Health Alerts
  • Brazil: Deadly measles in border region

    There are reports that the measles outbreak circulating in two northern states and across the border in Venezuela has spread to a tribe of Amazonian Indians, with more than 60 cases and one death resulting. The Yanomami people are an isolated tribe and as such are extremely vulnerable to the infection. 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.

    Cuba: Dengue kills 3 in east

    A local news source last week announced the deaths of three people from dengue fever infection in the central-eastern region of Camagüey. The victims were residents of the town of Florida, 50kms from the provincial capital, Camagüey. A number of suspected Zika virus infections are also under investigation. Read more (translate from Spanish). 

    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.

    Democratic Republic of Congo: Ebola countdown

    In the two weeks up to July 13, over 180 Ebola alerts were investigated and subsequently dismissed. The situation as reported on July 13 by the Ministry of Health: Of the 53 haemorrhagic fever cases in Equateur province, 38 were confirmed as Ebola virus disease (EVD), 15 were classified as probable. Fourteen deaths were confirmed as due to EVD of the 29 registered. Read more. The UN News Service has announced that a countdown to the end of the Ebola outbreak has been started, with the announcement confirming the fact due on July 25th. Read more 

    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.

    Europe: Measles, 3 EU countries with 2,000-plus cases this year

    The European Centre for Disease Control (ECDC) year-to-date measles data released on July 13th paints a concerning picture of the large ongoing outbreak: ‘In 2018 and as of 11 July, most of the cases in the EU were reported from Romania (4,317), France (2,588), Greece (2,238) and Italy (1,716). Thirty-one deaths have been reported in 2018 from Romania (22), Italy (4), France (3) and Greece (2)'. More in-depth information from across the EU: for the 12 months to the end of May 2018, there were a total of 12,921 measles cases & 17 deaths, and most likely more due to reporting issues in some countries. Read more

    Fiji: Fighting dengue with bacteria

    The World Mosquito Program (previously Eliminate Dengue) announced the first release of Wolbachia-carrying mosquitoes this week in Tamavua Village, Suva, almost two weeks after a similar release in Vanuatu. Kiribati (later this year) and New Caledonia (2019) are next among Pacific Island countries to participate in the project. Read more

    India: Gastro illnesses spike, dengue and malaria reports

    Gastrointestinal infections including cholera are being reported from parts of Vadodara (Gujarat state). In the state of Odisha, dengue treatment wards have been re-opened in a large government-run hospital in Cuttack as new cases arrive from 12 affected districts. Teenagers and adults in the 15 to 35 year age group have been hardest hit by dengue infections in the city of Pune (Maharashtra state). It's other mosquito-borne infections that are on the rise in Hyderabad (Telangana), cases of malaria are increasing, while in Delhi, more than 120 malaria cases have been reported this year. With the arrival of heavy rains, there can be a short-term dip in reporting of mosquito-borne infections as breeding sites are washed away. States such as Bengaluru have reported a slow start to the dengue season, but are not letting their guard down. And in Jaipur (Rajasthan), checks have revealed large numbers of mosquito breeding sites increasing the risk of vector-borne diseases. 

    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

    Namibia: Hep E case numbers near 2,000

    From a regional WHO office update, there has been a widening of the hepatitis E outbreak, with three regions now reporting cases. The report states that since the onset of the outbreak in early September last year and up to July 5, the situation involves ‘a cumulative total of 1,915 cases including 17 deaths … from Khomas (1,694), Omusati (103), Erongo (93) and seven other regions of Namibia (25)’. Most of the cases have a link with the largest outbreak in the informal settlements of Havana and Goreangab in the capital Windhoek (Khomas region). Read the weekly bulletin on regional outbreaks here

    Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. Infection contracted 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. The majority of hepatitis E infections occur in East and South Asia. Read more about the virus and how to prevent it.

    Papua New Guinea: Polio drive starts

    The Global Polio Eradication Initiative (GPEI) has announced on its website the start of polio immunisation drives in Morobe, Madang and Eastern Highlands provinces in response to the circulating vaccine-derived poliovirus type 1 diagnoses in June. There will be four campaigns over the months of July to October which will target children under five. Read more. The US Centers for Disease Control & Prevention (CDC) has issued a travel advisory in view of the situation, recommending ‘all travelers to Papua New Guinea be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.’

    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

    Philippines: Dengue counts rise

    Dengue has struck in the second largest city of the central province of Leyte. A health emergency has been declared in Baybay City which should enable local authorities to limit the spread of the mosquito-borne infection. Read more. Meanwhile in the Western Visayas, over 4,000 people have been infected with dengue this year - highest numbers in the province of Negros Occidental (1,850 cases and 15 deaths). The archipelago province of Batanes has also reported an increase in dengue fever cases.

    Reunion Island: Dip in dengue numbers

    There has been a drop in new dengue fever cases over the past reporting week - 119 infections with the majority (82) in the western zone, 26 in the south and seven in the north (including 3 in the capital Saint-Denis). Efforts to contain the outbreak continue during the cooler months, with the hope of halting the spread before summer. For the year to July 17, there have been 6,152 confirmed dengue fever cases, 131 required hospitalisation. Read more (translate from French).

    Taiwan: Dengue linked to travel

    Two dengue fever cases reported in New Taipei City are believed to be part of a cluster, with investigations into the source of infection for the initial case finding it ‘may have come from a reported imported case of a patient who had returned from the Maldives’. Another locally-acquired dengue fever case was earlier reported in Kaohsiung City. Read more 

    Uganda: RVF spread continues with rains

    Heavy rains in the East African region have revealed the wider extent of Rift Valley fever infections, in both animal and humans, with more cases found in western districts of Uganda and others suspected in Rwanda. In a summary of the situation, the local WHO office notes that due to the ‘suitability for vector amplification in several countries in East Africa, the ongoing RVF outbreaks in Uganda and in the subregion may have wider public health and economic impacts if not attended to appropriately’. 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.

    United States of America: Food recalls; Legionnaire in Big Apple; Hep A in 10 states

    Two multi-state outbreaks of intestinal infections, one caused by Vibrio bacteria, the other by the microscopic Cyclospora parasite, are behind large food recalls involving salad sold at a fast food chain and imported crab meat
    A LEGIONNAIRE'S disease outbreak in Upper Manhattan has killed one of the 18 people infected and several others have required admission to hospital. The cases have been identified as coming from lower Washington Heights. Investigations into the source or sources of infection are underway. Read more
    ARRIVING passengers at Nashville’s airport are being made aware of the hepatitis A outbreak ongoing in Tennessee. It is one of 10 states with outbreaks that have been concentrated among homeless people and illicit drug users; the other states are Arkansas, California, Indiana, Kentucky, Michigan, Missouri, Ohio, Utah, and West Virginia. Read more. A pre-emptive Hep A vaccination campaign targeting homeless people is underway in Texas' Dallas County. 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 some types of 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.

    Vietnam: Malaria warning for border province

    When compared with last year, malaria cases have increased by two-thirds in the south-eastern province of Binh Phuoc, situated north of Ho Chi Minh City and sharing a border with Cambodia’s Kratié Province. Almost 1,000 cases have been recorded this year – many from the rural district of Bu Gia Map (site of the Bù Gia Mập National Park). Earlier this year, it had been reported that two regions had the highest malaria burden, Binh Phuoc and the Central Highlands. Read more  

    Advice for travellers: Malaria is a low risk for most short-term travellers to Vietnam who stay in cities or coastal areas and use strict mosquito bite avoidance measures. Travelvax recommends that travellers visiting this region discuss their itinerary and preventative medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164. More on malaria

    Malaysia: HFMD in Borneo’s north

    Last week there was news on the hand, foot and mouth disease (HFMD) outbreak in Penang, this week the situation in Sabah is highlighted with reports of 1,600 cases for the year, one quarter of those in Kota Kinabalu (followed by Beaufort, Penampang and Sandakan). Children aged 12 years and under make up the majority of cases. 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, but good hand hygiene will greatly reduce the risk of infection.

  • Brazil: Chikungunya, dengue in various states; Hep A incidence rises

    The municipality of Campos dos Goytacazes, which is around 290kms north of Rio de Janeiro, has been placed under a state of emergency due to the ongoing chikungunya outbreak. The declaration allows for a raft of measures aimed at reducing mosquito infestations to be instituted. Read more (translation required). Ministry of Health data on mosquito-borne infections recorded in the state of Alagoas up to June 9 this year: 818 cases of dengue were confirmed, 62 of zika and 51 of chikungunya.  Over 12,000 suspected dengue fever cases have been reported this year from the NE state of Rio Grande do Norte – this represents an almost 3-fold increase over last year’s figures for the same period. Read more. In Foz do Iguaçu (Paranà), with over 1,000 suspected dengue fever cases already recorded this year and the presence of large numbers of mosquitoes capable of transmitting dengue, chikungunya and Zika virus, the announcement of a ‘state of attention’ will enable city authorities to tackle mosquito-borne diseases, leishmaniasis and bat rabies. Read more
    YEAR-on year, hepatitis A notifications climbed by over 70 percent in 2017 and over half were reported in the state of São Paulo. The state capital recorded a three-fold increase in cases from July last year, with 156 in that month alone. Read more (translation required). 

    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.

    China: Rubella rates rise

    In the city of Wuzhou – Guangxi Zhuang Autonomous Region, bordering Guangdong province – cases of rubella (German measles) have been increasing among unvaccinated teenagers and adults. According to a local news source, there is a risk of a larger outbreak due to low rubella vaccination rates. Read more 

    Advice for travellers: Rubella is spread by airborne droplets and can cause serious birth defects if infection occurs during early pregnancy. Rubella is the 'R' component in the triple MMR (measles, mumps, rubella) vaccine, one of the routine immunisations which should be current for prior to overseas travel. Travellers should also check their immunisation status for tetanus, diphtheria, and whooping cough. Read more about rubella.

    Democratic Republic of Congo: Polio outbreaks in 3 regions; Ebola ‘largely contained

    Over four months after the declaration of a national health emergency over outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2), the World Health Organization (WHO) reported on two separate strains infecting residents of five provinces (Haut Lomami, Tanganyika, Haut Katanga, Ituri and Mongala) this year. Surveillance is being carried out in Zambia, Tanzania and Uganda, as they share borders with the affected provinces. The WHO considers the risk of spread both nationally and internationally to be high as it ‘is magnified by known population movements between the affected area of Democratic Republic of the Congo, Uganda, Central African Republic and South Sudan, and the upcoming rainy season which is associated with increased intensity of virus transmission.’ Further, the agency ‘recommends that all travelers to polio-affected areas be fully vaccinated against polio.’ Read more
    IN THE latest update on the Ebola virus disease (EVD) situation in Equateur Province, the WHO states that the outbreak ‘has largely been contained’ but that there ‘remains a risk of resurgence from potentially undetected transmission chains and possible sexual transmission of the virus by male survivors’. Surveillance and contact tracing is to continue. 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 vaccine-derived poliovirus.

    India: Surge in rain-related infections

    Dengue fever rates have risen across a number of cities (Bilaspur & nearby towns in Himachal Pradesh, Indore in Madhya Pradesh, Kolkata in West Bengal,  Cuttackin  Odisha) and also rural districts of the states of Andhra Pradesh and Goa. In neighbouring Bangladesh, Dhaka South City has seen a rise in dengue cases. Read more  

    Advice for travellers: Dengue occurs throughout India – both in urban and rural areas. The virus is spread by two types of Aedes mosquitoes. Both breed in shady places close to dwellings and bite mainly during the daylight hours, making them difficult to avoid when 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 oil of lemon eucalyptus (or PMD) when outdoors to all exposed skin. Read more about dengue fever and preventing insect bites.

    Japan: Large spike in STI

    A local news post reported on the gradual rise in syphilis cases, with a more than 3-fold increase in cases between 2014 and 2017, reaching almost 6,000 for the year. According to the article, ‘the rise last year was especially notable among people living in provincial cities and young women’. One doctor puts the reason partly down to increased promiscuity ‘especially with the prevalence of dating and hookup apps’. Read more 

    Advice for travellers: Syphilis is a sexually transmitted infection (STI) caused by a bacterium that enters through wounded skin or mucous membranes. You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. Infections can cause long-term complications if not treated correctly with an effective antibiotic. Read more about syphilis and other STIs.

    Libya: Measles cases top 80

    ProMED reports on a measles outbreak involving over 80 cases from most of the country’s 22 districts. A state of emergency has been declared covering all medical facilities. 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.

    Malaysia: HFMD in peninsula state

    Hand, foot and mouth disease (HFMD) notifications in Penang have risen by more than half over 2017 figures, with 1,675 cases recorded so far this year. Parents have been asked to seek prompt medical treatment for their children at the first signs of the infection’s typical symptoms. 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, but good hand hygiene will greatly reduce the risk of infection.

    Namibia: Hep E toll swells to 17

    A health official stated this week that the hepatitis E outbreak, which started in the informal settlements of Windhoek in December before spreading to other areas, has now produced 1,867 suspected cases and caused 17 deaths. 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. Read more about the virus and how to prevent it.

    Papua New Guinea: Response to polio underway

    Response activities planned by the WHO to address the outbreak of circulating vaccine-derived polio virus in a district of Lae include widespread monitoring of non-polio Acute Flaccid Paralysis (AFP) cases and the collection of stool samples from contacts of AFP cases. Surveillance will be more intense in the highest risk provinces of Morobe, Madang, Eastern Highlands Province, Jiwaka, Chimbu, Western Highland Province and National Central District. Read more from ReliefWeb. The government plans to increase polio vaccination rates from 30 to 80 percent by the year 2020. Read more

    Philippines: Manila’s dengue spike

    Compared to the first six months of 2017, this year in Metro Manila there have been 1,500 more dengue fever cases, with 7,200 infections recorded up to July 7. The rainy season extends from June until the end of October. Read more

    Reunion Island: Dengue cases near 6,000

    Local and regional authorities have raised the level of response to the dengue epidemic (now categorised as Level 4 - moderate intensity) with efforts planned for the control of the virus during the cooler months. For the year to July 10, there have been 5,970 dengue fever cases – over 3,000 of those from the large municipality of Saint-Paul. Read more (in French). In a European Centre for Disease Control (ECDC) assessment on the risk of spread to southern EU areas with the competent mosquito species, the agency notes ‘vector abundance is currently considered sufficient to permit autochthonous transmission of dengue virus and potentially generate local outbreaks’. The ECDC recommends travellers heading to dengue fever-affected regions use mosquito bite avoidance measures, doctors should be aware of the potential for dengue cases in returning travellers, and travellers must report ‘symptoms compatible with dengue fever in the first two weeks after return’. 

    Saudi Arabia: June MERS update; Dengue in Mecca region

    Another four MERS Co-V cases were reported in June and one succumbed to the infection, according to the WHO situation update for June. The update also notes that the ‘age group 50–59 years continues to be at highest risk for acquiring infection of primary cases’. Read the June situation update here
    THREE cases of dengue fever have been confirmed in the city of Al-Taif city, Al-Taif Governate (Mecca region). Read more 

    Sweden: Frozen fruit hep A risk

    Frozen strawberries imported from Poland have been identified as the source of 13 confirmed or suspected hepatitis A cases reported in the counties of Skane, Blekinge, Kalmar and Gavleborg. A recall of the products, sold by a wholesaler and used in smoothies or desserts by caterers or restaurants, is under way, however the risk of new cases appearing remains as some of the product may still be in the marketplace and hepatitis A infection has a long incubation period – ranging from 15 to 50 days, but averaging 28 days. Read more 

    Switzerland: Tick season’s hike in related infections

    The incidence of tick-borne encephalitis (TBE) infections has climbed sharply this year. The Federal Office of Public Health reported 73 early-summer meningoencephalitis infections last month alone, a significant increase from 46 to 109 cases per year for the period 2000-2017. But TBE is not the only tick-borne disease occurring in areas of the country below 1,500metres, there have also been 6,900 cases of Lyme disease. Vaccination against TBE is recommended for residents of TBE endemic areas, and for those visitors who plan activities that put them at risk of tick bites. 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, vaccination can be obtained by a medical practitioner through a Special Access Scheme. Read more about TBE.

    Uganda: Changes to proof of vaccination

    Four African countries have been added to the list of WHO state members requiring mandatory proof of yellow fever vaccination at entry; the others are Cameroon, Chad and South Sudan. The UK’s National Travel Health Network and Centre website travelhealthpro lists the main changes to the yellow fever vaccination requirements for all countries in 2018. 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

    United Kingdom: Bacterial infection strikes

    There has been plenty of publicity about the spread of measles in England resulting from travellers returning home from EU countries reporting large outbreaks, but Public Health England is also highlighting a steep rise in scarlet fever infections, with almost 27,000 cases for the year. Read more

    Advice for travellers: A mild bacterial infection, scarlet fever generally causes strep throat or, less commonly, streptococcal skin infections. It affects people of any age, but is most common among children. The classic symptom is a sandpaper-like red rash. Scarlet fever is treatable with antibiotics which helps clear up symptoms faster, reduces spread to other people and prevents rare but serious long-term health problems. Read more on scarlet fever.

    Vietnam: Capital’s measles threat

    Measles cases reported in the capital Hanoi have reached 200 this year, which is 140 more than the total for 2017. At the end of last year there were concerns of a looming outbreak due to the large cohort of unvaccinated children. Read more

  • Brazil: Measles surge in 2 states; Chikungunya, dengue reports

    Vaccine supplies are being sent to the states of Amazonas and Roraima to stem the spread of measles. The majority of Amazonas’ confirmed cases have been the capital, Manaus; there are a further suspected 1,368 cases in the state. To the north in Roraima, there have been 200 confirmed measles notifications and 177 more suspected. Read more
    UP TO 9,000 residents of the state of Rio de Janeiro have been infected with chikungunya this year and despite the arrival of the cooler months the number is increasing. While all areas of the state have been affected, it’s the northern city of Campos dos Goytacazes that has borne the brunt of the outbreak. Separate reports on mosquito-borne infections in other states have also been published, including Paraná, Minas Gerais, Maranhão and Bahia. Read more (translation required). 

    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.

    China: HFMD cases mount in capital

    Beijing’s 4,014 hand, foot and mouth disease (HFMD) infections in June represent an almost 90 percent increase over last year’s figures for the same month. June is also the start of the city’s peak HFMD season which is likely to extend until November. Read more (translation required).

    Advice for travellers: HFMD 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, but good hand hygiene will greatly reduce the risk of infection. Read more about HFMD.

    Democratic Republic of Congo: Measles epidemics; Ebola updates

    The World Health Organization (WHO) regional update for various reporting dates in June notes that cumulative suspected measles cases for the DRC climbed to 14,031 (149 deaths), Liberia 3,025 (15 deaths, epidemics in 22 health zones) and Ethiopia 2,244 suspected cases.
    MORE than three weeks have lapsed (June 12) since the last confirmed Ebola virus disease (EVD) case was released from a treatment centre and in the latest sitrep, the WHO notes on July 3 that ‘13 suspected EVD cases were reported in Bikoro (10), Iboko (2) and Wangata (1) health zones. Of the 13 suspected cases, 11 tested negative, while two suspected cases reported on 30 June 2018 are awaiting collection of the second specimens for a repeat test after the first specimens tested negative.’ Surveillance will continue in the interim: ‘The 12 June 2018 marked the start of the countdown towards the end of the EVD outbreak, which requires 42 days (two maximum incubation periods) without notifying new confirmed EVD cases.

    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.

    Guatemala: Dengue surge in west

    There has been a two-fold increase in dengue fever cases over 2017 figures in some areas of Quetzaltenango department, situated in the SW near the Mexican border (Chiapas state). The towns of Coatepeque, Colomba, Genoa, Flores, and El Palmar have been hardest hit. 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.

    India: Dengue, JE, leptospirosis reports; Nipah outbreak source update

    THIS week, there have been news reports on dengue fever in Visakhapatnam (Andhra Pradesh) and Patna (Bihar); 30 cases of Japanese encephalitis infection and five associated deaths in Dibrugarh district, Assam; and the Municipal Corporation of Greater Mumbai has advised of the rise in a number of monsoon-related illnesses. Read more
    NO further Nipah virus disease cases have been reported since May and testing has confirmed that almost 20 percent of the fruit bats caught in the two affected districts of Kerala (Mallapuram and Kozhikode) during the outbreak carried the virus. 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 an effective repellent when outdoors to all exposed skin. Read more about chikungunya and avoiding insect bites.

    Ireland: Gastro illness upswing

    VTEC (verocytoxin producing E. coli) gastrointestinal illness has spiked recently, causing health authorities to issue a warning with particular mention of young children and the elderly who are more at risk of severe complications. Infections like VTEC (aka STEC or Shiga toxin-producing E. coli) are more common in the warmer months and are acquired through contamination of foods with faecal material. Advice from the Health Protection Surveillance Centre, ‘Always wash your hands before and after handling food, wash your fruit and vegetables thoroughly before eating them and always ensure minced meats are cooked all the way through.’ Read more

    Kenya: RVF in 3 counties, 8 more at risk

    Wajir, Marsabit, and Siaya counties have all reported human RVF cases although a further eight counties are considered risk areas. The situation as outlined by the WHO on June 29 – 90 cases and 10 deaths. Most cases were acquired through contact with blood or tissues of infected animals (livestock); but recent flooding in one district led to an increase in cases acquired through bites from infected mosquitoes, a less common mode of transmission. 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.

    Malaysia: Fifth JE case in Sarawak: Tinned fish recall

    Sri Aman, situated in the east of Sarawak state, is the latest district to report a Japanese encephalitis case this year, the others being Kota Samarahan, Lawas, Julau, Kuala Baram. The health department now categorises the infection as endemic to the state. Read more. Sri Aman is also included in the list of districts containing 31 rabies-declared zones, together with Serian, Kuching, Samarahan, and Sarikei. Read more
    EIGHT brands of tinned sardines and mackerel have been recalled from sale after they were found to contain Anisakis species roundworms. None of the worms were alive, having been killed in the cooking process. Read more. More on Anisakiasis, the parasitic infection contracted through eating some types of uncooked or undercooked seafood.  

    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

    Namibia: New Hep E hotspot

    Hepatitis E infections, four confirmed and 32 under investigation, have been reported in the central coastal city of Swakopmund. Many of the cases are in the Democratic Resettlement Community (DRC), an informal township in the NE of the city. Read more. In a separate news report, the Hep E outbreak in the informal settlements of the capital city, Windhoek, continues to spread to new areas. Read more

    Advice for travellers: The hepatitis E virus is transmitted mainly through faecal contamination of drinking water. 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. The majority of hepatitis E infections occur in East and South Asia. Read more about the virus and how to prevent it.

    Nigeria: Cholera in northern state

    Eleven of 132 people suffering from cholera infections have perished in the northern state of Katsina. Six districts in the state, which shares borders with Niger, are affected. Read more. Cameroon is also being impacted by cholera outbreaks in Nigeria after the infection spread from the NE state of Adamawa to some border districts. 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

    Pakistan: Travel warning due to resistant typhoid

    The US Centers for Disease Control and Prevention (CDC) has issued a Level 2, Practice Enhanced Precautions travel advisory for travellers to Pakistan, in particular those who are visiting friends and relatives, relating to the presence of an extensively drug-resistant (XDR) strain of typhoid fever. One tourist from the UK and two from the US have returned home infected with the virulent bacteria this year. First identified in Hyderabad in late 2016, it has since spread to Karachi and beyond. 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 is itinerary specific, but is generally recommended for those staying or travelling extensively in rural areas, as well as for adventurous eaters. All travellers visiting endemic areas should follow safe food and water guidelines, and adopt strict personal hygiene practices. Read more about typhoid fever.

    Philippines: Infections from contaminated water rise

    Health authorities are directing money and resources towards tackling this year’s climb in leptospirosis cases – they have risen by more than 30 percent compared with 2017. To date there have been 1,040 cases and eight resulting deaths. The capital Manila and Bacolod City (Western Visayas) are two of the areas affected by the increased incidence. Read more

    Advice for travellers: Leptospirosis is spread through the urine of infected animals, typically rats. The bacterium enters the body through the mucous membranes of the eyes, nose, or mouth, as well as through broken skin. Outbreaks are typically associated with exposure to floodwaters, making leptospirosis a low risk for most travellers. Read more about leptospirosis.

    Papua New Guinea: Morobe Province polio update

    From a ReliefWeb post on the circulating vaccine-derived polio case reported last week, ‘In response to the detection of poliovirus in the index case, mop-up vaccination was undertaken in Lae where the case lives and in Eastern Highlands Province where the case had stayed prior to onset of paralysis… Prior to the detection of VDPV1 in contacts of the index case, preparation is underway for implementation of broader polio supplementary immunization activities as well as surveillance system strengthening in the affected province and surrounding provinces.’ From the WHO’s risk assessment: ‘Given substantial vaccination coverage gaps across the country and suboptimal surveillance for AFP and poliovirus, the risk of further spread of cVDPV within the country is deemed to be high.’ 

    Advice for travellers: Read more on vaccine-derived polio from the WHO. 

    Sri Lanka: Dengue fever cases top 25,000

    Nationwide, dengue fever cases have now topped 25,000 for the year, with the Western Province recording almost one-third of all cases (including the districts of Colombo, Gampaha & Kalutara). The peak of last year’s dengue season occurred at this time of year - June and July. Read more

    Taiwan: Southern city’s dengue case

    Until this week, all dengue fever cases recorded this year have been imported, but the first locally-acquired infection, a man from the large southern city of Kaohsiung, has been announced by the Centers for Disease Control. The man’s contacts and neighbours have been tested for dengue infection but all proved negative. Read more

    Ukraine: Weekly measles count drops, to 935

    New measles infections have decreased in number over the past week, but they remain high – 935 cases in the 7-day period. Country-wide, the year-to-date total has climbed to 24,027 cases, the death toll remains at 12. Read more. While eastern districts of Slovakia are also experiencing a measles epidemic, with cases reaching a 20-year high. Eighteen towns and villages have reported cases; around half of the 101 suspected measles infections have been confirmed to date. Read more

    Vietnam: Dengue season onset

    A Russian health agency, Rospotrebnadzor, has warned travellers of the heightened risk of dengue fever infection in areas including Da Nang, Hanoi , Ho Chi Minh City and southern provinces. According to Russian news reports, there have been more than 21,000 dengue infections and four related deaths this year in Vietnam. Read more (translation required).