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-specific advice and vaccination recommendations. Recommended vaccines, travel medication, accessories and trip-specific advice are available during a medical consultation with a travel health professional at any of Travelvax Australia’s 32 clinics. Visit our website or call 1300 360 164 for details.


WORLD TRAVEL HEALTH ALERTS – JULY 28, 2010

– Dengue tightens its grip on Caribbean
– Dengue toll rises in Malaysia
– Hurricane Alex brings rising tide of dengue
– Swine flu lingers in Asia
– JE continues to spread in India’s north
– Malaria death toll soars in Zimbabwe
– Cholera widespread in Vietnam’s south
– AFRICA: Cholera toll mounts in Cameroon, Nigeria
– Malaria epidemic in Philippines province
– Whooping cough on the move in USA
– Mumps rampant in Israel
– Reunion hopes for respite from fever

Dengue tightens its grip on Caribbean
The death toll is mounting as epidemics of dengue fever intensify in the Caribbean with warm weather and early rains bringing an explosion in mosquito numbers.

The Dominican Republic, Puerto Rico, and Trinidad and Tobago are experiencing their worst outbreaks in at least a decade, according to this week’s global dengue bulletin. Honduras and Belize are also feeling the impact as hospitals struggle to cope with a flood of patients.
In Indonesia, dengue is firmly entrenched in urban areas of Yogyakarta and case numbers have jumped from 688 cases (5 deaths) for all of 2009, to 814 (1 fatality) to July 19 this year.

In Sri Lanka, dozens of patients are being treated for dengue each day in the capital, Colombo. Nationwide, there have been 148 deaths among 20,647 cases this year.

Yemen’s worsening dengue outbreak claimed the lives of 7 children last week, with the governorates of Hadramout, Hajjah, Shabwa, Aden, Abyan, and Lahj the worst effected. Outbreak details.

Advice to travellers: Dengue fever poses a significant travel health risk for Australians visiting tropical countries, especially in the Caribbean, Latin America and SE Asia. An effective insect repellent containing DEET or Citriodiol is essential and should be applied regularly to all exposed areas at all times when outdoors – even within resorts and hotels. Preventing mosquito bites is the only way to avoid the risk.

Dengue toll rises in Malaysia
Malaysia recorded 7 dengue fatalities and 1071 new cases last week, bringing this year’s toll to 91 deaths from 27,400 cases. Areas worst effected include Selangor (17 districts), Johor (6), Kuala Lumpur (6), and Sarawak (5). More details.

Hurricane Alex brings rising tide of dengue
In Mexico, cases of the haemorrhagic form of dengue fever have topped 1900 – 500 more than last summer. Flooding near the US-Mexico border following Hurricane Alex has created ideal breeding conditions for the Aedes aegypti mosquito that spreads the disease. More details.

Swine flu lingers in Asia
The swine flu virus remains active in Cambodia, Singapore and, most notably, India’s Kerala and Maharashtra states. This update provides details of swine flu and emerging strains of influenza around the world. More details.
Advice to travellers: Travellers to countries where swine flu persists should receive the seasonal flu vacci ne, which protects against swine flu and this season’s B/Brisbane and A/Perth H3N2 like –strains.

JE continues to spread in India’s north
Japanese encephalitis [JE] virus infections continue in northeastern India, with new cases reported in Ri-Bhoi and West Khasi Hills districts of eastern Meghalaya state. More details.
Advice to travellers: JE is spread by infected mosquitoes. It presents a low risk for most travellers, with the season, destinations, length of stay and activities among the contributing risk factors. People planning longer stays in rural areas should seek advice from Travelvax on whether vaccination is recommended for their itinerary. Avoiding mosquito bites using an insect repellent containing DEET or Citriodiol is essential.

Malaria death toll soars in Zimbabwe
Zimbabwe has recorded 189 deaths among 130,000 cases of malaria in the last two months, with a lack of drugs and failure to spray mosquito-breeding areas blamed for the worrying figures. More details.

Cholera widespread in Vietnam’s south
Epidemics of cholera and acute diarrhoea continue to spread extensively in Vietnam’s southern provinces (Cau Mau, An Giang, and Ben Tre), and Can Tho City. However, the cholera crisis in the country’s north has eased. More details.
Advice to travellers: While the risk of cholera for most travellers is low, those heading to developing countries where cholera is endemic should practice strict personal hygien e and take care with food and water. Drinking unchlorinated water, adding ice to drinks and eating unrefrigerated food from street market stalls should be avoided. Travelvax can advise travellers if cholera is a significant risk for their journey and recommend vaccination if appropriate.

AFRICA: Cholera toll mounts in Cameroon, Nigeria
In Africa, epidemics of cholera and acute diarrhoea are occurring in Cameroon, Somalia (Mogadishu), Guinea-Bissau (Bafata), and Zimbabwe (Chiadzwa). Kenya’s widespread outbreaks appear to be in decline. More details.

In Cameroon’s far north the disease has claimed 83 lives (1147 cases) with the Moloko district the worst affected.
In Nigeria, cholera has claimed 6 lives in the northeast city of Bauchi (Bauchi State). More details.

Malaria epidemic in Philippines province
In the Philippines, authorities have declared a malaria epidemic in Camarines Norte province (Bicol region, Luzon) with most of the 182 cases in Jose Panganiban. More details.

Whooping cough on the move in USA
In the USA, whooping cough (pertussis) continues to spread across state borders. Case numbers are well above average in Idaho, Ohio, Michigan and Georgia. In California, there have been six infant deaths among 1500 cases this year – fives times higher than in the same period last year. More details.

Advice to travellers: The high incidence of whooping cough in parts of the USA (and Australia) this year highlights the risk of so-called childhood diseases in developing and developed countries. Regardless of their destination, we recommend all travellers to check their immunisation status for measles, whooping cough, mumps and polio as part of their pre-travel medical preparations.

Mumps rampant in Israel
In Israel, mumps has been widespread among unvaccinated young men of high school and college age. There have been more than 3400 cases this year – 2400 in Jerusalem  – compared to the annual average of 6-10. More details.

Reunion hopes for respite from fever
On Reunion Island, approaching cooler weather should slow the long-running outbreak of mosquito-borne Chikungunya fever, ‘imported’ from nearby Madagascar. There have been 136 confirmed or suspected cases. More details.