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 12th of April 2018
Campaigns to target polio
Earlier this week, Afghanistan and Pakistan initiated polio vaccination campaigns aimed at interrupting wild poliovirus transmission. This year, there have been eight cases from the two countries – only one of those in Pakistan (Balochistan province). 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. 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.
Malaria’s tragic toll
The four provinces of Luanda, Benguela, Uige and Bié have recorded over 400,000 of the nation’s year-to-date 720,000 malaria cases. Measures are being employed tackle the huge burden of the disease, which is responsible for the most deaths, hospitalisations and absenteeism in the country. Read more (translate from Portuguese).
Advice for travellers
For most travellers, Africa presents a significant malaria risk. Travellers can discuss their itinerary and the need for anti-malaria medication with a trained travel health professional at their nearest Travelvax clinic. For details call 1300 360 164. Read more about malaria.
YF arrives on coast; Measles for Amazon, northern state
News from São Paulo this week that two monkeys died of yellow fever (YF) infection in areas of the state’s north coast: One in Ubatuba (300kms to the west of the city of Rio de Janeiro) where a human death is also being investigated for possible YF causes. As under half of Ubatuba’s population has been immunised against YF, a reactive vaccination campaign is under way. Read more. MANY of the growing number of suspected measles cases reported in the states of Amazonas and Roraima (bordering Venezuela) have links to the ongoing outbreak in Venezuela (also producing cases in Colombia and Ecuador). 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.
Tainted oysters in BC
Two oyster farms on the east coast of Vancouver Island are closed while investigations continue into an outbreak of norovirus that has sickened at least 40 people. It is believed that human waste contaminated the waters near the farms. Read more
Advice for travellers
While it is extremely contagious, norovirus infection is generally short-lived, causing nausea, vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly, and the sick. To minimise the risk, wash your hands after using the toilet and before eating, and practice good hygiene. Read more on norovirus.
HFMD cases surging
Public health officials have warned of rising rates of hand, foot and mouth disease (HFMD). In excess of 28,000 cases were recorded in March which was double the previous month’s total, signalling the start of the infection’s peak season that generally runs from April to July. Each year China reports over two million cases of HFMD. Read more
Advice for travellers
Parents of young children should be aware of that seasonal epidemics of HFMD occur throughout Asia. The virus mainly affects young children and symptoms include fever, oral lesions, and rash on the hands, feet and buttocks. There is no vaccine or preventative medication in Australia, but good hand hygiene will greatly reduce the risk of infection.
Men. meningitis response
In a media release, the Ministry of Health and Medical Services advised that adverse weather conditions had delayed the administration of meningococcal vaccinations planned for students at a Tailevu high school until April 5th. As six (of the country’s 38 cases) were at the school, regular medical checks of the students were also carried out and antibiotics administered as a preventive measure. All 38 cases were under 19 years of age. 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. More about meningococcal meningitis.
Local & regional measles persists
Another 192 measles cases were recorded in the week from Mar 28 to April 3 taking the total since early November to 1,605, with Nouvelle-Aquitaine still in epidemic mode. According to a French Public Health bulletin, infants under 12 months of age are most affected and more than 20 percent of all cases have required hospitalisation. Read more. While in England there have been almost 700 measles cases this year - currently there are alerts in Birmingham, Kent & Medway; in Ireland the outbreak is now in its fourth month, with many of those infected aged between 15 and 50 years.
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.
Tick-borne disease in 2 states; Ice tests reveal bacterial load
The districts of Sattari in the NE of Goa state and Sindhudurg in Maharashtra are the focus of two outbreaks of Kyasanur Forest Disease (KFD). Approx. 50 cases have been identified this year in Sattari, and this is the third consecutive year of cases in Sindhuburg, with 60 reported. As many as 500 cases of KFD occur each year nationally, with a case fatality rate of 3%-5%. Mainly seen in the dry season, the tick-borne viral disease occurs in humans and monkeys. YOU may have heard it before, but the advice is to avoid ice in drinks unless you know it is made from purified water. From a local news source: recent testing of ice sold at various food outlets in Mumbai found 98 percent of the 410 samples were contaminated with E Coli, a common cause of gastrointestinal illness. Health authorities have tried to crack down on the sale of the impure ice, but the numbers of facilities producing ice in the hotter months surges.
Hep A in SW
Drought conditions have led to an increase in the number of hepatitis A cases and heightened the risk of cholera in the SW province of Khuzestan, including its capital Ahvaz. Read more
Advice for travellers
Hepatitis A (HAV) is a vaccine-preventable viral disease passed on to humans primarily through oral contact with faeces of an infected person. This can occur through contaminated food and water, by handling everyday items and sexual contact. It is a significant risk in travellers to developing countries where sanitation and hygiene are lacking. A course of hepatitis A vaccine offers immunity that is 99%-plus effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.
Regional alert for south
Four cases of Monkeypox have been confirmed in the south-central county of Rivercess and an additional two are under investigation. As a precaution, the Chief Medical Officer has issued an alert for the region. Read more
Advice for travellers
Closely related to the smallpox virus, monkeypox is mainly found in Central and Western Africa. Rodents are the suspected reservoir, with 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. Read more on monkeypox.
Peninsula reports rise in chickenpox
The Yucatan Peninsula has recorded a rise in the number of cases of chickenpox, with nearly 1,500 to March 25 - 46 percent more compared with the same period last year. 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.
Two dengue virus types circulating
The case count in the current dengue fever epidemic (to Apr 6) is now 589. Dengue serotype 2, which is also behind other outbreaks in the region (Vanuatu, Fiji, American Samoa, Samoa and Tonga) is dominant, however DENV 1 is also circulating. Yaté, Nouméa and Dumbéa have the highest infection rates. Read more (translate from French).
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.
South Island measles scare
Contact with a person infected with measles at Queenstown airport has generated five more cases in Queenstown, Christchurch, Wanaka and Nelson – at least four of whom were unvaccinated. Some of those infected had gone on to visit other areas of the South Island and taken domestic flights, sparking fears of a widening outbreak. Read more
Lassa fever update; Cholera surges in 9 states
Since mid-February there has been a gradual decline in the numbers of new Lassa fever cases – a further eight were recorded last week from the states of Edo, Ondo, Bauchi, Plateau and Abia (42 percent of the 1,706 suspected cases were from Edo). According to a Nigeria Centre for Disease Control (NCDC) Sitrep, ‘From 1st January to 8 th April 2018, a total of 1781 suspected cases have been reported from 20 states.’ And ‘Since the onset … there have been 101 deaths in confirmed cases, 9 in probable cases.‘ The World Health Organization (WHO) expressed concern that ‘the peak transmission period is not yet over’ and issues including ‘poor sanitation conditions in high burden communities and multiple outbreak activities in some States are limiting commitment to the Lassa fever outbreak response.’ Read more. A RISE in cholera cases this year also has the NCDC concerned: Nine states have reported a total of 2,000 cholera cases and 37 related deaths. Bauchi, Borno, Ebonyi, Kano, Yobe and Zamfara are most affected. Read more
Advice for travellers
Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for most travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.
Fears for post-quake disease risk
International aid agencies consider the risk of water- and vaccine-preventable diseases will be high in those areas of the highlands affected in the recent earthquake. Immunisation rates are very low and the condition of the children and their surroundings is poor. Read more
Luzon dengue rates grow
While dengue fever cases have risen by over 180 percent this year in the province of Pangasinan in western Luzon, highest infection rates have been in Calabarzon, followed by Metro Manila. Read more
Dengue advice for tourists
Advice given to arriving travellers on the current dengue fever epidemic includes the need to avoid mosquito bites and to monitor themselves for symptoms of dengue during the stay on the island and for one week after leaving. To April 10, the bulk of the 955 confirmed cases have been in western and southern districts; however isolated infections have also been found in the north. Read more (translate from French).
New Year dengue risk
This weekend is the Thai New Year festival, or Songkran, and health authorities are warning of a possible flare-up in dengue fever cases due to recent rains. Bureau of Epidemiology data reveal 3,878 cases reported from 74 provinces to Apr 9. Southern and central provinces have been most affected – highest rates were in Phuket, Samutsakorn, Pangnga and Nakornsrithamarat. Read more
Mumps, measles reports persist
Mumps cases continue in Hawaii – up to Apr 5 the total had reached 949. The State Department of Health reports that ‘Nearly 60% of cases have been in adults aged 18 years and older. There have been 29 reports of complications due to mumps infection (e.g., orchitis, hearing loss).’ FIVE measles cases in the Bay area of San Francisco (Santa Clara and Alameda Counties) have been linked to an infected traveller returning from Europe; one further contact of the initial case also became infected and had travelled on to Nevada. The San Francisco Department of Public Health advisory stated that none of those infected were vaccinated.
Advice for travellers
These consequences of mumps outbreaks highlight the importance of current immunisation against contagious childhood diseases, such as whooping cough (pertussis), diphtheria, rubella and measles for travel to any destination – be it a developed or developing country. Read more about mumps.
Cholera situation deteriorates again
Following significant improvements in the rates of cholera after early-year vaccinations, existing poor water infrastructure and large population movements have led to a re-emergence of the bacterial infection centred primarily in the Kanyama district of the capital Lusaka. Current bad weather conditions are expected to worsen the situation. Read more. Zambia is just one of the countries highlighted in a cholera report from across the Eastern and Southern African region.