MASTA Travel Health Alert- 14th December 2016
Outbreaks of cholera have been reported from 12 governates, including the capital Sana'a, Oct-Dec 16. Around 9,000 suspected cases have been recorded with many in Taiz and Aden.
The Central region has been hit by an outbreak of cholera, Nov-Dec 16. At least 500 cases have been reported by aid agencies, the majority from the Cape Coast metropolis. 692 cases were reported to the WHO during 2015.
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 throughout Myanmar, over 9,800 cases (54 deaths) have been recorded, Jan-Dec 16. Mandalay (C), Yangon (S) and Ayeyarwady (S) regions report many cases.
Over 3,000 suspected dengue fever cases reported nationally, Jan-Dec 16.
US Virgin Islands
32 suspected cases of dengue fever have been reported on St Thomas, St Croix and St John, Dec 16.
Dengue fever is a continuing problem with over 6,400 cases, (32 deaths) during 2016. Provinces most affected: Gran Santo Domingo, Santiago, La Vega and Duarte. 16,871 probable cases (103 deaths) were reported in 2015.
30 suspected cases of dengue fever have been reported by the Ministry of Health, Dec 16.
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.
2 cases of Hantavirus have been reported in New Mexico, Dec 16. An average of 25 cases are reported annually in the USA, the majority from states west of the Mississippi River.
Hantavirus is a viral disease which is primarily transmitted by contact with infected rodent excreta. The infection usually affects the lungs and kidneys. The risk is low but it would be wise to avoid rodent infested areas.
The Saudi Ministry of Health continue to report additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV), Dec 16. 1,506 cases (624 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.
The Ministry of Health have issued a warning advising people to avoid drinking unregulated 'white wine' or 'medicated wine' after 62 people (13 deaths) suffered from methanol poisoning in Kampong Chhnang province (C), Dec 16.
Methanol poisoning remains a problem in many countries where methanol is used in the production of ‘bootleg’ alcohol. Symptoms include vomiting, seizures and visual disturbances sometimes leading to blindness. Deaths are common.
The CDC have reported 2,900 cases of mumps across 45 states during 2016, the highest level for 10 years. A large outbreak was reported in NW Arkansas with at least 1,028 cases recorded, Nov 16. The Marshallese community (originally from the Marshall Islands) were especially affected. Outbreaks have also been reported at a number of US universities including Harvard (Boston), New York and the University of Missouri, Nov 16.
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.
Democratic Republic of Congo
7 cases of yellow fever have been reported in Lualaba province (S), Dec 16. These are the first recorded cases since a large outbreak was declared in the country, with over 2,800 suspected cases, Jan-July 16. Cases were reported from provinces including Kinshasa and the Kongo-Central (W) and local vaccination campaigns have taken place. Many cases were imported from Angola where a large outbreak was reported.
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.
715 suspected cases of Zika virus have been reported, including on Caye Caulker Island, Apr-Dec 16.
St Martin has reported over 2,950 suspected cases of Zika virus, Jan-Dec 16.
898 suspected cases of Zika Virus have been reported, to Dec 16. Tumbes region (N) reports cases, media sources state that some cases are also from Jaen, Cajamarca region (NE)
58 suspected cases of Zika virus (ZIKV) have been reported from this island, Jun-Dec 16.
Antigua and Barbuda
465 suspected cases of Zika virus have been reported, to Dec 16.
5 locally acquired cases of Zika have been reported in Cameron County, Texas, Nov-Dec 16. 222 local cases have been reported from Florida State (S), some in pregnant women, Aug-Nov 16. Affected areas include: South Beach/Miami Beach area and Wynwood district in Miami-Dade County. Sporadic cases have been reported from Pinella, Broward and Palm Beach counties, Aug 16.
Zika virus (ZIKV) is transmitted by daytime biting mosquitoes and is similar to dengue fever. Symptoms include rash, conjunctivitis, muscle or joint pain. Neurological complications have been reported. There is consensus that ZIKV infection during pregnancy may cause some birth defects such as microcephaly. There is a low risk of sexual transmission of the disease. Countries/territories/areas with active or past Zika transmission have now been classified into 4 risk categories: high, moderate, low and very low, based on the current and potential epidemiological situation. These categories ensure travel advice is appropriate and proportionate to the defined ZIKV transmission risk. See current national advice from Public Health England for more details, including that for pregnant travellers, who are advised to postpone non-essential travel to high risk countries and also regarding condom use for preventing sexual transmission of the disease. https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance