southern districts most affected) already and authorities anticipate higher case numbers this year. Read more
Anthrax warning for central province
An outbreak of anthrax in central Ningxia Hui Autonomous Region provoked a travel warning in Russia for any of its nationals planning on visiting the area. According to a social media post, there has been further spread from rural areas to Yinchuan City. Read more
Advice for travellers
The anthrax bacterium is transmitted to people in the form of spores which are can produce disease through consuming contaminated meat, through inhalation or via contact with the wool, hair or hide of infected animals. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about anthrax.
WHO reports on Ebola outbreak
Testing has confirmed two cases of Ebola virus disease (EVD) near Bikoro, a north-western town that sits on Lake Tumba (Equateur province). The World Health Organization (WHO) report notes: ‘In the past five weeks, there have been 21 suspected viral haemorrhagic fever in and around the iIkoko Iponge, including 17 deaths.’ A comprehensive program is being put in place to control and contain the outbreak, but there are fears of further spread as the affected area is part of a domestic waterway network, providing transport to major cities on the Congo and Ubangi Rivers. Neighbouring countries have been notified of the outbreak; Kenya and Nigeria have started screening arrivals at airports and land borders using thermal guns. 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 travellers visiting infected areas. Read more about Ebola.
Possible hep A ties to Morocco
European health authorities are investigating a number of hepatitis A cases in from various regions in Denmark, the Netherlands and Germany – two had a history of travel (to Morocco). The ECDC has assessed the situation and noted the possibility of a ‘multi-strain, multi-country foodborne outbreak. The circulation of the strains has been observed in Morocco in the past. The outbreak is possibly ongoing also in Morocco where a number of European travel-related cases may have been recently infected.’ Read more from the ECDC.
Men. meningitis, dengue updated
The Minister of Health and Medical Services presented an update on the meningococcal meningitis outbreak on May 3rd, pronouncing that the success of the recent public awareness campaigns has resulted in no further deaths over the last five weeks. The minister also provided current details: ‘a total of 58 cases from January 1 to April 22 … 24 confirmed cases and 34 suspected or probable…38 from the Central Division, 17 from the West, 2 from the North and 1 from the Eastern Division.’ Most cases were under 19 years of age, ‘close to 40 percent under age 5’ and ‘all deaths this year in the under 5 age group’. A vaccination campaign targeting the 1 to 19 years of age cohort is due to start on May 14th. Dengue outbreak news was also supplied during the conference: case numbers are decreasing in all areas. Of the almost 3,200 dengue infections, the Northern Division reported 1,443 followed by Western (908) and Central (825). Read more
Advice for travellers
Advice on the prevention of meningococcal infection, as stated on the Fiji Ministry of Health and Childhood 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 travel doctor.
Rise in malaria for SW
The district of Dakshina Kannada in the state of Karnataka (including the capital Mangaluru) has recorded over two-thirds of the 941 malaria cases recorded this year to the end of March. This represents an increase on last year’s figures and puts in some doubt the plan to eliminate malaria from the state by 2025. Read more
Advice for travellers
Malaria is widespread in India and occurs year-round in both rural and urban areas, including major cities. Travellers visiting India should discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. Read more on malaria in India.
More measles cases
In an update on the measles outbreak that started just over a month ago: the case count in Okinawa is now up 91 (most under 50 years of age) and a further 17 in Aichi prefecture. Officials in Okinawa are advising high risk individuals to avoid the area, known for its domestic tourism. 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.
Tandem outbreaks after rain
Two outbreaks – cholera and chikungunya – underway since the beginning of the year are expected to flare as heavy rains produced flooding and damage to infrastructure. Nearly one-quarter of a million people have been driven out of their homes by the floods and there have been 112 deaths. Active cholera transmission is occurring in five counties, while chikungunya continues in the counties of Mombasa, Lamu and Kilifi. Read more. Floods have affected the local populace in five states of Somalia while in Uganda, authorities are advising the public on clean water and sanitation after an outbreak of cholera was declared in two locations in Kampala City. 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.
New rabies death in Sarawak
Another human rabies death, the third this year, has been reported in the district of Simunjan, SE of Sarawak’s capital Kuching. It is believed the rabies was transmitted through a dog bite, however this hasn’t been confirmed. 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 those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.
Dengue count nears 2,600
A May 7th update from the Indian Ocean Health Agency (L'ARS Océan Indien) on the dengue fever outbreak: in the most recent reporting week there were an additional 356 confirmed cases, taking the total to 2,598 for the year. More areas of the island are now involved, with six new communes recording cases in recent weeks. Western districts remain those most affected. Read more (translate from French).
Three red alert dengue clusters
The number of dengue fever infections in Jurong West, a residential area in the island’s west, now sits at 70 and includes three associated deaths. This is one of three active high-risk clusters the National Environment Agency (NEA) is monitoring. The national cumulative case count for the year to May 5 is 867, with the peak season approaching. Read more
Diphtheria in NE; Fly larva infections
Two years after the last reporting of diphtheria in the NW province of KwaZulu-Natal, three cases (2 confirmed, 1 suspected) have occurred since the end of March. The patients were aged from 10 to 20 years; two of them have subsequently died from the infection. Read more from the National Institute for Communicable Diseases (NICD). WET weather has led to the tumbu fly spreading beyond its usual geographical limits. Last week the NICD advised that it was providing guidance on several maggot infestations reported in humans in North West Province and, to a lesser extent, Gauteng. The flies lay their eggs onto clothing; on hatching the larvae burrow into the skin causing itchy sores that enlarge, resembling a painful boil – a condition known as Myiasis. NICD advice on prevention: ‘washing should not be laid on the ground to dry. Ironing of clothes will kill eggs or larvae.’ More on Myiasis from the CDC. Read more
Rains boost mozzie numbers
Heavy rains in Zanzibar have hampered fumigation drives put into place following an outbreak of chikungunya earlier this year in Stone Town and other isles. The mosquito-borne infection has flared again; currently Zanzibar’s main hospital is treating 50 patients for symptoms of chikungunya each day. Read more
Advice for travellers
Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent during daylight hours (and evening, if area is brightly lit) to all exposed skin. Read more about chikungunya and avoiding insect bites.
Seasonal insect pest stings; Beverages’ bacterial loads
The emerging larvae of oak processionary caterpillars in numerous London locales has health officials warning of the detrimental effects the white-haired insect can have on people and animals (and oak trees). The hairs contain a toxic protein that can produce reactions such as skin irritation, vomiting, asthma and conjunctivitis. The advice: Don’t touch! (and report sightings to the Forestry Commission). Read more. THREE cinema chains are responding to a BBC report on the ‘unacceptably high levels of bacteria’, including salmonella, found in drinks and ice sold at some of their branches. Read more
Multi-state food/water-borne infections
The extensive hepatitis A outbreak is now in its 15th month and the number of cases has exceeded 1,200 across at least six states. While the overwhelming majority of those sickened have been homeless or illicit drug users, a spill-over of infections to people who work as food handlers is now being reported. The hepatitis A vaccine series is included in the routine US immunisation schedule for children aged 1-2 years. Read more. TWENTY-nine states have reported E. coli infections linked to the consumption of contaminated lettuce grown in the Yuma, Arizona. This week the CDC announced that the number of cases had reached 149 - almost half required hospitalisation. Read more
Rabies in NW, national disease data
Three people died of rabies last week in the NW province of Lào Cai (location of Sapa), taking the national year-to-date toll to 18. Most cases occur in rural areas where people are unaware of the dangers of the infection and how to prevent and treat at-risk exposures. The health department has warned that the highest incidence of rabies each year is from May to August. Read more. WHILE in other news, data from the health ministry reveals there have been 135 measles infections across the country this year and numbers of hand, foot and mouth disease rose in late April taking the total to 7,000 cases. 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.