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Weekly travel health update from Nomad

Weekly round-up of the world's travel health news from Nomad

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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.

Thailand – undiagnosed deaths

The deaths of seven tourists – including an elderly British couple – have been connected to a toxic bed bug pesticide found in the Thailand hotel they all visited.

According to Thai authorities, the elderly couple suffered fatal heart attacks within minutes of each other, though family members say the couple had no history of heart problems. Thai officials were quick to attribute the deaths to "toxic seaweed" that was being sold at a nearby bazaar, but the persistent campaigning of one victim's father, over what he alleges is a "cover up", has sparked extensive probes from the media.

An investigation aired by New Zealand's 60 Minutes program found small traces of the insecticide Chlorpyrifos -- used to kill bed bugs -- in the hotel room where the female New Zealander was staying. The fact that Chlorpyrifos was found three months after the young woman's death, and after the room was cleaned, suggests there was a high concentration of the toxin present while she was staying there.

The governor of Chiang Mai, ML Panadda, claimed the tourists' deaths were just bad luck: "I do believe coincidence ... it is a very bad occasion and such bad luck for that hotel." The Downtown Inn continues to operate.

Brazil – Dengue Fever

Sertaozinho, Sao Paulo state: 885 dengue cases have been registered in the first five months of 2011, almost double that of last year.

Sorocaba, Sao Paulo state: From the beginning of 2011, Sorocaba has recorded
1,034 dengue cases.

Rio de Janeiro city, Rio de Janeiro state: The Rio de Janeiro municipality registered 4,330 new dengue cases in the last seven days, for a total of 34,734 confirmed cases.

Natal, Rio Grande do Norte state: The Natal municipality recorded 2,859 dengue cases.

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

USA – Bubonic plague

A 58-year-old man in New Mexico was recently treated for bubonic plague, the first case of the disease to surface in 2011. Doctors said the man was most likely bitten by a flea carrying the plague bacteria, the most common method of transmission to humans.

Only about 10 to 15 people in the USA catch the illness each year, typically in western states. It is particularly prevalent in New Mexico because the state has a high population of both rodents and fleas.

Advice to travellers

In plague-endemic areas travellers should avoid contact with rats and should be advised on how to store and dispose of food product to prevent attracting rodents. Avoid flea bites where possible by using DEET on skin and premethrin on clothing. Travellers should also be discouraged from camping and handling rodents both dead or alive.

Pneumonic plague can also be spread via the respiratory route so travellers should avoid close contact with people in affected areas especially in crowded situations. Consider taking an anti bacterial handwash such as H2ONO.

Indonesia (Java) – Rabies

A 16-year-old youth was reported to have died of a suspected rabies-related disease at Buleleng Regional Hospital, adding to the island's 147 victims of rabies since the deadly disease emerged in November 2008. The victim was rushed to hospital when he exhibited
symptoms of rabies such as difficulty breathing, hydrophobia, and a sore throat. The hospital director said that the patient's family stated the boy had been bitten by a dog in his village in Banjar about a year ago. I Nyoman Sutedja, head of the province's Health
Agency, said that dog bite cases in Bali remained high, with 130 cases per day despite the province's ambitious target to eliminate its rabies outbreak by the end of 2012.

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.

Indonesia – Avian ‘Flu

The Indonesian Ministry of Health has announced a confirmed case of human infection with avian influenza A(H5N1) virus. The case is an eight year old female from West Jakarta district, DKI Jakarta Province. She developed symptoms on April 1, 2011 and died on April 11, 2011. Of the 177 cases confirmed to date in Indonesia, 146 have been fatal.

Advice to travellers

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.

Kenya – Yellow Fever

The government has dispelled fears over the presence of yellow fever in Baringo and the country in general. Public health minister Beth Mugo said on Wednesday (May 4, 2011) that currently there are no laboratory confirmed cases of the disease, allaying fears on the
prevalence of the fever-disease.

"I assure the general public that those intending to visit the country that there are no known cases that meet the case definition standard or are laboratory confirmed to be yellow fever," she told journalists at a media briefing at her Afya House office.

Uganda – Ebola

The deadly Ebola hemorrhagic fever has broken out in Uganda, killing one person and leaving over 30 others being monitored by health officials, the ministry of health has announced.

The epicenter of the outbreak is in the central Ugandan district of Luwero, located about 50km north of the capital Kampala.

A 12-year-old girl in Zirombwe Sub-county developed symptoms of ebolavirus infection, and when she was admitted at a military hospital in the district, laboratory tests confirmed that it was an ebolavirus infection. The girl died on May 6, 2011; around 30 people with whom she had contact with are being asked to avoid contact with the public, as health officials monitor them for 21 days.

This viral subtype has a human case fatality rate of 60%, meaning that it will kill 60% of infected people. The ministry urged the public to avoid direct contact with body fluids of a person suffering from ebolavirus infection by using protective materials like gloves and
masks. The public is also urged to bury people who have died of ebolavirus infection immediately and to avoid feasting and funerals.

Advice to travellers

Ebolaviruses are highly contagious and cause a range of symptoms including fever, vomiting, diarrhoea, generalized pain or malaise, and in many cases, internal and external bleeding.

They are transmitted through excreta from rodents and from infected patients in conditions of poor hygiene. Travellers should avoid travelling to area affected by an Ebola outbreak,
however if it is unavoidable, should follow Government guidelines.

Cameroon – Cholera

An ongoing cholera outbreak has been reported in the centre of the country. Littoral and the South West regions are the worst affected. Around 5,600 cases and 179 deaths have been reported by a charitable organisation working in the area.

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.

Canary Island – Measles

The Canary Islands are suffering the worst measles outbreak for the past decade. The 25 confirmed cases that have occurred in the last month were diagnosed in Tenerife. This condition initially occurred in a 14-month-old baby living in Santa Cruz.

Switzerland – Measles

The number of cases of measles in Switzerland has risen to 337 so far this year (2011). The outbreak is already four times higher than for the entire year of 2010, likely due to cases spreading from bordering France, federal government officials say. Nearly half of the cases were recorded in Geneva, with another 78 cases in the Canton of Vaud.

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.

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