– DENGUE: Rio in for record numbers this summer
– Flooding brings malaria, dengue to Pakistan
– Measles cases mount in Europe, Africa
– Two more polio cases in western Pakistan
– Cholera widespread across Nigeria’s north
– Mumps: Another legacy of Bosnia’s war
– Thailand goes on war footing over bird flu, HFMD
– Bacteria kills Queensland fisherman
– Anthrax-infected hippo meat kills 3
– Listeriosis claims more lives in Colorado

DENGUE: Rio in for record numbers this summer
In Brazil, Rio de Janeiro city’s health authorities predict a major epidemic of dengue fever this summer, possibly topping 2002 (290,000 cases; 91 deaths) and 2008 (250,000;174). The prediction follows unusually high cases recently. "Everything points to a new cycle of the disease, certainly the worst epidemic in Rio's history,” Mayor, Eduardo Paes said. More details.

This week’s global dengue roundup includes details of outbreaks in the following regions:

ASIA: Cambodia, Pakistan (Punjab province), India – Delhi, Ludhiana (Punjab state), Ahmedabad (Gujarat state), Orissa state; Philippines – national figures, Lucena (Quezon province), Central Luzon; Vietnam (national figures).

LATIN AMERICA: Costa Rica, El Salvador, Brazil (Ceara and Parana states).
CARIBBEAN: The Bahamas.

More details on all roundup items.
In other dengue news…
BANGLADESH: With more than 1000 cases (5 deaths), the capital, Dhaka is having its worst outbreak in 5 years. More details.

TAIWAN: The first locally acquired dengue haemorrhagic fever fatality occurred last Friday. The island has had 85 locally acquired dengue cases this year. More details.

SINGAPORE: Control efforts have been concentrated in the northern residential district of Seletar. More details.

Advice to travellers: Seasonal rains in Asia continue to create ideal conditions for dengue and other mosquito-borne disease, while outbreaks persists in Latin America and the Caribbean. In the tropics, 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. The mosquitoes that transmit the dengue virus inhabit urban areas, including leading hotels and resorts, and bite mainly during the day.

Flooding brings malaria, dengue to Pakistan

Malaria and dengue are the latest threats in the Sindh and Punjab provinces of Pakistan. Floods have claimed 88 lives as the military and UN agencies are coordinating rescue and relief efforts. More details.
Pakistan’s rains are likely to bring more malaria to Karachi. On average, 20-25% of Pakistanis are exposed to malaria each year, but the rains could double infection rates, according to a senior doctor. More details.

In India, the Yamunanagar district of Haryana State is at the centre of outbreaks of malaria (2900 cases) and cholera. More details.

In Cambodia, text messaging and web-based technologies are at the front lines in the fight against malaria. They are part of a $US22.5 million malaria containment effort, launched by the government in 2009 and funded by the Gates Foundation. More details.

Advice to travellers: Malaria is endemic many parts of the tropics . Travelvax recommends that travellers discuss their itinerary and preventative malaria medication at their nearest Travelvax clinic, or with their healthcare provider. For more advice, call Travelvax on 1300 360 164.

Measles cases mount in Europe, Africa
Europe’s measles count has now passed 26,000 cases this year.

The majority have been in France 14,000 (6 deaths), in contrast to 1361 cases in Germany. Pneumonia (1245 cases), encephalitis (20), and spontaneous abortions (2) were among the severe measles-related events reported from just three countries (France, Italy and Romania). More details.

In Africa, the Democratic Republic of Congo has now recorded 1100 deaths among 106,000 cases during a 9 month-long outbreak, which is now spreading to the provinces of Katanga, Kasai Oriental, Occidentale, Maniema, and South Kivu. Aid agencies fear the country’s eastern provinces will be next.
Angola recorded 16 ca ses (2 deaths) in central Benguela Province during August, while Somalia’s measles tally has passed 9000 cases in 2011. The Horn of Africa is facing what may be the worst drought in more than 50 years and overcrowded camps around the capital, Mogadishu make ideal conditions for the disease. More details.

In the USA, outbreaks are occurring in Indiana and Maryland. Nationally, there have been 15 outbreaks this year, while 90% of the 198 cases were associated with international travel. The figures are the highest since 1998. Elsewhere in the Americas, there are outbreaks in Canada (Alberta) and Colombia (Barranquilla).

In New Zealand, Auckland’s outbreak continues to wane with just 6 cases in the past fortnight. They bring the total to 117.More details.

Advice to travellers: Measles epidemics are continuing in many parts of the world, including those regions where reporting is scant. Australian travellers should ensure they are protected against measles. Those who have not had measles or have not received two documented doses of live virus vaccine should consider a booster, regardless of their destination. 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.

Two more polio cases in western Pakistan
Two more polio cases have been detected in Quetta and Chaman, in Pakistan’s far west. There have been at least 77 cases of the virus nationwide this year, with Balochistan province the worst affected region. More details.

Cholera widespread across Nigeria’s north
NIGERIA: Cholera has struck in 5 states – Yobe, Nasarawa, Benue, and Kaduna in the north, and Osun in the southwest – with more than 1600 cases and at least 63 deaths reported. More details.

Advice to travellers: For most short-stays, cholera presents a low risk to travellers. Those heading to areas where cholera outbreaks are occurring should adhere to strict personal hygiene and choose only safe food and beverages. For advice on a particular journey and whether vaccination should be considered, call Travelvax on 1300 360 164.

Mumps: Another legacy of Bosnia’s war
Almost half the 5261 cases of mumps recorded in Bosnia-Herzegovina this year have been among teenagers aged 15-19. They missed being vaccinated during Bosnia’s war from 1992-95, Eurosurveillance reports. More details.

Advice to travellers: Mumps one of the pre-travel vaccinations that Travelvax routinely recommends to all travellers, particularly young adults. They should also check their immunisation status for measles, whooping cough, diphtheria, and polio 4-6 weeks before departure.

Thailand goes on war footing over bird flu, HFMD
Thailand’s Ministry of Public Health will set up a ‘war room’ to monitor and prevent the spread of avian influenza and reduce the incidence of hand-foot-and-mouth disease (HFMD) in children. After a peak of 600 cases in the last week of August, only 400 HFMD cases were recorded last week. They bring the year’s total to 8842, including 4 deaths. More details.

Meanwhile, the US Centres for Disease Control and Prevention (CDC) moved quickly this week to play down ‘misleading information’ in the media that new H5N1 (bird flu) virus strains had dramatically raised the risk to human health. “The CDC does not believe the risk from H5N1 to humans has increased," it said in a statement. “There have been no recent changes that pose any additional risk to humans.” More details.

Bacteria kills Queensland fisherman
An elderly Queensland man has died a week after an aggressive bacterium entered his leg through an open wound while he was fishing in shallow water at Weipa. Vibrio vulnificus usually occurs after eating seafood, especially raw or undercooked oysters, but can enter the body through wounds. On average, it causes a death every two years in the state’s Far North. More details.

Anthrax-infected hippo meat kills 3
In Zambia, anthrax-infected hippopotamus meat being sold in markets has killed three people and infected over 200. More than a dozens hippos have died around the Luangwa River in the Chama District of Eastern Province in recent weeks. More details.

Listeriosis claims more lives in Colorado
An outbreak of listeriosis claimed 2 more lives in the US state of Colorado last week. Another 6 people are ill. The summer-long outbreak began in June with 2 deaths, but health authorities have been unable to find the source of the bacterial disease. 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 34 clinics. Visit our website or call 1300 360 164 for details.