Health Alerts
  • Brazil: ‘Spiked’ açaí juice; Floodwater risk in Petrópolis

    Ripe açaí berries coming onto the market has led to a rise in the number of Chagas diseases cases in the northern state of Amapá, bordering French Guiana. Health inspections in seven towns have been ramped up, targeting establishments that sell blended açaí juice after a number of them were found to have equipment contaminated with the faeces of infected triatomine bugs. Read more
    EVEN before this year’s rainy season has hit, leptospirosis cases have risen sharply in Petrópolis. Authorities in the city, a mountain retreat for nearby Rio de Janeiro’s residents, have issued warnings after cases rose by almost 80 percent. Read more

    Advice for travellers: Chagas disease (American trypanosomiasis) is widespread in Mexico, Central America, and South America. However, it presents a low risk to Australians travelling to the region who stay in air-conditioned or screened accommodation. Infected triatomine bugs infest poor-quality dwellings and take a blood meal from victims at night. However, as has become more common, the disease can also be transmitted through freshly pressed juice contaminated with the insects attracted to the ripening fruit. Read more on Chagas disease.

    Democratic Republic of Congo: Ebola outbreak update, malaria in North Kivu

    The number of confirmed Ebola virus disease cases (EVD) has reached 276, with a further 35 deemed probable and 65 more under investigation. CIDRAP reported today that ‘in research developments, scientists yesterday reported durable protection for three Ebola vaccines, including the one currently deployed in the DRC’. But Ebola is not the only crisis in North Kivu. Dr Pete Salama, Deputy Director-General for Emergency Preparedness and Response for the World Health Organization (WHO), tweeted news of a malaria outbreak in the region that is producing up to 2,000 cases per week.  More children have died in this, the country’s third largest EVD outbreak, mostly from receiving treatment for malaria in traditional healing clinics where EVD patients were also present amid poor infection control. Read more

    Advice for travellers: Ebola Virus disease 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.

    India: Zika case in Rajasthan’s neighbouring state; Late wave of dengue

    With Rajasthan’s Zika virus disease count now at 147, a single case has been identified in Gujarat, the state to the south. It was in Gujarat that Zika was first identified in India, in January 2017. Read more. Public Health England and NaTHNaC have now raised the risk rating for Zika transmission in Rajasthan from moderate to high. Read more. A late surge in dengue fever infections in Hyderabad (Telangana) has gone against the annual trend of decreasing cases in October, while in Delhi the usual rise in cases that starts in October and continues through November has occurred, however the city has experienced a relatively mild season with less than half infections compared to last year  Hospitals in Tamil Nadu are currently reporting a steady stream of ‘fever’ cases. Read more 

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT).

    Namibia: Help to tackle Hep E outbreak

    The WHO is providing assistance to government agencies to enforce efforts needed to contain the ongoing hepatitis E outbreak. Infections have been recorded in half of all regions: up to mid-October there have been 3,630 cases, many of those in Windhoek and Swakopmund. Read more

    Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Infection during the latter stages of pregnancy carries a higher rate of severe disease and mortality. 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. Read moree about the virus and how to prevent it.

    Nepal: Dengue in trekkers’ hub, capital

    Dengue fever has sickened up to 35 people in the trekking hub of Pokhara, the gateway to the Annapurna Circuit. A local news source cites the chief of the local health division saying ‘this is the first time that such a large number of dengue patients have been reported in Pokhara’. Read more. ‘Dozens’ of dengue fever cases have been reported in the capital, Kathmandu, and the risk of spread within Kathmandu valley is said to be high during the October-December peak dengue season. 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. 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.

    New Zealand: Beach litter hazards

    For beach-goers, the rates of injuries and infections from coming into contact with litter has been rising annually, now currently at five percent. A NZ Herald article on the hazards states ‘the most common injuries were infected wounds, soft tissue strains, damage to the eye and fractures or dislocations’. Read more 

    Pakistan: Rabies vax shortage bites; Tick-borne infections in Sindh

    Without supplies of Chinese rabies vaccines, health institutions have had to rely on Indian formulations, but those are now in high demand for the domestic market, limiting exports to countries such as Pakistan. At one hospital in Karachi the shortage means that ‘only a few and extremely serious patients would be vaccinated in case of dog-bite incidents’. Read more
    OVER 100 cases of tick-borne Crimean-Congo Haemorrhagic Fever (CCHF) and 11 associated deaths have been recorded in Sindh province this year. The latest death occurred in a grazier from one of Karachi’s administrative districts, Malir. Read more. Moving livestock during drought conditions in regions of the north and west has led to a climb in CCHF cases in Afghanistan with cases almost doubling over last year’s – from 244 to 455. 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. Read more on rabies

    Papua New Guinea: More environmental polio samples, CDC issues travel notices on polio

    The polio case count has risen to 19 with a new case identified in the Southern Highlands and three more under investigation. Read more. Intensified surveillance in the wake of the outbreak has uncovered more environmental samples of the circulating vaccine-derived poliovirus, this time in two ponds in Morata and Waigani, near Port Moresby. The lakes take sewage discharge from the city so the discovery is not unexpected – residents of the area have been warned to stay away from the ponds. Read more. The US CDC last week added five new Travel Notices (Alert Level 2, Practice Enhanced Precautions), for PNG, Democratic Republic of the Congo, Nigeria, Somalia, and Syria due to the ongoing polio outbreaks.  Details of the cVDPV2 cases in southern Niger have been published in a Disease outbreak news piece from the WHO published on Oct 30. 

    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 and vaccine-derived polio

    Switzerland: TBE rise warrants higher vax coverage

    Following a 30 percent rise in tick-borne encephalitis (TBE) cases this year, health authorities are considering broadening vaccination recommendations against TBE to ‘entire cantons or even for the whole country’. The 334 recorded infections constitute a new high in TBE case numbers with concerns the current vaccination coverage is inadequate. Read more

    Advice for travellers: A viral infection, tick-borne encephalitis (TBE) can cause fever, vomiting, cramps and paralysis, which can be prolonged. In rare instances, infection can be fatal. Travellers who spend time in regions where TBE is endemic – mainly forested areas of Central and Eastern Europe, Russia, Northern China, and Mongolia – may be at risk. The highest risk is during the warmer months from April to November, especially when hiking or camping in areas below 1500m. While safe and effective vaccines are available in Europe, none are licensed in Australia; however, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE

    Taiwan: Dengue total nears 170

    The city of Taichung has recorded the highest dengue fever count this year with 101 of the 169 cases nationwide. Other affected areas include New Taipei, Kaohsiung and Changhua County. Read more

    Thailand: Dengue at 20-year peak; Measles outbreak in south worsens

    This year’s dengue fever season has been severe, representing a 50 percent rise in cases over the past six years and a 20-year high. According to one local news source, ‘the country could see up to 200,000 cases this year’ which would exceed the 174,000 reported in the largest outbreak in 1987. Read more
    A DOOR-to-door vaccination campaign is underway in the southern province of Yala in response to the measles outbreak which has infected over 850 children in the 9 months to five years of age group and caused 10 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.

    United States of America: WNV cases top 2,000

    To date this year the national death toll from West Nile virus (WNV) fever infections has reached 86 from approx. 2,000 cases. According to data from the CDC, ‘states that have reported more than 50 cases include California, Colorado, Illinois, Iowa, Louisiana, Michigan, Nebraska, North Dakota, Pennsylvania and South Dakota. Read more

    Advice for travellers: Most human WNV infections (70-80%) are mild, subclinical or asymptomatic, but around 1-in-150 cases involve potentially severe neuroinvasive 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

    Yemen: Cholera’s comeback

    IRIN reports that cholera has made a resurgence this year, after infecting over 1 million people and killing 2,510 last year. In a recent reporting week, there had been 15,000 suspected cases, with the conflict-torn Hodeidah province most affected. Read more. Xinhuanet.net reports that cholera vaccinations are being offered in the city of Aden with the assistance of the WHO.

    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

  • Angola: Zika suspected in microcephaly cases

    News reported by the UK’s Fitfortravel website this week, ‘Public health authorities quoted by media in Angola have reported more than 70 children with defects suspected to have been caused by infection with Zika virus before birth. Zika virus was first reported in Angola at the end of 2017 and the appearance of birth defects suggests a widespread outbreak, but case numbers are uncertain’. Weak health infrastructure in Angola has meant that the extent of the outbreak cannot be accurately monitored. Read more 

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT). 

    Brazil: Measles update for 2 northern states

    In an update of the measles epidemic that has roared through the northern states of Amazonas and Roirama: government data now puts the total number of cases at 2,192 and 12 deaths, but another nearly 8,000 cases are still to be confirmed. Reactive vaccination campaigns have been ongoing since the beginning of the year. Read more. Measles reports are many times lower in Argentina, however health authorities in Buenos Aires are still concerned about the ‘active viral circulation’ occurring in two health districts, also noting ‘at least three transmission chains were identified, without having been able to find the source of infection in any of them’. 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.

    Central African Republic: Single YF case in Bocaranga

    Two weeks after the announcement of a hepatitis E outbreak in the prefecture of Ouham-Pendé, a single case of yellow fever (YF) was identified in Bocaranga, an area situated in the prefecture and reported to have low YF vaccination rates and large numbers of the vector mosquitoes. The Minister of Health and Population has called for an ‘urgent response’ due to ‘the speed of its transmission on a large scale’. 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

    Democratic Republic of Congo: More violence slows progress in Ebola affected areas

    Local conflict is slowing Ebola virus disease control measures, including vaccination and public awareness focused on the current epicentre, Beni. CIDRAP reported on a similar situation which occurred several weeks ago and ‘caused a second wave of the virus that is still wreaking havoc in Beni and Butembo’. There has been an update on the data from the Oct 23 WHO situation report: there have now been 244 cases of haemorrhagic fever (209 confirmed, 35 probable & 37 suspected) and 122 deaths. Read more

    Advice for travellers: Ebola Virus disease 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.

    India: Rajasthan’s Zika cases increase again; Dengue’s late strike

    Shastri Nagar in Jaipur’s north remains the site of most recorded Zika infections as more cases were reported this week, taking the total to 131 including 41 pregnant women. Insecticide fogging is being carried out in the area amid intensified surveillance. Read more
    JUST over half of Delhi’s dengue fever cases were recorded in the first three weeks of this month. Additionally, 103 people were confirmed to have malaria infection during the same period. Fines are being issued to households found to contain mosquito breeding. Dengue continued to produce cases in Gujarat’s largest city, Ahmedabad, in early October; among food and water-borne infections, the number of typhoid infections has risen compared with last with 233 recorded to date. At a national level, the number of dengue fever infections and related deaths is lower than last year. Of the states, Maharashtra fared worst (4667 cases), followed by Odisha (3883) and Kerala (3660). The death toll from dengue climbed sharply in Kerala following recent floods – 35 recorded for the year to the end of September. 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. 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.

    Japan: Rubella travel warning

    The US CDC has now added the rubella outbreak (previously reported in our travel health alerts) to its list of travel notices, noting ‘Most cases continue to be reported in the Kanto region (Tokyo, Kanagawa, Chiba, and Saitama)’. A local news source stated earlier this week that the number of cases has risen to 1,103 and ‘about 70 percent of infected people are men in their 30s through 50s’. 

    Advice for travellers: Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine. Highly contagious, rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Travellers should also check their immunisation status for all childhood diseases, including measles, mumps, tetanus, whooping cough and diphtheria as part of their pre-travel medical preparations.

    Nigeria: Monkeypox alert

    A CDC travel notice has also been posted in response to the year-long outbreak of monkeypox which has caused 115 cases (and 7 deaths) in 17 states up to Sept 15; three cases have also been diagnosed in travellers – UK (2) and Israel (1). The worst affected are Rivers, Bayelsa and Cross River, all of which fall in the South-South geopolitical zone. 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

    Papua New Guinea: Polio count climbs to 18

    More polio cases have been diagnosed as heightened surveillance continues across the country; three cases from the provinces of Enga, Eastern Highlands and Madang were reported by the Global Polio Eradication Initiative (GPEI) on October 16th. Vaccination campaigns continue for all children under 15yo. The GPEI also reported on one new wild poliovirus case in Afghanistan’s Hilmand province and cVDPV cases in Somalia (1 case) and Niger (3). 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 and vaccine-derived polio

    Philippines: Dengue in north, measles in Central Visayas

    The Cordillera Administrative Region encompasses six provinces in the far north of Luzon, including the large city of Baguio. This year dengue fever cases in the region have risen to almost double those of last year. Most affected municipalities were Kalinga, Benguet, Apayao and Abra. In total there have been almost 6,000 cases and 11 deaths. Read more. Measles vaccinations are provided at no charge but not enough people have taken up the offer resulting in low immunisation rates and an almost 560 percent rise in measles cases in the Central Visayas. Read more 

    United States of America: Hep A cases rise in Florida

    Since March last year, the Centers for Disease Control & Prevention (CDC) has reported on a large increase in the incidence of hepatitis A predominantly among homeless people and illicit drug users, and this week health authorities in Pinellas County in Florida have announced they are closing in on a 13-year high in Hep A cases. Free vaccinations have been offered as a public health measure. 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 highly effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Venezuela: Malaria cases rocket

    Lack of funding is one of the reasons behind a spiralling of malaria cases with more than 665,000 recorded this year. Many medical facilities lack the necessary treatments and the president of the Medical Federation ‘also warned that "alarms are also activated" for an imminent epidemic of hepatitis and measles’. Read more

    Advice for travellers: Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria

    Zimbabwe: More cholera deaths in Buhera

    The localised cholera outbreak in Buhera, south of Harare, has spread further within the local community. Thirty cases have been confirmed and 82 more are suspected plus there have been seven deaths. A vaccination campaign has been underway in Harare, then moving on to Epworth and Chitungwiza. 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

  • Brazil: Inadequate vax coverage in at-risk YF cities

    From a Ministry of Health update, published on Oct 8, containing yellow fever (YF) data for 12 months from July 1 last year: 1,376 confirmed cases of yellow fever, 770 still under investigation and 483 deaths. In a computer translation of the release, the ministry ‘warns the population for the arrival of summer, the period of greatest risk of transmission of the disease. This concern is due to the fact that recently affected areas with large populations, such as the metropolitan areas of Rio de Janeiro, Minas Gerais and São Paulo, still have large numbers of unvaccinated people, i.e., those at risk of infection. It should be noted that these states, since the beginning of this year, are already areas with vaccine recommendation (ACRV).’ Regarding YF vaccine usage, the release also notes ‘at present, fractional doses are not being applied, but rather the standard ones’. 

    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

    Democratic Republic of Congo: Decision pending on raised Ebola alert

    A decision will be made this week by a gathering of experts from the World Health Organization (WHO) on whether to escalate the Ebola outbreak in North Kivu and Ituri provinces to a Public Health Emergency of International Concern. Read more. The Oct 16 Ministry of Health update announced that there have been 216 cases of haemorrhagic fever, of which 181 are confirmed, 35 are probable and 32 suspected cases are under investigation. Of the 181 confirmed, 104 have died. It also notes that ‘The number of alerts in Beni has risen sharply indicating an improvement in the surveillance system and better collaboration of the community that uses emergency services’. Read more

    Advice for travellers: Ebola virus disease 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.

    France: Single Côte d'Azur dengue case

    Reports last week of the first locally-acquired dengue fever infection in mainland France for 2018 – a resident of Saint-Laurent-du-Var in the Provence-Alpes-Côte d'Azur region, <10kms west of Nice. Surveillance has been increased in the area, but more cases are unlikely due to the onset of cooler weather. Isolated cases of dengue fever have been reported in the area in previous years; the Aedes albopictus mosquito was first detected there in 2004. 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. 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.

    India: Zika cases rise to 72; Dengue, malaria persist

    There are some concerns for the upcoming tourist season in the northern state of Rajasthan as Jaipur’s Zika virus disease cases rose to 72. The health minister commented on the outbreak this week, stating that it was localised, monitoring and insecticide fogging are underway and quarantine measures have been applied to the area. Read more
    ELSEWHERE, there has been a late rise in dengue and malaria cases in Delhi, Kotkapura and Jalandhar in the state of Punjab, Lucknow (Uttar Pradesh) and  in areas of Telangana state.

    Advice for travellers: Zika’s symptoms include a rash, pain in the joints, and the eye condition, conjunctivitis lasting 4-7 days. Long-term ill-effects are rare, although the joint pain may linger for weeks, even months. Like dengue and chikungunya, Zika is spread by Aedes mosquitoes which bite by day and are found in urban setting, including leafy gardens and outdoor restaurants – even in upmarket hotels and resorts. Transmission of Zika virus has also occurred during pregnancy, breastfeeding, sexually and also through blood or blood products. Travellers should take particular care to avoid being bitten just after sunrise and just before sunset, the main feeding time for Aedes mosquitoes. All travellers, but particularly pregnant women or those planning pregnancy, should seek medical advice before travel to Zika-affected areas. Read information on smartraveller (DFAT). 

    Israel: Measles circulating

    The number of measles infections is climbing, with Jerusalem reporting over half of all cases (341) this year. One local news source quotes one doctor who claims there are five to 10 new cases per day in the city. An expansion of the outbreak to other towns and cities is on the cards due to low vaccination rates in some areas. 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.

    Laos: Flu season update

    A 5-year peak in influenza infections (predominantly A(H1N1)pdm09) affecting mainly children under 5yo has been reported in the latest WHO global flu update, while elsewhere in the region the same strain is behind a rise in flu notifications in India and Thailand. See the full WHO update here

    Advice for travellers: Seasonal flu is the most common vaccine-preventable travel-related illness because it is a potential risk during every stage of the journey. Whether you are travelling within Australia or overseas, Travelvax recommends vaccination, when available, for all travellers over 6 months of age. Read more on influenza.

    Nigeria: Monkeypox export

    A third monkeypox infection originating in Nigeria but diagnosed outside the country has been reported, this time in Israel. The infected man, an Israeli working in Port Harcourt, Nigeria, is believed to have contracted the disease while in Rivers state. This is also where the two recent UK cases were infected (a third UK infection was healthcare-related). 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

    Papua New Guinea: Polio case count rises to 15

    As reported by the GPEI, a fifteenth case of polio (cVDPV1) was reported this week from the province of East Sepik and ‘two VDPV1 positive environmental samples, both collected on 5 September, were reported from Port Moresby’. Vaccination campaigns targeting all children under 15yo continue, while the WHO has released a report: ‘The First 100 Days of the Polio Outbreak Response in Papua New Guinea: A Summary’. 

    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 polio

    Sudan: Chikungunya spreads to 7 states

    During the current chikungunya outbreak, the WHO has categorised the risk of further spread to other states to be very high due to the widespread presence of the mosquito vector. ‘From 31 May through 2 October 2018, seven States (Kassala, Red Sea, Al Gadaref, River Nile, Northern State, South Darfur and Khartoum) have been affected with a total of 13,978 cases of chikungunya, 95% of which are from Kassala State’. 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 vaccine or prevention medication; using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Read more about chikungunya.

    Thailand: Measles outbreak in south kills 5

    A measles outbreak has struck the landlocked province of Yala in southern Thailand killing five children and infecting nearly 350 people since last month. Highest rates of infection have been recorded in Yaha district, Bannangsata and Than Toh. Other provinces reporting outbreaks were Prachuap Khiri Khan, Samut Sakhon, Chiang Mai and Amnat Charoen. Read more

    United States of America: Hep A toll continues to rise

    Hepatitis A cases, primarily among the homeless and illicit drug users, continue to mount, however, as noted by a ProMED moderator, ‘Spillover into other portions of the population, such as restaurant diners affected through infected food handlers will continue’. Kentucky (2,050 cases, 14 deaths since Aug “17) and West Virginia (1527 cases & 5 deaths since Mar ‘18) have been hardest hit among the 11 states cited in the ProMED post on Oct 16 (Archive Number: 20181016.6094878).

    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 highly effective and protects for 20-30 years. Travellers should also follow these guidelines for safe food and water.

    Vietnam: Diphtheria returns to Central Highlands province

    Two deaths from diphtheria infection, and a further five suspected cases, have been reported in the central highlands province of Kon Tum, adjacent to the borders with Laos and Cambodia. These are the first diphtheria cases in 11 years in the province which has pockets of low immunisation in some communities. Read more

    Advice for travellers: Spread by coughing and sneezing or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more on diphtheria.

    Zimbabwe: New cholera cases slowing

    The death toll in the cholera outbreak has climbed to 54 with five fatalities reported in the village of Buhera, around 220kms south of Harare - all five were related. A second round of vaccinations is due to start this week aimed at halting the spread of cholera – with more than 9,000 cases now recorded. Read more. Harare has borne the brunt of the outbreak. As stated in a ReliefWeb post on Oct 12, ‘The ten hot spot areas in Harare are: Glenview, Budiriro, Mbare, Epworth, Glen Norah, Granary, Mabvuku, Mufakose, Stoneridge, and Kambuzuma'. 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