Travel Health Alerts

Dengue, chikungunya outlook update

The provinces of Tucumán, Salta and Santa Fe have recorded the highest number of the dengue fever cases this year, with recent totals exceeding those posted for the same period in the past two years. At the latest count, there had been ‘9,389 cases of dengue (type 1 and 2) from 63 localities located across 13 provinces nationwide’. The expansion in the range of mosquito-borne infections reported by the WHO last month, has seen chikungunya transmission spread from Salta and Jujuy provinces to Tucumán, Salta and Santa Fe. 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.

Life lost to MVE in west; Holiday travel and mosquitoes

Late last week the Western Australian health department announced the tragic death of a young child from the West Kimberley region after contracting Murray Valley encephalitis (MVE). Alerts had been issued recently for the Kimberley and Pilbara regions when viral activity was observed in mosquitoes and sentinel chickens. According to the department, eight MVE cases have been reported from across the country this year. Read more

A TIMELY reminder from a state health department about the risk of Japanese encephalitis and other mosquito-borne infections as many people head out over the Easter period and school holidays. Mosquito season is not over so avoiding mosquito bites remains an important preventive measure. Read more

Advice for travellers

While the risk of contracting MVE is low if insect bite avoidance measures are employed, the virus can cause severe illness, even death in very rare cases. The vector mosquitoes are active at dawn and dusk, particularly in the first two hours after dark. They pass on the virus to humans after feeding on infected birds attracted to flooded wetlands. Travellers to wetland and recently flooded areas of Australia should take all measures to prevent bites. Apply an insect repellent containing DEET, picaridin, or oil of lemon eucalyptus to exposed skin when outdoors. Read more about MVE.

Malaria success certified

Malaria-free certification was granted to both Azerbaijan and Tajikistan by the WHO last week, signalling the successful completion of ‘a sustained, century-long effort to stamp out the disease’. Elimination is dependent on three consecutive years with no indigenous transmission and the capability to prevent its re-establishment. Tajikistan’s last (P. vivax) malaria case was registered in 2014, Azerbaijan’s two years before that. Read more

Yellow fever virus activity in east, NW

Evidence of yellow fever (YF) virus circulating in forested areas of Santa Cruz department was confirmed last month when a young military recruit stationed at Mutún, near the border with Brazil, was diagnosed with the disease. It has been two decades since locally acquired YF cases were reported in the area and vaccination coverage is at 87 percent. The community has been advised to avoid insect bites and ensure YF vaccinations are current. In recent days, a YF infection has been reported in another lowland area, this time in the NW department of El Beni (San Borja). Read more

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.

Global polio digest

Five circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were reported to the GPEI last week from Region Sanitaire 1 and 6, matching the entire 12-month total for last year. The same strain was behind infections logged by Chad (Batha and Logone Oriental provinces) and the D R of Congo, which posted 22 cases with dates of illness onset from this year and last, plus 11 cVDPV1 patients. The GPEI report said the DRC infections were ‘primarily from the eastern part of the country’. Read more

Advice for travellers

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

Measles uptick in south, west

More than 390 suspected measles cases have been reported in sporadic outbreaks in the municipalities of Sabha and Bani Waleed. The development is said to be a cause of concern for the WHO, as routine immunisation programs have lapsed or slowed during the pandemic. In other news on measles, authorities in the Maldives are conducting enhanced surveillance after the confirmation of one case and another is suspected in two children from Addu City, located on Addu Atoll in the extreme south. The Maldives was declared measles-free in 2017.  South Africa’s NICD published an update on the ongoing outbreak on March 31. Lastly, a situation report on the D R of Congo clearly shows its heavy measles burden, with epidemics underway in 21 provinces and suspect cases more than double the same period last year - passing 52,000 (with almost 600 deaths). 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.

More MVD cases, deaths

Fourteen Marburg virus disease (MVD) case have now been detected, 10 fatal, in the provinces of Centre-Sud, Wele-Nzas, Littoral and Kie-Ntem, which share borders with Cameroon and Gabon. Another 20 probable cases, all fatal, were recorded earlier in the outbreak. According to the health department’s April 2 update, eight MVD cases have been confirmed in the large port city of Bata and more than 600 contacts are being followed up. The WHO director-general said last week that the agency is “working to begin trials of vaccines and therapeutics as soon as possible”. The latest news reports on the MVD outbreak in Tanzania’s Kagera region show no change in case numbers (eight) and the death toll (five). 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

Sand fly-borne disease in south

Médecins Sans Frontières (MSF) has described high rates of visceral leishmaniasis (VL), or kala-azar, among tribespeople living in the sparsely populated South Omo Valley, which forms part of a national park near Lake Turkana. The Mursi and other indigenous groups living in the high risk area are receiving treatment for kala-azar from MSF. And in Kenya, a VL outbreak remains active in one of nine counties reporting cases over the past four years: West Pokot. Read more

Advice for travellers

Leishmaniasis is generally a low risk for travellers. The parasitic disease is found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. There is no vaccine or preventative medication: avoiding infection relies on avoiding sand fly bites. Read more on the disease and prevention.

Malaria spikes in eastern state

A foreign news outlet reported on a sharp rise in malaria cases in the country’s east, with infections in Kayin state up by 1,000 percent over the past three years. Northern districts of the state are seeing more Plasmodium falciparum cases, including infections with drug-resistant strains. Read more

Advice for travellers

Travelvax recommends that travellers visiting malarious regions discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. More on malaria.

First rabies fatality recorded

A traveller arriving from overseas last month and subsequently diagnosed with rabies has succumbed to the infection, becoming New Zealand’s first rabies death. Te Whatu Ora (Health New Zealand) reported that the person’s exposure to rabies occurred in another, unspecified, country – New Zealand is rabies-free – and had received treatment employing full infection control at hospitals in both Whangarei and Auckland. 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 – especially dogs, the main source of infection. If bitten, urgent post-exposure treatment is required. Vaccination recommendations are itinerary-specific but include those travellers planning to live in, or travel extensively or repeatedly through, endemic countries and also for children. Read more on rabies.

Dengue outbreak set to expand

Almost a year after the first-ever outbreak of dengue fever was announced, two districts are still reporting active cases - Lobata and Água Grande. The rainy season is expected to increase dengue activity and allow its spread into other areas, causing cases to spike again. Read more

Advice for travellers

Avoid mosquito bites to protect against dengue fever. To avoid biting insects, apply repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) to all exposed skin when outdoors. 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 also cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active.

Uptick in dengue, malaria

A senior health department official said earlier this week that recent rains had pushed up dengue fever and malaria case numbers in Honiara, Central Islands, Malaita and Temotu provinces. Delays in fumigation programs against the malaria vector have contributed to the uptick in cases, together with medication shortages and gaps in patient compliance. Read more

Advice for travellers

Travelvax recommends that travellers visiting malarious regions discuss their itinerary and the possible need for anti-malaria medication during a pre-travel medical consultation. More on malaria.

Cholera cases in Gauteng

At least 10 cholera infections have been reported from Gauteng province since early February; the most recent indigenous cases were from Johannesburg and Ekhurhuleni and were associated with ritual ceremonies carried out in a local river. The NICD considered that ‘the increasing number of indigenous cases is very concerning’ in view of the cholera outbreaks in neighbouring countries. 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.

Q fever in southern canton

A herd of goats has been confirmed as the source of Q fever infections in several residents living in the southern canton of Valais. Six cases have been detected to date in people from the area between Visp and Brig, and the community has been cautioned to report flu-like symptoms. Read more

Advice for travellers

This bacterial infection is contracted from infected animals or through inhaling dust contaminated with their body fluids. Around half of infections are asymptomatic, but it can cause a flu-like illness with symptoms including fever, fatigue and muscle pain which appear up to 2 to 3 weeks following infection. The disease may progress to become severe with complications such as pneumonia and hepatitis, or it may become a chronic infection with secondary effects. Vaccination is recommended for certain high risk groups and pre-vaccination screening is required. Read more