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Blog Words : Wanderlust health advice | 25 August

Wanderlust travel health update: Brazil, Nepal, Greece and more

Weekly round-up of the world's travel health news from Nomad including dengue fever in Brazil, Japanese encephalitis in Nepal and malaria in Greece

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.

Philippines – Dengue Fever

Health officials expressed concern over an upsurge of dengue cases in the Philippine capital, Manila, that has killed 70 people in the first eight months of the year. The Department of Health said dengue cases in Metropolitan Manila from 1 January – 6 August 2011 rose to 10,487 compared to 5,416 cases for the same period last year.

Pakistan (Lahore) – Dengue Fever

Twenty-four dengue cases were reported in Lahore, bringing the total number of reported dengue cases to 91. According to the Punjab Health Department, 27 fresh cases were reported from across the province. Out of these, 24 were from Lahore, two from Faisalabad and one from Muzaffargarh.

Brazil (São Paulo state) – Dengue Fever

In one month, the number of dengue cases has increased from 15,325 to 16,240. The number of deaths has not changed, remaining at 12.

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 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.

Nepal – Japanese Encephalitis

At least two people have died of Japanese encephalitis virus infection in the past two days in Kanchanpur district in far-western Nepal. Although the government has started a campaign to eradicate Japanese encephalitis from Nepal by vaccinating all against the disease, the programme hasn't been able to address all. Dozens of people still die of the disease contracted particularly through pigs and ducks. In the same month (August 2011), one more death was reported. Hence, the death toll has reached three in the district due to encephalitis.

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.

Greece – Malaria

The Centers for Disease Control and Prevention (CDC) has received a report from the GeoSentinel Surveillance system of a confirmed case of Plasmodium vivax malaria in a person who traveled to Elos and Skala in southern Greece around the last week of July (The patient was a citizen from Romania and was admitted and diagnosed in Bucharest, Romania).

The traveller had no history of travel to any malaria-endemic areas. Greece has been malaria free since 1974; however according to Greek health authorities, since June 2011, a total of six malaria cases have been reported in people with no history of travel to a malaria-endemic area. All cases were confirmed to be P vivax and occurred in the southern region (Peloponnesus) of the country, specifically in Laconia and Evoia districts.

Advice to travellers

Travellers to the affected area should seek expert advice before they travel. There are currently no recommendations to take malaria tablets for travel to Greece although travellers should ensure good bite avoidance. 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 sunrise and sunset.

Dominican Republic – Cholera

The number of deaths caused by the cholera epidemic in the Dominican Republic has reached 109; while there are 15,876 suspect cases, according to figures revealed by the health authorities. A statement by the Health Ministry reads that the intensity of the outbreak has been decreasing since six weeks ago, but the region of Gran Santo Domingo, which includes the capital city, still faces a serious epidemic situation.

Mali – Cholera

Since the notification of the first case of cholera in Youwarou, through medical tests done by the laboratory of the Public Health Research Institute (INRSP) the number of victims has increased daily. Twelve health zones have been affected, mainly in the regions of Mopti, with 363 cases including 14 deaths and in Tombouctou, with 242 cases including five deaths.

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.

Ireland – Measles

The Health Service Executive (HSE) has reported a rapid rise in measles cases, with most of them centred on the north side of Dublin. There have been 135 cases of measles in Ireland so far this year, with over 70% of the cases in the north of Dublin city.

New Zealand – Measles

The Auckland Regional Public Health Service has confirmed 108 cases of measles in the Auckland region as of the 15 August 2011. Three contacts are in quarantine and seven cases have required hospitalisation during this outbreak. Most cases have occurred in West Auckland with some spread to Central Auckland, North Shore and Manukau.

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.

All outbreak information has been sourced from Promed.

More like this

For more travel health stories see our health news pages

For travel health articles check our Dr Jane Wilson-Howarth's features here

More information on Dengue Fever can be found here: Dealing with Dengue and other mosquito-borne diseases

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