Travelvax Australia would like to wish readers a safe and happy festive season, and New Year.

WORLD TRAVEL HEALTH ALERTS – December 22, 2010

- WA ‘imports’ 430 dengue cases from Bali
- Other unwanted holiday ‘mementoes’ from Bali too
- Cholera toll continues to rise in Haiti
- Swine flu spreading across Europe
- Poverty behind UK’s alarming TB rates
- Drug resistant TB on the rise in Indonesia
- Colombia braces for disease after devastating floods
- Kala Azar epidemic compounds southern Sudan’s medical crisis
- Measles alert in Buenos Aires

WA ‘imports’ 430 dengue cases from Bali
West Australian travellers have been warned of the risk of dengue fever in Bali after a record 430 people returned from the island with the disease this year – three times more than in 2009 (130). This week’s dengue bulletin also includes details of outbreaks in Saudi Arabia (Jeddah), Mexico (Senora), Brazil (Mato Grosso do Sul and Rio de Janeiro) and Honduras. Honduras has had its worst year for dengue in 30 years – 66,646 confirmed cases (81 deaths). More details.
Advice to travellers: Australians heading to tropical regions should continue to take measures to avoid mosquito bites, despite fewer dengue outbreaks. As this report states, the disease remains a risk in the Americas. Travellers should regularly apply repellent containing DEET or Citriodiol to exposed skin when outdoors. The aedes mosquitoes that transmit dengue inhabit urban areas and preventing bites is the only sure way to avoid infection.

Other unwanted holiday ‘mementoes’ from Bali too
There has also been ‘a large increaseR 17; in the number of West Australians returning from Bali with gastroenteritis, hepatitis A and sexually transmitted infections in recent years, according to Dr Paul Armstrong, WA Health's Communicable Disease Control director. More details.

Cholera toll continues to rise in Haiti
Haiti's cholera toll has now passed 2500, dashing hopes the death rate was beginning to decline. About half of the 114,497 Haitians infected have received hospital treatment. Neighbouring Dominican Republic has now had 46 cases. More details.
Meanwhile, the UN will set up an independent scientific panel to investigate the source of Haiti’s cholera outbreak amid claims that the base for UN’s Nepalese troops was the likely source of the devastating outbreak. More details.
Advice to travellers: The risk of cholera for most short-stay travellers is low. However, the disease spreads rapidly and travellers heading to infected regions should adhere to strict personal hygiene guidelines and choose food and beverages with care. Travelvax can offer advice on the risk for a journey, and whether vaccination should be considered. Contact Travelvax on 1300 360 164.

Swine flu spreading across Europe
In the UK, the number of severe cases of swine flu (H1N1 2009) has continued to rise during December. Other seasonal influenza viruses, particularly influenza B virus, are also circulating a cross the UK. More details.
The northern winter flu season is also underway across Europe, with rising rates of swine flu in 11 countries. Swine flu was also reported in Egypt, Israel and Yemen last week. More details.
Advice to travellers: All overseas travellers should consider receiving the seasonal influenza vaccine, particularly those heading into the northern winter or visiting countries with significant flu outbreaks. The vaccine currently available in Australia protects against swine flu and B/Brisbane and A/Perth (H3N2-like) strains.

Poverty behind UK’s ‘alarming’ TB rates
Rates of TB are also rising alarmingly in Britain, with some 9000 cases now reported annually. In London, where 40% of UK cases are diagnosed, cases have risen by almost 50% in the last decade – up from 2309 in 1999 to 3450 in 2009. A new study attributes the rise to people living under ‘Victorian’ conditions, with poor housing, inadequate ventilation and overcrowding in deprived areas of London. More details.
Advice to travellers: There has been a marked increase in the incidence of TB in both developed and developing countries in the last decade. While the risk of infection for short-stay travellers is low, those anticipating prolonged close exposure to local people (such as expatriates working in a hospital, cla ssroom or some other confined space; or budget travellers using buses, trains or local aircraft extensively) should assess the risk of TB, especially if visiting high-risk countries. Read more on TB.

Drug resistant TB on the rise in Indonesia
Multi-drug resistance and a huge increase in HIV/AIDS cases are behind the re-emergence of tuberculosis as a major health threat in Indonesia, according to health experts. Indonesia now ranks behind only India, China, South Africa and Nigeria among countries with the highest number of cases. More details.

Colombia braces for disease after devastating floods
Colombian authorities fear cholera and other water- and mosquito-borne diseases will follow in the wake of flooding caused by the heaviest rains in 30 years. Along Colombia’s Pacific and Atlantic coasts, muddy water has submerged dozens of towns and villages. More details.

Kala Azar epidemic compounds southern Sudan’s medical crisis
As southern Sudan prepares to vote on secession next month, the region is battling to contain an 8-fold increase in visceral leishmaniasis (kala azar) – its biggest outbreak in almost a decade, according to Medecins Sans Frontieres (MSF). MSF says tens of thousands of southerners returning from Northern Sudan and abroad will also be exposed to endemic diseases, such as malaria, measles, meningitis, and TB. Their presence will put enormous additional strain on already limited food, water and healthcare. More details.

Measles alert in Buenos Aires
After 12 years without measles in Buenos Aires (Argentina), 17 cases have been reported since August. The government hopes a national vaccination campaign will prevent the further spread of the disease. Advice to travellers: Measles outbreaks have been widespread across the globe this year. A booster may be recommended for travellers who have not had two documented doses of live virus vaccine as part of their pre-travel vaccination regime.

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.