MASTA Travel Health Alert- 18th January 2017
A large outbreak of chikungunya has been reported in Sindh province, especially Karachi, Saudabad and Lyari, Dec 16-Jan 17. Reported number of cases vary.
Chikungunya (CHIK) is a viral infection spread by day-time biting mosquitoes. Symptoms may include fever and muscle/joint pain. Some people experience persistent joint pain and fatigue lasting weeks or months.
Cholera continues to be reported in Haiti with 39,000 cases (420 deaths) recorded during 2016. Currently the most affected departments are Grand Anse and Sud (SW).
Media sources have reported an outbreak of cholera in Zaire Province (NW), Jan 17.
31 cases of cholera have been reported in Cibitoke district (N), Jan 17.
Cholera cases continue with outbreaks reported in Katavi (W) and Dodoma (C) regions, Jan 17. A large outbreak which began in Dar es Salaam spread to at least 12 regions during 2016. At least 9,000 cases were recorded.
Over 1,200 cases of acute watery diarrhoea/cholera have been reported in Bay, Hiraan, Lower Juba and middle/lower Shabelle regions, Dec 16-Jan 17. Large outbreaks were recorded during 2016 with at least 13,000 cases.
An outbreak of cholera has been reported in Lamu, Tana River Counties (S), Jan 17. At least 15,000 cases were reported from 30 counties during 2016.
Cholerais 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.
A case of Crimean-Congo haemorrhagic fever has been confirmed in a farmer from Mamre (Western Cape Province), Jan 17. On average around 5 cases of this disease are reported each year in South Africa.
Crimean-Congo haemorrhagic fever is an unpleasant viral disease which is fatal in 20-35% of cases. It is usually transmitted by infected tick bites or direct contact with the blood of infected individuals. Take steps to avoid tick bites by covering exposed skin and using an effective repellent.
Over 8,000 suspected cases of dengue fever have been reported by the Ministry of Health, with Honiara, Guadalcanal, Malaita, Isabel, Choiseul, Makira, Temotu, Western and Central reporting the largest numbers, Aug-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.
An outbreak of diphtheria has been reported at a school in Quang Nam province (C). 24 cases and 2 deaths have been recorded.
Diphtheria is a bacterial infection affecting the respiratory tract usually spread through respiratory droplets such as coughing. The risk is increased in conditions of overcrowding and poor hygiene. It can cause serious throat symptoms and also affect the skin. Vaccination is part of the standard UK immunisation schedule and boosters are given in combination with tetanus and polio.
2 Swiss tourists have been diagnosed with Hantavirus after travelling along the Pacific Coast of South America visiting Ecuador, Argentina and Chile, Nov 16. 2 further cases have been reported in Los Lagos in central Chile, Jan 17.
A case of Hantavirus has been reported in southern Taiwan, Jan 17. Cases are rarely reported.
Hantavirus is a viral disease which is primarily transmitted by contact with infected rodent excreta. The infection usually affects the lung and kidneys. The risk is low but it would be wise to avoid rodent infested areas.
16 cases of Lassa fever have been reported from Nasarawa (C), Jan 17. Over 874 suspected cases (107 deaths) were reported from 29 states during 2016.
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.
A number of explorers/archaeologists studying the 'City of the Monkey God' in the jungles of Mosquito Coast have been diagnosed with mucocutaneous leishmaniasis, Jan 17.
Leishmaniasis is a parasitic disease spread by infected sand flies that bite between dusk and dawn. The disease occurs in three forms of varying severity affecting the skin and/or internal organs. Treatment can be prolonged with skin ulcers taking a long time to heal. Travellers should avoid sand fly bites by using effective repellents and sleeping under insecticide treated bed nets.
10 cases of malaria have been reported in Rodas, south-central Cuba, Jan 17. Cuba was officially declared malaria free in 1973. Occasional cases are possible in the Caribbean when infected individuals travelling into the area infect local mosquitoes. The risk to travellers is low but strict mosquito bite avoidance (such as effective repellents on exposed skin) is recommended.
Malaria is a serious and sometimes fatal disease common in many tropical countries. It is spread by the bite of infected mosquitoes which bite between dusk and dawn. Symptoms can vary and include fever and a flu-like illness. More serious forms can be fatal and progress to organ failure and coma within 24 hours of symptoms first appearing.
2 children have died from measles in Sherani district, Balochistan province (SW), Jan 17. Media sources reported 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), Jan 17. 1,537 cases (640 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.
A child has died from rabies after being bitten by a stray dog in Boumerdes Province (N), Jan 17.
Rabies is a viral infection spread by the saliva of infected animals. Human cases are usually due to dog bites but any mammals can be infected. Rabies is fatal once symptoms begin. Pre-exposure vaccinations are recommended for long-stay travellers; those remote from medical help (>24 hours) and animal handlers. All travellers must know how to treat a wound and seek prompt post-exposure vaccines if bitten/scratched.
Around 500 students from 4 schools/universities have become unwell with food poisoning, Jan 17. The same catering service supplied meals and preliminary investigations suggest bacterial contamination is responsible.
A state of emergency has been declared in Minas Gerais (SE) after 133 suspected cases of yellow fever were reported, Jan 17. 6 cases (1 ex Angola) were reported nationally in 2016.
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.
6 locally acquired cases of Zika have been reported in Cameron County, Texas,
Nov 16-Jan 17. 257 local cases have been reported from Florida State (S), some in pregnant women, Aug 16-Jan 17. 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.
52 cases of Zika virus were reported in the country during 2016.
At least 212 confirmed cases of locally acquired Zika virus have been reported, from Ho Chi Minh City, Binh Duong, Khanh Hoa, Long An and Phu Yen provinces, Apr 16- Jan 17.
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