Weekly travel health update from Nomad

This health advice is provided by Nomad who are offering Wanderlust readers a 10% discount on equipment online and in store, including 10% off travel vaccinations.

April 15, 2011

India – Malaria

Malaria claimed 185 lives in the state from April 2010 to March 2011, which is the highest annual number of casualties from the disease reported in the last seven years. Of the 185 casualties, Mumbai alone accounted for 137.

Swaziland – Malaria

The National Malaria Control Programme (NMCP) has declared a malaria outbreak in the Sidvwashini area of Northern Hhohho and surrounding locations at Masutaneni, Nya-katfo, and Ngonini. Over 20 malaria cases have been detected in the area through community screening and have been referred for treatment to the local health facility.Although investigations are still ongoing, the outbreak was likely due to someone who travelled outside the country and became infected after being bitten by malarial mosquitoes. When the traveller returned to the community, he/she was bitten by local mosquitoes, which transmitted malaria to surrounding neighbors.

Mosquitoes are common in the Sidvwashini area due to stagnant water related to agricultural operations.

Torres Strait Islands, Australia – Malaria

Health authorities say they have detected another case of malaria in the Torres Strait. Four people became ill on Saibai and Dauan islands last month and authorities were optimistic the outbreak had been contained. But a fifth case of malaria has now been detected.

Advice to travellers

Travellers to the affected area should seek expert advice before they travel regarding the most suitable form of malaria tablets for their trip and medical history (if tablets are required). 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.

Maldives – Dengue

The Maldives is battling a growing epidemic of dengue fever which is believed to have contributed to the deaths of at least five people this year. More than 300 cases were reported in the first two months of 2011, compared with 737 cases and two fatalities reported last year. Many cases have been reported in Male’, although most of the fatalities have been islanders. One patient died during transit to Indira Gandhi Memorial Hospital (IGMH), and the more serious cases have disproportionately affected children.

Bolivia – Dengue

Santa Cruz - So far this year, 1,499 confirmed and 4,299 suspected dengue cases with 11 deaths have been reported in Santa Cruz. Of the deaths, eight are from the urban area and three from the provinces.

Paraguay – Dengue

Paraguay reports 17,467 suspected dengue cases so far this year. In less than one month, the positive dengue cases increased from 2,495 to 3,898. There have been more than 20 deaths.

Brazil – Dengue

Rio de Janeiro municipality - The municipality has tallied 18,829 dengue cases with 11 deaths.

Rio de Janeiro state - The state of Rio has now registered 35,274 dengue cases since January 2011, according to the state Secretariat of Health.

Londrina, Parana - Londrina has now confirmed 3,518 dengue cases since the beginning of the year. This number is an increase of 38 per cent of confirmed cases in relation to the previous week.

Rio Grande do Norte - From the beginning of the year a total of 6,643 dengue cases were tallied, of which 1,470 were confirmed.

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, rash. It lasts a few days and will resolve itself. If caught a second time it has a two per cent chance of developing into Dengue Haemorrhagic fever which can be fatal. There is currently no vaccine available and therefore insect bite avoidance is essential.

Australia – Melioidosis

The Health Department is warning about the ongoing risk posed by a potentially deadly soil disease, which has infected 56 people in the Northern Territory this wet season. Melioidosis claims a number of lives each year in the Territory but its impact has been more significant in the past two wet seasons with a record number of infections, including some in Central Australia.

Advice to travellers

Melioidosis is a disease caused by a bacteria that resides in soil and warm waters of rivers, seas and plantation paddy fields. It is acquired mainly via skin penetration but also by the respiratory route and by drinking contaminated water. Symptoms may include pain in chest, bones, or joints; cough; skin infections, lung nodules and pneumonia.

Travellers to affected areas (mainly Asia and Australia) should avoid bathing or walking in rice paddies, still waters, plantations and other water logged soils other than when wearing protective garments.

Bangladesh – Avian ‘Flu

There has been a confirmed new case of human infection with avian influenza A(H5N1) virus. The case is a two year old male from Kamalapur, Dhaka. He developed symptoms on March 1, 2011. He has since made a full recovery.

Cambodia – Avian ‘Flu

There has been a confirmed case of human infection with avian influenza A(H5N1) virus in an 11-year-old girl from Steung Trang district, Kampong Cham Province. She developed symptoms on March 22, 2011, was initially treated by local villagers with no effect and was admitted to a local hospital on March 29, 2011.

Further treatment at the local hospital was ineffective, and she was referred to a regional hospital where she died within four hours of admission on March 31, 2011. There have been reports of poultry die-offs in her village. The girl is the 14th person in Cambodia to become infected with the H5N1 virus and the 12th to die from complications of the disease. All four cases of H5N1 infections in humans in Cambodia this year [2011] have been fatal.

Egypt – Avian ‘Flu

Four new confirmed cases of human infection with avian influenza A (H5N1) virus. The first case is a 20-year-old female from Behaira Governorate. She was in a critical condition and died on March 28,2011. The second case is a two year old female from Menofeya Governorate. She is still undergoing treatment and is currently in a stable condition. The third case is a 55-year-old female from Behaira Governorate. She recovered and was discharged. The fourth case is a one year old male from Fayoum Governorate. He is still undergoing treatment and in a stable condition.

Avian Flu is spread through close contact with infected poultry. Avoid contact 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.

Sudan - Leishmaniasis

Cases of visceral leishmaniasis, or kala azar, in Gedaref [Al Qadarif] state, have increased to more than 5,550 cases. The total number of deaths is now more than 142 a year, increasing by 10 to 15 deaths a month, and medical sources fear that the disease is turning into a pandemic.

Advice to travellers

Visceral Leishmaniasis is spread by the bite of an infected sandfly. It is characterized by high fever, substantial weight loss, swelling of the spleen and liver, and anaemia. If left untreated, the disease can have a fatality rate as high as 100% within two years.

Bite avoidance is essential. Cover all exposed skin with DEET and treat clothing with permethrin. Sleep under a mosquito net whenever possible.

Madagascar – Food poisoning

At least 14 people have died in Madagascar from poisoned fish. Around 120 other people are seriously ill, with some in hospitals, after ingesting the toxic sardines which had been caught in the south-western town of Toliara. Samples of the fish have been sent for analysis. In previous food poisoning incidents the contaminated sardines had eaten poisonous seaweed, which now proliferates on local reefs. Officials have blamed global warming and changed sea conditions for the incident.

Scotland – Legionnaires

The Landmark hotel's leisure club and spa have been off limits since March 17, 2011 after staff and guests reported feeling unwell with flu-like symptoms that sparked testing for Legionella infection. A total of 112 people who work in or have visited the Landmark are known to have had a flu-like illness with respiratory infection. One person remains in Ninewells Hospital, the only confirmed case of legionnaires' disease in a person who visited the hotel's leisure club. There are no further confirmed cases.

Venezuala – Influenza

At least 712 positive cases of influenza A/H1N1 virus infection and eight deaths were recorded in the country during the past three weeks.

Advice to travellers

Influenza is spread by droplet infection. You are at higher risk in crowded situations such as on public transport, markets etc. Ensure good hand washing and consider vaccination before you travel to an area especially if you are in the high risk groups (defined by your GP) or if travelling into an outbreak situation.

Pakistan – Poliomyelitis

The World Health Organization (WHO) have declared four new cases of wild poliovirus type 1 have been reported in Pakistan, bringing the total for 2011 to 24.

Nigeria – Poliomyelitis

Four cases of the wild polio virus have been recorded in Kebbi and Jigawa States, in a shocking reversal that underscores the continued threat posed by the disease in Nigeria. The new cases bring to five the number of cases of the wild poliovirus, which cripples and even kills children, recorded so far in the country in 2011.

Advice to travellers

Transmission of polio occurs primarily through person to person contact and is spread mainly through the faecal-oral route. It is found in areas where sanitisation is poor. In rare cases milk, and other food stuffs, contaminated with faeces have been reported as the vehicle for infection. Travellers should ensure good food and water hygiene – seek advice before you travel. Travellers to affected areas should also ensure their vaccinations are in date prior to travel. Boosters lasts ten years.

Zimbabwe – Cholera

Three people have died of cholera while 122 cases have been reported in Chiredzi District over the past week. Two people died at home in Rupang-wana communal lands near the border with Manicaland province while the other person died at Chiredzi District Hospital. Sources say the outbreak might have been caused by people who came from Manicaland Province where cases of the disease have been reported.

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.

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