WORLD TRAVEL HEALTH ALERTS – July 6, 2011

-  Dengue alerts for Asia, Africa, Middle East, South America
-  Hong Kong’s scarlet fever may continue until September
-  WA travellers warned over Bali travel
-  Don’t eat sprouts in Europe, travellers warned
-  Signs Aussie flu season may be underway
-  Suspected JE case in northern India
-  India braces for more monsoon cholera
-  Cholera hits Nigeria, DR Congo
-  As aid dries up, cholera rains down
-  Chikungunya skyrockets in DR Congo
-  Measles alerts for Europe, Africa, Asia, Americas, Pacific
-  Tick diseases on the rise in Russia
-   Polio-plagued Pakistan may face travel restrictions
-  Travellers warned off fresh fish dish

Dengue alerts for Asia, Africa, Middle East, South America
ASIA: Case numbers are rising in Cambodia, while Singapore has seen clusters of rare type 3 dengue in the Marsiling area.
AFRICA: Cases are steadily increasing in the Maldives’ capital, Mali.
MIDDLE EAST: The Saudi capital, Jeddah is recording 130 new cases a week .
SOUTH AMERICA: Peru has declared a yellow alert for Loreto, Madre de Dios, San Martin and Amazonas departments due to persistence outbreaks. In Brazil dengue continues to claim victims in Sorocaba (Sao Paulo state), while there was a sharp decline in Volta Redonda (Rio de Janeiro state) in June – 340 cases compared to 2589 in May.
More details.
Advice to travellers: Urban-breeding Aedes egypti mosquitoes spread dengue fever. Travelvax urges travellers to tropical destinations to pack an effective insect repellent containing DEET or Citriodio l and to apply it regularly when outdoors – even within the confines of resorts and hotels. There is no vaccine against dengue.

Hong Kong’s scarlet fever may continue until September
Hong Kong is recording as many as 20 new cases of scarlet fever each day, with the Health Secretary predicting the outbreak will continue until September. The total number of cases in Hong Kong could be as high as 700, although no new data is available on the extent of the disease in neighboring regions of southern China and Macau. More details.

WA travellers warned over Bali travel
In Western Australia, almost 200 people have been treated for dengue fever after travelling to Bali this year, while another 40 have received precautionary treatment for rabies. WA Health last week warned residents planning to holiday on the island to take preventative measures to avoid being bitten by mosquitoes, and potentially rabid dogs and monkeys. More details.
Advice to travellers: Along with travellers’ diarrhoea, dengue fever presents the main health risk for travellers to Bali. The daytime-feeding mosquitoes that transmit the virus inhabit urban areas, including hotels and resorts. Cover up and apply an insect repellent with an effective active ingredient such as DEET (30-50%), Picaridin, IR3535, or oil of lemon eucalyptus. While rabies is a low risk for short-stay travellers to Bali and most rabies-endemic areas, the potential for exposure increases the longer the stay – especially for children. Travellers should avoid contact with dogs and other domestic or wild animals, and if bitten, seek urgent post-exposure treatment.

Don’t eat sprouts in Europe, travellers warned
Europe’s health authorities continue to advise residents and travellers against eating raw bean sprouts. Investigations are continuing to confirm if fenugreek sprouts grown from seeds imported from Egypt caused the major E. coli O104:H4 outbreak in Germany and smaller outbreak in France. The toll has now risen to 4211 cases and 49 deaths.  More details.

Signs Aussie flu season may be underway
Australia’s flu season may be underway. In its latest flu report, the WHO says an increase in flu activity in South Australia and Queensland, and more emergency department visits for influenza-like illness (ILI) Australia-wide, could be the first signs the 2011 flu season has begun.
Meanwhile, the season is underway in South Africa, where there’s been an increase in mild and severe cases, mainly of the A(H1N1)2009 strain.
Flu activity in the temperate regions of the northern hemisphere is at low, between-season levels. In tropical areas transmission is low overall, except for some parts of Central America and northern South America, western and eastern regions of sub-Saharan Africa, and tropical Asia.
More details.
Advice to travellers: Influenza is the most common vaccine-preventable illness for travellers and Travelvax recommends vaccination for all travellers. The southern hemisphere seasonal flu vaccine protects against both the A(H1N1)2009 swine flu and B strains.

Suspected JE case in northern India
In India’s far north eastern Manipur State, health authorities are investigating a suspected case of Japanese encephalitis (JE) in a teenage boy from Lilong Arapti. More details.
Advice to travellers: India is endemic for JE and the transmission season is now underway. Travellers whose itinerary may put them at risk should discuss their plans with a travel health professional at Travelvax (landline toll-free 1300 360 164). Australians heading to any rural or urban areas of In dia should also consider anti-malaria medication, and use an effective insect repellent at all times when outdoors.

India braces for more monsoon cholera
The monsoon has visited cholera on Mumbai, with the suburbs of Antop Hill and Bhiwandi each reporting a case. In Pubjab, two tourists are among 5 people hospitalised with cholera in Ropar, while in Kalpetta (Wayanad district, Kerala State) 7 people are dead and as many as 114 were admitted to local hospitals.
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.

Cholera hits Nigeria, DR Congo
NIGERIA: 370 cases (10 deaths) have been reported in the Plateau local government areas of Jos South, Jos North, Mangu, Shendam, Barkin Ladi and Pankshin. More details.
In Kano and Takai, acute diarrhoea has killed 4, with 8 hospitalized. More details.
CONGO DR: 7 cases have been recorded in the outer suburbs of the capital, Kinshasa. More details.

As aid dries up, cholera rains down
As rainy season flooding causes a spike in cholera cases, international aid is evaporating in Haiti, which has now registered 344,623 cholera cases and 5397 deaths. Meanwhile, in neighbouring Dominican Republic, doctors fear the country’s epidemic is out of control as hospitals see 30 new cases each day. More details.

Chikungunya skyrockets in DR Congo
Five weeks after Chikungunya virus arrived in the Democratic Republic of Congo, the number of cases has soared to 7074. Most are in the southern suburbs of Brazzaville, including Makelekele and Bacongo, along with 460 in the neighbouring Pool region, according to the WHO. More details.
Advice to travellers: Like dengue fever, Chikungunya is spread by daytime-feeding Aedes mosquitoes. Travellers should cover up and apply an insect repellent containing effective active ingredients, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin when outdoors. As with dengue, there is no vaccine or preventative medication for Chikungunya.

Measles alerts for Europe, Africa, Asia, Americas, Pacific
FRANCE: The third measles epidemic in France since 2008 is now subsiding, but not before pushing the number of cases to almost 20,000 – a third of them in 2011. So far, there have been 14 cases with neurological complications, 444 with severe pneumonia, and 6 deaths this year. More details.
UNITED KINGDOM: As the UK’s measles tally reaches 500 for the year, vaccination rates are also steadily increasing as more parents have their children immunised. More details.
CHAD: A mass vaccination campaign has been launched to stem an epidemic among measles-infected refugees escaping the conflict in Libya. There have been 5311 cases (63 deaths) in 20 of Chad's 22 regions this year. More details.
TANZANIA: Measles is impacting on the nomadic Maasai of the vast northern Ngorongoro district, with 20 deaths among 650 cases. More details.
NEPAL: Measles has swept through a Muslim community in Sikwakataiya, a village in south-central Mahottari District. Most of the community had not been vaccinated and the outbreak has effected 80% of the local children. More details.
USA: Measles is spreading in Indiana (Noble County, LaGrange County) and New Jersey (Bergen County). More details.
NEW ZEALAND: With 39 cases, Auckland's measles epidemic is worsening and health officials say new cases coming from overseas are adding to the tally. In Hawke's Bay, children without a measles immunization certificate will be banned from attending schools and early childhood centres where cases have occurred to help stem a local outbreak. There have been 25 cases at district schools.
Advice to travellers: 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.

Tick diseases on the rise in Russia
Russia has experienced a major increase in tick bites – and the diseases they transmit – this year. Almost 16,500 people were bitten to mid-June compared to 11,547 in the same period last year, resulting in 379 suspected cases of tick-borne encephalitis (TBE) and 63 confirmed diagnoses of Lyme disease. More details.
Advice to travellers: TBE and Lyme disease are low risks for most travellers. The potential for tick bites increases with time spent walking in forests and rural areas of Europe and the northeastern US states during the northern summer. There are an average 20,000 cases of Lyme disease in the USA each year. There is an effective vaccine for TBE, but not for Lyme disease and all travellers should use an effective repellent to avoid tick bites. Travellers can call Travelvax on 1300 360 164 for further information.

Polio-plagued Pakistan may face travel restrictions
Some European countries are so concerned at the rising incidence of polio in Pakistan that they are considering placing travel restrictions on Pakistanis if their country fails to eradicate polio by 2012. Pakistan has had 57 cases this year, far exceeding Nigeria (11), India (5) and Afghanistan (4), the three other countries where polio still exists. A global campaign is underway to eliminate the disease. More details.

Travellers warned off fresh fis h dish
The WHO has highlighted the risk to travellers of eating uncooked freshwater fish in southeast Asia. Rivers in northeast Thailand, Vietnam, Laos, Cambodia, the Koreas and China are infested with a tiny parasitic worms that find their way into people who eat raw fish dishes such as Koi-pla. The dish is a culinary favourite in the Mekong and other parts of Asia, such as Hong Kong and Singapore, because of the popularity of Thai cuisine. In northeast Thailand authorities plan a screening program to detect and treat infections. 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.