WORLD TRAVEL HEALTH ALERTS – October 5, 2011
–  Polio reaches Beijing
–  Typhoid sidelines Rugby tournament
–  Dengue Alerts: The latest from Africa, Americas, Asia
–  NZ’s measles epidemic reaches central Auckland
–  America’s listeria toll climbs to 18
–  Disease warning for flooded Manilla
–  Malaria rampant in Vizag
–  Southern Sudan hit by malaria epidemic
–  Surge of cholera outbreaks in Africa
–  Haiti chalks up horror Year of Cholera
–  Encephalitis death toll soars in northern India
–  Record numbers of tick disease in Sweden, Austria
–  Chickenpox hits Cayman Islands

Polio reaches Beijing
CHINA: Polio has been detected in Beijing for the first time in 27 years. Three students from remote Xinjiang, where wild poliovirus first entered China from Pakistan last month, are receiving treatment in the capital. Ten cases have now been recorded in Xinjiang – 9 from Hotan Prefecture. Chinese health authorities plan to introduce testing across the country. More details.
Advice to travellers: Polio is a low risk for travellers. However, we advise travellers check their immunisation status for all childhood diseases, including polio, whooping cough, tetanus, diphtheria, mumps, and measles 6 weeks before departure.

Typhoid sidelines Rugby tournament
FIJI: An outbreak of typhoid fever at Bau, on the northern island of Vanua Levu, has forced organisers to postpone the Nasolo 7s Rugby Tournament, this week. A Health Ministry spokesperson said the social gatherings were banned to prevent the disease from spreading. Already this year there have been 28 cases of typhoid in Bau. More details.
Advice to travellers: Typhoid is a persistent problem in Fiji, but the disease presents a low risk for short stays in hotels or resorts. Vaccination is more likely to be recommended for travellers staying in rural areas, and for adventurous eaters. Travellers should also follow safe food and water guidelines, and personal hygiene practices.

Dengue Alerts: The latest from Africa, Americas, Asia
AFRICA
Kenya: In northeast Mandera, more than 5000 cases have overwhelmed the local health facilities. Local sources say 10 people have died in the last month. More details.
AMERICAS
USA: In Florida’s Hillsborough County, 2 people have returned with dengue from a Caribbean holiday and infected a third person. In Miami-Dade County, there’s been a second locally acquired case.         Mexico: In coastal Veracruz State, Alto Lucero, Actopan, and Vega de Alatorre municipalities have been recorded 45 cases, including 10 of dengue haemorrhagic fever. There have been 165 confirmed or suspected cases in Queretaro State, and 4 in Valladolid, Yucatan state. More details.
Brazil: Bauru, Catanduva, and Araraquara are among the regions of Sao Paulo State worst effected by dengue this year, while Londrina has been hard hit in Parana State. More details.
El Salvador: There has been a surge in new cases recently. Despite fewer cases overall this year, the dengue outbreak is more severe, due to the presence of all 4 serotypes. More details.
Bahamas: In the Caribbean, the Bahamas has now recorded 40 cases since dengue was first diagnosed in early September. More details.
ASIA
Pakistan: Punjab province has recorded 93% of the 12,466 cases (125 deaths), with flood-hit Lahore and Sindh worst effected. This bulletin also details outbreaks in Hoshiarpur (Punjab province), Bahawalpur (Punjab), and Khyber (Pakhtunkhwa). More details.
India: Delhi has reported hundreds of new cases in the past fortnight. The city’s worst affected areas include the Central Zone (Lajpat Nagar, Defe nce Colony, GKI, and South Extension) and South Zone (Saket, Vasant Kunj, and Mehrauli). More details.
There is a new outbreak in Ahmedabad (Gujarat state). More details.
In Punjab State, almost half the 670 recent dengue cases were recorded in Ludhiana, along with Bhatinda (147), and Jalandhar (100). However, 4400 cases of other (undisclosed) mosquito-borne diseases have forced the closure of government schools for 10 days. More details.
In Thiruvananthapuram (Kerala state), Kaliyoor, Aryanadu, and Vattiyoorkkavu have recorded most of the 814 cases of dengue. More details.
Bhubaneswar (Orissa state) has had 25 dengue fatalities. More details.
Taiwan: Dengue has hit 7 areas of Penghu county. Of the 238 confirmed cases, Kaohsiung has had 211. It is the offshore county’s first outbreak in a decade. More details.
Cambodia: There has been 12,392 cases between January and September, compared to 5497 in all of 2010.
Advice to travellers: All travellers visiting tropical countries 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.

NZ’s measles epidemic reaches central Auckland
The central Auckland suburbs of Parnell, Ponsonby, and Herne Bay, along with the CBD, are the latest areas hit by a new surge in measles cases in the past week. Of the 203 cases recorded since May, 31 people have been hospitalised. More details.
A university student is in Wellington hospital with measles after being infected on a flight from Auckland to Wellington. More details.
With 24 already confirmed, Waikato is also expecting more cases after a fresh outbreak in a daycare centre. More details.
Meanwhile, Australia has now had 136 cases of measles in 2011 – almost double last year’s figure. The outbreaks are hampering efforts to eliminate the disease. More details.
In Ecuador, there is an outbreak (34 cases) in Ambato, a city in the country’s central Andean Valley. More details.
Advice to travellers: Measles epidemics are continuing in many parts of the world, including regions where reporting has been sca nt. 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.

America’s listeria toll climbs to 18
In the USA, listeria-infected rock melons from Colorado have caused at least 18 deaths and sickened 100 people in 20 states, according to the CDC. More details.
Meanwhile, romaine lettuce from California’s Salinas Valley is being recalled after a sample tested positive to listeria. No cases were recorded. The region is famous for primary produce. More details.

Disease warning for flooded Manilla
Metro Manilla’s health authorities have warned of more leptospirosis after much of the city was inundated by floodwaters following a typhoon this week. More than 450 leptospirosis cases and 32 deaths were recorded in the first half of 2011 – up almost 75% on the same period last year.
Advice to travellers: Leptospirosis is typically associated with exposure to floodwaters and presents a low risk for most travellers. The bacteria that cause the disease are spread through the urine of infected animals, entering the body through skin or mucous membranes (eyes, nose, or mouth) – especially if the skin is broken. While it occurs worldwide, the disease is most common in temperate or tropical regions. As an extra precaution, Australians travellers to the Philippines should first wash fresh vegetables and fruit in clean water, and cook or peel them before eating.

Malaria rampant in Vizag
INDIA: Malaria is rampant in Vizag city, a major seaport on the south east coast in Andhra Pradesh state. Authorities say 10 new cases are being recorded each day, but unofficial sources put the number closer to 50. More details.
Advice to travellers: Malaria is endemic throughout India. Travelvax recommends that 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.

Southern Sudan hit by malaria epidemic
AFRICA: There has been a surge in malaria cases in newly independent Southern Sudan, notably in Unity State. Doctors say that 80% of hospital patients are being treated for the disease. More details.

Surge of cholera outbreaks in Africa
Central African Republic: A new epidemic in the south has claimed at least 10 victims.
Somalia: 50 more children have died in the capital, Mogadishu. Hundreds of people are seeking treatment.
Ethiopia: Hundreds of cases and scores of deaths have been reported in Qabridahare (Kebri Dahar, Somali Regional State).
Nigeria: Cholera has claimed 6 lives in the north – the latest of more than 200 fatalities in recent few months. Local media reports 234 cholera deaths in 15 Nigerian states this year. 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.

Haiti chalks up horror Year of Cholera
Twelve months after the outbreak began, cholera deaths in Haiti now total 6435, with 455,727 people infected. Artibonite province continues to be the hardest hit with 1196 deaths, while the capital, Port-au-Prince, has confirmed 221 deaths since last October. Haiti’s health ministry says the epidemic is waning.
Neighboring Dominican Republic has reported 135 deaths. More details.

Encephalitis death toll soars in northern India
Encephalitis has now killed more than 100 children in the northern Indian state of Bihar since June – 51 from the Gaya district in the last 7 weeks alone. More details.
In eastern Uttar Pradesh, the death toll has risen to 376 following 8 more deaths in the past 36 hours, although the ratio of Japanese encephalitis to the unknown acute encephalitis syndrome (AES) remains unclear. 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.

Record high tick infections in Sweden, Austria
In Sweden, 2011 may be a record year for tick-borne encephalitis. There have been 207 cases in 9 months, compared with 174 for all of 2010. Experts put the increase down to a decade of higher temperatures, ideal tick-breeding conditions, and more people venturing into the tick-infested rural areas. More details.
For the first time, Austria's total has exceeded 100 – with 3 months of the year remaining. More details.
Advice to travellers: TBE is a low risk for most travellers to Europe. The potential for tick bites increases with time spent walking in forests and rural areas during the northern summer months. All travellers should use an effective repellent to avoid tick bites when outdoors and check for ticks after outings. There is an effective vaccine for TBE. For more information, call Travelvax on 1300 360 164.

Chickenpox hits Cayman Islands
Chickenpox has been widespread across the Cayman Islands in the last fortnight. More than 50 cases have been confirmed – around half of them in children under 15.

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.