WORLD TRAVEL HEALTH ALERTS – July 27, 2011

– French toddler sparks measles panic in Mexico
– Dengue rains on Asia
– Europe warns travellers as Caribbean cholera escalates
– Contaminated water behind Cebu’s typhoid outbreak
– HFMD cases skyrocket in southern Vietnam
– Malaria outbreak in India’s northeast
– Monsoon continues to visit death on Uttar Pradesh
– Polio eradication plan ‘off track’

French toddler sparks measles panic in Mexico
An 18-month-old French girl with measles sparked a panic in Mexico after she travelled from Paris to Mexico City last week.
It is Mexico’s first case of measles since 2007 and health authorities immediately began tracing other passengers. They placed a health cordon around Mexico City airport and began monitoring 7 other airports.
The government will purchase 3.6 million doses of measles vaccine, which is being offered to travellers bound for Europe and the USA in the next 20 days. Airport employees are getting shots.
In the northeastern state of Tamaulipas, local authorities have set up sanitation barriers around affected neighbourhoods after two possible cases were detected in the city of Nuevo Laredo. More details.
NEW ZEALAND: Four new confirmed measles cases in 7 days have brought Auckland’s total to 76, while authorities fear the outbreak will escalate during the school holidays. More details.
AFRICA: A measles epidemic has now killed 1145 children in the Democ ratic Republic of Congo since January. The UN says more than 115,600 people have been infected. More details.
The latest measles update includes details of outbreaks in the USA and background information on Europe’s epidemic. More details.
Advice to travellers: Regardless of their destination, Australian travellers should be protected against measles. Those who have not had measles or have not received two documented doses of live virus vaccine should consider a booster. We also advise travellers to check their immunisation status for childhood diseases such as whooping cough, diphtheria, mumps, and polio, as part of their pre-travel medical preparations.

Dengue rains on Asia
Heavy seasonal rain is increasing the risk of dengue fever for travellers in Southeast Asia. The latest dengue update from the WHO’s Western Pacific Regional Office reported significantly higher case numbers in Cambodia, Singapore and Vietnam compared to last year. More details.
THAILAND: Continuing rain in Thailand has seen an increase in the incidence of the more severe dengue haemorrhagic fever. Thailand’s health authorities warn that July and August are the country’s peak months for transmission. Dengue has killed 13 people among 23,324 cases this year. More details.
CAMBODIA: Cambodia is also well into its rainy season and health authorities have warned dengue could spiral out of control if communities do not eliminate mosquito breeding sites arou nd buildings. This year 4626 Cambodians – mostly children – have been hospitalised compared to 2888 last year, while deaths are up from 9 to 23. Seven provinces are battling outbreaks. More details.
SINGAPORE: There was a surge of 424 dengue cases in the first 2 weeks of July. The largest cluster was in the Tai Keng Gardens. The year’s total is now 2545, compared to 2211 in 2010. More details.
SOUTH ASIA: Cases are rising in India’s capital, Delhi, while in the Maldives a record 11 people have now died this year. More details.
SOUTH AMERICA: Rio Claro was another region of Brazil’s Sao Paulo state to experience record dengue cases this year, while new figures showed much fewer cases in Mato Grosso state, despite the year’s sixth fatality last week. More details.
AUSTRALIA: The Red Cross has had to destroy 33,600 litres of donated blood for fear it was contaminated with dengue fever virus after the large outbreak in northern Queensland in late 2009-10. Losing 7% of its supplies has cost the service almost $4 million. More details.
Advice to travellers: As Asia’s seasonal rains continue, dengue and other mosquito-borne diseases pose a risk for Australian travellers heading to the region. Personal protection against insect bites is important: The mosquitoes that transmit the dengue virus inhabit urban areas, including leading hotels and resorts, and bite mainly during the day. Travellers should 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.

Europe warns travellers as Caribbean cholera cases climb
In Haiti, health workers are seeing more than 1000 new cases of cholera a day with the return of the rainy season. Officially, there have been 6000 deaths. More details.
In the Dominican Republic, 16 new cases have increased the death toll to 87 from 13,200 confirmed or suspected cases. More details.
European Union health officials have warned travellers about the risk cholera in the Dominican Republic, which attracts more than a million tourists from Europe annually. Two Europeans contracted the disease in May, however the ECDC says the overall risk is low. More details.
In Africa, there have been major cholera outbreaks along the Congo River in recent weeks. Among the regions worst affected are the provinces of Bandundu, Equateur, Kinshasa, and P Orientale in the Democratic Republic of Congo (3896 cases, 265 deaths), and the provinces of Brazzaville, Cuvette, Likouala, and Plateaux in the Republic of Congo (181, 6). More details.
Advice to travellers: For most short-stays, the risk of cholera is low. For those heading to areas where cholera is endemic or outbreaks are occurring, it is important to practice strict personal hygiene and make safe food and beverage choices. For advice on a particular journey and whether vaccination should be considered, call Travelvax on 1300 360 164.

Contaminated water behind Cebu’s typhoid outbreak
In the Philippines, typhoid has killed 2 people and infected at least 100 in 2 barangays (districts) in Alegria (Cebu Island). Authorities found the town’s water supply had not been properly chlorinated. More details.
Advice to travellers: Typhoid generally presents a low risk for short-stay travellers. Immunisation is generally recommended for travellers staying for longer periods, travelling or staying in rural areas, and for adventurous eaters. Travellers should also follow safe food and water guidelines, and personal hygiene practices.
http://travelvax-px.rtrk.com.au/home/home/tips/FoodWater.html

HFMD cases skyrocket in southern Vietnam
There have been almost 10,000 new cases of hand, foot and mouth disease in Vietnam in the last month. Countrywide, cases rose from 7300 to 17,000 (90 deaths) – the majority in Ho Chi Minh City and the surrounding southern provinces of Dong Nai, Binh Duong, Long An, and Tien Giang. The peak season is August to November. More details.
Advice to travellers: HFMD is spread by direct contact with infected persons, or with virus-contaminated surfaces. The disease mainly occurs in children and good hygiene practices will greatly reduce the risk of infection. There is no vaccine or preventative medication.

Malaria outbreak in India’s northeast
There have been more than 150 cases of cerebral malaria in the Bokaro district in India’s northeastern Jharkhand state. More details.
Advice to travellers: Malaria is present year-round in rural and urban areas of India, including major cities. Travelvax recommends travellers discuss their itinerary and preventative malaria medication at their nearest Travelvax clinic, or with their healthcare provider. For advice, call Travelvax on 1300 360 164.

Monsoon continues to visit death on Uttar Pradesh
Monsoon rains continue to herald death in India’s ‘rice bowl’ state, Uttar Pradesh. The toll from the still undiagnosed acute encephalitis syndrome (AES) is now 85, while 21 have died from mosquito-borne Japanese encephalitis (JE). More details.
Advice to travellers: The JE transmission season is now underway in northern India. The JE ‘belt’ extends from South Asia, through Southeast and East Asia, to the northern tip of Australia. It is the main cause of viral encephalitis in Asia and some 30,000-50,000 cases occur annually. Travellers should discuss their plans with a travel health professional at Travelvax (landline toll-free 1300 360 164).

Polio eradication plan ‘off track’
The goal to wipe out polio by the end of 2012 is ‘off track’, say experts monitoring the Global Polio Eradication Initiative. While cases have declined by 99% worldwide since the initiative began in 1988, it persists in Afghan istan, India, Nigeria, and Pakistan. New cases in the Democratic Republic of Congo and Chad are causing even greater concern. 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.