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Wanderlust travel health update: UK, Cambodia, Philippines

This week's travel health news from Nomad, including the lasting-health effects of the recent typhoons in the Philippines

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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.

Indonesia – Avian ‘flu

The Ministry of Health of Indonesia has announced a confirmed case of human infection with avian influenza A (H5N1) virus. The case is a one-year-old who died on 25 August 2011. According to reports, a family member in the case's household works as a caterer, frequently processing poultry product, including slaughtering. There were also poultry in the neighbourhood but there were no reports of chicken deaths within the last 14 days.

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.

Cambodia – Dengue fever

A high level of dengue activity is continually observed in Cambodia. Official authorities have stated that 12,392 cases and 54 fatalities of dengue infection had been reported during the first nine months of 2011.

India (Hyderabad) – Dengue fever

There is a massive dengue fever outbreak in Hyderabad city with private hospitals recording a collective average of 20-30 cases a day over the last two weeks.

Pakistan (Punjab) – Dengue fever

The number of dengue fever patients in Punjab has reached 14,760 and 12,761 of these coming from Lahore.

Philippines – Dengue fever

Dengue fever cases in the National Capital Region increased by 32% and is expected to rise further, given the massive floods caused by the recent typhoons. There have been 19,432 dengue cases reported from 1 January to 24 September.

Brazil – Dengue fever

According to the totals of the Surveillance Secretariat of the Ministry of Health, about 715,000 dengue cases have been registered in the country in the first half of this 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 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.

India – Japanese Encephalitis

Encephalitis has killed hundreds of people, many of them children, in the past two months in India. Gorakhpur, in the northern state of Uttar Pradesh, has been the worst hit so far with more than 370 reported dead. The disease appears to be spreading outside the state with Delhi and Chandigarh reporting similar cases.

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.

Angola – Rabies

At least nine children aged between five and seven years have died in the province of Huambo, in the past nine months as a result of bites from suspected rabid dogs, compared with only 15 cases recorded previously in the region.

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.

UK (ex-Greece) – Legionnaires

There have been nine cases of Legionnaires' disease in the United Kingdom (UK), all linked to travel to Corfu (Greece) since the beginning of August (2011), according to the Health Protection Agency (HPA).

However, the HPA cannot rule out a UK source of the infections and is still investigating. It is advising people to be aware of the symptoms of Legionnaires' disease if they are going to the Greek island (Travax).

Advice for travellers

Travellers should follow local advice. If anyone develops respiratory symptoms while in Greece or on their return home they should seek the advice of a GP.

Estonia – Hepatitis A

The Hepatitis A outbreak that has hit southern Estonia continues to find new victims – eight new cases were registered in the country last week, bringing the total number of those infected since the beginning of the year to 80. While health authorities have not pinpointed the origin of the infection, the Veterinary and Food Board said that it was unrelated to food, food preparation or drinking water. Doctors say that the disease is now being transmitted primarily person-to-person, through contact with those infected.

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.

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