WORLD TRAVEL HEALTH ALERTS – March 2, 2011

– Dengue alerts: South America, South Asia, Australia
– Deadly bird flu hits Cambodia, Egypt, Indonesia
– Measles-infected passenger sparks three-State alert
– Surge in measles in Switzerland, Turkey, Zambia
– Teens hit by Scotland’s mumps epidemic
– Polio flares in Africa, Pakistan
– New Caledonia on alert after imported Chikungunya case
– Flooding brings disease to Sri Lanka’s north
– Flu activity slowing in Europe
– Leishmaniasis alerts for Argentina, Colombia
– Ackee deaths spark probe

Dengue alerts: South America, South Asia, Australia
This week’s global dengue fever bulletin provides details of ongoing epidemics in Brazil (Bauru, Araraquara, Sorocaba, Ijui, Bom Jesus do Itabapoana, Parana, Londrina, Federal District, Amazonas, Manaus, and Ceara), Bolivia (Tarija, Santa Cruz, Beni), Paraguay, and Sri Lanka (Colombo). In North Queensland, 31 people have now been diagnosed with type-2 dengue in East Innisfail, south of Cairns. More details.

Deadly bird flu hits Cambodia, Egypt, Indonesia
A woman and her 11-month-old son are Cambodia’s latest bird flu (avian A/H5N1) victims after eating sick poultry in southeastern Prey Veng province. There have now been 3 deaths this month and a total of 11 fatalities from just 13 cases. More details.
Bird flu is spreading in West Java, with 41 human cases in 11 of the region’s 26 cities and regencies. More details.
Egypt has had 6 bird flu cases (1 death) in 2011 for a total of 125 (41) since the current epidemic began. In each case the cause was the same – exposure to infected poultry. More details.
Advice to travellers: While the rising number of bird flu outbreaks is worrying, the risk for travellers remains low. Travellers visiting affected areas should avoid eating poultry from street stalls, and avoid contact with chickens and birds in live animal markets and poultry farms, including free-ranging or caged poultry.

Measles-infected passenger sparks three-State alert
In the USA, a woman who contracted measles in the UK may have infected hundreds of passengers on three flights, as well as in airport terminals in Washington, Denver and Albuquerque. Federal authorities are urgently trying to contact passengers on her flights and people in the airports at the time she passed through on her way home to New Mexico. More details.
Advice to travellers: As the many recent outbreaks in Australia and abroad confirm, measles is a highly mobile and highly contagious airborne disease. Aircraft passengers are at risk of infection, especially if seated near someone with measles. Travellers who have not had measles or have not received two documented doses of live virus vaccine should consider a booster as part of their pre-travel vaccination regime. We recommend all travellers check their immunisation status for measles and other childhood diseases, including whooping cough, diphtheria, mumps and polio, as part of their pre-travel medical preparations.

Surge in measles in Switzerland, Turkey, Zambia
In Geneva (Switzerland), there are fears for a major outbreak after a surge in measles cases this year – 20 in February alone. The likely source is the nearby French town of Rhone-Alps, where there have been 2000 measles cases since early December – 1300 in February. More details.
After seeing virtually no measles in recent years, Turkey had 24 cases this year. Most of the cases were not among children, rather young adults aged 20-35 living in Istanbul. More details.
In Africa, there have been more than 400 measles cases in the Serenje district of northern Zambia. More details.

Teens hit by Scotland’s mumps epidemic
In Scotland, there have been 119 cases of mumps in the last 3 months, mainly affecting teenagers in Oban. More details.

Polio flares in Africa, Pakistan
In Africa, testing is expected to confirm that polio has killed two children in Kinshasa (DR Congo), and another in Angola. In Pakistan, another four cases have taken the total for the year to 8. More details.

New Caledonia on alert after imported Chikungunya case
New Caledonia has recorded its first cases of Chikungunya fever after a resident was infected while holidaying in Indonesia. Authorities are concerned about the potential for further transmission as the Aedes aegypti mosquito that spreads the virus is common in the French territory. More details.
Advice to travellers: As with dengue fever, there is no vaccine or preventative medication for Chikungunya fever, which is prevalent throughout Asia. Both diseases are spread by Aedes mosquitoes, and travellers should regularly apply repellent containing DEET or Citriodiol to exposed skin when outdoors.

Flooding brings disease to Sri Lanka’s north
Devastating flooding in northern Sri Lanka has led to a widespread outbreak of leptospirosis, with nine deaths from the disease confirmed or suspected, and 50 people infected. Since torrential rains began i n January, flooding has displaced almost a million people and caused widespread devastation in Sri Lanka's North Central and Eastern provinces. More details.
Advice to travellers: Leptospirosis is a low risk for most travellers. The bacteria that cause leptospirosis are spread through the urine of infected animals, typically in floodwaters. The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch. While it occurs worldwide, the disease is most common in temperate or tropical regions.

Flu activity slowing in Europe
While significant influenza continues in Europe, there are signs intense activity is declining. Pandemic influenza A(H1N1) 2009 is dominant in 16 countries, and co-dominant with influenza B in 10 countries. Influenza B was dominant in 5 countries. More details.
Advice to travellers: With flu activity persisting in the northern hemisphere and other regions, all travellers should consider flu vaccination as part of their pre-travel preparations.

Leishmaniasis alerts for Argentina, Colombia
In Argentina, 13 cases of sand fly-borne Leishmaniasis have been recorded in Corrientes, the capital of Corrientes province, amid fears the disease is spreading across the region north of Buenos Aires. (This ProMED alert naming Cordoba as the location of the outbreak was later corrected – Ed). More details.
In Colombia, leishmaniasis has also been detected in a village in Santander department (province) in the country’s north. Cutaneous leishmaniasis occurs throughout Colombia, with Guaviare department the most highly endemic region. More details.
Advice to travellers: Travellers visiting Argentina’s north should take measures to prevent all insect bites, including sand flies and mosquitoes. Previously, outbreaks of cutaneous leishmaniasis in South America had occurred in northern countries, including Brazil, Colombia, Peru and Bolivia. Read more on leishmaniasis.

Ackee deaths spark probe
In Jamaica, a popular local fruit called Ackee has killed 23 people in less than 3 months. Although Ackee-related deaths are not uncommon, government chemists are conducting intensive tests to determine the reason for the recent increase. It is thought the victims may have eaten the pulp of unripe fruit. More details.

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.