MASTA Travel Health Alert- 29th December 2016
A US tourist who visited Zambia and Botswana on safari has been diagnosed with African trypanosomiasis (sleeping sickness), Dec 16.
African trypanosomiasis (Sleeping Sickness) is spread by the bite of the tsetse fly. These are large black flies which are found in rural areas and are active during the daytime. They are attracted to moving objects (e.g. safari vehicles) and dark colours. They are not particularly affected by insect repellents, and can bite through lightweight clothing. A skin ulcer may occur at the site of the bite and swollen lymph nodes may appear. The disease can progress to affect the brain, causing confusion and poor coordination. The disease is fatal if left untreated.
At least 22 suspected cases of Haff disease have been recorded in the eastern state of Bahia, Dec 16. Many of the victims had eaten a local fish called ‘bull’s eye fish’.
Haff disease is a rare illness thought to be caused by ingesting unidentified toxins in fish. It results in ‘rhabdomyolysis’ where muscle cells break down causing dark urine and severe muscle pain.
Over 2,141,000 cases (204 deaths) of hand, foot and mouth disease have been reported, 2016. This follows the previous seasonal pattern.
There have been 723 hospital admissions due to hand, foot and mouth disease during 2016.
Almost 62,000 cases of hand, foot and mouth disease have been reported during 2016.
Almost 40,000 cases of hand, foot and mouth disease have been reported during 2016.
Over 46,000 cases of hand, foot and mouth disease have been reported from all provinces during 2016.
Hand, foot and mouth disease is a viral infection which affects mainly young children and causes fever, mouth ulcers and blisters on hands and feet. It is transmitted by person to person contact. The majority of cases are mild but serious complications are occasionally reported.
A death from Hantavirus has been reported in Quillota province (C), Dec 16. An average of 57 cases (20 deaths) are reported annually in Chile.
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 to travellers is low but it would be wise to avoid rodent infested areas.
Medical experts are investigating outbreaks of hepatitis in Kothamangalam, Kerala (SW) and Odisha (E), Dec 16. A number of deaths have been recorded. The hepatitis strain has not been confirmed but is suspected to be either A or E. Take care with food/water hygiene.
Hepatitis E infection affects the liver and is usually transmitted through contaminated food and water in areas with poor sanitation. Symptoms include fever, fatigue and jaundice. It is especially dangerous in the latter stages of pregnancy when fatality rates can reach 20%. There is currently no vaccine.
Hepatitis A symptoms include fever, digestive disturbance and jaundice. Effective hepatitis A vaccines are available and can be given on their own or in combination with hepatitis B or typhoid.
2 confirmed cases of Japanese encephalitis reported in Pune (W), Dec 16. At least 119 deaths from encephalitis have been reported in Odisha, Oct-Nov 16. About 1/3 have been confirmed as Japanese encephalitis whilst the rest acute encephalitis syndrome (AES). The causes of AES are still under investigation but may be linked to toxins from the seeds of a wild plant called 'bada chakunda'. The majority of reported cases countrywide are from Uttar Pradesh, West Bengal, Assam, Odisha, Jharkand and Tamil Nadu. India reported over 1,600 cases (275 deaths) of Japanese
encephalitis and over 11,000 cases (1,277 deaths) of acute encephalitis syndrome (AES) in 2015.
Japanese encephalitisis 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.
There has been an increasing number of Lassa fever cases, with over 874 suspected cases (107 deaths) reported from 29 states during 2016. Lassa fever is a serious problem in many of the 36 states in Nigeria.
Lassa fever is a viral infection which occurs in West Africa. It is primarily transmitted by contact with infected rodent excreta but can also occur following direct contact with the blood or secretions of infected individuals. It is especially dangerous if contracted during pregnancy. The risk is low but it would be wise to avoid rodent infested areas.
United Arab Emirates
At least 26 cases of Legionnaires' disease have been reported in European travellers returning from Dubai, Oct-Dec 16. The source of the infection is unknown.
Legionnaires’ disease is a bacterial infection which can cause a life-threatening pneumonia. Outbreaks are often associated with communal water facilities such spas, showers and cooling towers.
Media sources report 40 cases of measles (5 deaths) in Awaran (S), Dec 16. Over 500 cases were reported from several districts of Karachi, May 16. Pakistan is one of the countries highlighted by the WHO as having a particular problem with measles.
Measles is a viral infection which causes a red blotchy rash and occasionally more serious disease. 2 doses of the MMR vaccine are recommended to provide protection against the disease.
The Saudi Ministry of Health continue to report additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV), Dec 16. 1,519 cases (631 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.
At least 60 cases (24 deaths) from methanol poisoning have been reported from Toba Tek Singh city (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.
Health authorities reported the first confirmed cases of Zika virus in Brazil in May 15. Since then over 211,000 suspected cases have been recorded, Dec 16. Most affected states are Rio de Janeiro and Bahia (NE). Nationally over 2,000 confirmed cases of microcephaly (a birth defect causing babies to be born with small heads) have been reported.
Since Zika virus was first reported in the Department of Bolivar in Oct 15, it has spread to the rest of the country. Over 97,100 suspected cases have been reported, to Dec 16.
Since the first reported case in the country 3,840 suspected cases of Zika virus have now been reported, Apr-Dec 16.
Since Zika virus was first reported in the country there have been over 35,600 confirmed cases during 2016.
Saint Vincent and the Grenadines
508 suspected cases of Zika virus have been reported, Feb-Dec 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