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Wanderlust travel health update: dengue fever, rabies and more

This week's travel health news, including dengue fever, rabies, how to stay safe in Thailand's flooded areas and more

Travel health news provided by Nomad

This health advice is provided by Nomad, who offer Wanderlust visitors 10% off equipment online and in store including 10% off vaccinations. See the Nomad website for more details.

Vietnam – dengue fever

Vietnam has recorded 42,181 cases of dengue fever nationwide, including 44 fatalities.

Brazil – dengue fever

Sao Paulo state: Health authorities this year have registered a dengue epidemic more serious than in 2010, the worst in its history. In less than ten months, 19,243 cases of the disease have been registered.

Marshall Islands – dengue fever

A public health campaign is underway in Marshall Islands after an outbreak of dengue fever was reported. The Ministry of Health has confirmed 11 cases of dengue fever and reports that this is the first outbreak of dengue fever on the islands (sourced by Travax).

Pakistan – dengue fever

Two people lost their battle against dengue raising the death toll to 253 in Lahore while 291 died in Punjab. In the past 24 hours, 201 new cases of dengue were confirmed raising the number of patients to 19,506 in the province. In Lahore, 161 cases were confirmed increasing the number of affected persons to 16,492.

Advice to travellers

Dengue fever is spread by daytime biting mosquitoes normally from sunrise to sunset and is more common in urban areas. It causes a high ‘breakbone’ fever (pain all over), accompanied with headache and rash. It lasts a few days and will resolve itself. If caught a second time it has approximately 2% chance of developing into dengue haemorrhagic fever which can be fatal. There is currently no vaccine available and therefore insect bite avoidance is essential.

Indonesia – avian ‘flu

A mother and daughter are being treated at the Sanglah General Hospital in Denpasar, Bali after contracting suspected bird flu. A hospital spokesman said the hospital was awaiting test results to determine whether the pair had avian influenza, which is prevalent on the island. There have been two confirmed deaths this month.

Advice to travellers

Avian flu is spread through close contact with infected poultry. Avoid contact with poultry and wild birds (eg markets, farms). Wash your hands frequently and well, consider carrying a hand sanitiser gel with you, avoid eating undercooked or uncooked poultry or eggs.

India (Delhi) – malaria

A total, 237 cases of malaria have been reported from New Delhi.

Greece – malaria

Since the end of September, a total of 20 malaria cases have been reported in persons with no history of travel to a malaria-endemic area. An additional 16 cases have been identified in persons from malaria endemic countries in whom importation versus local transmission of malaria could not be determined. The majority (20 cases) occurred in the southern region of the country, specifically in the Laconia district in the south.

Other cases occurred in the Evia/Euboea (island east of the central Greece region), Eastern Attiki, Voitia, and Larissa districts.

Advice to travellers

Travellers to the affected areas/countries should seek expert advice before they travel. Malaria tablets are not currently advised for these areas and therefore bite avoidance is essential. Always wear 20-50% DEET on all exposed skin, sleep under a mosquito net and wear long clothing to protect you. Malaria-carrying mosquitoes generally bite between sunset and sunrise.

New Zealand – whooping cough

A whooping cough outbreak in Nelson and Marlborough may cause a nationwide epidemic, health officials warn. There is an outbreak in the top of the South Island, with similar outbreaks in West Coast and Hawke's Bay, which may develop into a nationwide epidemic. So far in October 2011, Nelson has had 27 cases with a further 16 still under investigation. In September, it had a total of 40 cases of whooping cough.

Australia – whooping cough

This year, 29,586 cases have been notified in Australia, with a peak during August and September. The majority of cases have occurred in four states: New South Wales (10,336), Queensland (6,884), Victoria (7,137) and Western Australia (2,086). Due to the increased number of pertussis notifications, several states (including Australian Capital Territory, New South Wales, Northern Territory, Queensland and Victoria) are offering a free targeted vaccination programme for unvaccinated children and some adults. Adults who are recommended to receive vaccine include parents of newborn infants,  grandparents and others who have household contact with babies (Sourced by Nathan).

Advice to travellers

Whooping cough is spread by the respiratory route – people coughing and sneezing. Children in the UK are routinely immunised as babies. If travelling into an outbreak situation, non-immune travellers should practice routine respiratory precautions such as good hand hygiene and avoid persons known to be infected. Check with your GP that you have received all routine vaccinations. If travelling long term into affected areas, or if planning to mix closely with young babies, and you are not immune, you may wish to consider getting vaccinated at your destination. Seek advice.

Ukraine – rabies

Two cases of bites by rabid cats were registered on 25 October 2011. The condition of the victims is stable, no signs of the disease. According to the data of the city council, 56 cases of rabies among animals have been registered in the Kharkiv region since the beginning of the year.

Indonesia – rabies

Central Kalimantan has been hit by at least 858 cases of rabies so far this year. Last year, 1118 cases were reported with one death.

Advice to travellers

Travellers are advised to consider pre-travel rabies vaccine, this consists of a course of three vaccines administered over the course of 21 to 28 days; this removes the need for rabies immunoglobulin in the event of an injury. Animal contact should be avoided wherever possible and in the event of contact with animal saliva any wound should be thoroughly washed with soap and water and Iodine or alcohol applied. Medical advice should be sought as soon as possible even if vaccinated with a full course of rabies vaccine.

Vietnam – hand, foot and mouth disease (HFMD)

HFMD has killed 137 people, mostly children, out of 77,895 infections in the 63 cities and provinces across the country. A report by the Vietnam Administration of Preventive Medicine showed 2,900 new cases were recorded last week, up 400 cases from the previous week.

Malaysia (Sarawak) – hand, foot and mouth disease (HFMD)

A total of 2,271 cases of HFMD and 108 clusters, involving pre-school facilities, schools and families were reported as of 22 October 2011.

Advice to travellers

HFMD is viral illness that most commonly affects children under ten years of age, however older children and adults are sometimes affected. It causes a fever, sore throat quickly followed by small spots that develop inside the mouth. These soon progress into small mouth ulcers, and sometimes also develop on the skin. It is spread via direct contact with nose and throat secretions and faeces from an infected individual and by aerosol droplet spread. Contact with infected children should be limited and crowded situations avoided; personal hygiene and hand washing is essential.

Estonia – hepatitis A

The outbreak of hepatitis A in Estonia that began in August 2011, is ongoing. Between 4 August and 3 October 2011, a total of 71 confirmed cases of hepatitis A were notified in Estonia, most cases (51) were recorded in September. Of those, 66 cases were linked to Viljandi county, 54 were reported from Viljandi county, eight from Tallinn, and one from Tartu, Pärnu, Harju and Rapla counties, respectively. The 12 cases who were not from Viljandi county had either visited Viljandi county or had been in contact with a Viljandi city resident (Sourced by Travax).

Advice to travellers

Hepatitis A is spread via the faecal-oral route; by people not washing their hands before preparing food, contaminated food (especially shellfish), water or just close proximity with an infected person. It affects the liver and adults can take many months to fully recover. Travellers should ensure they eat ‘safe’ food and drink ‘safe’ water and be vaccinated prior to travel. Vaccination consists of two injections, the first lasts approx one year and the second at least 20 years.

Thailand – flooding

The Foreign and Commonwealth Office currently advises against all but essential travel to the city of Bangkok and the 25 provinces in Thailand affected by widespread flooding. This reflects the large volume of flood water that needs to pass through Bangkok to the Gulf of Thailand. The flooding is likely to disrupt transport, may affect some tourist areas (including the Grand Palace and Khao San Road), and may disrupt electricity and water supplies, though the authorities have said they will do all they can to maintain these.

Travel through Suvarnabhumi International airport and onto other destinations in Thailand including Chiang Mai, Pattaya, Phuket, and Koh Samui, is operating as normal. The advice against all but essential travel to the city of Bangkok does not include transit through Suvarnabhumi airport. Please see Foreign Office Website www.fco.gov.uk for more information.

Central America – flooding

Heavy rains have brought the death toll from the floods in Central America to approximately 130. Over 1.9 million people have been affected by severe floods in the region, as various aid organisations are providing humanitarian support and implementing appeals.

In Guatemala, more than 470,000 people have been affected and 11,000 homes were damaged. The Ministry of Health continues to provide healthcare in 149 shelters throughout the country.

Chile – volcano activity

The government of Chile has issued a red alert for regions surrounding the increasingly active Hudson volcano. The crisis committee for Regional Emergency Operations has ordered prevention measures and evacuations for 100 residents in surrounding areas of the volcano.

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