WORLD TRAVEL HEALTH ALERTS – October 26, 2011

AUSTRALIA: Local flu peak passes; World breathes easy
CARIBBEAN: Haiti begins vaccinating amid new cholera outbreak; Bahamas on alert
EUROPE: Measles eipdemic finally slows
FIJI: Authorities clamp down on food stalls
INDIA: Metro mozzie menace; Call for WHO support
INDONESIA: Central Java braces for surge of Chikungunya
MADAGASCAR: Polio cluster raises concerns of resurgence
MALDIVES: More severe dengue in 2011
MARSHALL ISLANDS: First local cases of dengue reported
MYANMAR: Cholera alert after deadly floods
NEW ZEALAND: South Island facing whooping cough
PAKISTAN: More polio in Sindh; Punjab dengue toll rises
SOMALIA: 1700 cholera deaths; Measles teams flee fighting
THAILAND: Fear of disease grows as floodwaters enter central Bangkok
New vaccine offers hope in fight against malaria

AUSTRALIA: Local flu peak passes; World breathes easy
While the flu season persists in Australia and New Zealand, the peak has passed, according to the WHO’s latest global bulletin. Flu activity remains ‘low or undetectable’ in much of the world, but ‘active’ in several countries, including Cuba, Honduras, El Salvador, Cameroon, Bangladesh, Cambodia, Thailand, Lao People's Democratic Republic, and Viet Nam. More details.
Advice to travellers: Influenza is the most common vaccine-preventable illnes s for travellers. We recommend vaccination for all travellers, regardless of destination.

CARIBBEAN: Haiti begins vaccinating amid new cholera outbreak; Bahamas on alert
Haiti: A massive vaccination campaign will be conducted to slow the country’s cholera epidemic outbreak. The world’s largest cholera outbreak has claimed more than 6000 lives and sickened almost 500,000 people. More details.
Dominican Republic: Meanwhile, there has been a new cholera outbreak on the Haitian-Dominican border. Haiti’s neighbour has had 1800 cases and 480 deaths this year. More details.
Bahamas: The country is on alert for cholera among refugees fleeing Haiti and the Dominican Republic after detecting the disease on a boat intercepted at sea.               Advice to travellers: For short-stays, cholera is generally a low risk for most travellers. In areas where outbreaks are occurring, travellers should adhere to strict personal hygiene, and choose only safe food and beverages. For more advice on whether you should consider vaccination for a particular journey, call Travelvax on 1300 360 164.

EUROPE: Measles epidemic finally slows
Measles cases in Europe this year topped 29,000 in September, but the outbreak is slowing, according to the European Centre for Disease Prevention and Control. About 800 new cases were detected in September, compared to 2000 in August, with no new outbreaks reported in the last month. Of the 31 countries monitored, only 4 – Cyprus, Hungary, Iceland, and Liechtenstein – have remained measles-free i n 2011. More details.
Advice to travellers: While Europe’s measles epidemic is easing, it is far from over. Outbreaks and epidemics continue in many regions of the world and international travel increases your risk of being infected. Australian travellers should ensure they are protected against measles. If you have not had measles or received two documented doses of live virus vaccine, consider having a booster. We also advise you check your immunisation status for other childhood diseases such as whooping cough, diphtheria, mumps, and polio, as part of any pre-travel medical preparations.

FIJI: Authorities clamp down on food stalls
To prevent the spread of food and water-borne diseases like typhoid and diarrhoea, Northern Division health official will require roadside food stalls to be licensed to ensure food is prepared and stored hygienically. More details.
Advice to travellers: The sporadic outbreaks of typhoid in Fiji represent a low risk for short-stay visitors staying in hotels and resorts. Typhoid is spread by contaminated food and beverages, and all travellers should follow safe food and water guidelines – especially when visiting rural areas. For advice on vaccination against typhoid, call Travelvax Australia’s travel health advisory service (1300 360 164).

INDIA: Metro mozzie menace; Call for WHO support
Delhi: Two dozen new dengue cases each day have pushed the city’s official tally to almost 600. Nine new cases of chikungunya were also reported. Along with malaria (218 cases) and Japanese encephalitis (5), the national capital has experienced all four main mosquito-borne disea ses this year. September and October are the city’s peak months for dengue and malaria. More details.
Jaipur: Malaria, not dengue, has been the main insect-transmitted disease in the city, with 1100 official cases – almost double last year’s number. Only 52 patients have tested positive for dengue, half last year’s figure. More details.
Madhya Pradesh: While malaria rates are falling in some countries, fatalities are increasing in parts of India, including Madhya Pradesh and other Indian states. National Institute of Malaria Research director, Neeru Singh has called on the WHO to provide more support in the form of anti-malaria medicine and bed nets. More details.
Advice to travellers: Malaria is endemic throughout India, including major cities. Discuss your itinerary and preventative malaria medication at your nearest Travelvax clinic, or with your healthcare provider. For advice, call Travelvax on 1300 360 164.

INDONESIA: Central Java braces for surge of Chikungunya
Central Java: At least 94 cases were confirmed recently in Ambawang and two nearby districts. Authorities predict hundreds more cases. For more details see ProMED report, Oct 23.
Advice to travellers: Like dengue fever, Chikungunya is spread by daytime-feeding Aedes mosquitoes. Travellers should cover up and apply an insect repellent containing e ffective 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.

MADAGASCAR: Polio cluster raises concerns of resurgence
Three polio cases in the south have raised fears of a possible resurgence of the disease. Political instability since 2009 has interrupted immunisation programs, reducing vaccination rates to below 40% in the south. More details.

MALDIVES: More severe dengue in 2011
There have more local cases of potentially fatal Dengue Shock Syndrome in 2011 than in previous years, according to a local doctor. More details.
Advice to travellers: Dengue is one of the main health risks for Australians travelling to tropical regions. Cover up and 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. Dengue is transmitted by mosquitoes that live almost exclusively in urban areas – including up market accommodation. They bite mainly during the daylight hours.

MARSHALL ISLANDS: First local cases of dengue reported
Dengue has been diagnosed in Majuro, the islands’ main administrative centre, for the first time. More details.

MYANMAR: Cholera alert after deadly floods
Officials are on alert for outbreaks of cholera following flooding in the central region of Magway, which has left at least 100 dead, destroyed 2000 homes, and inundated 6000 others.

NEW ZEALAND: In contrast to the North Island’s measles epidemic, the South Island is experiencing a widespread epidemic of whooping cough, with 147 cases this month. Most were recorded in Nelson/Marlborough (44 cases) , along with West Coast (35), Canterbury (34), Wellington/Hutt Valley (25), and Hawke's Bay (9). More details.

PAKISTAN: More polio in Sindh; Punjab dengue toll rises
Karachi: On the eve of another polio vaccination campaign, 6 more polio cases have been recorded in Sindh province, including 2 in Karachi. They bring the provincial total to 27 and the national total to 128 this year. More details.
Lahore: Another 5 deaths from dengue on Monday have taken Punjab’s tally to 274 – 92% in the provincial capital. There have been an estimated 118,600 cases. More details.
Advice to travellers: We routinely recommend that travellers check if their polio immunisation is current. If required, have a primary or booster course at least a month before departure, along with other childhood immunisations such as whooping cough, diphtheria, measles, and mumps.

SOMALIA: 1700 cholera deaths; Measles teams flee fighting
Cholera is rampant in central regions, fuelled by famine and poverty. The disease killed more than 1700 children last week, according to medical sources quoted in media reports. More details.
Meanwhile, intense fighting near the capital, Mogadishu has forced Doctors Without Borders teams to halt a meas les immunisation campaign, with fewer than 5000 of 35,000 children vaccinated. Measles, combined with malnutrition, is the main cause of death among children in Somalia. More details.

THAILAND: Fear of disease grows as floodwaters enter Bangkok
Bangkok: The WHO has warned diarrhoea, respiratory illness and conjunctivitis are among the health risks now facing hundreds of thousands of people living in shelters after losing their homes to the worst flooding in decades. There was also a risk of fungal infections and leptospirosis, a bacterial infection spread through contaminated floodwater.    Water began entering central metro areas of Bangkok yesterday, including the Chatuchak district, popular with tourists for its Weekend Market. There were also reports crocodiles have escaped from breeding farms into floodwaters. More details.

ALSO THIS WEEK…

New vaccine offers hope in fight against malaria
A new malaria vaccine is being hailed as a major breakthrough following clinical trials involving 6000 children in 7 African countries. If licensed, it will be the first vaccine for a parasitic disease.

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.