MASTA Travel Health Alert- 2nd November 2016
An outbreak of cholera has been reported in Amuru District (N), Oct 16. Cases were reported from Butaleja and Namayingo districts (E), Apr-May 16. Over 1,400 cases were reported to the WHO during 2015.
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.
Dengue fever is an ongoing problem in Nepal. 329 cases have been reported from 13 districts, though the majority are reported from Chitwan (C), Jan-Oct 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.
There have been 3 cases of Hantavirus in Los Santos province (S), to Oct 16. Cases were reported from Los Santos, Veraguas, Herrera and Cocle provinces in 2015.
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.
At least 68 deaths from Japanese encephalitis have been reported in Odisha, Oct 16. The majority of reported cases countrywide are from Uttar Pradesh, West Bengal, Assam, Odisha, Jharkand and Tamil Nadu. India reported over 1,700 cases (290 deaths) of Japanese encephalitis and nearly 10,000 cases (1,200 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 841 suspected cases (98 deaths) reported from 28 states, Jan-Oct 16. 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.
935 cases (6 deaths) of measles have been recorded, Jan-Oct 16. Arad and Mures counties record the most cases. Only 7 cases were confirmed during 2015.
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.
Media sources report hundreds of cases of schistosomiasis in the county of Gbarpolu (N), Sep-Oct 16.
Schistosomiasis is a parasitic worm infection that can penetrate intact skin when swimming or wading in freshwater lakes and rivers. Left untreated the worm eggs travel to the intestine, liver or bladder, causing inflammation or scarring. If exposed, screening tests and effective treatment are available.
428 cases (9 deaths) of scrub typhus have been reported from 39 different districts of the country, Jul-Oct 16. The majority of these cases are from Chitwan district (C). Outbreaks were reported from various districts including Kathmandu, Nawalparasi (C) and Dhading (E), Oct-Nov 15.
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.
Sporadic cases of Zika virus have been reported in the country, Mar-Oct 16.
Locally acquired cases of Zika virus have been reported for this year, from Ho Chi Minh City, Binh Duong, Khanh Hoa, Long An and Phu Yen provinces, Apr-Oct 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