WORLD TRAVEL HEALTH ALERTS – December 14, 2011

AUSTRALIA: Dengue warning for North Queensland
BRAZIL: Dengue epidemic alerts; Tourists shun Costa do Sauipe after Meningitis outbreak
CANADA: Vancouver district hit by Hepatitis A
FIJI: Typhoid closes another village
INDIA: JE, AES toll rises; Monsoon brings Hep A; Scrub typhus deaths
INDONESIA: South Jakarta a hot spot for dengue
MALAYSIA: Sarcocystosis cluster on Tioman Island
MARSHALL ISLANDS: Dengue count now tops 500
NEW ZEALAND: New wave of measles; Port stops ‘illegal immigrants’
PAKISTAN: New dengue surge in Karachi
SRI LANKA: Dengue targets young adults
UGANDA: National alert for measles
UKRAINE: Six-fold rise in measles
Globa l Polio Update: 6 new cases in Pakistan

AUSTRALIA: Dengue warning for North Queensland
Heading to North Queensland? Beware of dengue. That’s the message to both residents and travellers as the state’s north prepares for the wet season. More details.
Advice to travellers: Travellers visiting Queensland’s tropical north should take the same bite-prevention measures as those heading to tropical destinations overseas. Cover up and apply an insect repellent containing effective active ingredients, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin when outdoors. There is no vaccine or preventative medication for dengue.

BRAZIL: Dengue epidemic alerts; Tourists shun Costa do Sauipe after Meningitis outbreak
The Brazilian Ministry of Health has is sued an alert warning of the potential for dengue epidemics in 48 municipalities due to high numbers of Aedes aegypti mosquito breeding sites. More details (ProMED update 49, Dec 15).
There has been a surge in Meningococcal meningitis in north-eastern Bahia state this year, with 1670 cases and 109 deaths. In the tourist resort of Costa do Sauipe, tourists have reportedly cancelled bookings after news of the outbreak was made public.
Advice to travellers: The risk of Meningococcal meningitis is low for short-stay travellers. Infection occurs through person-to-person transmission of airborne droplets or saliva. Those anticipating extensive contact with local populations should consider vaccination. Read more.

CANADA: Vancouver district hit by Hepatitis A
Vancouver is recording 3 cases of Hepatitis A each week in an outbreak which has now reached 91. Most have occurred in the Port Alberni - West Coast region. The source of the infection is unknown. More details.
Advice to travellers: Typically, the Hepatitis A virus (HAV) is contracted by eating or drinking food or water contaminated by the faeces of an infected person, or from contaminated items such as crafts, money, door-handles etc. It is a common vaccine-preventable infection in travellers to developing countries, as this CDC map shows. Vaccines offers high-level, long-term protection, but good personal hygiene is also important. Read more on Hepatitis A.



FIJI: Typhoid closes another village
Another Fiji village is under quarantine following 39 typhoid cases. Nanokoko village is in Ba province, in north-western Viti Levu island. More details.
This outbreak follows 60 confirmed or suspected cases of typhoid 2 weeks ago at Nayook village, in nearby Navosa Province, where a 3-week quarantine is in place.
Advice to travellers: Typhoid presents a low risk for most short stays in hotels or resorts, despite becoming a persistent problem in Fiji. Travellers should follow safe food and water guidelines, and personal hygiene practices. Discuss the advisability or not of vaccination for your journey wi th Travelvax (1300 360 164), or your healthcare provider.

INDIA: JE, AES toll rises; Monsoon brings Hep A; Scrub typhus deaths
Despite cooler temperatures, dengue outbreaks continue in many regions. In Delhi, the number of cases has reached 1111. The death of 4 people and 27 cases in Pakka Sahidhan, a village in Chandigarh’s Sirsa district, has sparked local fears, while authorities have declared an outbreak in the Churachandpur district of Manipur state.
Six months after it began, the death toll from the mystery acute encephalitis syndrome among the children of Uttar Pradesh has now reached 462. Japanese encephalitis (JE) has claimed at least 27 young lives. Meanwhile, in the Gaya district in Bihar, 92 children have died and 384 are being treated for the two deadly infections.
Hepatitis A cases have skyrocketed in Kerala State (Kochi district) during the monsoon. After just 36 cases last year, this year’s tally has reached 237 confirmed and 726 suspected. There have also been more cases of Hepatitis B and C. More details.
Scrub typhus has killed as many as 12 people and infected 40 others in the north eastern state of Meghalaya. Villages affected include Moodymmai, Sohkymphor, Sutnga, Mawlein, Umsning, and Ummat. More details.
Advice to travellers: Scrub typhus is a zoonotic illness caused by Orientia tsutsugamushi, a pathogen transmitted through the bite of larval mites (chiggers) usually found on rodents. It is typically found in poor communities and, as such, is a low risk for travellers. Those 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, call Travelvax on 1300 360 164.

INDONESIA: South Jakarta a hot spot for dengue
The Kebayoran Lama district in South Jakarta has one of the highest rates of dengue in the national capital. Other districts with high case numbers include: Pasar Minggu (194), Tebet (151), Jagakarsa (123), Cilandak (118), Pesanggrahan (93), Kebayoran Baru and Setiabudi (85), Pancoran (61), and Mampang Prapatan (49). More details.

MALAYSIA: Sarcocystosis cluster on Tioman Island
A cluster of sarcocystosis cases have been reported among travellers returning to various countries from Tioman Island, located on the east coast of Peninsular Malaysia. More details.
Advice to travellers: Sarcocystosis is caused by a parasite called sarcocystis, and occurs in tropical or subtropical countries, mainly in South East Asia. Most people infected with sarcocystis do not have symptoms, however it can cause muscle pain, mild diarrhoea, and fever. While there is no vaccine or treatment for sarcocystosis, most infected people recover without treatment. Travellers should follow safe food and water guidelines, and practise good hygiene.

MARSHALL ISLANDS: Dengue count now tops 500
Three months after i ts sudden arrival, 506 dengue cases have been reported, including 138 hospital admissions. There have also been cases on Ebeye Island (3) and the outer islands of Arno (5), Utrik (7), and Enewetak (3). The outbreak has prompted a massive local clean-up. More details.

NEW ZEALAND: New wave of measles; Port stops ‘illegal immigrants’
Tairawhiti is experiencing a second wave of measles after several new cases among children and teens, who authorities fear may have been in contact with hundreds of people. More details.
Giosecurity staff at the port of Auckland detected 2 ‘illegal immigrants’ last week – Asian Tiger Mosquito and Culex quinquefasciatus – aboard a cargo ship from Vanuatu. The ship was treated and traps set in the p ort. The aggressive, striped Asian Tiger mosquito (Aedes albopictus) can carry West Nile, Yellow fever, St. Louis encephalitis, dengue, Chikungunya, and Ross River virus, while C. quinquefasciatus can transmit filariasis, West Nile virus, and St Louis encephalitis. More details.

PAKISTAN: New dengue surge in Karachi
Karachi had a sudden surge of 15 new dengue cases last week. The city has seen 823 official cases, and 15 deaths. More details.

SRI LANKA: Dengue targets young adults
Young adults have been worst effected by dengue this year. There have been 23,260 cases and 160 deaths to date, the latest being 3 students in Colombo last week. More details.

UGANDA: National alert for measles
Measles is now widespread in the eastern, central, and western regions, prompting a national alert this week. The worst effected districts include Bududa, Bukedea, Bushenyi Kabarole, Kampala, Rakai, Ntungamo, Luweero, Namayingo, Nakasongola, and Namutumba.
UKRAINE: Six-fold rise in measles
Europe’s measles epidemic has led to a 6-fold increase in cases, notably in the Lviv, Ivano-Frankivsk, Zakarpattia, and Rivne regions. More details.

Global Polio Update: 6 new cases in Pakistan
Six new cases in Pakistani bring the country’s total this year to 167 – almost a third of the global total of 560. Many Pakistani children remain unvaccinated: The Taliban claiming the vaccine is part of a Western plot. Recent cases were also confirmed in Afghanistan (1) and Cameroon (1 - ex Nigeria). Confirmation of a case in Niger is pending. 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.