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, August 11, 2010

- Another rabies death on Bali spurs government action
- Dengue fears in Games city
- Costa Rica fears unwanted 'export' from neighbours
- Malaria tightens grip on Mumbai
- Rising rates of malaria, dengue near Manilla
- Sand fly disease claims 17 in Gujarat (India)
- Swine flu sweeps through Wairarapa (NZ) schools
- Measles outbreak kills 110 in Zambia
- South Africa link to measles outbreak in Buenos Aires
- Measles revisits Brazil
- PNG's cholera case tally tops 1200
- Cameroon struggles to contain worst cholera in a decade
- Leishmaniasis claims 48 lives in Sudan
- West Nile virus suspected in fatalities
- Russia's fires prompt travel health warning
- Australians warned of kidnap threat in Africa

Another rabies death on Bali spurs government action
Following another fatality last week, Indonesia says it will speed up its program to vaccinate Bali's dogs against rabies. The number of people bitten by dogs this year has risen sharply: 34,000 to date, compared to 28,000 for all of 2009, according to new government figures. Officially, the disease has now claimed 78 lives, but the figure is closer to 100 with suspected deaths included. More details.
Advice to travellers: As stated previously, the risk of rabies for most short-stay travellers to Bali is 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 tra vellers 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.

Dengue fears in Games city
With the Commonwealth Games looming, a rise in dengue cases is causing concern in Delhi. Health authorities have intensified efforts to eliminate mosquito-breeding sites in the city, and prepare medical personnel and local facilities to treat infection among Games athletes and spectators. Ironically, previous reports confirmed mosquitoes are breeding in construction sites associated with the Games.
This bulletin also details outbreaks elsewhere in Asia, including the Philippines (national figures, Negros Occidental, Davao Sur, and Aklan), and Malaysia; and the Americas - Dominican Republic, Martinique, and Brazil (national figures, Rio de Janeiro, Alagoas). More details.
Last week's second dengue bulletin provides details of other outbreaks in the Philippines, Malaysia, Thailand, Vietnam, USA, Mexico, El Salvador, Brazil, and Africa's Cote d'Ivoire. More details.
Advice to travellers: Dengue fever continues to be 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 outdoo rs - even within resorts and hotels. Preventing mosquito bites is the only sure way to avoid the risk.

Costa Rica fears unwanted 'export' from neighbours
Costa Rica fears 'imported' Type 4 dengue currently circulating in Nicaragua and Honduras will lead to a rise in the potentially fatal dengue haemorrhagic fever. Costa Rica has experienced Types 1, 2, and 3, but people previously infected with any strain are at higher risk of developing life-threatening haemorrhagic symptoms if infected with a new strain. More details.

Malaria tightens grip on Mumbai
Mumbai's malaria epidemic is worsening, with 8614 cases (6 deaths) recorded this month and hundreds admitted to hospitals each day. More details.
In India's northeast, an outbreak of cerebral malaria has caused panic in the Bokaro district of Jharkhand State. More details.
Advice to travellers: Malaria is a risk in many tropical countries. At-risk travellers should consider taking a preventative malaria medication and use an effective repellent to minimise insect bites. They should seek advice from a travel health professional regarding appropriate medication. Read more on malaria.

Rising rates of malaria, dengue near Manila
In the Philippines, authorities are concerned at high rates of malaria and dengue in Rizal Pr ovince, which borders metro Manila (Luzon island). More details.

Sand fly disease claims 17 in Gujarat (India)
In India's Gujarat State, authorities have sent emergency teams to investigate the deaths of 17 people from encephalitis in the districts of Vadodara, Kheda, and Panchmahal. This report confirms earlier suspicions that the deaths were due to sand fly-borne Chandipura virus. More details.
Advice to travellers: Chandipura virus poses no risk to travellers. It was first identified in Chandipura village in Maharashtra state in 1965 and has been associated with a number of otherwise unexplained outbreaks of encephalitic illness in central India. The most recent occurred in Andhra Pradesh and Maharashtra in 2003 with 329 children affected and 183 deaths. There have been no human cases outside India. Read more on Chandipura virus.

Swine flu sweeps through Wairarapa (NZ) schools
In New Zealand's Wairarapa district, a severe outbreak of swine flu (H1N1) is raging in the community, with almost half of the students at district schools ill with the virus. Wairarapa is a region in the southeastern corner of the North Island, east of metropolitan Wellington. More details.
Advice to travellers: Travellers to countries where swine flu persists should receive the seasonal flu vaccine, which protects against swi ne flu and this season's B/Brisbane and A/Perth (H3N2-like) strains.

Measles outbreak kills 110 in Zambia
Zambia's capital Lusaka has recorded 106 of the 110 deaths in an ongoing measles outbreak sweeping the country. Nationwide there have been 6200 cases. More details.
Advice to travellers: Regardless of their destination, we recommend all travellers check their immunisation status for measles, diphtheria, pertussis (whooping cough), mumps and polio as part of their pre-travel medical preparations. There has been a surge in measles activity in many regions, including Europe, this year and outbreaks of childhood diseases are common in both developing and developed countries.

South Africa link to measles outbreak in Buenos Aires
In Argentina, authorities suspect an outbreak of measles in Buenos Aires province is linked to travellers returning from South Africa, where a widespread outbreak is occurring. More details.

Measles revisits Brazil
In Brazil, measles has spread quickly in the city of Belem (Guama district, Para State) with 216 suspected cases. It is Brazil's first local epidemic (unrelated to overseas travel) in a decade. More details.

PNG's cholera case tally tops 1200
A year on, cholera continues to spread in Papua New Guinea, with 8 new cases in the capital Port Moresby last week, bringing the total of confirmed cases to more than 1200. The disease first surfaced last August in Morobe Province and has since spread to Lae, Madang, East Sepik and the capital. This report also provides details of confirmed or suspected cholera outbreaks in Nepal (Banke), China (Hong Kong), Philippines (Zamboanga), India (Maharashtra), Vietnam (Tay Ninh - ex Cambodia, southern provinces), Cambodia (Prey Veng). More details.
Advice to travellers: The risk of cholera for most travellers is low; however, those heading to developing countries where cholera is endemic should practice strict personal hygiene and choose food and beverages with care. Regardless of their destination, all travellers should avoid drinking unchlorinated water, adding ice to drinks, and eating unrefrigerated food from street stalls. Travelvax can advise travellers if cholera is a significant risk for their journey and recommend vaccination against cholera if appropriate.

Cameroon struggles to contain worst cholera in a decade
In Africa, there are significant cholera outbreaks in Cameroon (far north), Angola, Nigeria (Bauchi), Somalia (Bay), Kenya, Guinea Bissau (Bafata), and Zimbabwe (Manicaland). Cameroon's outbreak is the worst in a decade. More details.

Leishmaniasis claims 48 lives in Sudan
Leishmaniasis killed 48 and hospitalised more than 130 people in Sudan's Jonglei state last week. Authorities are seeking international assistance to stop the outbreak. More details.
Advice to travellers: Leishmaniasis is widespread in the tropics, subtropics and southern Europe. Travellers can greatly reduce the risk of infection by using an effective repellent to avoid sand fly bites. Read more on leishmaniasis.

West Nile virus suspected in fatalities
In Greece, doctors suspect mosquito-borne West Nile virus caused the deaths of three elderly people in the northern city of Thessaloniki. Of the 22 patients treated since last Friday [6 Aug 2010], 7 remain in hospital. More details.
Advice to travellers: WNV generally causes only mild flu-like symptoms. However, in a small number of cases the virus can cause meningitis or encephalitis, a potentially fatal inflammation of the brain or spinal cord. Travellers visiting an infected area should take precautions to avoid mosquito bites

Russia's fires prompt travel health warning
Travel health warnings are in place for Russia after devastating forest and peat fires in 14 regions, including Moscow, continue to produce hazardous levels of air pollution this week. On Friday, the US State Department warned Americans on Friday to 'carefully consider' plans to travel to parts of Russia, while the Australian government's Smartraveller website warned poor air quality could cause respiratory problems. Areas to the south and east of the capital are worst effected and a state of emergency has b een declared. More details.

Australians warned of Africa kidnap threat
Smartraveller last week also issued a warning to Australians of an 'ongoing high threat' of kidnappers targeting westerners in north, west and east Africa, especially Mauritania, Mali, Niger, Burkina Faso, southern Algeria, Nigeria, Kenya, Sudan, Tunisia and Somalia. More details.