WORLD TRAVEL HEALTH ALERTS – March 16, 2011

– New Caledonia fears Reunion-like Chikungunya epidemic
– New twist in mystery of tourist deaths
– Mozzie virus suspected in Victorian man’s death
– Rio battles epidemic as dengue grips Latin America
– Tourists back in the water at Kuta
– Smoldering bird flu flares in West Java
– Swine flu makes way for B strain
– Yellow fever deaths prompt mass vaccinations
– Aid agencies join forces to halt meningitis epidemic
– Figures highlight malaria risk
– Sudan’s poor fall victim to black fever
– Cholera toll rising in Accra

New Caledonia fears Reunion-like Chikungunya epidemic
With 2 more cases last week, New Caledonia’s senior public health officer says there is now an ‘extreme’ risk of a Chikungunya epidemic unless urgent steps are taken to contain outbreak. A resident infected during a holiday in Indonesia ‘imported’ the virus late last month. Authorities fear an island-wide outbreak like the one in another French territory, Reunion Island, in 2006, when at least 252 people died and 266,000 were infected – more than a third of the population. More details.
The WHO is concerned at the appearance of Chikungunya in the Pacific. More details.
Advice to travellers: As with dengue fever, there is no vaccine or preventative medication for Chikungunya fever, which is prevalent in Asia and Africa. Travelvax advises Australians visiting New Caledonia to cover up at dusk and apply an insect repellent containing DEET or Citriodiol regularly to exposed skin at all times when outdoors.

New twist in mystery of tourist deaths
THAILAND: The mystery surrounding the deaths of four people who stayed in the Downtown Inn in Chiang Mai deepened last week. An autopsy has revealed a 23-year-old New Zealand backpacker was infected with an echovirus, which can cause acute inflammation of the heart. Thai authorities also announced a fifth victim, an American woman who died on January 11, had similar symptoms as the backpacker, although she had not stayed at the hotel. More details.

Mozzie virus suspected in Victorian man’s death
AUSTRALIA: Health authorities suspect Murray Valley encephalitis (MVE) may have killed a man in Victoria’s northwest. It would the first case of MVE in the State since 1974. Test are also being carried out to determine if the mosquito-borne virus killed a horse and infected several others in the region and in the nearby Riverland area of South Australia. Health authorities have renewed warnings for residents and visitors to take measures to avoid mosquito bites. More details.
Advice to travellers: Heavy rains and flooding in January and February, especially along the Murray River, resulted in a significant increase in mosquito breeding habitats. With no vaccine for MVE, travellers are advised to take measures to avoid mosquito bites. MVE virus is transmitted by the common banded mosquito (Culex annulirostris), which bites after sundown in the first 2 hours of the night.

Rio battles epidemic as dengue grips Latin America
Dengue fever epidemics continue to pose a significant travel health risk in Latin America, notably in Brazil. Rio de Janeiro city has now recorded 5064 cases (13,144 statewide) since January, an increase of almost 700% on the same period last year. Other regions effected include Belem (Alagoas state), Lorena (Paribo), Mato Groso do Sul, Sorocaba and Ribeirao Preto (Sao Paulo), Natal (Rio Grande do Norte), and Amazonas state. Alerts are current for Colombia (El Espinal, Tolima), Bolivia (Santa Cruz), Paraguay and Argentina (Romang, San Javier department, Santa Fe). In Australia, the number of dengue cases in Innisfail, south of Cairns, has risen to 53 (45 type 2, 8 type 4).
More details.
Advice to travellers: Epidemics in Latin America and other tropical regions, including North Queensland, highlight the need for travellers to take all measures to avoid mosquito bites. The mosquitoes that transmit the dengue virus inhabit urban areas, including up market hotels and resorts. Travellers should cover up at dusk and apply an insect repellent containing DEET or Citriodiol regularly to exposed skin.

Tourists back in the water at Kuta
INDONESIA: Bali’s popular Kuta Beach has been declared safe for swimming after it was closed following a massive plankton die-off in the first week of March. More details.

Smoldering bird flu flares in West Java
INDONESIA: Deadly bird flu (A/H5N1 virus) has now claimed 3 lives this year following 2 more deaths in West Java province. There have now been 174 cases (144 deaths) in Indonesia since the outbreak began in 2005. More details.
BANGLADESH: There’s been a suspected case of bird flu in Dhaka. If confirmed, it will be the first since 2008. More details.
Advice to travellers: Bird flu first appeared in 2003 in China and Vietnam. WHO figures reveal 532 cases with 315 fatalities, notably in China (26 deaths), Egypt (40), Thailand (17) and Vietnam (59).
While the rising number of bird flu outbreaks is worrying, the risk for travellers remains low. Australians visiting affected areas should avoid eating poultry from street stalls, and avoid handling chickens or birds in live animal markets and poultry farms, including free-ranging or caged poultry. Read more on bird flu.

Swine flu makes way for B strain
The northern hemisphere flu season appears to be peaking or in decline in most areas, although activity continues in North America and Eastern Europe. Influenza A(H1N1)2009 (Swine flu) has been the most common virus in Europe and northern Asia, while influenza type B has been increasing in Europe and is now the more common virus in many countries. More details.
Advice to travellers: The new seasonal flu vaccine is now available in Australia and protects against both the swine flu (H1N1) and B strains. As influenza is the most common vaccine preventable illness, Travelvax recommends vaccination for all travellers.

Ye llow fever deaths prompt mass vaccinations
SIERRA LEONE: A yellow fever vaccination campaign was begun in Bonthe district (Southern province) last week after 2 recent deaths – the first in the North African country in 2 years. More details.
Advice to travellers: While yellow fever is a low risk for most travellers, proof of vaccination against yellow fever is a mandatory requirement for travel to regions of Africa and South America. Global statistics show that yellow fever cases are on the increase with 90% of the 200,000 annual cases occurring in Africa.

Aid agencies join forces to halt meningitis epidemic
CHAD: A major international effort is underway to bring an epidemic of meningitis under control. WHO, UNICEF and other aid agencies have begun vaccinating people in 5 districts of the Logone Occidental region, where 923 cases have been recorded. More details.
Advice to travellers: Major epidemics of meningococcal meningitis occur annually during the dry season (December to June) in sub-Saharan Africa. Chad is in the middle of the ‘meningitis belt’, which stretches from the east to the west coast of Africa, taking in Burkina Faso, Benin, Democratic Republic of the Congo, Ethiopia, Ghana, Ivory Coast, Kenya, Mali, Niger, Nigeria, Sudan, Togo, and Uganda. Meningitis is spread by person-to-person contact and travellers planning to visit the region in coming months should consider vaccination.

Figures highlight malaria risk
Malaria continues to be a significant travel risk in parts of Asia.
In Myanmar, new figures reveal an estimated 200,000 confirmed cases and some 1200 deaths occur each year. Although much of the population is at risk, the most vulnerable are non-immune migrant workers involved in gem mining in forests, logging, agriculture, and construction. More details.
In India, malaria infection rates are climbing in central state of Chhattisgarh, a rice-growing agricultural region. There were 152,303 confirmed cases (47 deaths) last year. More details.
Advice to travellers: Malaria is present year-round in rural and urban areas of India and Myanmar, especially during and after the monsoon season. The number of cases caused by the potentially fatal Plasmodium falciparum strain is increasing. Travellers to Asia should discuss their itinerary, the need (or not) for preventative medications, and the available options at a Travelvax clinic, or with their healthcare provider.

Sudan’s poor fall victim to black fever
SUDAN: The epidemic of visceral leishmaniasis (Kala azar) in southern Sudan is the worst in a decade, with WHO estimates of 500,000 cases a year. Untreated, the sand fly-borne disease known locally as black fever is usually fatal. Many of its victims cannot afford to travel to the MSF clinic in Malakal. More details.
Meanwhile, 15 cases of human anthrax were reported in Sudan’s Western Bahr al-Ghazal state last week. More details.
Advice to travellers: Leishmaniasis is widespread in the tropics, subtropics and southern Europe. For short-stay travellers, it generally presents a low risk. However, they should use an effective repellent to avoid sand fly bites. Read more on leishmaniasis.
Anthrax is a bacterial disease that primarily affects animals but can
be transmitted to humans through consumption of infected meat or
contact with an infected carcass.

Cholera toll rising in Accra
GHANA: Cholera fatalities continue to mount in the capital, Accra, with 636 cases (17 deaths) since January. 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.