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With over 30 years at the forefront of travel health, MASTA is proud to bring you alerts and topical information from across the globe. Make MASTA your one stop shop for expert advice, leaving you concentrate on what is most important… enjoying your travels.

MASTA Travel Health Alert- 28th February 2017

Egypt

A death from suspected H5N1 (avian influenza) has been reported from Fayyoum (NE), Feb 17. 10 cases were reported in 2016. The first human case of avian influenza (H9N2) in Egypt was reported in Aswan, Feb 15. This strain has rarely been seen in humans.

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.

Brazil

3,190 suspected cases (1 death) of chikungunya virus have been reported, Feb 17. Almost 260,000 confirmed cases were reported during 2016.

Panama

207 suspected cases of chikungunya have been reported, Feb 17. 6 confirmed cases were reported in 2016.

Peru

The WHO have reported 175 suspected cases of chikungunya virus, Feb 17. 124 confirmed cases were reported in 2016.

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.

Dominican Republic

9 cases of cholera (1 death) have been reported, Feb 17. Over 1,100 suspected cases (27 deaths) were reported during 2016. Most of the cases have been reported in the National District, Pedernales, Santiago and Santo Domingo. Over 33,000 cases have been reported since the epidemic began in 2010.

Haiti

Cholera continues to be reported in Haiti with over 1,800 cases (28 deaths), Feb 17. 39,000 cases (420 deaths) were recorded during 2016. Currently the most affected departments are Artibonite (NW), Centre, Nord, Nord-Ouest and Ouest.

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.

Namibia

Media sources have reported a death from Crimean-Congo haemorrhagic fever in Omaheke region (W), Feb 17.

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.

Panama

Health officials have reported a case of Hantavirus in Los Santos province (S), Feb 17. 3 cases of Hantavirus were reported from the province in 2016.

USA

Media sources are reporting a suspected case of Hantavirus in Texas, Feb 17. 2 cases of Hantavirus were 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 lung and kidneys. The risk to travellers is low.

Marshall Islands

Health authorities have reported 121 cases of hepatitis A, with most cases in the capital Majuro, Sep 16-Feb 17.

Hepatitis A is a viral infection which affects the liver and occasionally causes severe disease. It is usually spread by contaminated food and water. 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.

Chad

Health authorities have reported over 950 cases (12 deaths) of suspected hepatitis E in Am Timan, Salamat Region (SE), Sep 16-Feb 17. Other areas in the same region are reporting suspected cases.

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.

Nigeria

196 cases of Lassa fever (31 deaths) have been reported from 9 states, Dec 16-Feb 17. Ogun (SW), Bauchi (NE), Plateau (C), Ebonyi (SE), Ondo (S), Edo (S), Taraba (E), Nasarawa (C) and Rivers (S) states are all reporting cases. 921 suspected cases (119 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.

Romania

Over 3,000 cases (16 deaths) of measles have been recorded, Jan 16-Feb 17. West Region is most affected.

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 travel consultation is good opportunity to ensure that all travellers are in-date with their primary vaccinations.

Togo

The WHO have reported 201 suspected cases of meningitis (17 deaths) in 19 health districts, Feb 17. A vaccination campaign is planned. 1,975 cases (127 deaths) were reported during 2016.

Meningococcal meningitis is a bacterial infection affecting the brain usually spread by respiratory droplets (coughing/sneezing). Highest infection rates usually occur during the dry season in the ‘meningitis belt’ of sub-Saharan Africa. The risk is highest for long-stay travellers and those mixing closely with the local population. There are a number of different strains of meningococcal meningitis and the vaccine used for traveller purposes contains 4 of these (A, C, W135 and Y). This vaccination is mandatory for pilgrims travelling to Hajj or Umrah in Saudi Arabia.

USA

A case of tularaemia has been reported following an injury from a fish hook in South Dakota, Feb 17. Cases were reported from several states, including Colorado and New Mexico during 2016.

Tularemia is a serious bacterial infection which can affect many different organs. It is transmitted by direct or indirect contact with infected animals, usually rabbits, rodents and is a particular risk to hunters. It can also be acquired by contaminated soil/water or infected tick bites.

Brazil

As of 26th Jan 2017 the yellow fever risk area has been extended to include parts of the SW states of Bahia, Espírito Santo and Rio de Janeiro. A state of emergency has been declared in Minas Gerais (SE). Over 1,200 confirmed and suspected cases (92 confirmed deaths) have been reported from the states of Minas Gerais, Espírito Santo, Bahia, São Paulo, Tocantins and Rio Grande do Norte, Jan 17. Local vaccination campaigns have begun.

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.

Japan

Over 940 cases of a foodborne illness have been reported in students and teachers in Tachikawa City (near Tokyo), Feb 17. The outbreak has been linked to school lunches prepared at a local facility.

Tags:Avian Influenza, Chikungunya, Cholera, Crimean-Congo Haemorrhagic fever, Hantavirus, Hepatitis A, Hepatitis E, Lassa Fever, Measles, Meningitis, Tularemia, Yellow Fever