Travelvax Australia compiles this weekly bulletin of global travel health alerts, risk assessments and advice for the information of Australian travellers and the travel industry. Please contact our travel health advisory service on 1300 360 164 for broad destination advice and vaccination recommendations. Recommended vaccines, travel medication, accessories and trip-specific advice are available from our travel health professionals during a medical consultation at any of Travelvax Australia's 32 clinics. Visit our website or call 1300 360 164 for details.

WORLD TRAVEL HEALTH ALERTS - JULY 14, 2010

- Dengue risk persists in the tropics
- Vietnam battles dengue, cholera outbreaks
- Boy's death brings Bali's rabies toll to 86
- Cholera continues deadly march across PNG
- Southern Indian states buck swine flu trend
- Whooping cough descends on more US states
- World Cup fan brings home measles
- JE tightens hold in India's far north
- Taiwan also fears more JE

Dengue risk persists in the tropics
In this week's global Dengue fever update, epidemics and major outbreaks persist in Latin America, the Caribbean, and South East Asia. This ProMED summary details the situation in the following countries : Puerto Rico, Dominican Republic, Honduras, Venezuela, Brazil (Mato Grosso), Philippines (Metro Manila, southern and northern Mindanao), Vietnam, and Singapore. More details.
Advice to travellers: We urge Australians travelling to all tropical destinations, especially Latin America, the Caribbean and SE Asia, to pack an effective insect repellent containing DEET or Citriodiol. Apply it to exposed areas regularly when outdoors at all times - even within the confines of resorts and hotels. There is no vaccine for dengue: preventing mosquito bites is the only way to avoid risk.

Vietnam battles dengue fever and cholera outbreaks
Major outbreaks of dengue fever and cholera continue in Vietnam. The Central and Central Highlands provinces of Binh Dinh, Phu Yen and Gia Lai are recording high numbers of dengue, while cholera continues to spread in Thanh Hoa, Ho Chi Min City, and Hanoi. More details. (For more details on cholera in Vietnam, see the cholera alert in this bulletin.)

Boy's death brings Bali's rabies toll to 86
An 8-year-old boy from Pangkung Jelati is Bali's latest rabies victim. His death last week following an untreated dog bite brings the tally of confirmed and likely cases to 86 across the island. This report lists the government-confirmed cases by regency. More details.
Advice to travellers: For most short-stay travellers to Bali, the risk of rabies remains low. While dogs are the most common carriers of rabies, cats, monkeys and many other animals can also transmit 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. If bitten, urgent post-exposure treatment is required. More on rabies.

Cholera continues deadly march across PNG
Cholera continues to have a devastating impact in Papua New Guinea. There have been 15 deaths in villages on PNG's Manam Island, while Central Province has reported almost 2000 cases (8 deaths) since the disease first hit the region.
This report also details current outbreaks of cholera and acute diarrhoea in Vietnam (northern and Mekong Delta provinces), Cambodia (Ratanakkiri), Thailand (Pattani, Songkhla, and Tak; Thail-Myanmar border), and India (Chhattisgarh). More details.
< strong>Advice to travellers: For most short-stay travellers, the risk of cholera is low. To avoid cholera, dysentery and travellers' diarrhoea, we advise travellers to adopt strict personal hygiene, and follow food and water guidelines. Unchlorinated water, ice and food from street markets carries a higher risk. Travelvax can advise travellers if cholera is a significant risk for their journey and recommend vaccination against cholera if appropriate.

Southern Indian states buck swine flu trend
While swine flu activity is in decline around the world, India is the exception. The disease has again flared in four southern States (Kerala, Karnataka, Tamil Nadu, Andhra Pradesh) and Maharashtra. With 10 of the 16 deaths, Kerala State has been hardest hit, according to a media report. More details.
Advice to travellers: This year's seasonal flu vaccine protects against swine flu and other emerging strains, and Travelvax advises vaccination for all travellers - particularly those travelling to southern India during the current monsoon season. With the southern hemisphere flu season underway, we also advise vaccination for non-travellers.

Whooping cough descends on more US states
California is not alone in facing record high numbers of whooping cough. The disease is also being reported in record numbers in upstate New York, Arizona, South Carolina, Michigan, Ohio and Texas. More details.
Advice to travellers: Childhood diseases are common in both developing and developed countries and outbreaks like this one in the USA are usually the result of sub-optimal immunisation levels. Regardless of their destination, we recommend all travellers to check their immunisation status for pertussis (whooping cough), measles, mumps and polio as part of their pre-travel medical preparations.

World Cup fan brings home measles
An Australian World Cup soccer fan has returned from South Africa with measles. The case has prompted a call for doctors here to be on alert, given the major outbreaks currently in South Africa and other African countries. More details.

JE tightens hold in India's far north
In India's Manipur State, an outbreak of suspected Japanese encephalitis is intensifying. In the past two weeks, the disease has claimed 15 lives and hospitalised 100 people in the far northern state, which borders Bangladesh. More details.

Taiwan also fears more JE
Taiwan health authorities are on alert after three new cases of Japanese encephalitis (JE) were confirmed last week. Only one was 'imported' - a businessman who returned from Guangdong (China), where the mosquito-borne disease is endemic. More details.
Advice to travellers: JE is a low risk for most travellers and is dependant on such travel factors as the season, destination, duration of stay, and the type of rural- based activities planned. At-risk travellers should discuss if vaccination is advisable for their itinerary with a travel health professional. Avoiding mosquito bites by using an insect repellent containing DEET or Citriodiol is essential.