MASTA Travel Health Alert- 17th November 2016
Various strains of avian influenza have affected humans in China. Cases of H7N9 have been identified in several provinces including: Liaoning (NE), Guangdong (S), Anhui, Hunan, Jiangxi and Zhejiang (E), Dec 15-Nov 16. At least 777 cases have been reported to date from 2013. Other strains of avian influenza (H5N1, H5N6 and H9N2) have also been detected, 2014-16.
Avian influenza is a serious viral infection usually transmitted to humans by contact with infected poultry. The risk to travellers is low. Travellers should avoid contact with poultry (e.g. visiting live animal markets) and wash their hands regularly.
Outbreaks of cholera have been reported from 11 governates, including the capital Sana'a, Oct-Nov 16. Over 4,000 cases have been recorded with the highest numbers in Taiz and Aden.
The Central region has been hit by an outbreak of cholera, Nov 16. 268 cases have been recorded, the majority from the Cape Coast metropolis. 692 cases were reported to the WHO during 2015.
Over 3,000 cases of cholera have been reported from 9 of South Sudan's states, July-Nov 16. Juba (S), has reported the highest number of cases.
Cholera is a bacterial infection usually spread through contaminated food and water in areas with poor sanitation. The risk is highest for those with limited access to safe water and medical care such as aid workers and travellers to remote areas with reported outbreaks. Symptoms include watery diarrhoea and dehydration. An oral vaccine is available for those at particular risk.
Dengue fever is a continuing problem in Malaysia. Over 90,500 cases (208 deaths) have been reported, Jan-Nov 16. Selangor (SW) has reported at least 40,000 of these cases. Johor (S), Perak (W), and Kuala Lumpur (E) are also affected. 120,836 cases (336 deaths) were reported in 2015.
Over 54,000 cases of dengue fever have been reported, Jan-Nov 16. All 77 provinces report cases but most affected currently are Mae Hong Son (N), Chiang Mai (N), Songkla (S), Phattalung (S) and Pattani (S). 140,000 cases (140 deaths) were reported in 2015, in the worst outbreak for 20 years.
Dengue fever is a viral infection spread by day-time biting mosquitoes. It is widespread across over 110 countries with large outbreaks reported in many regions including South East Asia and South/Central America. Dengue fever commonly causes flu-like symptoms including fever, joint pain and rash. Severe forms of the disease are rare in travellers but can lead to excessive bleeding and organ failure.
At least 277 cases (3 deaths) from Kyasanur Forest Disease have been reported, Jan-Nov 16. A large outbreak affected Maharashtra (W) in April but cases have also been reported from Karnataka, Goa and Kerala.
Kyasanur Forest Disease is an unpleasant viral disease transmitted by tick bites or direct contact with infected animals such as monkeys. It can cause fever and encephalitis. Take steps to avoid tick bites.
Ayeyarwady region (S) has been affected by a Japanese encephalitis outbreak with at least 69 cases, Nov 16. Over 170 cases (19 deaths) were reported, (Jan-Aug 16), mainly in Rakhine and northern Shan states.
Japanese encephalitis is a viral infection affecting the nervous system spread by mosquitoes. There is no treatment and around a third of those who develop encephalitis will die. It is found in parts of Asia, particularly in rural areas where there are rice fields and pig farms. The risk is highest during the rainy season. Vaccination should be considered for long stay or rural travellers.
The Saudi Ministry of Health continue to report additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV), Nov 16. 1,479 cases (617 deaths) have been reported since 2012.
MERS-CoV is a viral infection which affects the respiratory system and can be fatal. Human to human transmission has been reported including amongst healthcare workers. There is some evidence that camels may also transmit the disease. Travellers returning from the Middle East who develop a significant respiratory illness with fever and cough should seek medical advice. There are no travel restrictions.
An outbreak of mumps has been reported in NW Arkansas, Nov 16. At least 1,028 confirmed and suspected cases have been recorded. The Marshallese community (originally from the Marshall Islands) has been especially affected.
Mumps is a viral disease which causes painful swelling of the salivary glands. 2 doses of the MMR vaccine are recommended but protection against the disease sometimes wanes over time.
Media sources have reported over 1,158 cases (37 deaths) of scrub typhus from Himachal Pradesh, Jan-Nov 16. Cases were also reported from Rajasthan, May 16.
Scrub typhus is an illness caused by a Rickettsia bacteria that is spread by mites on rodents. Symptoms vary but often include headache, fever and rashes. Travellers should minimize exposure by avoiding rodents and using insect repellents.
The WHO reported 12 cases of jungle yellow fever during 2016 (6 confirmed, 6 probable). The departments of Antioquia (N), Amazonas (S), Meta (central), Vaupes (S) and Vichada (E) were affected.
Yellow fever is a viral disease, found in tropical regions of Africa and the Americas. It principally affects humans and monkeys, and is transmitted by the bite of an infected mosquito. The risk is highest in rural areas. 15-25% of those infected will develop severe disease with organ failure, jaundice and bleeding. An effective vaccine is available but may not be suitable for everyone. International regulations are in place to prevent the spread of the disease and as such the vaccine must be administered in a registered ‘Yellow Fever Centre’ and a certificate of vaccination issued.