Travel health news provided by Nomad
Blog Words : Wanderlust health advice | 10 November

Wanderlust travel health update: India, New Zealand, Malaysia and more

This week's travel health news from Nomad includes: encephalitis in India, measles outbreak in New Zealand, hand and foot disease in Malaysia and more

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. 

Pakistan – Dengue Fever

With four more deaths, the total number of fatalities has risen to at least 337. Health officials said 118 new cases of dengue fever were confirmed in Punjab's provincial capital of Lahore, which has been the most affected area. With hundreds of new cases this week alone – nearly all of them in Lahore – the dengue fever outbreak has now affected at least 31,979 people in the country, including 20,399 in Punjab, of which 17,006 are in Lahore.

Marshall Islands – Dengue Fever

The Marshall Islands has declared a state of emergency after an outbreak of dengue fever. In the last three weeks, more than 75 cases of dengue have been reported in Majuro, the capital. This number is expected to rise.

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.

India – Encephalitis

An increased number of cases of acute encephalitis syndrome (AES) with unknown cause have been reported in a number of states in India. Some of these cases have been confirmed as Japanese encephalitis (JE). As of October 2011, there have been an estimated 6,160 cases of AES and JE with 844 deaths.

The majority of cases have occurred in four states: Uttar Pradesh (3,021 with 462 deaths), Assam (1,319 cases with 250 deaths), West Bengal (589 cases with 40 deaths), and Tamil Nadu (502 cases and 14 deaths). Case numbers appear to be higher than over the previous five years (sourced from NaTHNaC).

Advice to travellers

Japanese encephalitis is spread by night biting mosquitoes in certain parts of Asia. Outbreaks occur mainly during or just after monsoon time however can happen year round. The risk to short-term travellers is very low, particularly if they are only visiting urban areas, with overall estimates of one case per million travellers.

The risk becomes greater for persons who intend to live or travel in risk areas for long periods of time, and have rural trips during transmission seasons. The majority of cases of JE are asymptomatic or non-specific. Travellers to affected areas should seek advice prior to their trip. Vaccination is available and consists of two or three injections over a four to six week period. Bite avoidance is essential.

India – Chikungunya 

Chikungunya is becoming a cause of concern for authorities in Delhi, as the number of affected people has shot up to 54. According to Municipal Corporation of Delhi (MCD) officials, there has been an unprecedented increase in the number of chikungunya cases. Last year, around this time, there were only 33 cases.

Advice to travellers

Chikungunya is spread by daytime biting mosquitoes normally from sunrise to sunset and is more common in urban areas. There is no vaccine available and therefore insect bite avoidance is essential.

Ireland – Measles

In August and September (2011) alone, 139 cases of measles were recorded, with 11 of these admitted to hospital. Seven of these – aged between five and nine – were either not vaccinated against the disease or were under-vaccinated. According to the Health Protection Surveillance Centres, 265 cases have been reported in 2011 with 90% of those in Dublin.

New Zealand (Auckland) – Measles

The measles outbreak continues to spread in Auckland, with the disease infecting another 75 victims in October. Since the outbreak began in May 2011, a total of 278 people have been infected in the region. Of those, 53 people have been hospitalised. The measles toll stood at 203 at the beginning of October 2011.

Advice to travellers

Measles is easily spread through coughing and sneezing. Ensure you have been fully vaccinated prior to visiting affected areas. If no history of vaccination or if you are unsure, in adults, two vaccines given ideally one month apart will provide cover.

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, and avoid eating undercooked or uncooked poultry or eggs.

Saudi Arabia (Hajj) – Diarrhoea illness

A total of 81 Bangladeshi pilgrims were taken to hospitals in Madina, with food poisoning, after eating a meal at an unlicensed caterer. They were suffering from abdominal pains associated with diarrhea and vomiting. The pilgrims were all treated and discharged, except for one who had to be hospitalised.

Russia – Rabies

During the first nine months of 2011, 42 outbreaks of animal rabies have been reported in 15 districts of the Tver Oblast Region. The infected animals included foxes (14), raccoon dogs (six), a lynx, a wild boar, a ferret, 11 dogs and eight cats. In all 4,169 people have sought medical treatment (post-exposure prophylaxis) due to the risk of rabies virus infection.

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.

Malaysia – Hand Foot and Mouth Disease

Sarawak: A total of 2,271 cases of hand, foot and mouth disease (HFMD) and 108 clusters, involving pre-school facilities, schools and families have been reported.

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 and 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.

Philippines – Typhoid

Tacloban City: At least 104 suspected typhoid cases were reported to the Department of Health (DOH) in Leyte as of Saturday. The patients came from the towns of Capoocan, Carigara, Barugo, and Tunga in Leyte.

Health officials have advised the public to boil water for drinking, keep their surroundings clean, and wash their hands regularly (sourced from Travax).

Zimbabwe – Typhoid

At least 21 people have been admitted at a Harare hospital, while 54 others are under observation following an outbreak of typhoid.

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