WORLD TRAVEL HEALTH ALERTS

- Thailand rabies scare for former model
- Bali's dengue outbreak 'worst in years'
- WA issues warnings to Bali travellers
- Concern over Giardia outbreak in Wellington
- Monsoon brings more malaria, dengue to Mumbai
- Cholera deaths mount in Africa
- Cambodia in grip of cholera, diarrhoea
- Indonesia hardest hit by deadly bird flu
- Swine flu activity in decline
- France tops Europe's measles tally
- Malaria threatens river villages in Sarawak
- Tree harvesting sparks rabies in India's far north
- Concern at rising typhoid numbers on Luzon
- Fever cases rise on Reunion

Thailand rabies scare for former model
Former UK Page 3 model, Samantha Fox is undergoing precautionary treatment for rabies after a stray cat bit her hand on Thailand's resort island, Koh Samui. Fox, 44, was feeding strays outside a restaurant she had been frequenting when an animal thought to be infected attacked her, according to a media report last week. More details.
Since then report, doubts have emerged. Spokesman for a US based animal group claims the island has been free of rabies for 25 years and that dogs are routinely vaccinated. More details.
Advice to travellers: For most short-stay travellers, the risk of rabies is low. However, Samantha Fox's decision to undergo the lengthy post-exposure treatment for rabies was a sensible one: The disease is invariably fatal once symptoms appear. While dogs are the most common carriers of rabies, cats, monkeys and many other animals can also tra nsmit the disease. Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals, especially if they appear sick or injured. If bitten, urgent post-exposure treatment is required. Read more on rabies.

Bali's dengue outbreak 'worst in years'
Bali continues to experience its worst outbreak of dengue fever in years and health authorities warn of the risk of dengue haemorrhagic fever, the often-fatal form of the mosquito-borne disease, in the capital, Denpasar. This report also includes details of outbreaks in Sri Lanka, Honduras, Puerto Rico, Mayotte and Cape Verde. More details.
Thailand too is having a bad year for dengue. This week's global dengue bulletin details the impact nationally, as well as regions and provinces, notably Maha Sarakham and Yala. Other countries covered include Dominican Republic, French Guiana, Colombia, Martinique, Malaysia, Myanmar and Mayotte. More details.
Advice to travellers: Avoiding mosquito bites is the only way to avoid dengue fever and we urge Australians travelling to all tropical destinations to pack an effective insect repellent containing DEET or Citriodiol. It should be applied to all exposed areas regularly when outdoors during daylight hours - even within the confines of resorts and hotels.

WA issues warnings to Bali travellers
Western Australia's health authorities have warned travellers of the risk of contracting dengue, rabies and gastro diseases in Bali. WA has had 150 dengue cases this year, while a third of its salmonella cases were acquired overseas, mainly in Bali. More details.

Concern over Giardia outbreak in Wellington
New Zealand has seen a 50% surge in giardia cases nationwide this year and authorities are concerned over an outbreak in the capital, Wellington. Health authorities suspect that the outbreaks are linked to water supplies and have urged residents to follow strict hygiene guidelines and boil drinking water harvested from roofs and local waterways. More details.
Advice to travellers: Giardia parasites are typically passed on in water, although chlorinated water is safe. The symptoms are generally mild, but are unpleasant and can last for up to six weeks. If in doubt, first boil untreated water.

Monsoon brings more malaria, dengue to Mumbai
With monsoon rains only just begun, Mumbai (India) has been hit hard by malaria and dengue fever. Thousands of the city's poor have been treated in recent weeks and massive construction projects across the city are providing ideal breeding grounds for mosquitoes. More details.

Cholera deaths mount in Africa
The death toll from cholera continues to mount in Cameroon (far north), Uganda, and Kenya. Kenya had 880 cases in June, mainly Lang'ata in Nairobi, and the Kilifi an d Kaloleni districts of Coast Province. Contaminated drinking water, and poor levels of sanitation and hygiene have been blamed. More details.
Advice to travellers: For most short-stay travellers, the risk of cholera is low. To avoid cholera, dysentery and travellers' diarrhoea, travellers should adopt strict personal hygiene, and follow food and water guidelines, especially when visiting areas with outbreaks. Avoid drinking unchlorinated water, adding ice to drinks and eating at street markets where food is not refrigerated. Travelvax can advise travellers if cholera is a risk in the country or region they may be visiting, and if the disease poses a significant risk.

Cambodia in grip of cholera, diarrhoea
Cambodia has recorded 4000 recent cases of acute diarrhoea and cholera in 11 provinces. Since January, more than 60 people have died, with 20 of the country's 24 provinces reporting cases. Most were due to contaminated water.

Indonesia hardest hit by deadly bird flu
The recent death of a 34-year-old Jakarta woman from H5N1 avian influenza (bird flu) brings Indonesia's death toll from the often-fatal virus to 137 from 166 cases, more than a quarter of tally worldwide. Authorities say the victim had no apparent contact with sick birds and may have been infected by contaminated manure in her plant nursery. More details.
Advice to travellers: Bird flu persists in several parts of the world, notably Indonesia. For most short-stay travellers, the risk of bird flu is very low. The Department of Foreign Affairs and Trade's website, Smartraveller has more information.

Swine flu activity in decline
Swine flu (H1N1) activity continues to be low around the world, the WHO reports. However, the virus persists in localised areas of the tropics, particularly in South and Southeast Asia, the Caribbean and West Africa. More details.
One exception is India, where swine flu deaths have again risen with the onset of monsoon rains. Most cases have been in Kerala and Maharashtra states. More details.
Advice to travellers: Travellers to countries where swine flu persists should receive the seasonal flu vaccine, which protects against swine flu and this season's B/Brisbane and A/Perth H3N2-like strains.

France tops Europe's measles tally
French authorities are concerned at a surge in measles this year, with figures showing the country's case numbers are the highest in Europe. More details.
Zambia is the latest country to be hit by measles epidemics sweeping Africa, with a staggering 1600 cases reported in the first week alone, according to an online news report. More details.
Advice to travellers: While it would seem an unlikely hot spot for measles, the high incidence of measles in France this year highlights the risk in developing and developed countries. Regardless of their des tination, we recommend all travellers to check their immunisation status for measles, whooping cough, mumps and polio as part of their pre-travel medical preparations.

Malaria threatens river villages in Sarawak
A major outbreak of malaria has been reported among villagers along sections of the Baram and Silat rivers in Sarawak (Malaysia). The outbreak threatens thousands of people from remote villages in the State's northeast. More details.

Tree harvesting sparks rabies in India's far north
In Himachal Pradesh (northern India), deforestation may be partly to blame for a sharp rise in rabies cases. In the town of Panchkula six cases are being reported each day. More details.

Concern at rising typhoid numbers on Luzon
A rise typhoid fever is causing alarm in Banguio City (Luzon Island, Philippines). More details.
Advice to travellers: Despite sporadic outbreaks, typhoid poses a low risk for most short-stay travellers to the Philippines. Following food, beverage and hygiene guidelines will greatly reduce the risk of typhoid and, more commonly, travellers' diarrhoea, particularly for travellers planning to visit or stay in rural areas outside resorts. Guidelines for avoiding food- and water-borne illness.

Fever cases rise on Reunion
On Reunion Island, the number of Chikungunya fever cases continues to rise. Since March, there have been 124 confirmed or suspected cases of the m osquito-borne disease. More details.