WORLD TRAVEL HEATLH ALERTS – September 28, 2011

– Refugees hit by suspected yellow fever
– More listeria fatalities expected in coming weeks
– Cup-mad Kiwis tackling four disease outbreaks
– Over 700 measles cases in Quebec
– Vietnam’s HFMD epidemic escalating
– Hepatitis E kills 3 in Kashmir
– JE confirmed in Delhi; toll rises in north
– Indian states hit by deadly outbreaks
– Dengue, malaria swamp Chennai hospitals
– Punjab’s dengue death toll reaches 111
– Typhoid rampant in Philippines province
– Hajj pilgrims at risk of polio, says WHO
– Cholera follows in wake of Sindh floods
– Greece’s malaria count reaches 28
– One-in-3 rabies deaths occur in India

Refugees hit by suspected yellow fever
Suspected yellow fever is spreading in the massive Zamzam and Abushok refugee camps in North Darfur region of Sudan, according to media reports. Housing 200,000 refugees, the Zamzam camp is one of the worlds largest. If confirmed by laboratory tests, an outbreak could worsen an already tragic situation in the Horn or Africa.
In Uganda, local health authorities and the WHO are investigating a suspected case ‘imported’ from Southern Sudan to Palabek (Kitgum district). More details.
Advice to travellers: Mosquitoes transmit yellow fever and avoiding bites is essential. Proof of vaccination against yellow fever is a mandatory requirement for Australians travelling to regions of Africa and South America. Across the globe, yellow fever is on the rise and 90% of the 200,000 annual cases occur in Africa.

More listeria fatalities expected in coming weeks
Listeria-infected cantaloupes (rock melons) from Colorado have now killed 14 people – all elderly – and sickened another 55, making it America’s deadliest food poisoning in a decade.
Shipped to at least 17 states, the fruit has been recalled. However, because the disease’s incubation period can be several weeks, the Centers for Disease Control and Prevention expects more fatalities. The original source of the contamination is still unknown. More details.

Over 700 measles cases in Quebec
In Canada, Quebec’s measles outbreak has exceeded 700 cases, mainly in the Mauricie region and, more recently, the Eastern Townships. More details.
There have been no reports of measles outbreaks from Africa and Asia during the past 7 days. This week’s global roundup includes reports from Europe – Finland, and the UK (Exeter, Surry & Sussex), and North America – USA (ex Malaysia, Wisconsin, and California). More details.
Advice to travellers: Measles epidemics are continuing in many parts of the world and we advise Australian travellers to check their vaccination status. 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 confirm their status for childhood diseases such as whooping cough, diphtheria, mumps, and polio as part of their pre-travel medical preparations.

Cup-mad Kiwis tackling four disease outbreaks
Meningococcal disease in New Zealand’s Northland region claimed a third victim last week. The death came on the eve of a vaccination campaign to protect the children and young adults of the north island’s most northern district following 9 cases in the area.
Also on the North Island, Auckland has recorded 179 cases of measles since late May, along with 7 cases of rubella (German measles), and 28 cases of meningococcal disease. More details.
NZ health authorities also have a major outbreak (41 cases) of whooping cough (pertussis) on their hands in Wellington and other South Island districts. More details.

Vietnam’s HFMD epidemic escalating
Vietnam’s epidemic of hand, foot and mouth disease is escalating. Some 2000 new cases each week have forced a dozen kindergartens to close in an attempt to contain the outbreak. More than 52,000 cases, including 109 deaths, have been recorded already this year – mainly children under 3. More details.
Advice to travellers: Travellers to Vietnam and other Asian destinations, especially parents accompanied by children, should be aware that HFMD is spread by direct contact with an infected person, or with surfaces contaminated with the virus. Good hygiene practices greatly reduce the risk of infection. There is no vaccine or preventative medication for HFMD, which mainly occurs in children. While most recover without treatment, paralysis or death can occur in severe cases.

Hepatitis E kills 3 in Kashmir
Hepatitis E is suspected in three deaths, including two newborns, in south Kashmir's Shopian district. Another 13 people are being treated. More details.

JE confirmed in Delhi; toll rises in north
Authorities confirmed 4 cases of Japanese encephalitis in the national capital, Delhi on Friday. More details.
In the country's north, the death toll from JE and acute encephalitis syndrome (AES) fatalities in Bihar State rose to 54, with the death of 3 girls from the Gaya and Nawada districts last week. Health authorities will set up special clinics to treat victims and raise community awareness, and deploy teams to control the outbreak. More details.
In eastern Uttar Pradesh, JE has killed 300 people - mainly children - in the past 2 months.

Indian states hit by deadly outbreaks
Widespread outbreaks of malaria (10,853 cases) and typhoid (262) are rampant in Gujarat State, in western India, in the wake of monsoon rains.
A quarter of the malaria cases have been the potentially fatal P.falciparum strain. The cities of Surat and Ahmedabad have been hardest hit. More details.
In addition, there have been almost 130 leptospirosis deaths in southern Gujarat in the last 2 months. More details.
Leptospirosis is also widespread in the Kozhikode region of Kerala State, with 256 confirmed or suspected cases. Special clinics will treat victims and raise community awareness, with teams deployed to control the outbreak. More details. The state is also recording cases of Hepatitis A, acute diarrhoea and chickenpox across the Kochi district.

Dengue, malaria swamp Chennai hospitals
In India, Heavy rain last week has seen a flood of dengue and malaria cases in Chennai city. Doctors are alarmed that whole families are sick with dengue. More details.
As dengue continues to spread in the Caribbean, the Cayman Islands is preparing for cases.
Advice to travellers: Seasonal rains in Asia continue to create ideal conditions for dengue and other mosquito-borne disease, while outbreaks persists in Latin America and the Caribbean. In the tropics, travellers 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.

Punjab’s dengue death toll reaches 111
The number of dengue-related deaths in Pakistan’s Punjab State has risen to 111, with another 10,585 infected, mainly in the capital, Lahore. More details.

Typhoid rampant in Philippines province
The Philippines’ Negros Occidental province has recorded 1318 cases of typhoid and 16 deaths this year, the majority from Kabankalan City (182 cases) and Calatrava (153). Leptospirosis is also widespread, with 77 cases diagnosed this year. More details.

Hajj pilgrims at risk of polio, says WHO
The prospects for eradicating polio seemed even more remote this week as the disease spreads across borders in Africa (Kenya) and Asia (Pakistan and China).
The WHO fears the more dangerous strain of the virus will spread during the upcoming annual Hajj pilgrimage in Saudi Arabia in early November. There have been 84 cases of polio in Pakistan this year, including 25 in the past 6 weeks, as well as 9 in neighbouring China, and 3 more in Kenya in recent weeks. More details.
Advice to travellers: Polio is a low risk for most travellers. However, as part of their pre-travel medical preparations, we advise you to check your immunisation status for all childhood diseases, including polio, whooping cough, tetanus, diphtheria, mumps, and measles.

Cholera follows in wake of Sindh floods
Pakistan’s flood-hit Sindh province has recorded almost 300 cases of cholera, including 3 deaths.
In the remote Khyber region, acute diarrhoea has killed 7 people, while dozens more are being treated. More details.
Despite official denials, cholera may be occurring in Uzbekistan’s Tashkent region. More details.
In the Caribbean, an outbreak of cholera is suspected in the Dominican Republic. More than 150 people from La Culata, Vaca Gorda, and Aminilla are ill after drinking water from the Maguata River. < a href="http://www.dominicantoday.com/dr/local/2011/9/26/41065/Dozens-of-cholera-cases-suspected-in-northwest-town" target="_self">More details.
Advice to travellers: For most short stays, cholera presents a low risk for travellers. However, those heading to areas where 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.

Greece’s malaria count reaches 28
Greece has now recorded 28 cases of P.vivax malaria, the generally milder strain of the disease, since the disease resurfaced in June. Most have been in Evrotas (Lakonia Prefecture) and other areas not usually visited by tourists. Almost half the cases have been among migrant workers. More details.

One-in-3 rabies deaths occur in India
Today (September 28) is World Rabies Day. Here are the sobering statistics: an average 55,000-70,000 deaths each year (20,000 in India) – 100 children a day; 10 million treated for bites from potentially infected dogs; most victims are under 15; and most western travellers are bitten by dogs in Asia (again, mainly India). More details.
However, not all deaths are from dog bites. Of the 20 rabies deaths in Peru this year – 19 were caused by infected vampire bats in northern Amazonas state. Mo re details.
Advice to travellers: Rabies generally is a low risk to most travellers, but the potential for exposure rises for longer stays. This is especially so for children. Dog bites cause 99% of human fatalities and rabies immunoglobulin for rapid post-exposure treatment is in short supply globally. Travellers should avoid any contact with wild and domestic animals, and seek urgent post-exposure treatment if bitten. To discuss the risk of rabies for your itinerary, call Travelvax on 1300 360 164.

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.