WORLD TRAVEL HEALTH ALERTS - April 27, 2011

WORLD TRAVEL HEALTH ALERTS - April 27, 2011

– Measles skyrockets in France
– Dengue warnings for South America, Asia, Middle East, and Pacific
– Murrumbidgee’s farmers on alert for leptospirosis
– Chennai’s ‘hidden’ rabies deaths anger animal activists
– Schoolboy’s death lifts rabies toll in Bali
– Malaria in Torres Strait; local travel ban imposed
– Malaria rife in Thailand’s border regions
– Chikungunya resurfaces on Madagascar and the Seychelles
– Fears for major cholera epidemic in Cameroon
– UK’s rising malaria, TB rates linked to immigrants

Measles skyrockets in France
France’s measles tally for 2011 has passed 7000 cases – 3000 in March alone. Elsewhere in Europe, 33 countries have outbreaks, including Belgium, Bulgaria, Serbia, Spain, and Turkey. Case numbers are rising in Germany, the Netherlands, Norway, Romania, Russian Federation, Switzerland, and the UK.
In the USA, cases numbers are rising in Salt Lake County (Utah) and Minnesota, where 13 of the 21 people infected required hospital treatment.
In Australia, there is now ongoing low-level measles transmission on the Gold Coast, with 3 more recent cases bringing the total to 7. Experts say that with measles widespread around the world the Gold Coast’s fluctuating tourist population is putting local residents at risk.
Advice to travellers: Australian travellers who have not had measles or have not received two documented doses of live virus vaccine should consider a booster as part of their pre-travel vaccination regime – regardless of their destination. Measles is a highly contagious airborne disease that can cause severe illness and passengers on planes, boats, trains and buses are at higher risk of infection – especially if seated near a contagious person. Travelvax recommends all travellers check their immunisation status for all childhood diseases, including whooping cough, diphtheria, mumps and polio, as part of their pre-travel medical preparations.

Dengue warnings for South America, Asia, Middle East, and Pacific
BRAZIL: Rio de Janeiro state has recorded 56,882 cases (39 deaths) this year to April 16, with epidemics in 18 municipalities. Epidem ics and outbreaks are also continuing in the states of Sao Paulo (Ribeirao Preto, Sorocaba, Campinas, and Mogi Mirim municipalities) and Grande do Sul (Porto Alegre, Cassilandia).
PARAGUAY: Dengue is affecting Paraguay’s tourism industry, with Easter figures down as much as 20%. This year there have been more than 27,000 confirmed or suspected cases and 31 deaths nationwide.
ARGENTINA: Santa Fe province has had 151 of Argentina’s 196 dengue cases this year, with cases also in Salta (18) and Buenos Aires (15). PAKISTAN: After a short winter recess, dengue is again appearing in Karachi’s hospitals, with 30 recent cases. SAUDI ARABIA: Dengue has reached epidemic proportions in the capital, Jeddah and will be hard to eradicate, local experts say. March to June is the peak mosquito-breeding season. AMERICAN SAMOA: There have been 131 dengue cases in the first 3 months of the year, down on the 195 last year. Advice to travellers: The continuing presence of dengue fever in many regions across the globe highlights the need for Australian travellers heading abroad to be aware of the risk and avoid mosquito bites. 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.

Murrumbidgee’s farmers on alert for leptospirosis
AUSTRALIA: Heavy rainfalls and floods on the east coast in December have left another legacy with 4 cases of leptospirosis in the Murrumbidgee district of southern NSW. Humans contract the disease through direct contact with soil or water infected with the urine of infected mice, which are in near plague numbers in the farming district following an ideal breeding season. Advice to travellers: The risk of infection for travellers to the Murrumbidgee region of NSW is very low. While it occurs worldwide, leptospirosis is most common in temperate or tropical regions and periodic outbreaks occur in Australia. The disease is typically associated with floodwaters.

Chennai’s ‘hidden’ rabies deaths anger animal activists
INDIA: Authorities in Chennai (formerly Madras, Tamil Nadu) have suppressed news of a rising incidence of rabies in the city, according to The Times of India. There have been 15 deaths already this year, compared to 12 for all of 2010. Merritt Clifton, spokesman for West Australian-based Animal People, along with local animal activists, are critical of the piecemeal approach to rabies control in India and have called on the national government to make rabies a notifiable disease throughout the country. Advice to travellers: Rabies is highly endemic in India: nearly half the estimated 60,000 rabies deaths worldwide each year occur there. Dog bites cause 99% of human fatalities. The risk of rabies for short-stay visitors to India is generally low, but rises for longer stays – especially for children. Travellers should avoid contact with wild and domestic animals, and seek urgent post-exposure treatment if bitten. Rabies immunoglobulin for rapid post-exposure treatment is in short supply.

Schoolboy’s death lifts rabies toll in Bali
Five months after a dog bit him on his way to school, a 12-year-old schoolboy from Dencarik village (Buleleng regency, north Bali) began showing symptoms of rabies. Three days later he died. His death brings the official rabies death toll to 130, although observers say the actual number is significantly higher.

Malaria in Torres Strait; local travel ban imposed
After 7 malaria cases in the last month, DFAT and Queensland Health are closely monitoring a malaria outbreak on the Torres Strait islands of Saibai and Dauan. A ban has been imposed on travel between PNG and the islands. Advice to travellers: Because of their proximity to Papua New Guinea, there is a continuous risk of malaria transmission on the islands of Torres Strait and more cases are possible in this outbreak. Both vivax and falciparum strains have been responsible for previous cases, the most recent in 2001.

Malaria rife in Thailand’s border regions
Malaria is rife in southern Thailand and along the Thai-Myanmar border, according to according to the WHO. In Thailand’s Yala province, which borders Malaysia, cases have increased 10-fold in recent years. Almost two-thirds of Thailand’s 24,816 malaria cases last year were among people living near the border with Myanmar, where there were more than 400,000 cases in 2009. Advice to travellers: There is a significant risk of malaria in southern and border regions of Thailand. Travelvax strongly advises travellers heading to these regions to discuss malaria prevention medication with Travelvax (toll free 1300 360 164) or a medical provider. Strict mosquito bite prevention measures are recommended.

Chikungunya resurfaces on Madagascar and the Seychelles
In the Indian Ocean, Chikungunya virus has reappeared on Madagascar and The Seychelles. There have been a handful of cases on Madagascar, while on Grand Isle (The Seychelles) 4 confirmed and more than 100 suspected cases in recent weeks after ideal breeding conditions for Aedes Albopictus mosquitoes. Advice to travellers: Madagascar has had periodic cases of Chikungunya virus infection for several years, while the last outbreak on The Seychelles was in 2006, when there were nearly 2000 cases. There is no vaccine; bite prevention is the only way to avoid the risk of infection.

Fears for major cholera epidemic in Cameroon
With 3000 cholera cases (150 deaths) in the last month, Cameroon’s epidemic is accelerating, particularly in the capital, Yaounde, and central and southwestern regions. An aid group says that the without outside intervention, the epidemic could assume Haiti-like proportions.

UK’s rising malaria, TB rates linked to immigrants
In the UK, malaria cases among returned travellers have risen by almost 30% in 2 years. There were 1761 cases in 2010, up from 1495 in 2009 and 1370 in 2008. In the past decade, around half of all the UK’s malaria cases have been in people who travelled to India or West African countries, mainly to visit friends and relatives, according to a report released to mark World Malaria Day yesterday (April 25). In another alarming report, 1-in-5 immigrants arriving in the UK from the subcontinent and 1-in-3 from sub-Saharan Africa carry latent tuberculosis, according to a study published in the leading British medical journal, The Lancet. The UK's TB rates almost doubled between 1998 and 2009, with 75% of the 9000 infections occurring among foreign-born immigrants. To protect the wider community, specialists have called for a new blood test to be used to detect latent TB among new migrants.

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 or call 1300 360 164 for details.