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WORLD TRAVEL HEALTH ALERTS – September 21, 2011
– Central Thailand hardest hit by dengue this year
– New strains of dengue hit Ecuador
– Encephalitis deaths mount in India’s north
– Mozzie diseases descend on New Delhi
– Rains bring disease to Karachi, Lahore
– “Welcome to India. Open wide…”
– Two more polio cases in Kenya
– Low vaccination rates blamed for France’s epidemic
– NZ tackles deadly meningococcal outbreak
– UN sounds warning over Haiti
– Hunt on for source of Italy’s Legionnaires outbreak
– Decade-long malaria fight reaping rewards, says UN
– Recognition for malaria’s unsung hero
DENGUE WATCH
ASIA – Central Thailand hardest hit by dengue this year
The majority of Thailand's 49,153 cases (36 deaths) this year have occurred in the Central region, followed by the Northeast, North, and South regions, new figures from the Ministry of Public Health reveal.
The provinces with the highest infection rates are Ayutthaya, Kamphaeng Phet, Si Sa Ket, Chachoengsao, and Suphanburi.
Meanwhile, dengue has struck a Karenni refugee camp in Mae Hong Song, northern Thailand, effecting more than 400 refugees - mostly children. More details.
LATIN AMERICA - New strains of dengue hit Ecuador
ECUADOR: Until recently only dengue serotypes 1 and 3 were in circulation. Now all four types are circulating with the appearance of types 2 and 4 in several provinces.
BRAZIL: Fortaleza, the capital of the northern Brazilian state of Ceara, has had 28,240 cases this year - a rise of 1000%
on 2010 – with a statewide total of 47,763. In the south, Rio de Janeiro state had 156 541 cases (130 deaths) to September 10, with 46,000 cases and 50 deaths in Rio municipality. Also in Rio state, the reappearance of dengue virus type 4 is causing concern in Niteroi.
PANAMA: The 2011 total has now passed 1000 cases (6 deaths), with scores of new cases each day.
DOMINICA: Dengue has arrived on this lush Caribbean island with 24 confirmed or suspected cases.
MEXICO: There have been 2 outbreaks in Queretearo state, including the capital, Santiago de Queretaro, and Quintana Roo.
This week’s dengue bulletin also includes details of outbreaks in Somalia, Pakistan, and India.
More details.
Encephalitis deaths mount in India’s north
Japanese encephalitis (JE) and acute encephalitis syndrome (AES) continue to have a devastating impact across India’s north.
Countrywide there have been 4458 cases and 584 deaths to September 13.
Uttar Pradesh has experienced the highest figures (1782 cases, 248 deaths), followed by Assam (1308, 246).
In a fresh outbreak in Uttar Pradesh’s Bahralch district, northeast of Lucknow, at least 61 people have died and 662 are being treated, many in the grounds of overcrowded medical facilities. More details.
In Gorakhpur, 11 deaths were recorded in just 24 hours. More details.
In Bihar state, the deaths of six children in Gaya last week, lifted the state’s death toll to 5
4 from 288 cases. More details.
Figures from other states include Andhra Pradesh (59 cases, 1 death), Assam (1308, 246), Goa (53, 0), Karnataka (94, 0), Kerala (79, 3), Maharashtra (4, 3), Manipur (2, 0), Nagaland (44, 6), Tamil Nadu (404, 13), and West Bengal (341, 10). More details.
Advice to travellers: AES and seasonal JE, along with other insect-, food- and water-borne diseases, currently pose a significant risk to Australians travelling to India, especially in monsoon-affected northern regions. They 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. As always, we also advise travellers to cover up and use an effective insect repellent at all times when outdoors.
Mozzie diseases descend on New Delhi
Mosquitoes are again bringing disease to India’s national capital New Delhi, particularly malaria (745 cases) and Chikungunya fever (4). Officially, there have been 124 cases of dengue, including 6 fatalities. However, the official figures do not include patients diagnosed and treated at major private hospitals and nursing homes across the city. More details.
Advice to travellers: Malaria is endemic year-round in rural and urban areas of India, including major cities such as New Delhi. The risk is higher during and immediately after the monsoon rains. Travellers should discuss their itinerary and the need for preventative malaria medication at their nearest Travelvax clinic, or with their healthcare provider. For more advice, cal
l Travelvax on 1300 360 164.
Rains bring disease to Karachi, Lahore
Pakistan’s woes continue. Karachi’s hospitals have been hit by a surge of hepatitis, gastroenteritis, acute diarrhoea, and malaria following fresh monsoon rains. Year-to-date national figures from the National Disaster Management Authority include: malaria (85,404), cholera (35,343), and skin diseases (59,763).
Karachi’s water and sewerage infrastructure is in a poor shape and cross-contamination is rife. As many as 1.2 million people die of waterborne diseases in Pakistan every year, 20% of them children under five. More details.
In Lahore, 824 new cases (6 deaths) have taken the year’s dengue tally to 12,109. More details.
“Welcome to India. Open wide…”
After recording just one case this year, India is determined to prevent polio entering the country from Pakistan, which has now recorded 87 cases.
The Punjab state government will vaccinate all children aged 0-5 years who cross the border by road or train. Health teams will staff booths to administer drops of polio vaccine every day for the next four months, the high-risk period for transmission.
The number of confirmed polio cases Pakistan’s Balochistan province has risen to 37 following two new cases. Qilla Abdullah District is the province’s worst affected area with 13 cases. More details.
Advice to travellers: Polio is a low risk for travellers. However, as part of their pre-travel medical preparations, we advise travellers che
ck their immunisation status for all childhood diseases, which include polio, whooping cough, tetanus, diphtheria, mumps, and measles.
Two more polio cases in Kenya
After a case was reported last week, there have been 2 more cases of polio in the Kamagambo area of Rongo District, Western Province. To stop the disease spreading, at least 1.8 million children under five will be vaccinated in Rongo and the neighbouring districts of Homabay, Kisii, Kisumu, Nyamira, Migori, and Transmara. More details.
MEASLES
Low vaccination rates blamed for France’s epidemic
Only 44% of six-year-olds have received the required second dose of the vaccine, according to the National Academy of Medicine. France had 14,000 cases (6 deaths) in the first half of 2011 – almost 3 times last year’s total number – and the academy has called for more effective education and vaccination campaigns to increase immunisation levels.
In Africa, outbreaks are occurring in Kenya (Dadaab), Somalia (Marere), and Zambia (Luapula).
The Colombian government plans to vaccinate over 8 million people in the next 8 months following an outbreak in Barranquilla.
In the USA, state health authorities report outbreaks in New Mexico and Wisconsin.
More details.
In New Zealand, passengers who flew with Jetstar between Auckland and Wellington last week may have been exposed to measles. England and Wales have had 777 confirmed measles cases in the first seven months of 2010, compared to 374 for all of 2010. Most were linked with travel to Europe. More details.
Advice to travellers: Australian travellers who have not had measles or have not received two documented doses of live virus vaccine should consider a booster, regardless of their age or destination. We also advise travellers check their immunisation status for childhood diseases such as whooping cough, diphtheria, mumps, and polio, as part of their pre-travel preparations.
NZ tackles deadly meningococcal outbreak
New Zealand health officials hope to end a deadly outbreak of meningococcal disease by vaccinating 44,000 young people aged from one to 20 in the Northland region. There have been 8 cases of meningococcal B and C, including 2 deaths from type C. More details.
UN sounds warning over Haiti
A UN report has warned that money and manpower are running low in the fight against cholera in the Caribbean. With 6000 dead and 420,000 infected since last October, cholera is far from being under control in Haiti. Haiti’s neighbour, the Dominican Republic, has recorded 1681 confirmed cases and 56 deaths in the first half of the year. More details.
Hunt on for source of Italy’s Legionnaires outbreak
There have been 11 cases of Legionnaires' disease among tourists who stayed at 4 different hotels in Lazise, a holiday town on the eastern shores of Lake Garda (Verona province). Authorities are searching for a common source of infection. More details.
Rates of Legionnaires' disease in Italy and
surrounding countries have increased dramatically since 2000, with travel-associated cases having almost tripled in Italy in the last decade. More details.
Decade-long malaria fight reaping rewards, says UN
A decade of intensive campaigns have cut new malaria infection rates by half and deaths by 38% in 43 countries worst hit by the disease, the UN announced this week. More details.
Recognition for malaria’s unsung hero
The story has become medical folklore… a Chinese scientist searches among traditional Chinese folk remedies hunting for a new malaria treatment. Her search uncovers a long-forgotten text that describes the malaria treatment benefits of Artemisia annua, or sweet wormwood.
It has been 40 years since Tu Youyou ‘rediscovered’ Qinghaosu. Its purified extract, known as Artemisinin, is still in the front line of malaria treatment today.
Now aged 81, Youyou will be presented with a Lasker Award in New York this Friday. Presented annually for major advances in medicine, the awards are known as ‘America's Nobels’ for catching the eye of Nobel committee members. 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.
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