WORLD TRAVEL HEALTH ALERTS – March 23, 2011

-  Bird flu adds to post-earthquake woes
-  India, Indonesia hit by bird flu
-  Diarrhoea outbreak on Vanua Levu
-  Victoria’s Ross River tally passes 600
-  Heart infection links mysterious Chiang Mai deaths
-  Flu continues to decline in Europe
-  Measles alerts for Gold Coast, Western Sydney
-  Malaria spreading rapidly in Andhra Pradesh
-  Plague death toll reaches 45
-  WHO steps up efforts to halt Ghana’s escalating cholera epidemic
-  India, Taiwan on alert for scrub typhus
-  Haemorrhagic dengue claims first victim in Taiwan

Bird flu adds to post-earthquake woes
JAPAN: Local authorities have culled more than 35,000 chickens and quarantined another 869,000 following an outbreak of avian influenza (A/H5N1 virus) in Chiba city, near earthquake-damaged Tokyo. Chiba is Japan's second-largest chicken egg producing region. More details.
Advice to travellers: For travellers, the risk of contracting bird flu is low, despite the rising number of outbreaks in Asia. 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.

India, Indonesia hit by bird flu
INDONESIA: Nearly 2000 birds have died of bird flu in Bengkulu province (southwest Sumatra) in the last fortnight. Most of the cases were recorded in the Seluma district. More details.
INDIA: Major outbreaks of bird flu have caused alarm in Tripura (Gandhigram state), with 11,000 birds and 200,000 eggs destroyed on 2 farms. More details.

Diarrhoea outbreak on Vanua Levu
FIJI: Poor hygiene and contaminated drinking water have been blamed for more than 220 recent cases of acute diarrhoea in seven northern villages on Vanua Levu island, including Labasa, Taveuni, Seaqaqa, Dreketi, Savusavu, Rabi, Wainikoro, and Natewa. More details.
Advice to travellers: Outbreaks of food- and water-borne diseases such as diarrhoea and typhoid persist in Fiji. Travelvax advises travellers to follow safe food and water guidelines, including regular hand washing, especially when visiting rural areas.

Victoria’s Ross River tally passes 600
AUSTRALIA: On the Murray River, there have been 600 cases of Ross River fever since mid January, notably in the Grampians and Loddon-Mallee regions of northwestern Victoria. Barwon, in the state’s southwest, has had 52 cases. Authorities say this season is the worst for mosquitoes and mozzie-borne diseases in more than a decade. Meanwhile, tests have failed to confirm if Murray River encephalitis killed a Sunraysia man earlier this month. More details.
Advice to travellers: While debilitating, Ross River is rarely fatal. Transmitted through mosquito bites, the virus is found in all Australian states, Papua New Guinea, and many South Pacific islands. In Australia, it occurs mainly from January through to March, when mosquitoes are most abundant. Preventing mosquito bites is the best form of protection. More on Ross River fever.

Heart infection links mysterious Chiang Mai deaths
THAILAND: Thai authorities say myocarditis (inflammation of the heart muscle) is the common link in the death of 6 tourists in Chiang Mai in less than a month. However, extensive investigations have failed to find the source of the infection or any common exposures. The victims were among 3 separate groups who stayed at the Downtown Inn in the popular northern tourist destination in January-February. More details.
Meanwhile, a seventh victim – a 59-year-old Canadian man – has also been linked to the hotel. The man stayed at another hotel but used the pool and other facilities at the Downtown Inn before dying of heart-related illness 2 weeks after leaving Thailand. More details.

Flu continues to decline in Europe
Flu continued its decline on the Continent last week. Intensity was medium in 20 countries and low in 23. While pandemic influenza A (H1N1) 2009 and influenza B currently co-dominate in northern, western and central Europe, pandemic influenza A (H1N1) 2009 i s the dominant virus in eastern Europe. More details.
Advice to travellers: Influenza is the most common vaccine-preventable illness and Travelvax recommends vaccination for all travellers. The new southern hemisphere seasonal flu vaccine protects against both the swine flu (H1N1) and B strains.

Measles alerts for Gold Coast, Western Sydney
AUSTRALIA: Queensland’s Gold Coast is again on alert for measles after a worker at a major Helensvale shopping centre tested positive for the illness on Saturday. It’s the region’s second measles outbreak in as many weeks. More details.
There have been 14 confirmed cases since the end of January in the Western Sydney suburbs of Rooty Hill, Seven Hills, Mt Druitt, and St Marys. Last week’s bulletin also includes details of outbreaks in Switzerland (Geneva), Taiwan (Taipei), and Spain (Seville). More details.
There was a sharp rise in the number of reports in the global measles summary issued today, including Ukraine (Donetsk, 2010), India (Uttar Pradesh), Niger, DR Congo (Maniema), Philippines (Central Visayas and Cordillera), Australia (Queensland), Chile (Santiago), USA (Minnesota and California). More details.

Mala ria spreading rapidly in Andhra Pradesh
INDIA: Malaria is spreading in tribal villages in Andhra Pradesh state. More than 79,000 malaria cases were recorded in Tulasipaka village alone in January and February, according to media reports. More details.
Advice to travellers: Malaria is present year-round in rural and urban areas of India and the number of potentially fatal Plasmodium falciparum cases is increasing. Travellers to India or other regions of 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.

Plague death toll reaches 45
MADAGASCAR: Plague has killed 23 of the 45 people infected in northern Ambilobe (Diana region) and Brickaville (Atsinanana) villages since January. Authorities say local people have been slow to seek medical treatment, adding to the death toll. More details.
Advice to travellers: International experts speculate that pneumonic plague, spread from person to person by airborne droplets, rather than the bubonic type, is the likely cause of this outbreak. Madagascar experiences plague between October and April almost every year.

WHO steps up efforts to halt cholera epidemic
GHANA: A six-month long cholera epidemic has now killed 60 people and infected almost 4000. With 482 new cases reported last week, the WHO has stepped up efforts to contain the epidemic. Hot spots include the Greater Accra, Central, Eastern, and Upper Eastern regions. More details.
< em>Advice to travellers: For most short-stay travellers, the risk of cholera is low. However, the disease spreads rapidly and travellers heading to infected regions should adhere to strict personal hygiene guidelines and choose only safe food and beverages. Travelvax can offer advice on the risks for a journey, and whether vaccination should be considered. Contact Travelvax on 1300 360 164.

India, Taiwan on alert for scrub typhus
INDIA: More than 200 people are being treated for scrub typhus in Jogindernagar (Mandi district, Himachal Pradesh state). More details.
In Taiwan, health authorities have warned more cases of scrub typhus are expected in April, the peak local season for the disease, which occurs mainly in rural areas. More details.
Advice to travellers: Humans are infected with scrub typhus when bitten by small mites carrying the bacteria Orientia tsutsugamushi. The mites are carried by rats. Without timely antibiotic treatment, scrub typhus can be fatal. There is no vaccine for the disease: avoiding rodent-infested areas and using an effective insect repellent are the best forms of protection.

Haemorrhagic dengue claims first victim in Taiwan
TAIWAN: Dengue haemorrhagic fever has killed a 75-year-old woman in Gaoxiong. It was Taiwan’s first dengue haemorrhagic death this year.