WORLD TRAVEL HEALTH ALERTS – February 23, 2011

– More dengue in North Queensland
– Ross River fever hits Victorian district
– Hong Kong on alert after swine flu deaths
– Cholera toll continues to rise in PNG
– Fiji lifts typhoid curfew
– Rabies claims 2 more victims in Bali
– Bats cause deaths in Asia, South America
– German measles, dengue outbreaks in central Vietnam
– Polio surfaces in Asia and Africa
– Plague kills 14 in Madagascar
– WHO sticks with current strains for northern flu vaccine
– Breakthrough in Chikungunya battle
– Egypt plans travel restrictions for pilgrims

More dengue in North Queensland
In North Queensland, the number of dengue fever cases in Innisfail has risen to 29. Health authorities are eradicating mosquito breeding sites, while also warning residents of the risk of tetanus, melioidosis and leptospirosis in soil and water as recovery efforts continue following Cyclone Yasi. More details.
Dengue outbreaks are widespread in Brazil, including Alagoas, Amazonas, Rio Grande do Sul, Ceara, Rio Grande do Norte, Minas Gerais, Votorantim, Sorocaba, Campinas, and Ribeirao Preto. This week’s dengue bulletin also includes details on outbreaks in Bolivia (La Paz, Santa Cruz), Peru (Piura), and Indonesia (Jakarta). More details.
Advice to travellers: Australians heading to the tropical regions, especially South America and Asia, should take all measures to avoid mosquito bites. Insect repellent containing DEET or Citriodi ol should be applied to exposed skin regularly. The Aedes mosquitoes that transmit the virus inhabit urban areas.

Ross River fever hits Victorian district
There has been a dramatic rise in Ross River fever cases in Geelong (Victoria) after heavy rainfall led to increases in mosquito populations. The 15 cases equal the total number recorded in 2010. More details.
Advice to travellers: There is no vaccine for Ross River fever, which generally occurs in summer and autumn. It causes flu-like illness with joint pains, fever, and a rash lasting 7-10 days, although symptoms may persist for weeks or months. As with dengue fever, there is no vaccine or specific treatment for Ross River virus. Using an effective repellent to minimise mosquito bites is the best form of protection.

Hong Kong on alert after swine flu deaths
Three elderly Hong Kong residents have died from swine flu, bringing the death toll to at least 17 in the past month. With a population of 7 million, Hong Kong is particularly nervous about infectious diseases: the 2003 SARS outbreak killed 300 people in the city. More details.
Advice to travellers: Stocks of  this year's seasonal flu vaccine are expected to be available in Australia within the next week or two.

Fiji lifts typhoid curfew
Fiji’s Ministry of Health says it has contained a typhoid fever outbreak (100 cases, no deaths) in the Natisiri area (north of Suva, Viti Levu). A curfew has been lifted and a mass vaccination program will begin this week in the affected area. More details.
Advice to travellers: As stated last week, sporadic outbreaks of typhoid in Fiji represent a low risk for short-stay visitors staying in hotels and resorts. Australians heading to Fiji, particularly travellers to these affected areas, those that are more adventurous in their eating habits and those visiting rural areas should seek advice on vaccination against typhoid by calling Travelvax Australia’s travel health advisory service (1300 360 164). Typhoid is spread by contaminated food and beverages, and all travellers should follow safe food and water guidelines – especially when visiting rural areas.

Cholera toll continues to rise in PNG
In PNG, cholera has returned to the city of Lae in Morobe Province, where the outbreak began in August, 2009. In 18 months, there have been 10,000 cases and 483 deaths in 7 regions, including the capital Port Moresby. Also included in this cholera update are reports from: Haiti, Dominican Republic, Saudi Arabia (Makkah Province), Zambia, South Africa, Ghana (Greater Accra), Cote d'Ivoire (Lagunes), and Nigeria (Kogi, Kano). More details.

Rabies claims 2 more victims in Bali
Tests are expected to confirm that rabies killed 2 more people in Bali on Sunday, bringing the total number of human fatalities this year to 7 and as many as 153 since August 2008. One of the latest victims had been bitten by a dog 2 years ago. More details.
Advice to traveller s: The risk of rabies for most travellers to Bali is low but the disease persists on the island and rabies immunoglobulin for rapid post-exposure treatment remains in short supply. Dogs are the most common carriers of the disease and all travellers to Indonesia should avoid contact with wild and domestic animals. More on rabies.

Bats cause deaths in Asia, South America
Disease-carrying bats have been responsible for fatalities on two continents.
In Bangladesh, 33 people have now died of encephalitis after eating dates or date juice contaminated with Nipah virus, transmitted by giant fruit bats which carry the virus. More details.
Rabies-infected vampire bats have killed at least 6 children in remote native communities in the Amazonas region of Peru. More details.
Advice to travellers: Authorities believe dates or raw date juice contaminated by urine or saliva from infected fruit bats are the most likely source of infection in this outbreak in Bangladesh. Outbreaks are rare and pose little risk to travellers.

German measles, dengue outbreaks in central Vietnam
In Vietnam, significant outbreaks of rubella (German measles) and dengue fever are occurring in the neighbouring central provinces of Da Nang and Quang Nam. There have been more than 1000 dengue cases already this year. More details.
Advice to travellers: Dengue fever is a concern for all travellers to Asia. German measles is a particular risk for pregnant women. Travellers should check their immunisation status for all childhood diseases, including whooping cough, diphtheria, mumps, and polio as part of their pre-travel medical preparations. Live attenuated rubella vaccine is the 'R' component i n the triple MMR (measles, mumps, rubella) vaccine.

Polio surfaces in Asia and Africa
Delhi is on alert after the polio virus was found in the city's sewage. With high numbers of migrant workers, there are fears the disease could show up in other regions of India. More details.
The polio strain detected in Delhi has been linked to a new case in West Bengal – the first in India this year – despite an intense vaccination campaign already underway to eradicate the disease. A secondary campaign to vaccinate 1.8 million children has begun in 5 selected districts, including Kolkata (Calcutta). More details.
In another blow to international efforts to eradicate polio, the disease has been confirmed in an infant from Yamethin, a town in the Mandalay region of Myanmar. More details.
In Africa, Angola has recorded its first polio case of 2011 just weeks before the start of a national campaign to vaccinate 5.6 million children. More details.

Plague kills 14 in Madagascar
An epidemic of pneumonic plague in northern Madagascar has killed 14 people. Most of the victims are from the region between Diana and Ambilobe Ambanja, east of Beramanja. More details.

WHO sticks with current strains for northern flu vaccine
Signaling that the current influenza strains (H1N1, H3N2, and B) are likely to persist, the WHO has recommended manufacturers include them in the northern hemisphere's next influenza vaccine. The advice matches the recommendation for the southern hemisphere flu season (May-October) made last September. In the six months leading up to the flu season, vaccine manufacturers gear up their production to grow the viruses in chicken eggs and formulate them into trivalent vaccines. More details.

Breakthrough in Chikungunya battle
Scientists in Singapore have moved a step closer to developing a treatment for chikungunya, a viral disease spread by the Aedes mosquito. The team has discovered 2 antibodies that could neutralise virus strains. More details.

Egypt plans travel restrictions for pilgrims
Egypt is planning to restrict travel for ‘high-risk’ individuals who apply for visas to visit Saudi Arabia for the Hajj and Umrah, according to documents released by Wikileaks. Among the measures proposed by Egypt’s Ministry of Health are a hospital-issued medical certificate verifying intending pilgrims are fit to travel, a doctor to monitor passengers on all Umra h flights, and more medical staff at the health clinics set up for Egyptian citizens in Mecca, Medina, and Jeddah.


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.