WORLD TRAVEL HEALTH ALERTS - JUNE 29, 2011
-  E.coli spotlight shifts to France as Germany’s toll rises
-  El Salvador gets tough in fight against measles
-  Measles numbers rising in NZ, Belgium, UK, USA, Africa
-  Mekong hit by dengue epidemic
-  Encephalitis claims more young lives in northern India
-  Scientists detect 2 strains of scarlet fever
-  Risk of aid ‘burnout’ as cholera toll mounts in Haiti, DR
-  Kids at risk as tens of thousands displaced by Philippines floods

E.coli spotlight shifts to France as Germany’s toll rises
E.coli in Europe has taken a bizarre turn with news of an outbreak in France involving an identical strain of E. coli O104:H4 bacteria that claimed it’s 47th victim in Germany this week. Six of the 8 people infected ate locally produced bean sprouts at an event at a commune near Bordeaux. Health authorities are investigating to confirm the source and waiting on results of genetic testing comparing the strains.
With many of the 3919 people effected in Germany and beyond still seriously ill, the death toll is expected to rise. More details.

El Salvador gets tough in fight against measles
El Salvador will require proof of vaccination against rubella (German measles) and measles from travellers older than 6 months arriving from, or travelling to, Europe from July 1. Other Central American countries may follow El Salvador’s lead after the Pan American Health Organisation recently recommended all travellers heading to and from the region be vaccinated against the two highly contagious viruses.

Advice to travellers: This decision is a predictable reaction to the widespread measles epidemics occurring i n Europe and other regions. We would advise vaccination against the two diseases be recorded in an official International Vaccination Record Book. Call Travelvax on 1300 360 164 (toll-free from landlines) for details and further advice on the health risks of travel to Latin America. Measles is a highly contagious airborne disease that can cause severe illness. Australian 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 – regardless of their destination. Travelvax recommends travellers also check their immunisation status for childhood diseases such as whooping cough, diphtheria, mumps, and polio, as part of their pre-travel medical preparations.

Measles numbers rising in NZ, Belgium, UK, USA, Africa
NEW ZEALAND: There are now 26 confirmed cases in west Auckland, while 300 other people are under precautionary self-quarantine in their homes. Almost all of the cases can be traced back to an unimmunised pupil at Oratia Primary School who caught the disease during a holiday to England. More details.

BELGIUM: Measles is now at epidemic levels in Belgium. The total has now passed 400 cases – 10 times last year’s figure. More details.
SWITZERLAND: Despite 18 new cases in the first weeks of June, Switzerland’s epidemic is now in decline. The year-to-date tally is 581, the majority of cases in Vaud (115 cases), Geneva (194), and Basel (65). More details.
UNITED KINGDOM: Travel abroad has been a recurring theme among the 500 cases of measles in England and Wales this year, according to the UK Health Protection Agency. The figure already far exceeds last year’s 12-month total, 374. However, there are signs that the widespread outbreaks at home and in Europe have helped to boost general immunisation rates. More details.
School students are coming down with measles in south-west England. Nearly 20 of the 70 students at a school in Ashburton (Devon County) have the disease, while in neighbouring Dorset outbreaks at schools in Bridport have prompted warnings to parents to ensure their children are vaccinated.
TANZANIA: Authorities are struggling to contain a measles epidemic that has killed 18 people and infected another 1573. Areas worst effected include Arusha's Ngorongoro and Karatu districts, and Dar es Salaam, the municipalities of Iringa and Morogoro, Coast Region's Kisarawe District, the Kilosa District, and Tanga. More details.
USA: State health officials are investigating measles outbreaks in north east Indiana, Utah’s Cache County, and in Vermont. More details.

Mekong hit by dengue epidemic
Dengue fever is widespread throughout southern Vietnam’s Mekong Delta provinces.
There have been fatalities in Ca Mau, Soc Trang, and Vinh Long provi nces, while cases are also concentrated in Vinh Thanh, Phong Dien, Co Do, and Thoi Lai districts of the Mekong’s biggest city, Can Tho.
Ca Mau Province has had 1400 cases (2 deaths), mainly in the Dam Doi, Thoi Binh, Tran Van Thoi, and Cai Nuoc districts, and in the provincial capital, Ca Mau City, Vietnam’s principal prawn-growing centre. Other southern provinces, including Soc Trang, Vinh Long, Dong Thap, Hau Giang, Tien Giang, and Tra Vinh, have reported high case numbers.
More details.
Year-to-date figures from two major Asian cities demonstrate the cyclic nature of dengue. Indonesia’s capital, Jakarta has recorded 691 in the first five months of 2011, compared to 2563 for the same period last year, while in southern India, Bangalore (Karnataka state) has seen only 102 cases (2 deaths) compared to 2285 (7deaths) last year.
In the Caribbean, there have been ‘disturbing’ levels of dengue fever and leptospirosis cases on St Lucia. More than 40 cases in May brought the year’s total to 169, compared to 95 last year and 18 in 2009. More details.
There have also been minor dengue outbreaks in the southern Mexican states of Veracruz and Oaxaca. More details.
In the Maldives, local hospitals are becoming crowded with dengue patients in capital, Male and on other islands. An infant who died this week became the third dengue fatality of the year. More details.
Advice to travellers: Australians heading to the tropics should continue to be aware of the need to avoid mosquito bites, despite reports of diminishing outbreaks in some regions. Cover up and regularly apply an insect repellent containing effective active ingredients, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin at all times when outdoors. Dengue is transmitted by mosquitoes that inhabit urban areas, including leading hotels and resorts, and bite mainly during the day.

Encephalitis claims more young lives in northern India
Another 10 children died last week from what is believed to be a mosquito-borne encephalitis in India’s northeastern Bihar state, bringing the total to 36 in three weeks. Another 40 children are receiving intensive care. Although the outbreak has occurred at the start of the region’s Japanese encephalitis season, there has still been no confirmation from government laboratories. More details.
Advice to travellers: Travellers heading to regions with seasonal JE or other severe mosquito-borne diseases should discuss their itinerary and risk of exposure with a travel health professional. For advice on whether vaccination should be considered, call Travelvax on 1300 360 164. Australians heading to all rural or urban areas of India should also consider anti-malaria medication. As always, we also advise travellers to cover up and use an effective insect repellent at all times when outdoors.

Scientists detect 2 strains of scarlet fever
Different strains of scarlet fever killed 2 children in Hong Kong, tests have revealed. Another 500 have been infected in Hong Kong, Macau, and Guangdong Province in mainland China, although reports from China are sketchy. The WHO is urgently assessing the outbreak. More details.
Meanwhile, Macao has entered its high-risk season for dengue fever as warm and wet weather provide ideal breeding conditions for mosquitoes, a senior health official warned last week. More details.

Risk of aid ‘burnout’ as cholera toll mounts in Haiti, DR
Seasonal rains, flooding, a shortage of clean water, and poor sanitation have led to a rise in cholera cases in Haiti, with the capital Port au Prince and the southern peninsula worst effected. With the toll at 5397 (344 623 cases), there are now fewer non-government organisations (NGO) to fight the outbreak and aid funds are drying up. In neighbouring Dominican Republic, 2 new deaths have brought the toll to 48 (1550 cases). More details.
Advice to travellers: Travellers heading to areas where cholera outbreaks are occurring should adhere to strict personal hygiene and choose only safe food and beverages. For most short-stays, the risk is low. For advice on a particular journey and whether vaccination should be considered, call Travelvax on 1300 360 164.

Kids at risk as tens of thousands displaced by Philippines floods
UNICEF fears outbreaks of diarrhoea, pneumonia and other diseases among the 500,000 children displaced by flooding in Manil a and southern provinces of the Philippines in the past fortnight. The region was flooded when water hyacinths clogged a huge section of the Rio Grande, the country's second-longest river, preventing it from emptying into the sea after heavy rain. More details.