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WORLD TRAVEL HEALTH NEWS – August 31, 2011
– Eradication setback: Polio returns to China
– Dengue: Surge in Asia, Caribbean
– New Zealand’s measles outbreak easing
– Cholera on the rise in Africa, Asia
– HFMD tops Vietnam’s infectious disease list
– High levels of worm infestation in Vietnam
– Nepal’s west hit by typhoid, viral fever
– Typhoid raging in Philippines province
– Swedish summer brings rise in deadly tick disease
– Mussels poison 60 in British Colombia
– Rains bring leptospirosis to Gujurat
– UN warns of bird flu threat
– Cholera winging its way across the globe
Eradication setback: Polio returns to China
In another setback to global efforts to eradicate polio, the disease has returned China after 11 years.
Four cases were reported in the Xinjiang Uygur Autonomous Region – 2 in Hotan city, and one each from Lop and Yutian counties. The region shares a border with Afghanistan, Pakistan and India – 3 of the 4 countries where poliovirus continues to circulate. The virus detected in Hotan is closely related to poliovirus type 1 that is currently circulating in Pakistan. Equally alarming is news that 222 of the 333 polio cases reported worldwide to date this year have been in non-endemic countries – 175 of them from Chad and the Democratic Republic of Congo. Militants and security forces are preventing children being immunised against polio in Pakistan, which has recorded 69 cases this year – almost double last year’s figure. The UN Children’s Fund (UNICEF) says security issues threaten to derail the global effort to eradicate the disease. Dengue: Surge in Asia, Caribbean
With 2 months of Cambodia’s rainy season remaining, 2011 is shaping as one of its worst years for dengue fever. Cambodia has had 7867 cases (40 deaths) in 2011, compared to 5907 (14) last year. Elsewhere in Asia this week, outbreaks have been reported in Pakistan (Lahore, Karachi and Khyber Pakhtunkhwa Province), India (Raipur, Delhi, Lucknow, and Angul), and the Philippines (Eastern Visayas, Metro Manila, Quezon City, La Union province, and Mabalacat). In Hong Kong, 2 new imported cases of dengue from Cambodia have prompted renewed warnings from health authorities. Local transmission does occur in Hong Kong, however all 13 cases in 2011 have involved travellers returning from infected regions. The Bahamas is preparing for more dengue following Hurricane Irene. While 3000 cases have been recorded, many more have gone unreported. Latin America recorded 890,756 official dengue cases, including 10,840 severe
cases and 488 deaths, in the first seven months of 2011 Latin America. The Pan American Health Organisation released case numbers, fatalities and details of the strains circulating in El Salvador, Panama, Mexico, Aruba, Bahamas, Santa Lucia, Bolivia, Peru, Colombia, and Paraguay. Advice to travellers: Seasonal rain in Asia, and rainfall from Hurricane Irene in the Caribbean, is creating ideal breeding conditions for dengue-carrying mosquitoes. In any tropical country, 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.
New Zealand’s measles outbreak easing
The measles outbreak on New Zealand’s North Island is showing signs of easing after only 2 new cases in Auckland last week. There have been a total of 132 cases in Auckland (111) and Waikato (21).
Auckland has had 5 cases of rubella (German measles).
Elsewhere, there have been outbreaks and alerts in Ireland, Angola (Cuando Cubango), Somalia (South & Central), Tanzania (Zanzibar), Canada (Alberta ex Thailand, and Western), the USA (Minnesota, Pennsylvania, Virginia), and Australia (Townsville, Queensland). Cases have been recorded on Reunion Island, not Mayotte, as reported by ProMED last week. Advice to travellers: Both measles and rubella are spread by airborne droplets. Both diseases can cause serious illness, with rubella a particular risk for pregnant women. Rubella is the 'R' component in the triple MMR (measles, mumps, and rubella) vaccine. Travellers should check their immunisation status for all childhood diseases, including whooping cough, diphtheria, and polio as part of their pre-travel medical preparations.
Cholera on the rise in Africa, Asia
Cholera is being reported across many central and northern regions of Africa in the wake of famine, seasonal rains, and civil unrest. Countries affected include Nigeria (Osun and Oyo states), Somalia (Benadir region), Somalia, Burundi, Ghana (northern, western, Brong Ahafo regions), Ghana (Western region), Cameroon (Far North region), Congo DR, and Mali.
In Asia, cholera and acute diarrhoea have been reported in Afghanistan (Ghor, Ghazni), India (Gujarat, Maharashtra), and Pakistan (Khyber Pakhtunkhwa). The UN expects more cholera in Cameroon, Chad, Niger, and Nigeria, the North Africa countries surrounding Lake Chad as the rainy season continues. Some 11 million people rely on the lake for commerce, fishing, and farming, which, along with population movement, contributes to the explosion of cholera once infection occurs. This year Cameroon has fared worst (14,730 cases, 554 deaths, 3.76% mortality rate), ahead of Chad (10,314, 314, 3.1%), Niger (976, 25, 2.5%), and Nigeria (12,840, 318, 2.5%).
Cholera, acute diarrhoea and dysentery are being reported among displaced persons in Somali’s capital,
Mogadishu, as well as three regions of Nigeria (Yobe, Nasarawa, and Sokoto), .
Advice to travellers: For most short stays, the risk of cholera is low. For those travellers heading to areas where cholera is endemic or outbreaks are occurring, it is important to practice strict personal hygiene and make safe food and beverage choices. For advice on a particular journey and whether vaccination should be considered, call Travelvax on 1300 360 164.
HFMD tops Vietnam’s infectious disease list
With 8200 new cases in August, Hand, Foot and Mouth Disease (HFMD) has nudged out dengue fever as Vietnam’s number one infectious disease. The latest cases bring the year-to-date total to 32,600 (82 deaths), compared to 31,000 dengue cases (27 deaths). Recent statistics from Vietnam’s Ministry of Health and the General Statistics Office also reveal that other infectious diseases are on the rise, including hepatitis, which affects 911,000 people; encephalitis (165 cases), and typhoid (184). The ministry is concerned about a rise in food poisoning events, with 9 deaths among 75 cases this year. Advice to travellers: HFMD is common in southeast Asia, and more cases are being reported in Singapore, Brunei, Taiwan, and Japan. The disease is spread by direct contact with infected persons, or with virus-contaminated surfaces. It mainly occurs in children and there is no vaccine or preventative medication. Good hygiene practices will greatly reduce the risk of infection.
High levels of worm infestation in Vietnam
An estimat
ed 60 million Vietnamese are infected with parasitic worms from consuming unwashed, unsafe vegetables, an expert has warned.
Of these, 40 million are affected by capillaria worms and 20 million by hookworms. The figures were included in a survey by the National Institute of Malariology, Parasitology and Etomology, tabled recently at a conference in Ho Chi Minh City.
Dr. Tran Thi Khanh Tuong, of Pham Ngoc Thach Medical University, said worm infection is very common countrywide, especially among children: 70% are infected in South Vietnam, 100% in the north. Nepal’s west hit by typhoid, viral fever
In western Nepal’s Doti district, an outbreak of typhoid and ‘viral fever’ (possibly Hepatitis A) has reached epidemic proportions, with patients overwhelming government and private hospitals, and clinics, the Himalayan Times reports. Advice to travellers: Both hepatitis A and typhoid vaccinations are recommended for travel to Nepal. Travellers should also follow safe food and water , and personal hygiene practices.
Typhoid raging in Philippines province
There have been 390 cases of typhoid in 2 weeks in the Philippines’ province of Central Visayas, bringing the year’s total to 1765 cases and 12 deaths. Alegria recorded 280 cases (3 deaths), followed by Guihulngan in Negros Oriental (244 cases) and Cebu City (220 cases). Swedish summer brings rise in deadly tick disease
Sweden has had 66 cases of tick-borne encephalitis during August – the highest number in 4 years. A mild winter and a warm summer have led to a rise in tick numbers, contributing to the year-to-date total of 144 cases. Sweden has the highest rate of tick-borne encephalitis (TBE) in Scandinavia, even higher than Russia. Mussels poison 60 in British Colombia
In Canada, 60 people are recovering from shellfish poisoning after a biotoxin contaminated mussels harvested off Cortes Island in British Columbia. The diarrhoeal shellfish poisoning (DSP) threatens the province's aquaculture industry. In 1984, DSP shut down Sweden's mussel industry for nearly a year.
Rains bring leptospirosis to Gujurat
Monsoon rains and flooding in western India have brought leptospirosis to southern regions of coastal Gujurat State this month. Two deaths in Valsad and Navsari last week raised the toll to 46 (228 cases). More are expected: Gujurat’s summer monsoon rains extend from late June to the end of September. Advice to travellers: Leptospirosis is typically associated with exposure to floodwaters and presents a low risk for most travellers. The bacteria that cause the disease are spread through the urine of infected animals, entering the body through skin or mucous membranes (eyes, nose, or mouth) – especially if the skin is broken. While it occurs worldwide, the disease is most common in temperate or tropica
l regions. As an extra precaution, Australians travellers to the Philippines should first wash fresh vegetables and fruit in clean water, and cook or peel them before eating.
UN warns of bird flu threat
The United Nations this week warned of the risks to human health from a resurgence of avian influenza virus (H5N1). The UN’s Food and Agriculture Organisation said there are signs that a mutant strain of the deadly bird flu virus is spreading throughout Asia, and beyond. It says variant strains circulating in Vietnam and China threaten Cambodia, Thailand, Malaysia, the Korean peninsula, and Japan. Wild birds can also spread the virus to other continents.
Cholera winging its way across the globe
British scientists say air travel probably enabled new strains of antibiotic-resistant cholera to spread from their original source in the Bay of Bengal to Asia, Europe and the Americas over the past 60 years. Three waves of cholera have emerged since the 1950s. Worryingly, since the second wave began, each new strain has been resistant to antibiotics. 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.
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