WORLD TRAVEL HEALTH ALERTS – December 8, 2010

- Call for Fiji to screen tourists for infectious diseases
- Dengue alerts in decline
- Pakistan provinces hit by hepatitis A
- Cholera alerts for Ethiopia, Tanzania, Uganda
- Mystery encephalitis toll climbs to 516
- Uganda grapples with deadly mystery, too
- Denmark hit by respiratory illness
- Norovirus off to an early start in northern winter
- Ottawa on alert after imported ‘red measles’ case
- Housewives the new face of AIDS in Nepal
- Florida sees case of locally -acquired falciparum malaria
- Tour guide’s infection prompts rethink on malaria in Libya
- Bed bugs get a taste of LA

Call for Fiji to screen tourists for infectious diseases
FIJI should monitor travellers entering the country to prevent outbreaks of infectious diseases, according to its national advisor on communicable diseases. More details.

Dengue alerts in decline
The number of dengue outbreak showed a noticeable decline last week, although intense epidemics persist in Mexico and Brazil. Included in this week’s dengue bulletin are alerts for:
Nepal – while the national figure has not been determined, the disease persists in Dhangadi, Butwal, and Bharatpur, where 5 deaths were recorded.
Mexico (Tamaulipas, Sonora states) – flooding of the Rio Bravo has led to 145 cases, 43 of them dengue haemorrhagic fever. In Sonora, there have been 2700 cases, prompting calls for an emergency plan to tackle the widespread outbreak.
Brazil (Amazonas) – a statewide outbreak continues. There have been 4212 cases this year (up 120% on 2009), including 1012 in the capital, Manaus. More details.
Karachi is at the epicentre of a long-running, widespread dengue outbreak in Pakistan’s Sindh Province. Officially, there have been almost 10,000 confirmed or suspected cases, and 19 deaths, this year, although many cases and deaths go unreported.               Advice to travellers: A second week of fewer dengue outbreaks is good news for Australians heading to the tropics. However, the disease remains a risk to in the Caribbean, Latin America and Asia. Aedes mosquitoes are found in urban areas; Preventing bites by covering up and using an effective insect repellent containing DEET or Citriodiol is the only sure way to prevent infection. Travellers should apply repellent regularly to exposed skin at all times when outdoors.

Pakistan provinces hit by hepatitis A
An outbreak of h epatitis A is spreading rapidly in Pakistan’s Azad Jammu and Kashmir regions. Attributed to poor hygiene, the disease is spreading at an alarming rate, especially in regions affected by an earthquake. More details.
Advice to travellers: Hepatitis A (HAV) is a viral disease of the liver. Typically it is passed on through eating or faecally-contaminated food or water, but also by touching contaminated items (crafts, money, door-handles etc). It is the most common vaccine-preventable infection in travellers to developing countries. Read more preventing hepatitis A.

Cholera alerts for Ethiopia, Tanzania, Uganda
In Ethiopia, a lack of medical supplies and clean water is exacerbating a month-long cholera outbreak in Fiq, a town in the blockaded Ogaden region. More details.
In Tanzania, cholera has been reported in three regions – Dar es Salaam (Temeke, Kinondoni and Bariadi districts), Tanga (Mkinga), and Shinyanga (Bariadi), according to a local news report. More details.
In Uganda, a local cholera outbreak has been reported in the Makerere University district of the capital, Kampala. More details.
Advice to travellers: Travellers heading to regions with cholera outbreaks should adhere to strict personal hygiene guidelines and choose food and beverages with care. While the risk of cholera for most short-stay travellers is low, Travelvax can offer advice on the risk for a journey and whether vaccination is recommended. Contact Travelvax on 1300 360 164

Mystery encephalitis toll climbs to 516
The cause of an encephalitis-like virus which has devastated eastern Uttar Pradesh State for almost 8 months continues to elude India’s health authorities. The death toll has now reached 516, with more than 100 people receiving treatment in government hospitals. No definitive diagnosis is in sight. More details.

Uganda grapples with deadly mystery, too
A nother undiagnosed haemorrhagic disease with a high mortality rate is raising fears of an Ebola-like epidemic in northern Uganda’s Acholi and Karamoja sub-regions. In less than a month, 38 people have died, with 91 infected. Tests have excluded deadly haemorrhagic fevers such as Ebola, Marburg, and Crimean-Congo fever, as well as Rift Valley fever and typhoid. Virus experts are in the region to establish the cause of the outbreak. More details.

Denmark hit by respiratory illness
In Denmark, an outbreak of respiratory infection caused by the Mycoplasma pneumoniae bacteria has been reported in all five regions of the country, with more than 500 cases in the last two weeks of November. Most of the cases have been in children over 5 years old and young adults.
Advice to travellers: Travellers to Denmark and other northern hemisphere countries should be aware of the heightened risk of influenza and other respiratory infections during the coming winter months. Consider getting the seasonal flu vaccine and maintain good personal hygiene practices, including regular hand washing; covering your nose and mouth with a tissue when you sneeze or cough, discarding it immediately; avoid touching your eyes, nose or mouth; and avoid contact with sick people.

Norovirus off to an early start in northern winter
With the northern winter barely underway, norovirus is gaining momentum in the UK and the USA.
In England, three hospital wards at the Cumberland Infirmary (Cumbria) were forced to close to new admissions following an outbreak of the winter stomach bug. More details.
In Wales, authorities suspect a guest was re sponsible for infecting 127 people at a function at a leading Cardiff hotel. More details.
In the USA, norovirus has infected 138 residents and staff at 3 aged-care facilities in McHenry County (Illinois, USA). More details.
In Troy, Detroit (Michigan) an outbreak forced the closure of a local school last week. More details.
Advice to travellers: Norovirus is the most common cause of infectious gastroenteritis in Britain. Although generally short-lived, it causes nausea, severe vomiting and diarrhoea, which may lead to more serious complications among young children, the elderly and the sick.

Ottawa on alert after imported ‘red measles’ case
In Canada, Ottawa authorities fear more cases of measles after an Ottawa woman contracted the highly contagious virus in the Philippines. More details.
Advice to travellers: Travellers who have not had two documented doses of live virus vaccine should discuss the need for a booster with their travel health specialist or doctor as part of their pre-travel vaccination regime. Measles outbreaks have been widespread in many developed and developing countries this year.

Housewives the new face of AIDS in Nepal
While HIV/AIDS infection rates are declining in Nepal, an alarming trend is emerging among new cases. Housewives now account for almost half the new cases, infected by husbands working abroad - especially in nei ghbouring India. Of the estimated 70,000 people living with the disease in Nepal, 41% are workers who have returned from India, and 21.5 % their spouses. More details.

Florida sees case of locally acquired falciparum malaria
Authorities in Florida (USA) are investigating a locally-acquired case of potentially fatal p.falciparum malaria in a Jacksonville (Duval County) woman with no history of international travel. It is thought the disease was transmitted when she was bitten by a mosquito which had fed on a local asymptomatic human carrier of malaria. An average 1300 malaria cases are diagnosed in the USA each year, most in travelers and immigrants returning from sub-Saharan Africa and South Asia. More details.

Tour guide’s infection prompts rethink on malaria in Libya
A German tour guide has contracted malaria in Libya, although officially the North African country is free of the disease. It is thought she had been infected in the southwestern Fezzan region, which is frequented by Tuaregs and other nomadic people from malarious countries to the south and west, GeoSentinal reports.

Bed bugs get a taste of life in LA
New Yorkers aren't the only ones coping with bed bug infestations. In Los Angeles, ritzy retail areas such as Beverly Hills and dozens of local communities across the county are under siege from the blood-sucking insects, the LA Times reports. More details.

Travelvax Australia compiles this weekly bulletin of global tra vel 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.