Travel Health Alerts

Routine vaccination reminder for all ages; Measles cases in 2 states

NSW Health has issued a reminder to older residents to ensure their tetanus vaccinations are current following the notification of three cases this year - one of the three (all women aged in their 70s or 80s) died of the infection, the first fatal case in 30 years. Read more

ANOTHER measles infection has been diagnosed in a returning traveller, this time in Western Australia. The state health department has posted a list of potential exposure sites, many of them public transport routes in Perth, in the week to April 13. And in Qld, a child care centre and a general store on the Sunshine Coast have been listed as venues of concern in relation to a confirmed measles case in a resident of the Mt Coolum area who worked in Noosaville. 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. In general the infection is relatively benign, but complications 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.

Measles outbreaks abound

Amid the ongoing conflict, malnutrition and shortages of medicines, vaccine-preventable diseases are surging. Almost 9,500 measles cases have been recorded this year and 77 children have died, while rates of polio, diphtheria and pertussis infections and deaths are also rising. In other news on measles, in the Indian state of Madhya Pradesh, cases have spiked in Sagar district to the north-east of Bhopal, while doctors in Telangana say they have seen increased case numbers since Feb-March in Hyderabad and Rangareddy districts. In Europe, after two years without any measles cases in Belarus, there are reports of an unspecified number of infections in Vitebsk region and, lastly, the case count in Austria’s outbreak had risen to 112 by April 14, with the most new cases in Styria; ‘associated follow-up cases are still to be expected’. The outbreak peaked in mid-Feb to mid-March. 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.

Global polio digest

A Disease Outbreak News post this week covered the circulating vaccine-derived poliovirus type 2 (cVDPV) cases confirmed in Aceh province and West Java since November last year. Another six positive VDPV2 samples have been identified from 30 healthy children in West Java during field investigations, confirming ‘that the virus was already circulating’. The first of two rounds of novel OPV2 immunisation for children aged under five years in all districts of West Java has been completed and the next will take place late in May. The WHO assessed the risk at a national level as high. In other news of polio as reported by the GPEI last week, cVDPV2 cases were logged by Benin (single infection in Atlantique department) and the D R of Congo (six in total from Kasai Oriental, Haut Katanga and Tshopo provinces), plus one more cVDPV1 case (Haut Katanga). 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.

Hantavirus warning for central region

After a second hantavirus infection was reported from the O’Higgins region, south of Santiago, in under a week, the area health office reminded residents and people planning recreational activities in rural locations to ensure they follow some precautions. For those camping and hiking, the advice includes ‘Walk only on improved trails. Do not go into bushes and grasslands. Do not collect or eat wild fruits. Keep garbage in closed containers; if necessary, bury it. Drink only safe water (potable, bottled, boiled or disinfected)’, all aimed at avoiding contamination from the virus’ rodent reservoir, the long-tailed pygmy rice rat. Also on hantaviruses, five hantavirus pulmonary syndrome cases have been reported this year from widespread locations in the Four Corners region of SW USA – one person has died. The area is endemic for the Sin Nombre hantavirus. Read more  

Advice for travellers

Hantavirus is passed on to humans through contact with hantavirus-infected rodents or their urine and droppings. Eliminating rats in and around living quarters is the main way of preventing hantavirus infection. Cases have been documented in Argentina, Brazil, Canada, Chile, Panama, Paraguay, and Uruguay, making HPS a pan-hemispheric disease. Read more about hantavirus.

Flu uptick in south

Media report a surge in influenza-like illnesses in Shenzhen (Guangdong province), with health authorities announcing a ‘significant increase’ in flu presentations in the city. Clusters of predominantly influenza A infections have been observed in school and pre-school settings. Read more

Advice for travellers

In most years, seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Vaccination is highly recommended and travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol wipes are a convenient alternative if soap and water is not available. Read more

Marburg virus situation update

The WHO Director-General said yesterday that the Marburg virus disease (MVD) outbreak response was at a “critical moment” as the agency assists in surveillance, case management and community engagement. The situation now stands at 16 confirmed cases and 11 dead after a healthcare worker in Bata (Litoral province) tested positive during the follow-up period for known contacts of a confirmed MVD patient. A further 23 probable cases proved fatal. Four provinces have logged cases - Kie Ntem, Centro Sur, WeleNzas and Litoral. In related news, an April 9 regional WHO office update on the situation in Tanzania advised that no new MVD cases have been confirmed since April 7, and over 80 percent of contacts have completed the required monitoring period. Read more

Advice for travellers

Marburg virus disease (MVD) is a severe viral haemorrhagic fever, related to the Ebola virus, and there is no treatment. Found in the African fruit bat, Marburg typically appears in sporadic outbreaks and laboratory-confirmed cases have occurred in Uganda, Zimbabwe, the Democratic Republic of the Congo, Kenya, Angola, and South Africa. Preventive measures are not well defined, as study in how it is spread continues, but travellers should avoid contact with fruit bats and sick primates in central Africa. Read more on MVD

STI awareness for festival season

Globally, new mpox cases have declined substantially since the outbreak peak last year, however transmission continues in many countries without previously documented transmission, primarily affecting the MSM community. As the festival season nears in Europe, the WHO wants attendees to be aware of, and minimise, the risk of mpox, as well as other vaccine-preventable STIs (including human papillomavirus and Hepatitis A and B). Six EU countries have reported mpox cases since late March (Poland, UK, France, Portugal, Spain and Malta), and ‘the possibility of further re-introductions from outside the Region, either from endemic areas or newly affected countries, is likely’. Read more

Advice for travellers

Closely related to the smallpox virus, mpox (monkeypox) was mainly found in Central and Western Africa, with rodents the suspected reservoir, and monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers in the affected African countries. An outbreak of mpox in countries without previously documented transmission began in 2022. Read more information on the 2022 global outbreak from the WHO. Read more on mpox.

Aid agency update on cholera response

The IFRC posted an update on its response to the ongoing cholera outbreaks, noting spread to more sub-counties in the counties affected earlier in the outbreak, as well as five new counties now reporting infections ‘with an increasing trend’. Those counties are Mandera, West Pokot, Homa Bay, Samburu, and Marsabit. 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.

Men. meningitis in more Zinder districts

A meningococcal meningitis outbreak that first began in November last year has now spread into eight health districts of Zinder region (which shares a border with Nigeria). Four areas are currently said to have passed the epidemic threshold and the situation exacerbated by humanitarian crises and concurrent outbreaks of measles, diphtheria and COVID-19. Testing performed earlier in the outbreak detected serogroup C in most confirmed cases. 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. Niger lies in North Africa’s ‘meningitis belt’, where meningitis outbreaks occur in the dry season (Dec-April) and just prior to the rainy season (May-June). Read more about Men. meningitis.

Chikungunya toll rises to 91

Media are reporting a decline in new chikungunya cases in Asunción and Central department, however numbers are still trending upwards in the provinces. To date, the death toll from this extensive outbreak is 91 - many of them were children aged under 12 months and adults older than 60 years of age. Read more

Advice for travellers

Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is currently no approved vaccine and preventing infection relies on avoiding mosquito bites. Apply an effective repellent when outdoors to all exposed skin. Read more about chikungunya.

Dengue alert for capital, port city

An epidemiological alert has been announced by the health ministry, MINSA, after more than 770 dengue fever cases were recorded in the capital Lima and the major seaport of Callao. The declaration serves as a warning to residents to take precautions, as well as a signal to Health Network Directorates to institute surveillance and control measures. More than 41,000 dengue fever cases have been reported in Peru this year. Read more

Advice for travellers

Dengue is spread by Aedes mosquitoes which breed in shady areas close homes and other accommodation. They 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 oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

Elevated typhoid fever rates

The three regions with the highest rates of typhoid fever for the year to March 18 were Cordillera Administrative Region, Northern Mindanao and Mimaropa, according to the health department. A disease surveillance report showed a doubling of the national case count compared to the same period last year - up from 1,633 to nearly 3,300 and 11 deaths. 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.

Hajj health requirements posted

The annual Hajj pilgrimage will take place in late June this year (1444h/2023). Information for the benefit of pilgrims and seasonal workers at the Hajj has been published by the health ministry, documenting vaccinations that are required or recommended, ‘Preventive measures by health authority at points of entry’ and General Health Recommendations. Read more

Hep E outbreak in NW

More than 90 people are suspected to have been infected with hepatitis E in an outbreak reported in Wau city, Western Bahr el Ghazal state. Five deaths have been recorded to date. Read more

Advice for travellers

The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Infection during the latter stages of pregnancy carries a higher rate of severe disease and mortality. Unlike the Hep A and B viruses, there is no vaccine for this strain in Australia, which is especially common in communities with lower levels of sanitation and hygiene. Read more about the virus and how to prevent it.