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, trip-specific advice and accessories 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 18, 2010

-  Dengue alerts: No respite as dengue marches on in Asia, Americas
-  Dengue fatalities rise in Philippines
-  Honduras seeks UN help to curb dengue
-  Devastated Pakistan braces for wave of disease
-  Sleeping sickness kills tourist in Malawi
-  JE continues deadly march in Uttar Pradesh
-  Rabies widespread in Philippine province
-  Rabid vampire bats attack 500 people - 4 dead
-  Mumbai under attack from influenza
-  Swine flu persists in India, New Zealand
-  Monsoon rains bring flood of disease to Hyderabad
-  Leishmaniasis deaths fly under the radar
-  Plague claims third victim in Peru
-  Cholera spreads in Cameroon, Nigeria
-  Children's disease at epidemic levels in SE Asia

Dengue alerts: No respite as dengue marches on in Asia, Americas
The nationwide epidemic of dengue in Thailand, including popular Phuket, and the growing number of cases in India's Commonwealth Games city, Dehli are included features of this week's dengue fever bulletin. The countries covered include: ASIA - India (Maharashtra state, Delhi), Thailand (nationwide, southern), Vietnam; AMERICAS - USA (Florida), Jamaica, Martinique, Guadeloupe, Venezuela, Colombia (Bolivar), Brazil (Roraima, Pernambuco). More details.
An earlier bulletin details epidemics and major outbreaks in: ASIA - The Philippines (Capiz, Ifugao, Rizal), Vietnam (southern provinces), Thailand (Ubon Ratchathani), Malaysia, India (Maharashtra State, Delhi); MIDDLE EAST - Yemen; AMERICAS - USA (Florida), Mexico (Tamaulipas), Dominican Republic, Martinique, Jamaica, Honduras, and Costa Rica. More details.
Advice to travellers: We repeat our regular warning that dengue fever continues to pose 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. Apply repellent regularly to exposed skin when outdoors - even within resorts and hotels - at any time of the day. There is no vaccine for dengue: Preventing mosquito bites is the only sure way to avoid the risk.

Dengue fatalities rise in Philippines
Dengue continues to spread in Zamboanga City (Luzon Island), with 20 fatalities among 428 cases. In Midsayap, North Cotabato, the death of four more children has raised the dengue toll to 11. More details.

Honduras seeks UN help to curb dengue
Honduras has sought UN help as seasonal rains worsen the country's epidemic of dengue haemorrhagic fever. At least 33,000 cases have been recorded, with 33 deaths and 1000 people in intensive care. UNICEF has sent industrial fogging machines to spray mosquito-breeding sites. More details.

Devastated Pakistan braces for wave of disease
Cholera has surfaced in flood-ravaged northern Pakistan, where 20 million people are affected by the worst floods in the country's history. While only one case of cholera has been confirmed, there has been 36,000 cases of acute watery diarrhoea. Widesprea d epidemics of water- and insect-borne diseases appear inevitable. More details.

Sleeping sickness kills tourist in Malawi
In Malawi, one tourist has died and several others infected with Human African Trypanosomiasis (HAT or 'sleeping sickness') in Nkhotakota Game Reserve, according to a media report. The resurgence of Trypanosomiasis-carrying tsetse flies in and around the reserve and nearby Kasungu National Park threatens international visitors, as well as impoverished local villagers and the precious cattle they depend on for their livelihoods. More details.

Malawi launches massive measles campaign
Meanwhile, the Malawi government has launched a nationwide campaign to vaccinate six million children against measles, which has claimed 195 lives (77,000 cases) this year. More details.
Advice to travellers: Childhood diseases are common in both developing and developed countries and outbreaks like those occurring in Europe are usually the result of sub-optimal immunisation levels. Regardless of their destination, we recommend all travellers to check their immunisation status for measles, diphtheria, pertussis (whooping cough), mumps and polio as part of their pre-travel medical preparations.

District quarantined to curb measles
In the Philippines, health officials have sealed off part of Barangay Poblacion (Palimbang town, Sultan Kudarat) in a bid to control the spread of measles, which has infected 70 children. More details.

JE continues deadly march in Uttar Pradesh
In Gorakhpur (India), five people died of Japanese encephalitis last Friday, taking the number of deaths in 29 eastern districts of Uttar Pradesh to 559 this year. Among the fatalities were three children from the Kushinagar, Siddhartha Nagar and Gorakhpur districts. More details.
Advice to travellers: Infected mosquitoes spread JE. It presents a low risk for most travellers, with the season, destinations, length of stay and activities among the contributing risk factors. People planning stays in rural areas should seek advice from Travelvax on whether their itinerary presents sufficient risk to recommend vaccination. Avoiding mosquito bites using an insect repellent containing DEET or Citriodiol is essential to guard against all mosquito-borne diseases.

Rabies widespread in Philippine province
On Cebu Island (Philippines), a rabies outbreak has reached seven cities and two towns in the Negros Occidental province, with one death in San Carlos City. The Bill and Melinda Gates Foundation has donated 300,000 doses of vaccine, enough to immunise high-risk health personnel and the estimated dog population in the province. More details.
Advice to travellers: Rabies is present in most countries and all travellers should be aware of the importance of avoiding contact with wild and domestic animals, especially dogs. If bitten, urgent post-exposure treatment is the only course of action. However, for most short-stay travellers, the risk of rabies is low. More on rabies.

Rabid vampire bats attack 500 people - 4 dead
Rabies-infected vampire bats have killed four children and attacked more than 500 people in northeastern Peru's Amazon region. While tribes slash-and-burn the jungle to grow crops, some also raise livestock, bringing them into contact with vampire bats. More details.

Mumbai under attack from influenza
Three types of influenza virus are circulating in Mumbai, adding to a deluge of respiratory-related illness in the city's hospitals. Ten people a day were hospitalised with swine flu this month (500 in July), but doctors are concerned at the emergence of a more virulent strain of influenza B. More details.
Advice to travellers: All overseas travellers, particularly those heading to countries where swine flu persists, should consider the seasonal flu vaccine. The vaccine currently available in Australia protects against swine flu and this season's B/Brisbane and A/Perth H3N2-like strains.

Swine flu persists in India, New Zealand
While the WHO declared the swine flu pandemic officially over last week, transmission remains intense in parts of India and New Zealand, according to the WHO. More details.

Monsoon rains bring flood of disease to Hyderabad
In India's Hyderabad State, the monsoon has brought an infectious disease to one-in-10 families, ranging from sw ine flu to acute diarrhoea, as well as mosquito-borne chikungunya, dengue and malaria. More details.

Leishmaniasis deaths fly under the radar
Sand fly-borne leishmaniasis is Paraguay's 'silent epidemic' with 6 deaths among 207 cases (127 cutaneous, 81 visceral) this year, according to a senior official. Dogs are a vector for the disease and hundreds have been culled in an attempt to control its spread. 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.

Plague claims third victim in Peru
A 29-year-old woman is the third victim of plague in two months, with 31 others undergoing treatment in the coastal province of Ascope, northwest of the capital, Lima. The expansion of farming has led to rodent infestations in nearby towns, officials say. More details.

Cholera spreads in Cameroon, Nigeria
Cholera has claimed more lives in northern regions of Cameroon (200 deaths) and neighbouring Nigeria (50). More than 2300 have been infected in Cameroon, making the outbreak the worst in a decade. More details.
< strong>Advice to travellers: The risk of cholera for most travellers is low - even when visiting countries where the disease is endemic. However, those heading to regions with cholera outbreaks should adhere to strict personal hygiene guidelines 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.

Children's disease at epidemic levels in SE Asia
Seasonal rains have resulted in widespread epidemics of hand, foot and mouth disease (HFMD) in South-east Asia. In Singapore, 900 cases last week have brought the number this year to 18,000 - 67% higher than 2009. About two-thirds of those affected were children under five. More details.
Ten cases of HFMD a day are being reported in Thailand. So far this year, there have been 9694 cases (1 death), compared to 5351 last year. More details.
Advice to travellers: Hand, foot, and mouth disease (HFMD) is a common viral illness of infants and children, causing fever and blister-like eruptions in the mouth and/or a skin rash. Reduce the risk of infection by following good hygiene practices and avoiding close contact with people exhibiting symptoms.