WORLD TRAVEL HEALTH ALERTS – November 23, 2011

CANADA: Measles alerts for Edmonton, Saskatchewan
CHINA: More bird flu expected in south
GHANA: Yellow fever campaign to target high-risk areas
INDONESIA: Chikungunya, Dengue, Hepatitis A
INDIA: Encephalitis, Chikungunya, Dengue, Measles
MALAYSIA: Contaminated river spreads Hep A
MARSHALL ISLANDS: Dengue reaches Ebeye Island
MEXICO: Schools hit by Hepatitis A outbreak
MICRONESIA: (Yap Islands): Dengue outbreak spreads
NIGERIA: Polio a deadly export
PAKISTAN: Dengue tally climbs; New polio cases
SOUTH SUDAN: Campaign targets polio
TAIWAN: Farm quarantined over bird flu
UNITED KINGDOM: Measles outbreak in Sussex
USA: Measles confirmed in Midwest
VIETNAM: Dengue flares in Ho Chi Minh City
Flu Report: Low level activity across the globe
US Army axes mefloquine


CANADA: Measles alerts for Edmonton, Saskatchewan
A traveller who returned from overseas with measles has infected at least two other people in Edmonton (Alberta). Saskatchewan is also on alert following a series of cases this year. More details.
Advice to travellers: Measles is highly contagious and can cause severe illness. Regardless of their destination, all Australian travellers should consider a booster if they have not had measles or received two documented doses of live virus vaccine. As part of pre-travel medical preparations, we also recommend travellers check their immunisation status for whooping cough, diphtheria, mumps, and polio 4-6 weeks before departure.

CHINA: More bird flu expected in south
H5N1 avian flu is widespread in China's poultry markets, especially in the south, according to the UN. More animal and human infections are expected during the coming autumn and winter months, although large-scale outbreaks are not anticipated. More details.
Advice to travellers: As stated previously, bird flu poses a low risk for most travellers. Almost all human bird flu infections have involved close contact with sick birds, or with an infected family member. Travellers visiting areas where outbreaks are occurring should maintain high levels of personal hygiene, washing hands before and after food preparation. Read more on bird flu.

GHANA: Yellow fever campaign to target high-risk areas
Some 56 high-risk areas for yellow fever will be targeted as 7.1 million people are vaccinated against the mosquito-borne disease. More details.
Advice to travellers: Yellow fever is endemic in a number of sub-Saharan countries in Africa, including Ghana, and parts of South America. Vaccination may be mandatory for travellers, depending on their itinerary. Read more on Yellow fever.

INDONESIA: Chikungunya, Dengue, Hepatitis A
Chikungunya virus has surfaced in West Sumatra's Agam Regency, including the sub-districts of Pakoan, Gulaibancah, Kenagarian Gadut, and Tilatang Kamang. More details (ProMED Nov 16).
In Palembang (South Sumatra province), the waterways and reservoirs of Jambi Selatan and Kotabaru sub-districts have emerged as high-risk area for dengue, with 500 cases this year. More details.
Hepatitis A outbreaks effecting mainly school and university students in Bandung, Tasikmalaya, and Depok (West Java) are easing following emergency measures, including treating water sources and placing infected people under quarantine. More details.
Advice to travellers: Dengue continues to be a health risk for Australians travelling to the world's tropical regions. With no vaccine or preventative medication available, travellers are advised to 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 bite mainly during the daylight hours. They live almost exclusively in urban areas.

INDIA: Encephalitis, Chikungunya, Dengue, Measles
Each year, encephalitis claims hundreds of lives in 10 districts in central Bihar and Jharkhand, most notably Jahanabad, Aurangabad, Chatra, and part of Patna. In the last 3 months, 84 children have died in Bihar's Gaya district. More details.
In Bengal, Chikungunya fever had been considered a disease of rural areas. However, this year the capital, Calcutta has had 173 of the 248 cases recorded this year. Lack of immunity among urban residents and mosquito-friendly weather may be behind the surprising surge. More details.
Dual outbreaks of Chikungunya and dengue have hit Bihar State. It is Bihar's first outbreak of Chikungunya, which has already been seen in Delhi and Uttar Pradesh this year. A widespread outbreak of measles in Dhanbad (Jharkhand) has prompted a public vaccination campaign. More details.
Dengue has been reported in Chhattisgarh’s capital, (119 cases, 5 deaths) and Chandigarh (Haryana and Punjab states).

MALAYSIA: Contaminated river spreads Hep A
Sewage-contaminated river water is believed to have caused 800 cases of hepatitis A in the villages of Basung, Kampung Pasir Dula, and Padang Setebu in the Hulu Terengganu district of Terengganu state. Read more.
Advice to travellers: Hepatitis A virus is usually contracted by eating or drinking food or water contaminated by the faeces of an infected person, or from contaminated surfaces. It is one of the most common vaccine-preventable infections in travellers visiting developing countries. Vaccines offer high-level, long-term protection, however strict personal hygiene is also important. Read more on Hepatitis A.

MARSHALL ISLANDS: Dengue reaches Ebeye Island
The dengue outbreak is easing in the capital, Majuro, but is spreading to Ebeye Island and two outer islands. Of the 751 suspected cases, 391 have been confirmed. More details.

MEXICO: Schools hit by Hepatitis A outbreak
Some 28 children from 10 schools have contracted hepatitis A in Altamira municipality (Tamaulipas state). Twenty local communities are now affected by the outbreak. More details (ProMED Nov 17).

MICRONESIA (Yap Islands): Dengue outbreak spreads
On Yap island (pop. 15,000) 286 cases have been confirmed, with another 70 cases recorded on an adjacent atoll, Ulithi. More details.

NIGERIA: Polio a deadly export
There have now been 44 cases of polio this year, four times last year's figure. Compounding the worrying trend, the disease is spreading to other countries, according to the WHO. Nigeria is one of 4 countries - along with Pakistan, India, and Afghanistan - where polio remains endemic. More details.

PAKISTAN: Dengue tally climbs; New polio cases
Dengue cases continue to mount in Karachi (Sindh province) and Lahore (Punjab). More details.
Four new cases of polio, one each from Mastung (Balochistan) and Khyber Agency, and two from North Waziristan has taken the year's tally past last year's total of 144. More details.

RUSSIA: Measles in Rostov; Hep A in Novosibirsk; New West Nile fever case in Volgograd
There have been 20 measles cases in the Rostov region. More details (ProMED, Nov 20)
Some 50 cases of Hepatitis A have been recorded in Novosibirsk during November. More details (ProMED, Nov 22).
West Nile fever persists in the Volgograd region. Following a recent case, there has now been 46 cases in the capital, Volgograd and 15 more in outlying districts this year. More details (ProMED, Nov 22).

SOUTH SUDAN: Campaign targets polio
In conjunction with the WHO and other international agencies, South Sudan has launched a mass polio vaccination campaign targeting 3 million children More details.

SRI LANKA: More dengue predicted
The health ministry has predicted further dengue outbreaks, particularly in the north and east, following sustained rain and high temperatures. Of the 22,244 dengue cases this year – 57% were in Western Province. More details.

TAIWAN: Farm quarantined over bird flu
A farm near Hsinchu City has been quarantined following a small outbreak of H5N2 avian flu (bird flu). More details.

UNITED KINGDOM: Measles outbreak in Sussex
Nine cases of measles have been recorded in two schools in Hove (Sussex). More details.

USA: Measles confirmed in Midwest
Measles has been confirmed in Kansas City (Missouri). More details.

VIETNAM: Dengue flares in Ho Chi Minh City
Ho Chi Minh City is seeing hundreds of dengue cases each week, with the city's year-to-date tally now at 10,550 (10 deaths). Nationwide, other dengue hot spots include Ca Mau, Dong Nai, Binh Duong, Binh Phuoc, Tay Ninh, Bac Lieu, Ha Noi, and Binh Thuan. Vietnam has recorded 49,011 cases and 46 deaths this year. More details.

FLU REPORT: Low level activity across the globe
Flu is at low levels in both hemispheres, with only isolated outbreaks in several tropical countries, according to the WHO's latest update.
Southern hemisphere flu levels are now at low, off-season levels in Australia.
In tropical Asia, localised transmission is occurring in Cambodia and Laos, while Vietnam has seen sustained 2009 H1N1 transmission for most of the year.
In the Northern Hemisphere, the flu season is yet to begin, although Canada has reported its first outbreak in Calgary. A handful of European countries, France, Norway, Sweden, Finland, the Czech Republic, and western parts of the Russian Federation are reporting sporadic activity, although actual case numbers remain low. More details.

US Army axes mefloquine
It’s taken 40 years, but the US Army will discontinue using the potent anti-malarial drug mefloquine because of side-effects.
"Mefloquine is a zombie drug. It's dangerous, and it should have been killed off years ago," said epidemiologist, Dr Remington Nevin, an Army major who has published research on the drug's potential toxic effects on the brain.
The Army has reduced use of the drug by almost 75% in the past 3 years, but other branches of the military continue to favor it, according to a media report.

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.