Nomad travel health update
Blog Words : Wanderlust health advice | 18 November

Wanderlust travel health update: dengue fever, yellow fever and more

This week's travel health news, including dengue fever, yellow fever and how to stay safe when you're travelling

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.

Indonesia (Java) – Hepatitis A

Hepatitis A has been reported in several locations in Bandung, Tasikmalaya, and Depok over the last two months, most recently striking 89 students and a teacher from a state vocational school.

In the last three weeks, 54 elementary school students in Tasikmalaya have contracted hepatitis, suffering from fevers and weakness, which are common symptoms of hepatitis A. Meanwhile, 40 students from Parahyangan University in Bandung contracted hepatitis in October (2011). Poor food hygiene at canteens near the schools was the likely to be the cause of the infections.

Malaysia – Hepatitis A

Terrengganu: 27 people including eight children from Kampung village, Basong and Kampung Pasir Dula here have been admitted to the Hulu Terengganu Hospital (HTT) after they were suspected to have contracted hepatitis A.

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  approximately one year and the second at least 20 years.

India – Malaria

Jharkhand (East India): A total of six people, including three in one family have died, because of cerebral malaria, and more than ten are suffering from the disease in Karmikund village. So far tests have been conducted on more than 55 people.

Advice to travellers

Travellers to the affected area should seek expert advice before they travel regarding the most suitable form of malaria tablets, which will best suit their trip and medical history. They should ensure that they take the tablets as advised or they will not work as well. Malaria tablets are approximately 90–95% when taken properly; bite avoidance should also be adhered to. 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.

Indonesia (Bali) – Avian ‘flu

The Ministry of Health of Indonesia has announced one new confirmed case of human infection with avian influenza A (H5N1) virus in Bali. The case is a 29-year-old female, mother of the two cases earlier reported from Bangli district, Bali Province. Human cases of avian influenza have been reported during 2011 including five new cases between 4 April and 4 November. Eight of the ten cases were fatal. The most recent cases have been reported from Bali and DKI Jakarta provinces

Egypt – Avian ‘flu

Since the beginning of 2011, 33 human cases of avian influenza have been reported, including 19 new cases between 4 April and 4 November 2011. Twelve of the 33 cases were fatal (sourced by NaTHNaC).

Cambodia – Avian ‘flu

Eight human cases of avian influenza have been reported during 2011, including five new cases between 4 April and 4 November 2011. Most of the recent cases have been reported in Banteay Meanchey, Kampong Cham and Prey Veng provinces. All cases of H5N1 infections reported in humans in 2011 have been fatal.

Bangladesh – Avian ‘flu

As of 11 April 2011, two human cases of avian influenza have been reported. Both cases occurred in March 2011 in Dhaka. All the human cases reported in Egypt, Indonesia, Cambodia and Bangladesh are known to have had contact with sick or dead poultry before the onset of symptoms.

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.

Pakistan – Dengue Fever

Punjab / Lahore: Another patient has fallen victim to dengue virus, mounting the total death toll to 306 in Lahore city. According to the Health Department, only 23 persons with positive dengue symptoms in their blood reports were reported in Punjab during last 24 hours; out of them, ten are from Lahore. The total number of dengue patients in the Punjab has risen to 3,678, out of them, 2,498 belong to Lahore.

Sindh province / Karachi: A total of 717 dengue fever patients have been counted in Sindh, while nine new patients were diagnosed dengue positive in Karachi. A total of 847 patients were admitted at different hospitals in Karachi and of them 717 were found dengue positive.

India – Dengue Fever

Hospitals in Delhi have diagnosed 15 new dengue cases in the past one day, thus indicating that dengue has started ebbing in the city. The total number of people affected by dengue fever this year (2011) has
reached the 945 mark. In the past 24 hours, 15 cases have been reported. Over 10,000 dengue cases have been detected in the country this year (2011).

Philippines – Dengue Fever

The Department of Health (DOH) Dengue Surveillance Report showed that 97 158 dengue
cases have been recorded from 1 January to 22 October this year.

Marshall Islands – Dengue Fever

There have been more than 250 confirmed cases of dengue fever in the Marshall Islands, according to Pacific Network, an information sharing network affiliated with the World Health Organization. According to the network, 68 people have been admitted to a Marshall Islands hospital, but there have been no deaths.

El Salvador – Dengue Fever

The Ministry of Health reports 6,163 cases of classical dengue fever and 138 of DHF (Dengue
Hemorrhagic Fever) to date, with seven deaths recorded.

Brazil – Dengue Fever

Brazil is again on alert against dengue to avoid the seventh epidemic of the disease. In the first nine months of 2011, more than 700,000 cases were registered.

Bolivia – Dengue Fever

In Bolivia there are now 47 dead from a dengue outbreak and 7,094 affected by the infection. The Amazon region is the most affected.

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.

New Zealand – Measles

Health authorities say measles is spreading throughout the Bay of Plenty. There have been ten cases in the region since early October, with most in Tauranga and Rotorua. Of the more than 400 confirmed cases across the country, at least 70 have required hospital treatment.

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.

Peru – Yellow Fever

Officials of the office of the Ayacucho Regional Director of Health (DIRESA) confirmed the first yellow fever (YF) victim in the Ene River valley. After a histopathologic study, epidemiological specialists confirmed the
first YF case in this river valley area, after the puerperal 15-year-old girl died on the third day after giving birth. She was considered, initially, as a victim of maternal death.

Ghana – Yellow Fever

The Upper West Region has recorded three yellow fever (YF) cases this year. Consequently, a district mass immunisation programme has been drawn especially for children above one year.

Advice to travellers

Yellow Fever is spread by the bite of an infected aedes aegypti mosquito that generally bites during the day. It is an untreatable acute viral disease, which can vary in severity and can be fatal. Bite avoidance is essential to prevent or avoid infection. Apply 50% DEET to all exposed skin regularly, treat clothing with premethrin or apply 100% DEET to collars and cuffs. Remember when wearing sunscreen to apply the cream first and the DEET on top. Always sleep under premethrin treated mosquito net. When vaccinated you will be provided with a Yellow Fever Certificate which you should keep with your passport and will
have ten years cover.

Latvia – Legionellosis

An increased number of legionellosis cases in 2011 have been reported in Latvia, compared to the ten previous years. A total of 30 legionellosis cases (1.35 per 100,000 inhabitants), including 19 females, have been confirmed until the end of September 2011. The majority of cases were inhabitants of the capital city Riga. The reason for the increase in legionellosis is unclear. Four of the 30 cases are travel-related.

Advice for travellers

Legionnaires is spread via droplet or aerosol inhalation of infected water. Person to person spread is uncommon. If infected symptoms include fever, cough, chills, headache leading to a potentially fatal disease. Flushing through showers in hotels or institutions with hot water when they have not been used recently may help prevent transmission.

Zimbabwe – Typhoid

Authorities believe there are 207 cases of typhoid in Harare. The outbreak was first reported in early November when two dozen people were under observation in a local hospital with suspected typhoid. No deaths have been reported so far.

According to the Combined Harare Residents Association, the city council has failed to address the water problems in the city and, as a result, many residents lack access to clean water. Impoverished residents often rely on water from open, shallow wells that are likely to be contaminated. Some have been without access to filtered, piped water for months as a result of Zimbabwe’s economic turmoil. The lack of water, combined with record high temperatures, has created a perfect environment for infectious disease. Many fear a return of cholera, another waterborne illness that killed more than 4,000 people in Zimbabwe in 2009.

Advice for travellers

Typhoid is spread through contaminated food and water such as shellfish, raw fruit or vegetables fertilised by ‘night soil’ (human faeces). Symptoms commence one to three weeks after infection and include fever,
headache, constipation, diarrhoea and enlarged liver or spleen. It is also possible to be a carrier without exhibiting symptoms. Travellers should seek specialist advice before they travel and if required should be vaccinated. A single vaccine provides protection for three years.

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