Travel Health Alerts

Measles response underway

Another country reporting an uptick in measles cases: authorities are tracking the contacts of 27 people diagnosed with measles - the majority of those infected (19) are in the northern city of Irbid, seven more are in the capital, Amman, plus one in Ajloun. In other news on measles, the return to school for students in the district of Bundibugyo in Uganda’s Western Province has been postponed after a measles outbreak sickened 119 children and killed four. A reactive vaccination campaign is planned. The district borders the D R of Congo and many of the infected are Congolese asylum seekers. Lastly, the emergency declaration enacted in American Samoa in response to two confirmed and 74 suspected measles cases will continue until June 8 as the health department awaits more test results. Schools and daycare centres have been re-opened for fully vaccinated children and a 21-day isolation period set for anyone testing positive to measles. 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.

Yellow fever cases confirmed in SE state

Health authorities in the state of São Paulo announced that they have been notified of four yellow fever (YF) infections this year, resulting in two deaths. The last two years have passed without any human YF cases in the state and the update provided no details on the location or the activities of those infected in 2023. While São Paulo’s YF vaccination coverage sat just under 65 percent last year, early figures for 2023 show it had increased to 82 percent. In other news on YF, the WHO African office has confirmed a yellow fever infection in a resident of Cocody-Bengerville in Abidjan, the largest city in Côte d'Ivoire. Onset of the illness was in early April. Lastly, the government of Uganda is preparing to roll out a mass vaccination campaign against yellow fever which is expected to be completed next year. 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.

Dengue cases on the rise

Nearly 40,000 dengue fever infections have already been recorded this year and weekly case numbers are rising in 23 of the 32 departments. Dengue virus activity has been highest in Amazonas, Vaupés, Meta, Guaviare, Putumayo, Tolima, Caquetá and Cundinamarca, while epidemiological alerts have been issued for the districts of Barranquilla, Cartagena and Cali. Meanwhile, Peru’s record-breaking dengue outbreak continues, having claimed 103 lives from the nearly 90,000 infections recorded to May 23. Highest case numbers have been in Piura, Lima, Ica, Loreto, Ucayali and Lambayeque. Read more

Advice for travellers

Dengue is spread by Aedes mosquitoes which breed in shady areas close to habitations 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 an effective 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.

Global polio digest; Buruli ulcer epidemic in NW province

The only country to report new polio cases to the GPEI last week was the DRC, where three circulating vaccine-derived poliovirus type 1 (cVDPV1) infections were logged in the provinces of Haut Lomami and Haut Katanga, plus another nine cVDPV2 patients across five provinces. Elsewhere, media report another wild poliovirus type 1 (WPV1) case in Afghanistan’s Nangarhar province. This is the third this year for the country and the province. Read more

MORE THAN 450 Buruli ulcer cases have been reported from a health zone near Gemena, the capital city of Sud-Ubangi Province. The NW province’s health minister has declared an epidemic of the debilitating disease, known locally as Mbasu. 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.

Tick season arrives

Residents are heading outdoors in the warmer weather, which has also seen tick activity increasing. The first tick-borne Crimean-Congo haemorrhagic fever (CCHF) infections were reported in late April and to date, eight cases have been recorded, mostly from the SW region of Samtskhe-Javakheti and Shida Kartli in the NE. While in Latvia, authorities have warned that more than 20 percent of ticks analysed this year have tested positive for the bacteria responsible for Lyme disease. Substantially fewer ticks showed the presence of the tick-borne encephalitis virus (TBEV) – nationally, 50 TBE cases were recorded last year. Read more

Advice for travellers

CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about the virus.

Monsoon’s arrival imminent

Last year, two dengue fever cases were detected in India’s territory on the high altitude Ladakh plateau, which was also the country’s last dengue virus-free region. Just 17 years ago, only eight states and territories reported dengue cases, but outbreaks are now a countrywide risk (and set to increase with the onset of the south-west monsoon over Kerala expected within the next week). Read more  

Advice for travellers

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 Aedes mosquitoes that 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. Read more about dengue fever.

WNV-positive mosquitoes in south

This year’s first detections of mosquitoes infected with West Nile virus (WNV) have been confirmed in a southern council area, located in the Negev Desert. Health agencies have advised the public to clear mosquito breeding sites from around their homes and ensure they avoid insect bites. WNV is endemic in Israel and between 40 and 160 cases are recorded each year. Read more

Advice for travellers

West Nile virus (WNV) is endemic and epidemic in Eastern Europe and the Mediterranean basin, with epidemics regularly reported in summer and autumn since the 1950s. Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuro-invasive disease.  The virus is transmitted by Culex mosquitoes, which feed mainly around dawn and dusk. While the risk of infection for most travellers is generally low, those visiting regions reporting human cases, particularly the peak transmission season, should take measures to avoid mosquito bites. Europe’s outbreaks are not as severe or widespread as in other regions where the virus occurs, notable North America. Read more about WNV in Europe.

Rains arrive, dengue risk increases

Another warning on the risk of dengue fever was issued by the director-general of the Department of Disease Control last week as the rainy season begins. The number of infections is already more than five times higher than for the same period last year. Residents were reminded to clear standing water from their environs and to refrain from self-medicating any dengue-like illnesses. To date the most affected provinces are Nan, Trat, Chumphon, Chanthaburi and Tak. In Myanmar, more than 1,700 people have contracted dengue fever this year and there were seven fatalities. Highest case numbers were recorded in Yangon, Taninthayi, Ayeyarwady, Mon and Kayin. Read more

Advice for travellers

Dengue fever is common in most tropical or sub-tropical regions of the world. The virus is spread by daytime-feeding Aedes mosquitoes and to avoid it and other insect-borne diseases, travellers should apply an insect repellent containing an effective active ingredient, such as DEET, Picaridin or oil of lemon eucalyptus (PMD), to exposed skin when outdoors during the day. In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, as well as other times when the mosquitoes are active.

Chikungunya case in capital

Up until a couple of weeks ago, the only place where locally-acquired chikungunya infections had been detected was in the department of Paysandú, in the country’s west. However on May 13, the health ministry announced a case in the capital Montevideo in a person with no history of travel. The individual has now recovered and residents have been advised to avoid mosquito bites. Also in the region, in its May 19 update the health ministry in Paraguay said new chikungunya cases were decreasing, following a trend seen since the mid-March peak in infections. Dengue fever cases, however, were on the rise, with more than half from Central, Boquerón and Asunción. Read more

Advice for travellers

Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is 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.

Rabies alert in NW province

An outbreak of rabies has been declared in Ilicos Norte province, in the NW corner of the island of Luzon. Five people have died of rabies infections this year in Batac City and the towns of Paoay, Nueva Era, Pinili and Sarrat, prompting the declaration. A government veterinary official said that funds are lacking to provide mass rabies vaccination for the province’s dogs, while health authorities have warned residents against seeking treatment through faith healing and supposed alternative cures for rabies. Read more

Advice for travellers

Despite successful efforts to control rabies through canine immunisation in several provinces of the Philippines, rabies remains a major problem in many regions. However, 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 exposed, 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. Read more on rabies.

Further spread of invasive mosquito species

The range of the Aedes albopictus mosquito continues to expand, having now spread north from the cantons of Geneva, Valais and Ticino to Vaud. Local media report the species is now established in Nyon and Bourg-en-Lavaux, on the shores of Lac Léman. Read more

Flu-like illnesses surge

Last week, Health Promotions Vanuatu declared a surge in influenza-like illnesses, with ‘increased cases of influenza A H1N1, influenza B, advenovirus, rhinovirus, respiratory syncytial virus and COVID-19’. A seasonal Flu Outbreak has been declared. 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