Weekly travel health update: Brazil, Vietnam, Germany, Nigeria

Weekly round-up of the world's travel health news from Nomad including an update on the E-coli outbreak in Europe, Dengue Fever in Brazil, Cholera and more

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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.

Europe – E-coli

Germany's national disease control center says a further 94 people have been sickened by the deadliest E-coli outbreak in modern history. The Robert Koch Institute (RKI) said the number of registered infections in Germany rose to 2,325 on Tuesday 7 June 2011, with those in other European countries still standing at about 100.

The institute adds the latest figures indicate that the number of new cases is declining, a sign that the epidemic might have reached its peak. But it cautions that it is not certain whether the latest decrease will continue in the coming days. It said the number of people suffering from a serious complication that may lead to kidney failure among those sickened rose by 12 to 642.

Advice for travellers

E-coli is transmitted via the faecal-oral route. There is no vaccine available for travellers to prevent E-coli infection. Travellers to Germany should practice food, water and standard hygiene precautions.

The Robert Koch Institute are advising their local population, in addition to the usual food and hygiene measures concerning the handling of fruits and vegetables, that consumption of raw lettuce, tomatoes and cucumber should be avoided in Germany until further notice.

Travellers to Germany should follow the advice of the German authorities. Returning travellers with symptoms indicative of EHEC infection (bloody diarrhoea, cramping, abdominal pain) should seek medical assistance as soon as possible and make sure they mention any recent travel history. (NaTHNaC)

Vietnam – Dengue Fever

More than 1,100 dengue cases with three deaths have been reported across Dong Nai province since the beginning of this year.

Brazil – Dengue Fever

Rio Grande do Norte state: The dengue problem in Rio Grande do Norte became even greater yesterday. The reason is that a new virus type has emerged that has not been confirmed in Rio Grande do Norte for over 30 years, so that few people are immune to this virus variety. Of the 13,265 cases reported in the state, 535 are in Santa Cruz.

Rio de Janeiro state: Despite the cooler days of autumn that reduce Aedes aegypti breeding cycles, the number of dengue cases continues to increase in Rio de Janeiro state. According to the state Secretariat of Health, there are now 117,922 people ill with dengue virus infections since the beginning of the year. The number of dengue deaths has now reached 88.

Sao Paulo state: Dengue advances in Sao Paulo state, which has now registered 32,494 locally acquired cases in the first four months of the year.

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 a headache and a rash. It lasts a few days and will resolve itself. If caught a second time it has a 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

The Ministry of Health of Indonesia has announced a confirmed case of human infection with avian influenza A (H5N1) virus. The patient is a one-year-old female from North Jakarta district, DKI Jakarta Province. She developed symptoms on 3 April 2011, and was referred to a hospital on 8 April 2011. She has fully recovered.

Advice to travellers

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

Ukraine – Cholera

On 6 June 2011, the State Sanitary and Epidemiological Service of Donetsk, Ukraine confirmed an outbreak of cholera in the port city of Mariupol on the Azov Sea, Donetsk Oblast, south eastern Ukraine. The first cases were reported on 24 May. As of 6 June, 14 cases have been confirmed (one child and 13 adults); all are recovering in hospital.

The source of the outbreak has not been determined, however, on 4 June local authorities implemented restrictions on the sale of raw, dried and smoked fish from the Azov Sea and the river Kalmius near Mariupol and prohibited fishing and swimming in the affected area.

Those travelling to Mariupol, Donetsk Oblast should practice food and water hygiene precautions and avoid all undercooked fish and shell-fish. Local authorities have prohibited swimming and fishing in the affected area.

Nigeria – Suspected Cholera

Health workers from the Abia State Ministry of Health have been drafted to Ugwueke community in Bende Local Government Area of the state, following the outbreak of cholera, which, as of 30 May 2011, had claimed 15 lives.

Advice to travellers

Precautions should be taken to ensure good food, water and personal hygiene. Hand washing is very important and the use of an alcohol based hand gel is recommended where soap and water are not readily available. If planning to visit for a long time or travelling into affected areas, travellers should consider vaccination. Vaccination involves two drinks given one to six weeks apart.

Vietnam – Hand, Foot and Mouth Disease

An infant died from hand, foot and mouth disease (HFMD) in the central Vietnamese province of Quang Ngai last Sunday. This was the second HFMD fatality in the province last month (May 2011). An estimated 200 HFMD cases have been reported in Quang Ngai since the beginning of May. The whole country has so far recorded more than 2,000 cases, 96% of which originated from the southern region.

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