Travel Health Alerts

Measles outbreak response in neighbouring territory

The government of Samoa has issued a special travel advisory that took effect on May 1: ‘With the outbreak of Measles in American Samoa, ALL travelers from the Territory (including infants aged 6 months and above) are required to be vaccinated with a Measles containing vaccine before entering Samoa.’ Full details of the requirement are listed in the April 26 government news release. The outbreak situation in American Samoa has evolved with two cases now confirmed in Tafuna (both fully vaccinated and no history of travel) and another 52 suspected infections presenting with a febrile rash illness. Pre-schools and daycare centres remain closed, but schools and colleges have re-opened for vaccinated students. 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.

YF vaccination rates stall

In a recent epidemiological update on yellow fever (YF) in the Americas, the PAHO warned that ‘vaccination coverage has stagnated over the past decade’ and nations must work to ensure high routine vaccination rates whilst also maintaining reserves for outbreak response. According to the report, human YF infections have been confirmed this year in Bolivia (one case each in the municipalities of Santa Ana de Yacuma, Beni department and Puerto Suárez, Santa Cruz department) and Brazil (two cases in São Paulo and one in Amazonas – all with known exposure to forested areas). 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.

Whooping cough rates spike in South Zone

Low immunisation rates in parts of Alberta’s South Zone have seen pertussis infection rates climb. Local media report that 146 have been registered, mostly in Lethbridge and Medicine Hat, and five children have been treated in hospital. Read more

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.

Malaria uptick in non-endemic areas

Senior researchers have raised concerns over the ‘outbreak situation’ relating to malaria in two municipalities (Tierralta and Puerto Libertador) of the NW department of Córdoba, and the detection of cases in five towns outside endemic zones. Just over 30 percent of malaria is reported from Chocó department, while Córdoba occupies second place with 20.5 percent. The release of the data coincided with World Malaria Day on April 25. 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.

Global polio digest

In the latest GPEI update, four circulating vaccine-derived poliovirus type 1 (cVDPV1) cases were reported from two regions of Madagascar – Analamanga and Androy, while the D R of Congo recorded 15 cVDPV1 patients in three different provinces and another 21 cVDPV2 cases from seven provinces. 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.

Mpox in north-central province

In the first four months of the year, 546 monkeypox cases were reported in the northern province of Tshopo and 45 people have died of the infection. The doctor in charge of epidemiological surveillance in the province said there are plans to curb the epidemic which has already spread into the city of Kisangani. 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.

Marburg virus disease update

In a May 1 health department update, the Marburg virus disease (MVD) outbreak total sat at 17 confirmed cases (none currently hospitalised) and 12 deaths. A further 23 probable cases, all fatal, have been reported. And in Tanzania, the health minister has said that the Kagera region MVD oubreak has been contained, however surveillance will be continued for the full 42-day 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

Meningitis incidence under scrutiny

An increase in the incidence of invasive meningococcal disease (IMD) cases over recent winter months when compared to pre-pandemic years is being monitored by health authorities - the peak in infections (serogroup varied by location) was in the last week of December, 2022. According to the ECDC, clusters of serogroup B (MenB) cases occurred last year in Auvergne Rhône Alpes and Strasbourg and the serogroup ‘causes the biggest burden of IMD in Europe, followed by C, W and Y’. In France, meningococcal C vaccination has been a requirement for infants born after January 2018, while the MenB vaccine has been recommended since April 2022. 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, extended contact with local people in crowded places and travel to 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.

Gastro illnesses increase

Rising temperatures in Mumbai (Maharashtra) have brought about a surge in food- and water-borne infections affecting, for the most part at least, people who purchase food and drinks from road-side stalls. These outlets are less likely to follow hygienic food preparation and storage processes. Healthcare practitioners in the city say there are treating greater numbers of typhoid, hepatitis and viral gastroenteritis cases this year. Read more  

Advice for travellers

Vaccine-preventable Hepatitis A (HAV) is a vaccine-preventable viral disease that is transmitted by the oral-faecal route, such as through contaminated food and water, and some types of sexual contact. A course of hepatitis A vaccine offers immunity that’s highly effective and long lasting. It is also important to follow safe food and water guidelines.

Measles activity up in 18 provinces; Meningitis cases in Bali

A WHO Disease Outbreak News post published late last week provides details on the surge in measles cases occurring ‘primarily from the provinces of West Java (796 cases), Central Papua (770 cases), and Banten (197 cases)’. More than 2,100 suspected cases have been recorded this year, continuing a marked rise in case numbers seen over the past two years. The ‘magnitude and extent of this outbreak’ is attributed to sub-optimal population immunity, so ‘the overall risk of measles at the national level is assessed as high’. In other news on measles, the WHO advised that cases in Europe had exceeded the 2022 total by the end of February this year, with more than 900 infections from 17 countries. The top three reporting nations were Russia, Tajikistan and Türkiye. And lastly, South Africa’s NICD issued another update on the measles outbreak on May 2, advising that recent figures may be skewed by the Easter holiday break. Read more

HEALTH AUTHORITIES in Bali have reported at least 38 meningitis cases - some have already been confirmed as resulting from Streptococcus suis infection (acquired through contact with infected pig carcasses or the consumption of under-cooked pork products). Five people have succumbed to S. suis infections and investigations are underway into the aetiology of the remaining meningitis cases. 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.

Dengue cases increasing

Foreign media reporting on the number of dengue fever infections recorded for the year to April 26 say the totals stand at more than 13,000 cases and 12 deaths. The provinces of Chanthaburi, Trat, Phuket, Narathiwat, and Songkhla have been most affected and an upward trend in cases has been observed in recent weeks. Elsewhere, Malaysia has recorded a marked increase in dengue cases so far this year, up from just over 11,900 in 2022 to more than 32,000. Dengue-related deaths also rose from six last year to 22 this year. Dengue hotspots have been identified in Selangor, with 62 locations reported, ‘followed by Penang (32), Sabah (eight), Kuala Lumpur and Putrajaya (seven)’. 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.

Adulterated medicine alert

A WHO Medical Alert posted recently related to a contaminated expectorant syrup sold in the Marshall Islands and the Federated States of Micronesia. According to the WHO, the product ‘contained unacceptable amounts of diethylene glycol and ethylene glycol as contaminants … [and] may have marketing authorizations in other countries in the Western Pacific region. It may have also been distributed, through informal markets, to other countries or regions’. Read more

Varicella infections double

The health ministry has registered more than 12,000 chickenpox cases this year, representing a 2-fold increase on the same period in 2022. The rates of infection have been highest in the states of Jalisco, the State of Mexico, Mexico City and Veracruz. Read more

Advice for travellers

Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Mainly passed from person to person by coughing or sneezing, it causes a blister-like rash, itching, tiredness, and fever. While the illness is generally mild in children, it can be more severe in young babies, adults, and people with weakened immune systems. Read more about chickenpox.

WHO posts on triple disease threat

Three WHO Disease Outbreak News items have been published in the last week, covering the ongoing outbreaks of diphtheria, meningitis and Lassa fever. The diphtheria outbreak is now showing a declining trend, with the NCDC confirming 557 cases this year from 21 states and the Federal Capital Territory. The assessed risk in all three outbreaks is considered high at a national level due to continuing insecurity, several public health emergencies and a humanitarian emergency in the NE, while sub-optimal vaccination rates have fuelled the diphtheria and meningitis outbreaks. Read more  

Advice for travellers

Lassa fever is a low risk for most travellers. Rodents shed the virus in urine and droppings before it’s passed on to humans through direct contact, touching objects or eating food contaminated with these materials, or through cuts or sores. For 80% of people infected, Lassa fever is mild or has no observable symptoms. The remaining 20% can experience severe, often fatal, multi-system disease. Read more on Lassa fever.

More chikungunya cases detected

The number of locally-acquired chikungunya cases in Paysandú department has risen from seven to 18 over the past two weeks, while another six locations have registered imported cases. Meanwhile, Paraguay’s extensive chikungunya outbreak continues, with highest case numbers in recent weeks in Central, Asunción and Alto Paraná. An update provided by the General Directorate of Surveillance noted expansion of the epidemic into regional areas: ‘mainly in Guairá, Amambay, San Pedro, Paraguarí, and Caaguazú. There are also increases in the Western Region, mainly in Boquerón and Presidente Hayes’. From October 2022 to mid-April, more than 77,700 chikungunya cases have been reported. Read more

Advice for travellers

The symptoms of chikungunya fever are similar to dengue fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes aegypti and Aedes albopictus. Acute joint pain with a rash is typical of chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no approved vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.

Leptospirosis, dengue cases rise after heavy rains

Galle District in the Southern Province is experiencing a sharp rise in leptospirosis infections, according to a specialist doctor, with 19 deaths already registered this year in the SW district. Dengue fever cases are also up - half of the nearly 28,500 infections recorded in the first four months of the year were in the Western Province. 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.

Cholera cases top 580

This year, the provinces of Matabeleland South and Manicaland have recorded more than 350 of the national total of 588 suspected cholera cases, while local news sources are now reporting seven confirmed and 21 suspected cholera infections in western suburbs of the capital, Harare. The confirmed cases are from Budiriro, Glenview and Mt Pleasant Heights. 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.