Health Alerts
  • Brazil: New YF case confirmed

    This week it was confirmed that a 76 year-old resident of the Itatiba/Jundiaí region (São Paulo state) had succumbed to yellow fever earlier this month and another case is under investigation. Read more. Under 80kms to the south, in the state capital of São Paulo, monkeys infected with the yellow fever virus have been identified in parks in northern districts prompting authorities to mount a campaign to ensure residents of the region are vaccinated. The large outbreak that started late in 2016 and produced 777 yellow fever cases (with 261 deaths) was declared over in early September. Read more. A research letter in the current Emerging Infectious Diseases journal has described the isolation of yellow fever virus RNA from urine and semen samples taken from a man who had contracted the infection in Brazil in late December 2016/January 2017. 

    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

    Burkina Faso: New dengue spike

    At the same time of year as the dengue fever outbreak that struck the capital Ouagadougou last year (1,266 suspected cases & 15 deaths), the mosquito-borne disease has struck again. In the past few weeks, there have been as many as 4,017 suspected cases and 11 deaths across the country, with two-thirds of those in the central health region (based in the capital). As part of a response plan instituted after the 2016 outbreak, insecticide spraying is to be carried out in the evenings between 4pm & 7pm. 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.

    Canada: Mumps persists in Manitoba

    It has been ongoing for over a year now and the mumps outbreak affecting the state of Manitoba does not appear to be over yet. After the initial cases were registered in Sept 1st last year, there have been 1,150 notifications when in most years there are 10. Read more.

    Advice for travellers: These lingering 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.

    India: Trailing monsoon effects

    A sudden surge in dengue fever & chikungunya cases has seen Bhopal city officials declare 10 districts to be most affected, with plans put in place ‘proactive vector control operations’. Read more. Similarly, the dengue season is persisting in New Delhi, with 650 cases reported over a recent week.  In the state of Punjab, nearly 200 dengue fever cases were reported in the central city of Ludhiana in the past week; chikungunya is also present, but to a lesser extent. Insecticide fogging is carried out on a regular basis to try to eradicate the infective Aedes mosquito. While to the north-west, the city of Kapurthala has experienced an almost doubling of dengue fever cases over the past 2 weeks. Recent heavy rains in the state of Andhra Pradesh (Krishna district) have compromised clean water supplies and some food supplies leading to a surge in typhoid cases – over 700 cases have been registered. Read more

    Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for short-stay travellers staying in western-style accommodation. Vaccination against typhoid fever is itinerary specific, but is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. Drug-resistant strains have been identified in South Asia and other regions. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. 

    Italy: More Chikungunya cases

    An update on the chikungunya outbreaks affecting the regions of Lazio and Calabria up to Oct 20th indicates likely further local transmission, with the total number of cases now standing at 358. 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.

    Madagascar: Aid to tackle plague

    The international medical humanitarian organisation Médecins Sans Frontières is now working with local authorities as they endeavour to halt the spread of plague that has caused 1,032 cases since the beginning of August (695 pneumonic and 89 resulting deaths). The port city of Tamatave in the country’s east is the focus of the outbreak. Read more (translate from French). Read US CDC travel advisory here

    Namibia: Bacterial threat in NE

    Anthrax has struck wildlife in the far north east – 2 weeks ago the deaths of numerous hippos and buffalo were confirmed to have been caused by the bacterial illness. To prevent spread into the local population, prophylactic antibiotics have been distributed to 724 people in the Kavango East region (Bwabwata National Park). Read more.

    Advice for travellers: The anthrax bacterium is transmitted to people in the form of spores which are can produce disease through consuming contaminated meat, through inhalation or via contact with the wool, hair or hide of infected animals. The majority of cases have occurred in people involved in the livestock industry, so infection is a low risk to travellers. Read more about anthrax

    Nepal: Terai’s dengue spike

    Dengue fever cases are on the rise in the eastern Terai district of Jhapa, adjacent to the Indian state of Bihar. The case count sits at 341, with almost 250 people under treatment in local hospitals and clinics. Read more

    Puerto Rico: Post-hurricane disease threat

    Advice to doctors from the US Centers for Disease Control & Prevention (CDC) given to doctors this week centres on the possibility of infectious diseases in travellers returning from hurricane-affected areas such as Puerto Rico and the US Virgin Islands. The CDC identifies those illnesses that occur when water sanitation is compromised and there is inadequate shelter i.e. ‘leptospirosis, dengue, hepatitis A, typhoid fever, vibriosis, and influenza.’ 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

    Uganda: Marburg virus in east

    On Oct 25, the WHO announced ‘a confirmed outbreak of Marburg virus disease in Kween District’ which today was updated by the Ugandan Ministry of Health. To date there has been one confirmed case, another is suspected, plus 105 contacts are being monitored. Kween district lies partly within and to the north of Mt Elgon National Park, an area popular with tourists for hiking, wildlife and caves. Read more about Marburg haemorrhagic fever from the CDC. 

    United States of America: Hep A update; Legionnaire’s in NY

    Less than 2 weeks after California’s governor declared a state of emergency over the current hepatitis a outbreak, the number of cases continues to rise. The counties of Los Angeles, San Diego and Santa Cruz have all been impacted. In San Diego County alone, as of Oct 19th, there had been 516 cases (19 deaths & 357 hospitalisations), with most cases among ‘homeless and/or illicit drug users’. Read more. IN New York, an outbreak of Legionnaire’s disease is under investigation. The district affected is Flushing in Queens, with 12 confirmed infections over the past 2 weeks. Read more.

    Advice for travellers: Legionnaire’s disease occurs worldwide and many of the increasing number of cases reported in Australia in recent years have been linked to overseas travel. Outbreaks have been associated with cruise ships, hotels, and resorts. The bacteria that causes Legionnaires’ disease is found in airborne droplets of warm, fresh water, such as from fountains, spas, showers and the cooling towers of buildings. Over 50s, current or former smokers, those with a chronic lung condition, and the immunocompromised are at higher risk of developing illness after exposure. Read more.

    Zimbabwe: Typhoid strikes capital’s southern district

    An outbreak of typhoid has been reported in Mbare district, known for its popular markets but also high density, impoverished living in places such as the Matapi hostels. To date 18 cases have been confirmed while others are under investigation. Read more.

  • Australia: Flu debate, NSW Measles, NSW Hep A warning

    This year’s Flu season was a bumper season and saw 212,365 (as at 16.10) laboratory confirmed notifications of Influenza for 2017, nearly 100,000 of those in NSW and 52,000 in QLD of which 5500 in QLD required hospitalisation. A flu summit held in Brisbane (18.10.17) saw the announcement from QLD Health Minister Cameron Dick that $1.3 million would be provided to help diagnose influenza and other infections faster and ensure future flu seasons are easier for the state's hospitals to manage. Read more FURTHER NSW Health urges everyone aged 20 -50 years to see their GP to have a measles mumps and rubella vaccine (free up to the age 50), after the 29th notification of measles has been confirmed in the State. The latest person to have been confirmed to have measles is the fifth case connected to the Sutherland Shire Read more FURTHER A hepatitis A warning has been issued for patrons who have dined at the Sokyo Restaurant in Sydney. The warning comes after a food handler was diagnosed with the disease contracted overseas. Communicable diseases director at NSW Health, Dr Vicky Sheppeard warned diners that they may have been exposed to the disease if they attended the restaurant during the evening of September 20-24, 26, 27 and 29, October 2 and October 4-8. 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 also a significant risk for 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.

    Europe: Measles outbreak continues

    Europe has reported 19,000 cases of measles since January 2016 to October 2017; most heavily affected are Romania (9539 cases/34 deaths, 7500 in 2017) Italy (4617 cases, including 4 deaths this year), and Germany (891 cases in 2017). World Health Organisation (2016) figures show that vaccination coverage for the 2nd dose of measles was below 95% in 20 of 27 EU/EEA countries. According to the European Centre for Disease Prevention and Control (ECDC), in order to achieve measles elimination vaccination coverage after the 2nd dose must be at least 95% to interrupt measles circulation and achieve herd immunity. Read more

    Advice for travellers: A highly contagious virus, measles occurs in developing and developed countries. 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 6 weeks before departure.

    France: Rabies ex Sri Lanka

    A 10 year old boy has been admitted to a hospital in Lyon after contracting rabies from an infected stray puppy while travelling in Sri Lanka in August 17. He had received no treatment following the bite and presented with symptoms to the hospital on the 1st of October. Sri Lanka is one of the heaviest rabies-infected countries. Read more

    Advice for travellers: Rabies is present in many countries around the world 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 is normally recommended for children,  those staying for more than a month, especially travellers planning to live in, or travel extensively through, rural areas; however the final recommendation is itinerary-specific. Read more on rabies.

    Haiti: Diphtheria on the rise

    Diphtheria is making a comeback in Haiti due to a gap in vaccination of children; there have been at least 300 cases reported in the last 12 months countrywide. National surveillance shows that for the period 2014-2017, more than 90 cases were notified with a mortality rate of 30%. Most of the deaths were aged between 5 and 14 years old. Read more

    India: Drug resistant TB

    Drug-resistant pulmonary tuberculosis (DR-TB) is a significant public health issue in many countries. A recent study published in the BioMedCentral found an alarming > 40% occurrence of DRTB in India. The authors concluding: that the ‘alarming increase in the trend of anti-TB drug resistance in India’ requires changes to the countries surveillance methods and treatment strategies to improve patient outcomes. Read more

    Advice for travellers: In Australia, routine BCG vaccination are no longer part of the National Immunisation program. BCG may be required for those who have not previously been vaccinated and are tuberculin negative, according to the destination and the nature of travel. The vaccine is recommended for those under 15 years of age who are going to live and work with local people for more than three months in an area where the incidence of tuberculosis is high. If you have concerns regarding exposure to tuberculosis and travel please speak to your travel health practitioner for more information.Read more on tuberculosis.

    Italy: Local Malaria, Chikungunya rises

    Health Authorities are investigating four Plasmodium falciparum malaria cases in the Apulia region. The cases were detected in 4 men aged 21 to 37-years-old, originally from Africa. All stated that they had been in Italy for more than three months. The risk of malaria spreading further is very low in the EU. Read more. FURTHER Italy is currently experiencing four areas of local transmission of chikungunya -in the cities of Anzio, Latina and Rome in the Lazio region, and the city of Guardavalle Marina in the Calabria region. Local transmission is possible in areas where Aedes albopictus mosquitoes are established and at a time when environmental conditions are favouring mosquito abundance and activity.  The outbreak is likely the result of the virus being introduced by travellers visiting Asia. The likelihood of further spread within Italy is still moderate with suitable but less favourable conditions for mosquito activity in the coming weeks. Read more

    Advice for travellers: Chikungunya virus is spread by the same daytime-feeding mosquitoes that transmit dengue fever. There is no vaccine and preventing infection relies on avoiding mosquito bites. Apply repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

    New Zealand: Mumps cases rise

    Auckland is in the grips of a mumps outbreak, with the Auckland Regional Public Health Service indicating that 527 individuals (October 5th 2017) have now been confirmed or likely to be confirmed as having Mumps. Compared to just 286 people being diagnosed with this illness in the 20 years prior (1997 – Jan 2017). Read more

    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.

    Nigeria: YF Mass vaccination campaign

    Nigerian Minister of Health, Isaac Adewole said a mass yellow fever vaccination campaign would get underway this month as a result of the current outbreak of yellow fever which started in Kwara state last month. There have been ten cases of yellow fever this year: four cases in Kwara state, two in Kogi, two in Plateau, one in Abia and one in Edo state. 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

    South Africa: Malaria Kruger NP

    The South African National Institute for Communicable Diseases has issued a warning to visitors visiting Kruger National Park. There is a risk of malaria all year round; however the main malaria season (September to May) has seen an above average number of cases reported from areas surrounding the Park in the Limpopo and Mpumalanga provinces, prompting a warning for travellers. Read more

    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. Read more about malaria.

    Venezuela: Failing economy malaria

    According to the Venezuelan government there were 240, 000 cases of malaria reported in 2016 an increase of 76% compared to 2015. The country’s savannahs and coastal plains provide ideal breeding grounds for mosquitoes. The increase can be contributed to Venezuela’s recent ailing economy, which has led to a shortage of medicines needed to treat the disease due to import controls and the scarcity of foreign exchange. Read more

    Advice for travellers: Malaria is endemic in many areas of Central and South America. Travelvax recommends that travellers visiting these regions discuss their itinerary and whether preventative medications are necessary with their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164.

  • Central African Republic, South Africa, West Africa: Watery diarrhoea ubiquitously

    Acute watery diarrhea (AWD) disease outbreaks (cholera) have been reported in a number of countries in Central Africa, including Ethiopia, Democratic Republic of Congo & Nigeria. In Eastern and Southern Africa, cholera has caused more than 102 800 notifications and 1550 deaths since the beginning of 2017 in Angola, Burundi, Kenya, Malawi, Mozambique, Rwanda, Somalia, South Sudan, Tanzania, Zambia, and Zimbabwe. According to a report in All Africa cited in Prome ‘Somalia accounts for 76.6 % of the total cases reported, followed by South Sudan at 15.9%. Heavy rains have been cited as the main culprit of the outbreak but poor sanitation is commonplace in the affected regions. Conflict and subsequent displacements in such countries as Burundi, Somalia, and South Sudan have exacerbated the outbreak of the water borne disease in the respective countries’. 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.

    Australia: Whooping cough spikes

    Pertussis is sweeping through Riverton [South Australia] with a total of 21 students from Riverton Primary School and 1 student at Riverton Kindergarten confirmed to have contracted the infection since the start of August (2017). The South Australian Health Minister Jack Snelling is urging all South Australians to get vaccinated. He reported back in June (2017) that the number of notifications received had risen alarmingly in the State with a nearly 50% increase (860 cases) compared to 2016 571 cases). Read more.

    Advice for travellers: Travelvax Australia recommends that all travellers ensure they are current for whooping cough (pertussis) and all childhood vaccinations, including, diphtheria, measles, chickenpox and tetanus for travel to any destination – be it a developed or developing country. Read more about pertussis.

    Belize: Pink eye in Americas

    According to local news reports, there have been 1108 cases of pink eye (conjunctivitis) reported in Belize up to the end of September 2017, in what they call one of the worst outbreaks since 2005. Belize now joins Panama (as reported last week) and several other Caribbean, Central and South American countries (Bahamas, Brazil, Costa Rica, Dominica, the Dominican Republic, Guadeloupe, Martinique, Mexico, Saint Lucia, Saint Martin, Suriname, and the Turks and Caicos Islands) which have all reported outbreaks. Read more.

    Advice for travellers: Pink/red eye, also known as conjunctivitis, is one of the most common eye conditions in children and adults. It is an inflammation of the conjunctiva, the thin, clear tissue that lines the inside of the eyelid and the white part of the eyeball. This inflammation makes blood vessels more visible and gives the eye a pink or reddish colour. Travellers are advised to frequently wash their hands with soap and water, and not to share sunglasses or bath towels. In addition, it is recommended to see a medical professional if they have itching, pain, swollen eyelids, grit eyes, or other discomfort. Read more.

    Brazil: MSM Hepatitis A

    According to the local Health Department, the city of Sao Paulo is in the throes of an outbreak of hepatitis A as a result of men having sex with men (MSM). There have been since January until the 16th of September been 517 cases of the disease, a very significant increase of more than 8 x the number of cases in 2016 (64 cases). The State Department of Health, in turn, reports that in Sao Paulo state, there have been 394 cases of hepatitis A by the 2nd week of August 2017 compared to just 154 cases in 2016. 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.

    Fiji: Enteric fever concerns

    The Fiji Ministry of Health and Medical services is closely monitoring reports of an outbreak of Typhoid fever, so called enteric fever caused by _Salmonella enterica_ serotype Typhi on Moturiki Island in the Lomaiviti Group. There have been 13 patients diagnosed on Moturiki island and all have received pertinent treatment. Symptoms of classical typhoid include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation. Diarrhea may develop but usually does not. Read more

    Advice for travellers: Typhoid is endemic in many developing regions, although it generally presents a low risk for travellers, vaccination is itinerary specific. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices and discuss with their doctor if vaccinations are necessary.

    Hong Kong: 5th case of JE

    The Hong Kong Centre for Health Protection (CHP) has reported its 5th case of Japanese encephalitis (JE) in Hong Kong this year, compared to 2016 and 2015 which saw 2 (imported) and 2 (local) transmissions. There have been sporadic cases of Japanese encephalitis virus (JEV) infection in Hong Kong in past years. 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 can occur in or near cities. The risk to short-stay travellers and those who confine their travel to urban centres is very low. The recommendations for vaccination are itinerary-specific. Read more on JE.

    Madagascar: An old foe

    There have been a total of 449 cases of plague (including pneumonic, bubonic and one case of septicemic) with 48 deaths in 20 areas and cities across Madagascar. Pneumonic plague is probably the most serious form of plague; it's when the bacteria infect the lungs and causes pneumonia. The risk of infection with Yersinia pestis for international travellers to Madagascar is generally low, however travellers to rural areas of plague infected areas may be at risk. A Seychellois basketball player taking part in a tournament contracted pneumonic plague and died in a hospital in Madagascar. Read more

    Advice for travellers: Travellers should avoid crowded areas, avoid contact with dead animals, infected tissues or materials, and avoid close contact with patients with pneumonic plague. Travellers can protect against flea bites using repellent products for personal protection against mosquitoes, fleas and other blood-sucking arthropods. Read more on plague

    Switzerland: Ticks on the rise

    According to the Swiss Federal Health Office encephalitis due to tick bites is on the rise in Switzerland with 214 people contracting this serious viral illness from a tick bite and 2 deaths, according to local Swiss newspaper (SonntagsZeitung Sun 8 Oct 2017. The WHO states, "Approximately 10000-12 000 clinical cases of tick-borne encephalitis are reported each year, but this figure is believed to be significantly lower than the actual total. Immunization offers the most effective protection. 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. VACCINE: While safe and effective vaccines are available in Europe, none are licensed in Australia. However, vaccinations can be obtained from Travelvax through the TGA special access scheme.

    United States of America: pesky mossies

    Local residents in Southern California are complaining about swarms of small, aggressive mosquitoes biting during the day, often indoors. The County Vector control unit inspected local traps and found A. aegypti_ and/or _A. albopictus_ mosquitoes capable of carrying mosquito borne illnesses such as West Nile, dengue, Zika virus, chikungunya and yellow fever. The concern is that this may lead to the introduction of one of the above named viruses. As of the 27 Sep 2017, there have been 25 cases of Zika virus infections imported into California so far this year (2017). Read more

    Advice for travellers: Mosquito borne diseases such as dengue are 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 preventing insect bites.  

    Zambia: Copper belt malaria

    The Province Health Director Costantine Mwale has told ZNBC News that malaria has continued to plague the Copperbelt Province in Zambia with 400,000 cases reported between January to October 2017. Read more

    Advice for travellers: 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