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 28th of June 2018
Hep E in port city
An outbreak of hepatitis E in the SE coastal city of Chittagong has sickened more than 300 people in the past three months and caused a number of deaths. The source of the outbreak is believed to be contaminated water supplies. Read more
Advice for travellers
The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. The virus is found worldwide, mainly in communities with low levels of sanitation and hygiene. There is no vaccine. More than 60% of all hepatitis E infections and 65% of deaths occur in East and South Asia, with up 1-in-4 people in some age groups having been exposed to the virus. Read more about the virus and how to prevent it.
Warnings of mozzie-borne illnesses
Dengue fever and Zika virus infection rates rose in the early part of the year in the NE state of Pernambuco and there is concern that the abundance in Aedes mosquito populations (the vectors of dengue, chikungunya and Zika) could lead to a more extensive outbreak. Almost half of all municipalities (80 of 185) have reported large mosquito infestations. Read more (translation required). While in the southern state of Paraná, of the 900 dengue fever cases recorded since August last year, 165 cases (and two deaths) were locally acquired infections in the city of Foz do Iguaçu, the tourist centre for visiting the famous Iguaçu Falls. 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.
Ebola, cholera outbreaks
Latest news on the Ebola virus disease (EVD) outbreak from the health ministry: 57 cases (38 confirmed), 15 probable and 4 suspected cases. Three new suspected cases have been identified in Bikoro; and at midnight on June 27, the last of the 1,706 previously identified contacts of confirmed cases were removed from a surveillance and limited movements list.
NINE health districts in the central province of Sankuru have again reported cholera infections after a 3-month lull. A further 256 cases and 43 deaths have been reported this month. Read more (translation required).
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.
Results from typhoid study
A study partnered by New Zealand’s University of Otago has determined that the rise in the incidence of typhoid fever in both urban and rural areas of Fiji over the last ten years is primarily due to ‘consumption of contaminated surface water and unwashed produce’. In the article, Co-Director of the Otago Global Health Institute, typhoid fever expert Prof John Crump, says that ‘Oceania is now the global region thought to have the highest typhoid fever incidence.’ Read more
Advice for travellers
Typhoid occurs in some Pacific countries, although it presents a low risk for travellers staying in hotels or resorts. Travellers should follow safe food and water guidelines, and personal hygiene practices. Vaccination is generally recommended for travellers staying in rural areas, as well as for adventurous eaters, however finall recommendations are itinerary-specific. Read more about typhoid fever.
Second measles death
New measles case numbers have stabilised since early May - down to around 50 per week. The total for the outbreak since its onset in November now sits at more than 2,500. This week Santé Publique France announced another death from measles complications, the second this year – neither victim was able to be vaccinated because of their immunosuppressed condition and were likely to have contracted the virus from a non- or under-vaccinated individual. According to the agency’s measles weekly bulletin, 22 percent of measles patients have required hospitalisation. Across the Channel, authorities in England and Wales are asking those young people travelling to the Continent to ensure they have received the full course of measles vaccinations.
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.
Bumper year for ticks
Early modelling had shown that this year would become a peak in the cycle of tick-borne encephalitis (TBE) infections, with the southern states and in particular, Bavaria, most affected. Castor bean (Ixodes ricinus) tick numbers have been increasing across the country, reaching a 10-year high this year. TBE cases in the south have exceeded last year’s record high figures - the advice for residents and travellers at risk is to consider vaccination and take appropriate measures to avoid tick bites. Read more
Advice for travellers
A viral infection, 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. VACCINE: While safe and effective vaccines are available in Europe, none are licensed in Australia. However, vaccination can be obtained through a Special Access Scheme. Read more about TBE.
Trio of monsoon-related infections rise
The SW state of Kerala gets the first of the monsoon rains in June, leading to early reports of the diseases associated with rain and mosquitoes, including dengue fever and leptospirosis. To the north in Mumbai, dengue and leptospirosis are also in the local news headlines, while in Delhi, ‘malaria was spreading faster than dengue’. An alert has been issued for the low hills districts of the northern state of Himachal Pradesh after several cases of Japanese encephalitis (JE) were reported from Solan district. Read more
Advice for travellers
A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE.
Further spread of RVF
The human death toll in the Rift Valley fever outbreak has reached 26, more counties have reported cases in livestock and six new areas are considered at high risk for spread of the virus. 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.
Mumps cases on the rise
A number of states have recorded outbreaks of mumps this year, with the northern states of Tamaulipas and Nuevo Leon, and Quintana Roo on the east coast of the Yucatán Peninsula experiencing the largest increases most recently. Over half of all cases have been in the 20 to 44 years of age cohort. Read more
Advice for travellers
These outbreaks of mumps 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.
Leishmaniasis sweeps through KP province
Sand flies infected with the leishmania parasite have spread the infection (leishmaniasis) across wide areas of the NW province of Khyber Pakhtunkhwa this year, with nearly 1,500 cases reported. At least nine districts have reported cases, most are the cutaneous form of the infection. Read more
Advice for travellers
Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. There is no vaccine or preventative medication: avoiding infection relies on minimising sand fly bites. Read more on the disease and prevention.
Polio makes unwelcome return
After 22 years without a case of polio and eight years after it was declared polio-free the virus has been identified in three children of Lufa Mountain Settlement in the northern province of Morobe – only one child was symptomatic. The first case of vaccine-derived poliomyelitis was initially diagnosed in April and further testing in the community revealed the other two cases. All children under 15yo in the settlement have now been vaccinated as, according to the WHO press release, ‘only 61% of children [in Morobe province] having received the recommended 3 doses. Water, sanitation and hygiene are also challenges in the area.’ The media release also provides the following advice: ‘all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel’. Read more on VPV in a WHO factsheet.
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. Vaccination is generally recommended for travel to affected regions and is a temporary requirement for travel to/from some countries. If at risk, adults should have a booster to the childhood series. More on polio.
Dengue cases, deaths mount
Pangasinan, a province on the western coast of Luzon island, has experienced a leap in dengue fever cases this year, recording almost 1,400 cases and six associated deaths. Read more. And to the south, in the region of Bicol, dengue fever has sickened 973 people and caused the deaths of nine (in Camarines Sur, Catanduanes & Albay). Read more
Warm weather and dengue persist
The cooler weather is yet to arrive, particularly in the south of the island, and so the dengue-transmitting Aedes mosquito prevails. The outbreak total has climbed to 5,393 cases since the start of the year. Read more
KwaZulu-Natal’s rabies toll rises; Flu activity rises
Another human rabies death, the fifth this year, has been reported in the province of KwaZulu-Natal. Authorities have issued a warning that rabies cases among animals have increased in three areas to the north of Durban (Phoenix, Newlands and Inanda), describing the area as a rabies ‘hotspot’. Read more
THE FLU season has started and influenza activity is already reaching moderate levels. Other southern hemisphere countries with rising flu activity as mentioned in the latest WHO global flu update are: New Caledonia, (the Maldives), Brazil, Peru and temperate regions of Bolivia.
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 the influenza vaccination, when available, for all travellers over 6 months of age.
Tick season arrives
Warmer weather means people spend more time outdoors, but also an increased risk of exposure to ticks. A local news report has announced there have been 56 tick-borne severe fever with thrombocytopenia syndrome (SFTS) infections - in the SW province of North Jeolla, five of the seven people diagnosed with SFTS have succumbed to the illness. There is no preventive vaccine and treatment is symptomatic. Read more
Advice for travellers
SFTS causes symptoms including high fever, vomiting, diarrhoea, thrombocytopenia, leukopenia, and multiple organ failure. The virus has a 6%–30% case-fatality rate. Read more about SFTS.