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 14th of June 2018
Measles summary
Up to June 10, Public Health in France registered 2,466 measles infections from 84 departments, however there has been a gradual decrease in new reports since early April. The department is also monitoring the outbreak in Mauritius amid concerns that infections could be imported by returning holidaymakers. Other EU countries with continuing large outbreaks include Romania (for the duration of the outbreak, 13,563 confirmed cases, 55 deaths), Italy (median age 24 yo, over 85% of cases from Sicily, Lazio, Calabria, Campania & Lombardy) and Greece (over 2,000 cases and 2 deaths this year alone). Read more
Measles in NW
Fourteen municipalities in the state of Amazonas and 11 in its northerly neighbour, Roraima, have reported measles outbreaks, with nearly 1,000 confirmed and suspected cases from across the NW region – a number of the cases in Roraima are among people from Venezuela, the site of a large ongoing outbreak. 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.
EVD surveillance, vigilance continues
The search for new Ebola virus disease (EVD) cases and their contacts has moved to the more remote areas of Iboko and Itipo in Equateur province. The latest World Health Organization (WHO) update advised that since May 17, ‘no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed case-patient in Iboko developed symptoms on 2 June 2018. From 1 April through 10 June 2018, a total of 55 EVD cases, including 28 deaths, have been reported from three health zones in Equateur Province.’ Read the WHO update here.
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.
Dengue count nears 3,500, outbreak ends
The dengue outbreak is over - under 60 new infections reported every week now, compared to more than 230 at its peak. In summary, the Health Ministry announced there were four deaths among the 3,437 confirmed cases – highest numbers from the Western Division (1315 cases), followed by the Northern (1242). The ministry continues to advise mosquito bite avoidance measures and removal of the insects’ breeding sites. Read more. The Western Division, taking in the towns and environs of Lautoka and Nadi, is to take part in the Wolbachia mosquito control program. 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.
Nipah virus update; Early monsoon effects
No new cases of Nipah virus disease have surfaced in Kerala for almost two weeks, leading authorities to declare that the outbreak has been checked; health department data up to June 12 shows of the more than 300 samples tested, there were 18 confirmed cases and 16 deaths (three more cases and one death are considered ‘suspected’). Read more
MONSOONAL rains have brought about the anticipated rise in mosquito-borne infections in the country’s south-west: Bengaluru and Kozhikode (Karnataka state) and Ernakulam (Kerala). State authorities in the state of Maharashtra have expressed consternation at the increased number of pre-monsoon dengue fever cases.
Advice for travellers
Fruit bats (flying foxes) are the natural hosts of Nipah virus, and females shed the virus when pregnant or lactating. The fruit-eating bats perch on the jars used for collecting juice from palm or date trees, contaminating the juice with infected saliva and droppings. People are infected when they drink the raw juice, although it is also spread through person-to-person contact.
Cholera count nears 5,000; RVF in north-east
There have been nearly 5,000 cholera cases, including 75 deaths, from 19 counties this year and a number of them continue to report new infections - Garissa, Turkana, Tharaka-Nithi, West Pokot, Nairobi, Kiambu, Elgeyo Marakwet and Isiolo. Read more
IN THE north-east county of Wajir, bordering Somalia, Rift Valley fever (RVF) is the confirmed cause of death for six people and the virus has sickened at least two more in this past week. As one of the modes of RVF transmission is through direct or indirect contact with contaminated meat/organs from infected animals (the other through mosquito bites), meat sales in the region have been halted. Most infections are fairly mild or asymptomatic. Read more
Advice for travellers
Rift Valley fever (RVF) is an acute viral disease that typically infects domesticated herd animals. It is generally found in eastern and southern Africa where sheep and cattle are raised, as well as in West Africa, Madagascar, and more recently Saudi Arabia and Yemen. People are infected after exposure to blood, body fluids, or the tissue of RVF-infected animals, or from the bite of an infected mosquito. The virus presents a low risk to travellers, but is another reason to use personal insect repellent and take other steps to minimise insect bites in places where it occurs. Read more about RVF.
Resources to check rabies
Rabies infections contracted through bites from rabid dogs have killed 22 people since last July in the SE district of Mulanje, bordering Mozambique. 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.
More Hep E in north, capital
There has been an increase in the number of suspected hepatitis E cases at the northern districts’ hospitals in Tsandi, Okahao, Outapi and Oshikuku. A local news report describes how a number of the confirmed cases had either travelled from the epicentre of the ongoing outbreak in the informal township of Havana in Windhoek or had links to those people. Read more
IN THE far NE of the country, the regions of East and West Kavango are reporting a rise in the numbers of malaria infections. Read more
Advice for travellers
The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Unlike the Hep A and B viruses, there is no vaccine for this strain, which is especially common in communities with lower levels of sanitation and hygiene. More than 60% of all hepatitis E infections and 65% of deaths occur in East and South Asia. Read more about the virus and how to prevent infection.
Cholera lingers in NE
More cholera infections (240 cases, two deaths) have been reported over a recent 7-day period in the Mubi districtsof the NE state of Adamawa, while to the north, in Borno, ‘low-level cholera transmission’ continues. The upcoming wet season is quite likely to worsen the outbreaks. 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.
End to malaria
The WHO confirmed this week that a 60-year programme to eliminate malaria in Paraguay has been successful and it was formally declared malaria-free - … ‘The first country in the Americas to be granted this status since Cuba in 1973’. It’s been seven years since a case of Plasmodium vivax malaria was reported and more than 20 years for P. falciparum. Other regional countries aspiring to achieve malaria-free status by 2020 include Belize, Costa Rica, Ecuador, El Salvador, Mexico and Suriname. Read more
West, south hit hard by dengue
The dengue fever count now exceeds 4,600 for the year and each week between three and four hundred cases continue to be reported – the west (over half of all cases) and south remain those areas most affected. It is hoped that the arrival of winter next month, combined with mosquito control programmes will bring the outbreak to an end, preventing an even larger outbreak next summer. Read more (translation required).
MERS cluster in SW
Eight MERS Co-V infections have been diagnosed in one family group from the SW region of Narjan – only one person had had contact with camels or camel products, a known risk factor for transmission of the virus. These latest cases take the total since April 2012 to more than 2,200 with 790 deaths. Read more
Hike in leptospirosis rates
The incidence of leptospirosis has risen in some districts where it is not considered endemic, adding to the national disease count of nearly 1,600 suspected cases. Several districts have each recorded more than 100 cases, while Colombo and Kegalle reported over 90. The monsoons are likely to generate an increase in cases. 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.
JE cases climb to 12
Kaohsiung, Taichung, Changhua, Chiayi and Tainan are the locations of the seven most recent cases of Japanese encephalitis (taking the total to 12), according to the Centers for Disease Control. The agency advises ‘people who frequent mosquito-prone areas such as pig farms and rice paddy fields to take precautions against mosquito bites and ensure age-appropriate children receive Japanese encephalitis vaccination in a timely manner in order to ward off infection’. 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.
Dengue Day brings renewed focus
In advance of ASEAN Dengue Day on June 15, local authorities have placed the focus firmly on prevention and control of the mosquito-borne viral infection. Over 22,000 cases have been recorded country-wide this year and there have been four deaths in southern regions. Last year’s peak produced more than 180,000 cases and 30 related deaths – most cases were in the largest cities of Hanoi and Ho Chi Minh City. Read more