WORLDWIDE HEALTH ADVISORIES FOR THE INTERNATIONAL TRAVELER

Given the importance of tourism in the underdeveloped world, accurate news of diseases that can affect visitors is often under-reported. Here is a list of some important worldwide health advisories that may be of interest to travelers in the months to come. Some of them have occurred in developed nations including portions of Europe. The most recent outbreaks are listed first. If you are concerned, we suggest that you consult with a travel medicine clinic for updated information or your personal physician if you are traveling or considering traveling to an affected/named region. Take a look at this healthmania article to learn more about Coronavirus and other frequent traveler conditions. Here are some total healt and fitness tips which really helps you.

Germany Severe Illness caused by E.coli – Cases in other EU Countries

In May 2011, authorities were alerted to a number of cases of Hemolytic Uremic Syndrome (HUS), a severe kidney disorder, occurring in Hamburg. Cases have snce been identified in other parts of Germany including Bavaria and now cases have been reported from other EU countries including Denmark, France, Netherlands, Sweden, Switzerland, UK. HUS usually follows a gastroenteritis-like illness caused by a toxin-producing strain of E.coli, in this case EHEC strain 0104:H4. Most cases in Europe appear related to the outbreak in Germany where over 20 deaths and over 2000 cases have occurred. Cases have also occurred in North American travellers returning from Europe. VisiClear is an eye vitamin that contains the power of unique natural ingredients. Unlike other supplements available in the market, VisiClear’s formula contains naturally occurring antioxidants, read the full review at taldemiamibeach.

Bubonic Plague in Madagascar

In August through November 2014 inclusive, a significant outbreak of bubonic plague has occurred in Madagascar with cases in the capital Antananarivo. Fatality rate has been 30% to date.

Legionnaires Disease in Portugal

In November 2014, health authorities advised of Portugal’s largest ever outbreak of Legionnaires Disease in Lisbon.

Ebola Virus Disease Case in Mali

In October 2014, health authorities advised that tests confirmed the death of a 2 year old girl in Kayes was due to Ebola Virus Disease (EVD). The child developed EVD in Guinea and travelled to Kayes where she was hospitalised and died. With WHO, health authorities have implemented contact tracing and other measures.

Leptospirosis in Popular Recreational Park Malaysia

In October 2014, health authorities temporarily closed the Jeram Toi waterfall and recreational park in Negeri Sembilan State (western Malaysia) after 4 teenage children became ill with leptospirosis after swimming at the park.

Chikungunya in Tahiti (French Polynesia)

In October 2014,authorities advised the first ever cases of Chikungunya virus infection have been reported in Tahiti. Chikungunya virus infection causes high fever, headache and joint pains. Well headache can cure from migrane remedies which can definitely help to recover. It is rarely fatal but needs to be distinguished from dengue and zika virus infections also seen in French Polynesia, all of which are transmitted by mosquito bite.

Ebola Cases (Suspected) in Addis Ababa (Ethiopia) Hospitals

In October 2014, four (4) cases of suspected EVD were reported to be hospitalised in Kenya’s northern neighbour, Ethiopia (in Addis Ababa hospitals), related to persons travelling from areas affected by the ongoing outbreak in West Africa. As Kenya and Ethiopia are hubs for travellers in Africa, authorities have marked Kenya and Ethiopia as high risk countries for importation of Ebola Virus Disease (EVD) cases.

Marburg Virus Case in Kampala Uganda

A healthcare worker in Kampala died in September 2014 from Marburg Virus Disease (MVD), which is caused by Marburg virus a filovirus from the same family as Ebola.Authorities have implemented surveillance and contact tracing measures.

Ebola Virus Case in Spanish Healthcare Worker in Madrid

A healthcare worker in Madrid who contracted Ebola Virus Disease (EVD) from a patient who arrived from Sierra Leone in September 2014 is the first case of person-to-person transmission of Ebola described outside of Africa.

Ebola Virus Death in USA

Following the death in Dallas Texas of a Liberian national of Ebola Virus Disease (EVD) in October 2014, travellers should be aware that authorities have advised of increased screening measures at five international airports in USA (Atlanta, JFK, Newark, O’Hare and Dulles).

Enterovirus (EV-D68) in USA and Canada

In September 2014, an Enterovirus (EV-D68) infection has been notified with cases in 12 states (Alabama, Colorado, Illinois, Indiana, Kansas, Kentucky, Louisana, Missouri, New York, Oklahoma, Pennsylvania) and likely in other states, and also in Canada: Toronto (Ontario), Alberta, British Columbia and likely other provinces. Symptoms include fever, runny nose, cough, body and muscle aches. There have been cases of paralysis with polio-like illness.

Chikungunya Virus Infection in Samoa and American Samoa

In July 2014, local transmission of chikungunya virus infection was reported for the first time in Samoa and American Samoa. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue virus infection, both of which are transmitted by mosquito bite. The concern is that the infection is now becoming widespread in the South Pacific Islands.

Ebola Virus in Democratic Republic of Congo

In August 2014, the seventh recorded outbreak of Ebola Virus Disease (EVD) was reported from DRC and continues through September 2014. It is unrelated to the outbreak described below. The index case was a pregnant woman who butchered a bush animal that had been killed and given to her by her husband. She subsequently died, as did health care workers who cared for her as well as relatives and persons who helped with funeral activities.

Ebola Virus in West Africa

Since the outbreak of Ebola commenced in early 2014, there has been, by end August 2014, over 3000 cases of Ebola virus disease (EVD) with over 1500 deaths. The outbreak continues through August. Quarantine zones have been set up in areas of high transmission, including some cities. The affected countries (Guinea, Liberia, Nigeria and Sierra Leone) continue to report new cases. A case (fatal) hospitalised in Lagos, Nigeria, travelled to Nigeria from Liberia via Lome (Togo) and Accra (Ghana) while unwell with EVD.

Chikungunya Virus Infection in Tonga

In April 2014, local transmission of chikungunya virus infection was reported for the first time in Tonga. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue virus infection, both of which are transmitted by mosquito bite. The concern is that the infection will become widespread in other South Pacific Islands. MERS-CoV Case Dies in

Zika Virus Infection in Cook Islands

Zika virus infections were reported from Cook Islands in March 2014. This virus was likely introduced from French Polynesia where it has been causing outbreaks. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue. Polio in Iraq

In March 2014, the first case of polio since 2000 was confirmed in a 6 month old boy who developed paralysis in the previous month. He had not been immunised against polio. Laboratory tests indicate the poliovirus was similar to the strain causing the ongoing Middle East outbreak.

Ebola Outbreak in Guinea

In February 2014, an outbreak of hemorrhagic fever later identified as Ebola, occurred in Southern Guinea and is continuing through March and likely April. Ebola is a virus infection that has a high case fatality rate (up to 90% but may be as low as 25%) and can be spread by direct contact with infected blood/secretions. Patients with Ebola may cross the border to enter Sierra Leone and Liberia for medical care.

Zika Virus Infection in Easter Island

Zika virus infections were reported from Easter Island in March 2014. This virus was likely introduced from French Polynesia where it has been causing outbreaks. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue.

Zika Virus Infection in French Polynesia & New Caledonia

Zika virus infection has been reported from New Caledonia. Cases have also been described from Tahiti. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue.

Chikungunya Virus Infection in Caribbean

In December 2013, local transmission of chikungunya virus infection was described for the first time in the Caribbean. The cases were detected on the island of Saint Martin. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue virus infection, both of which are transmitted by mosquito bite. The concern that the infection will spread to other Caribbean islands has proven well-founded with cases now being reported from other Caribbean islands.

Measles in Travellers

Measles transmission occurs in many overseas destinations including tropical countries. Measles cases in returned travellers can lead to outbreaks in their home country upon return. Travellers have returned from some popular destinations in recent times (e.g. Bali) and have subsequently been diagnosed as having measles. Travellers should know their measles immune-status and check with their doctor to determine whether they require measles vaccination.

Japanese Encephalitis in Brunei Darussalam

Japanese Encephalitis cases were reported in Brunei in October 2013, with cases reported from Belait, Tutong and Brunei-Muara Districts. This mosquito borne virus infection has never previously been reported from Brunei.

Cholera cases in Mexico

An outbreak of cholera in October 2013 has led to cases in the states of Hidalgo, Mexico, San Luis Potosi, Vera Cruz and Distrito Federal. Government authorities are on alert. The strain of cholera is similar to that circulating in Cuba, Haiti, Dominican Republic in recent years.

Influenza A (H7N9) in China

On 31 March 2013 China notified three laboratory confirmed cases of Influenza A (H7N9) and since then a number of cases have been notified with over 100 cases notified as at late April 2013.

Liver Fluke in Travellers Returning from Bali

A recent report advises of 6 travellers diagnosed with liver fluke (Fasciola) infection that was acquired in Bali. Initially some travellers were diagnosed with liver cancer and one had major surgery for that. Infectious diseases consultation led to the diagnosis. The most likely mode of acquisition was from eating fresh or under cooked water plants including watercress salad.

Chikungunya in Papua New Guinea

Outbreaks of dengue fever and Chikungunya, both transmitted by mosquitoes, have been reported in recent years, with the first recorded outbreaks of Chikungunya being in 2012, the first descriptions coming from West Sepik (Sundaun) Province. Both virus infections are transmitted by daytime biting mosquitoes so travellers should take steps to avoid mosquito bites.

Contaminated acai juice risk for Chagas Disease

A recent outbreak of American trypanosomiasis (Chagas Disease) was reported from Para state Brazil. Contaminated fruit juices made from berries of acai and bacaba palms are thought to be the source. Eating contaminated food and drink was discovered to be a way of acquiring the disease in 2005. Adequate preparation of acai is required to avoid contamination.

Unusual parasitic illness in travellers returning from Malaysia

An unusual parasitic illness called Sarcocystis has been described in a few French travellers returning from Tioman Island in the middle of 2011. This illness causes a variety of symptoms, most prominent being fever, muscle pain, abdominal pain, dizziness, diarrhoea and generalised symptoms. There could be treatment for dizziness and other symptoms to resist or end the illness or infection. Symptoms usually occur a few weeks after exposure but tests may not become abnormal until over a month after exposure.

Ebola virus outbreak confirmed in Uganda & New Outbreak DRC

In July 2012 an outbreak of Ebola virus infection was confirmed in western Uganda (Kibaale District) with at least 20 cases (14 deaths) by late July. As at mid-August there have been 24 probable and confirmed cases cases (16 deaths). An isolation facility in Mulago Hospital is available. Ebola virus outbreaks occur episodically in Uganda. Risk for travellers is low but all travellers to Uganda should be on alert until the outbreak is contained. On 17 August 2012, WHO was notified of an Ebola outbreak in Democratic Republc of Congo (10 suspected cases and 6 deaths). See Travel Health Reports for further information and updates.

Sleeping Sickness in Tourists

Two European travellers have became unwell from Sleeping Sickness (Human African Trypanosomiasis or HAT) following visits to Masai Mara National Reserve in Kenya. This has focused attention on a parasitic illness (fatal if untreated) that most travellers to Africa rarely consider, until they get bitten by the insect that transmits the infection – the tsetse fly (Glossina species). WHO reports that, from 2000 to 2010 inclusive, there have been 94 cases of HAT reported in countries outside the endemic area. By far the largest percentage of these reported cases of East African Sleeping Sickness (caused by the parasite Trypanosoma brucei rhodesiense) has been in tourists, who have often acquired it while on short trips especially to the Serengeti (Tanzania), but also to rural areas and game parks in Kenya, Malawi, Tanzania, Uganda and Zambia. A case from Zimbabwe was in a park ranger.

Greece and Malaria Cases

Malaria cases (P.vivax) are still occurring in Greece with at least 11 more locally acquired cases reported since June 2012. Originally, by October 2011, locally acquired P.vivax malaria cases were described from Evrotas (Lakonia District), Eastern Attiki, Evia, Viotia, Larissa, with most cases being from rural areas of Evrotas. Since then cases have been documented from other towns. While malaria cases have been described in persons entering Greece from malaria endemic areas, some cases have been acquired by persons who have not travelled to a malaria area, indicating that they acquired malaria in Greece. Travellers are advised to be vigilant with anti-mosquito measures and consider malaria in cases of fever.

South Africa & Yellow Fever Requirements for Travel from Zambia

In the past there has been some debate as to whether the western provinces of Zambia are included in the yellow fever endemic zone. World Health Organisation advises that it is not. However some maps from other (usually older) sources include this region within the endemic zone. Since the Yellow Fever outbreak in Uganda, East African and other African countries have been on high alert. South Africa authorities proclaimed that will be requiring a valid Yellow Fever Vaccination Certificate from all persons travelling from Zambia to South Africa from 1 July 2011, unless there is a medical contraindication. See the personalised Travel Health Advisor Health Report for further information. This requirement was reversed on 21 July 2011 but appears to have been reinstated effective from 1 October 2011 –

Hepatitis E in France from Uncooked Pig Liver Sausages

An outbreak of Hepatitis E has been reported in the first quarter of 2011 from Marseille in south eastern France, with most cases occurring from the end of February 2011. Of the initial 11 cases, 10 were males. Cases are thought to have been associated with consumption of uncooked pig liver sausages. Hepatitis E is a virus infection which has an incubation period of 2-9 weeks. With diagnosed illness there is a reported mortality rate of 1-4%. Infected pigs (because virus replicates in their liver) are a reservoir for the virus. Following this discovery, health authorities now require that producers label pig liver sausages with a warning advising the sausages must be cooked thoroughly.

Malaria in Swaziland

April 2011, health authorities advise of a malaria outbreak in the Sidvwashini region of Northern Hhohho and surrounding areas of Masutaneni, Ngonini and Nya-katfo. It is thought cases relate to travellers infected with malaria returning from neighbouring malaria countries. Local transmission in Swaziland is thereafter likely due to the presence of Anopheline mosquitoes in Swaziland.

Legionnaires’ Disease Outbreak in Dundee Scotland

As at 25 March 2011, health authorities advise of more than 60 persons having an illness thought to be Legionnaires’ Disease after suspected exposure to the Legionella bacterium at the Landmark Dundee four star hotel. The hotel’s leisure centre is the focus of public health investigations.

East Africa on Yellow Fever Alert

The Yellow Fever outbreak in Uganda has placed health authorities in Kenya and Tanzania on alert. Travellers should be aware that immigration authorities will be checking Yellow Fever vaccination status upon entry into both Kenya and Tanzania, with the possibility that travellers without a valid Yellow Fever Vaccination Certificate may be vaccinated “on the spot” upon entering Tanzania or Kenya. Reports indicate that authorities are requesting valid Yellow Fever vaccination certificates for entry into Zanzibar. Ackee Fruit Poisoning in Jamaica

Health authorities, February 2011, advise of an increase in deaths and sickness in Jamaica in the last 3 months from ackee fruit poisoning. Ackee is a fruit related to the lychee and longan. It is widely used in local cuisine. Illness is caused by a substance in the fruit (especially unripe fruit) called hypoglycin which cause dangerously low blood glucose and an illness associated with abdominal pain, diarrhea and often severe vomiting. There are no reports of travellers being affected to date but travellers should be aware to report any episodes of severe gastroenteritis or drowsiness. See the personalised Travel Health Reports and Fact Sheets for further information.