Novel Corona Virus 2019-nCoV - SARS-CoV-2 (COVID-19)
In January 2020, health authorities notified cases of pneumonia acquired in Wuhan (Hubei Province of China). The exact cause of the illness had not been determined as at 7 January 2020, but was soon thereafter shown to be due to a novel coronavirus (initially named 2019-nCoV), closely related to SARS virus. Travellers who had visited Wuhan were advised to report any unusual respiratory illness to their regular health provider although, by late January 2020, almost all provinces in China had notified a case, so risk was likely already countrywide by then. Cases had been detected in so many countries by February 2020, that an eventual global spread is inevitable. In February 2020, global health authorities and expert virologists advised that, because this novel coronavirus is so closely related to the SARS coronavirus, it would henceforth be referred to as SARS-CoV-2, and the illness that it causes will henceforth be referred to as COVID-19. See travel health reports for further information. See our Fact Sheet (Novel Coronavirus 2019-nCoV - SARS-CoV-2).
Sabah - Polio Cases
In December 2019, then later in January 2020, cases of paralytic poliovirus infection were notified from Sabah (Kinabatangan and Sandakan in the north-east and Tuaran in the West). All travellers are reminded to be up to date with their polio vaccination. See travel health reports for further information.
Bali - Legionnaires' Disease
In 2019, Australian health authorities have been notified of cases of Legionnaires' Disease acquired in Bali. In 2010, West Australian health authorities reported cases of severe pneumonia caused by Legionnaires' Disease in travellers returning from Bali. Most cases had stayed at the same hotel in Kuta Beach (The Ramayama Resort & Spa). On 23 December 2019, West Australian health authorities released another travel health advisory on Legionnaires' Disease linked to exactly the same resort. See travel health reports for further information.
Qatar - MERS-CoV Death
In December 2019, a woman in Doha, with underlying risk factors for infection, died of Middle East Respiratory Syndrome-Corona Virus (MERS-CoV). Asymptomatic related cases were detected. Risk to travellers is thought to be minimal at this stage, but travellers returning from the Middle East with respiratory illness that appears different to a standard "cold" are advised to report early to medical care. For more detail see our Fact Sheet on MERS-CoV.
Mali - Yellow Fever Outbreak
In early December 2019, health authorities declared a yellow fever outbreak in two regions of Mali. See travel health reports and our fact sheets for further information.
Philippines - Paralytic Polio Caused by Vaccine Derived Poliovirus Strains
Paralytic polio caused by vaccine derived poliovirus strains has been documented in Philippines since September 2019, and coincides with detection of such strains in sewage collected in a locations including Manilla. All travellers to Philippines should ensure they are in date for polio vaccination. See travel health reports for further information.
Measles in Travellers to New Zealand and Pacific Island Countries
Measles cases are continually encountered in travellers returning to Australia and New Zealand, but in 2019, troublesome measles outbreaks are ongoing in New Zealand and some Pacific Island countries. All travellers should know their measles immune status. If not immune, or uncertain about immune status, all travellers should consult their regular medical practitioner to discuss measles vaccination. If in doubt, or non-immune, measles vaccination should be undertaken before travel.
Philippines - Pufferfish Poisoning
In August 2019, a local outbreak of 17 cases of illness, 2 needing intensive care management, was reported from the Philippines. This outbreak of a potentially rapidly fatal poisoning is a reminder that all travellers should take great care with their food choices. See travel health reports for further information.
Philippines - Fake Rabies Vaccine and Immunoglobulin
In 2019, fake rabies vaccines and rabies immunoglobulin (RIG) purporting to be well known brands are the subject of major concern. All travellers who may be at risk of rabies should have pre-exposure prophylaxis prior to travel to Philippines. See travel health reports for further information.
Yellow Fever Outbreak - Cote D'Ivoire
In August 2019, medical authorities advised of a yellow fever outbreak in Cote D'Ivoire, with cases in Abidjan. See travel health reports for further information.
Serious Fungal Infection in Italian Travellers - Mexico
In April 2019, Italian medical authorities advised of mutiple cases of a serious fungal infection (histoplasmosis) in a group of travellers recently returned from Mexico. See travel health reports for further information.
Extensively Antibiotic Resistant (XDR) Gonorrhoea - United Kingdom
In January 2019, health authorities advised of two cases of extensively resistant gonorrhoea (caused by the bacterium often called "gonococcus"). Both cases had sexual contact while in Ibiza, Spain. There was also sexual contact after return to UK whilst infected. Prevention is by avoiding unprotected sexual intercourse. See travel health reports for further information.
Yellow Fever Outbreak in Nigeria - Status
As of January 2019, vigilance is advised concerning an ongoing Yellow Fever outbreak in Nigeria. Almost 4000 cases have been notified since the onset of the outbreak in 2017. Travellers who are unable to have yellow fever vaccination should reconsider their travel plans. See travel health reports and our fact sheets for further information.
Measles in Travellers
Measles cases are continually encountered in travellers returning to Australia and New Zealand. Travellers may encounter measles in any country, even in places thought to be safe such as Japan, North America and Europe. All travellers should know their measles immune status. If not immune, or uncertain about immune status, all travellers should consult their regular medical practitioner to discuss measles vaccination.
Poliomyelitis in Papua New Guinea
In June 2018, it was confirmed that a case of poliomyelitis had occurred in a 6 year old child who attended a health centre in Morobe Province (capital city is Lae), and that poliovirus was circulating in the community. The child presented with lower limb weakness. Travellers should be up to date with polio immunisation and take care with food/water hygiene. See travel health reports and Fact Sheets for further information.
Infections With Another Monkey Malaria Species in Sarawak
Researchers who previously described Plasmodium knowlesi infections in Malaysian Borneo have now reported cases of infection due to Plasmodium cynomolgi, formerly thought to only be a significant infection in non-human primates. See travel health reports and Fact Sheets for further information.
Meningococcal Outbreak in Fiji
An outbreak of meningococcal infection (Serogroup C) was declared by health authorities in March 2018. Most cases were in children aged less than 15 years of age. Travellers are reminded that children travelling to Fiji should be in date for meningococcal C vaccination. See travel health reports for further information.
Yellow Fever Outbreaks in Brazil - Status
As at end February 2018, vigilance is still advised concerning Yellow Fever outbreaks in Brazil. Since 1 July 2017, over 700 cases with more than 230 deaths have been reported, an increase compared to the same time period last year. Cases have now been reported in urban areas of Sao Paulo city. Cases have also occurred within 100 kilometres from Rio de Janeiro city. Travellers who are unable to have yellow fever vaccination should reconsider their travel plans. See travel health reports and our fact sheets for further information.
Diphtheria Cases Rise in Jakarta
In December 2017 Indonesian authorities advised of an Outbreak Response Immunisation (ORI) campaign in Jakarta following almost 600 cases of diphtheria having been notified for the year (an over 40% increase on 2016). Travellers are reminded to be in date for diphtheria vaccination. See travel health reports and our fact sheet for further information.
Yellow Fever Outbreaks in Brazil - Status
As at end November 2017, vigilance is still advised concerning Yellow Fever outbreaks in Brazil. Cases have now been reported in urban areas of Sao Paulo city. Travellers who are unable to have yellow fever vaccination should reconsider their travel plans. See travel health reports and our fact sheets for further information.
Pneumonic Plague Outbreak in Madagascar
By end November 2017, local authorities reported that over 2300 cases of plague with over 1700 cases of pneumonic plague with over 200 deaths had occurred since August 2017, with cases occurring in large cities including the capital Antananarivo and the main seaport of Toamasina. Seychelles authorities have restricted travel to and from Madagascar until the outbreak settles. Other countries also have measures in place to screen travellers coming from Madagascar. Travellers departing Madagascar are being screened to detect any traveller with possible plague. There is no vaccine currently available. See travel health reports for further information.
Chikungunya Outbreaks in France and Italy
In August and September 2017 France and Italy reported cases of Chikungunya virus infection that were locally acquired. Cases have occurred in Rome. Travellers are reminded to be vigilant with anti-mosquito measures wherever they travel. See travel health reports for further information.
Cholera Outbreak in Kenya
In June and July 2017 two cholera outbreaks affected attendees at meetings in Nairobi County. Cholera outbreaks have been increasingly reported in Kenya in many areas of Kenya since late 2016. Care with food and water and personal hygiene are important for prevention. Vaccination may be indicated for travellers. See travel health reports for further information.
Fatal Japanese Encephalitis in an Australian Traveller
In June 2017 a fatal case of Japanese Encephalitis (JEV) was reported in an Australian traveller returned from Thailand. This is a very rare occurrence, with few cases ever having been reported in Australian travellers. Care with antimosquito measures and consideration of vaccination with JE vaccine are the main forms of protection. See travel health reports for further information.
Eosinophilic Meningitis in Hawaii
The recent report of cases of eosinophilic meningitis on Maui has increased the likely risk areas in Hawaii for angiostrongyliasis. Travellers should be aware of protective measures. See travel health reports for further information.
Yellow Fever Outbreaks in Brazil - Status
As at June 2017, vigilance is still advised concerning Yellow Fever outbreaks in Brazil, although there are signs that the outbreak that commenced in late 2016 is declining. Rio de Janeiro city has been added to the areas for which vaccination is recommended. Travellers who are unable to have yellow fever vaccination should reconsider their travel plans. See travel health reports and our fact sheets for further information.
Yellow Fever Outbreaks in Brazil - Status
As at 27 March 2017, Yellow Fever outbreaks remain a problem in Brazil. Monkey deaths in Sao Paulo State have led to vaccination recommendations being expanded. There have been over 400 human cases in Brazil since the current outbreak commenced with a death rate of approximately 30%. Countries in the Americas (that would nor normally request it) are requesting a valid Yellow Fever Vaccination Certificate for travellers who have been in Brazil. Travellers are reminded to check yellow fever vaccination requirements for travel. See travel health reports and our fact sheets for further information.
Yellow Fever Outbreaks in Brazil - New Areas Involved
As at early March 2017, Yellow Fever outbreaks remain a problem in Brazil. In January 2017, health authorities reported the outbreak in Minas Gerais state has spread to neighbouring states of Espirito Santo and Bahia. Cases have also been reported from Sao Paulo state. This is the worst yellow fever outbreak in Brazil since records have been kept (since 1980). Travellers are reminded to check yellow fever vaccination requirements for travel. See travel health reports and our fact sheets for further information.
Yellow Fever Outbreak in Brazil
Yellow Fever outbreaks remain a problem in Brazil. In January 2017, health authorities reported over 100 suspected cases of yellow fever in the state of Minas Gerais. Death rate in laboratory confirmed cases was over 50%. The previous outbreak in Minas Gerais (2002-2003) caused over 60 cases with a death rate of almost 40%. Travellers are reminded to check yellow fever vaccination requirements for travel. See travel health reports and our fact sheets for further information.
Legionnaires Disease cases in Spain
In October 2016, a cluster of cases of Legionnaires Disease was notified from Catalonia (North East Spain), related to a hotel in Salou (Tarragona). Seven cases were originally identified with 1 death. Outbreaks in travellers linked to hotels have occurred in Spain in the past. See travel health reports for further information.
Diphtheria cases in Venezuela
In late September 2016, Venezuela authorities advised of 13 cases of diphtheria notified in San Antonio (Sifontes municipality) in Bolivar State (North Central Venezuela). Travellers are reminded to be in date for diphtheria vaccination. See travel health reports for more information.
Zika Virus cases in Singapore
In late August 2016, over 50 cases of Zika virus (ZIKV) infection were documented in residents of Singapore who had no recent history of travel to a Zika virus area. See travel health reports and our Fact Sheets for further information.
Zika Virus cases in Florida USA
In late July 2016, 4 cases of Zika virus (ZIKV) infection were documented in residents of Florida who had no recent history of travel to a Zika virus area. The areas concerned are close to Miami. See travel health reports and our Fact Sheets for further information.
Yellow Fever Vaccination - Important New Requirements for Travellers
The World Health Organisation (WHO) advises that, from 11 July 2016, a single yellow fever vaccination is valid for life and so international travellers do not require a booster dose or revaccination providing a valid certificate of yellow fever vaccination is carried by the traveller. See our special new Fact Sheet.
CDC - Zika Virus Does Cause Microcephaly and Brain Defects in Foetus
In April 2016, the USA CDC (Centers for Disease Control and Prevention), following publication of an article in the New England Journal of Medicine that reviewed the available evidence, issued a statement that concluded, after careful review of existing evidence, Zika virus infection in pregnancy is a cause of microcephaly and other severe foetal brain defects. See our travel health reports and Zika Virus Fact Sheet for further information and advice.
Correct Information on Insect Repellents
In view of the concerns about Zika virus and other mosquito-borne infections, and in response to queries from subscribers, we advise the following:
Of the personal insect repellents on the market in Australia, the peak USA public health body, the Centers for Disease Control & Prevention (CDC), advises that the only repellents that are effective enough to recommend are those that contain adequate amounts of the following:
deet (available in multiple brands in Australia)
picaridin or icaridin (available in multiple brands in Australia)
oil of lemon eucalyptus (OLE) or PMD (the only product available in Australia is Mosiguard)
An evidence-based review of insect repellents (Goodyer LI et al Journal of Travel Medicine 2010*) advises that there are only 3 active ingredients in insect repellents that provide enough protection (when in appropriate product concentrations) to be recommended. They are those listed above.
The CDC advice has been available for almost 10 years. A review on 1 February 2016 of health department websites in Australia reveals that there is only one federal, state or territory health department (South Australia) that even mentions PMD/OLE as a personal insect repellent choice. Many travel health clinics and other authorities also are failing to provide the same up to date information as provided by the South Australia State Health website.
When providing advice, rather than just referring to the active constituent as PMD, it is advisable that it be referred to as extract of lemon eucalyptus, and that the concentration must be 30% or greater (i.e. greater than 300g/kg). This would assist members of the public in selecting the effective products that contain the correct active ingredient and the correct concentration.
*Goodyer LI et al. Expert Review of the Evidence Base for Arthropod Bite Avoidance. DOI: 10.1111/j.1708-8305.2010.00402.x. Journal of Travel Medicine 2010; Volume 17 (Issue 3): 182–192
Chikungunya in Argentina
Chikungunya cases have now been detected in Argentina. The first cases were detected throughout January and February 2016. Prevention is by protection against mosquito bites as for dengue and Zika. See travel health reports and our Fact Sheets for further information.
Yellow Fever in Angola
In February 2016, it is reported that, because of ongoing cases of yellow fever, especially in Luanda Province (but also other provinces), Angolan authorities are aiming to vaccinate over 1.5 million persons in a mass vaccination campaign. Travellers to Angola should be in date for yellow fever vaccination unless there are contraindications. For persons who are unable to have yellow fever vaccination, travel to Angola should be avoided. See travel health reports and our Fact Sheets for further information.
Zika Virus Infection - more countries affected
In January 2016 it was confirmed that Zika virus infections acquired locally have now occurred in Haiti, St Martin and Guadeloupe in the Caribbean. In March 2016, locally acquired infections were reported in Cuba and Dominica. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports and our Fact Sheets for further information.
Zika Virus Infection in Puerto Rico
Zika virus infections acquired locally have been reported from Puerto Rico for the first time ever in late December 2015. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports and our Fact Sheets for further information.
Zika Virus Infection in Colombia and Suriname
Zika virus infections acquired locally have been reported from Colombia and Suriname for the first time ever in 2015. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports for further information.
Dengue in Egypt
In November 2015, an outbreak of fever involving over 250 cases in October 2015 in Dayrout District (Assiut Governorate), was confirmed as dengue. See travel health reports for further information.
Scrub typhus in Nepal
In 2015 (October) authorities reported an increase in cases of scrub typhus, with a number of deaths, in a number of districts in Nepal. This infection caused by the bacteria Orientia tsutsugamushi is transmitted by mite bites. Treatment is with doxycycline. Prevention is by bite avoidance measures including effective personal insect repellents. See travel health reports for further information.
Cholera in Iraq
In 2015 (September) a significant outbreak commenced. The outbreak is thought to be related to a contaminated water source. Cholera is transmitted by contaminated food and water. Outbreaks tend to occur in areas with poor sanitation. An oral cholera vaccine is available for those at risk. See travel health reports and our Fact Sheet on cholera and the vaccine (Dukoral).
Trichinellosis Outbreak in Argentina
In September 2015, authorities reported a large outbreak of trichinellosis in Bahia Blanca, with over 100 cases including children. Trichinellosis is caused by the roundworm Trichinella spiralis. A large outbreak was also reported in February 2015 (see below) in Pehaujo Municipality, Buenos Aires province, after eating sausages from a butcher shop in Pehaujo. This infection can cause severe illness in humans. See travel health reports for further information.
Cholera in Tanzania
In 2015 (July) a significant outbreak commenced with cases reported into September and occurring in Kigoma region, thence Dar es Salaam region, Iringa, Morogoro and Pwani (Coast). The outbreak was continuing into October-November 2015, involving Dar es Salaam, Dodoma, Geita, Iringa, Kigoma, Kilimanjaro, Mara, Morogoro, Mwanza, Pwani, Shinyaga, Singida and Zanzibar.Cholera outbreaks occur commonly throughout Tanzania. Cholera is transmitted by contaminated food and water. Outbreaks tend to occur in areas with poor sanitation. An oral cholera vaccine is available for those at risk. See travel health reports and our Fact Sheet on cholera and the vaccine (Dukoral).
Parvovirus not Chikungunya Case in Spain and France
In July 2015, authorities advised of a case of Chikungunya virus in a 60 year old male from Gardia Valencia with no history of travel to an endemic area. The patient was diagnosed in Spain but had travelled to France. Subsequent testing could not confirm Chikungunya. The illness may have been caused by Parvovirus. Nevertheless, travellers are reminded that ill travellers may introduce infections into their home country on return.
Poliovirus in Madagascar
In July 2015, authorities advised of at least 8 cases of flaccid paralysis caused by a vaccine-derived poliovirus strain, linked to a strain from a case notified in September 2014. Travellers should be fully immunised against polio. See individual travel health reports and our Fact Sheet on Polio.
MERS-CoV in Thailand
In June 2015, Thailand notified its first case of MERS-CoV (Middle East Respiratory Syndrome Coronavirus) in a male who travelled from Oman to Bangkok. This case is unrelated to the ongoing outbreak that recently commenced in South Korea that was also following return of an infected traveller to South Korea from the Middle East. See individual travel health reports and our Fact Sheet on MERS-CoV.
MERS-CoV in South Korea
A large outbreak of MERS-CoV (Middle East Respiratory Syndrome Coronavirus) commenced in South Korea following return of an infected traveller to South Korea from the Middle East. A related case also occurred in China (after travel from South Korea to Hong Kong SAR and mainland China) . See individual travel health reports and our Fact Sheet on MERS-CoV.
Measles in Chile
A number of measles cases were notified in Santiago in May 2015. Travellers should know their measles immune-status. Unless there is a history of confirmed measles in the past, or of having had two measles vaccinations, measles vaccination is recommended for all travellers, providing there are no contra-indications to having the vaccine.
Zika Virus Infection in Brazil
Zika virus infections acquired locally have been reported from Brazil for the first time ever in 2015. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue.
Zika Virus Infection in Vanuatu
Zika virus infections were reported from Vanuatu in May 2015. Zika virus 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. See travel health reports for additional details.
Ebola Virus Case in Italian Healthcare Worker in Rome
An Italian healthcare worker who contracted Ebola Virus Disease (EVD) in Sierra Leone was confirmed by laboratory diagnosis in May 2015 and hospitalised in Rome. See health reports and website for further information.
Typhoid in Uganda
A typhoid outbreak was reported in the Ugandan capital Kampala, commencing early 2015, ongoing as at April 2015 and with spread to other parts of Uganda. Contaminated water and juices were thought to be significant sources. See our travel health reports for futher information.
Measles Outbreak in USA - Reminder to Travellers
The current (2014-2015) measles outbreak in USA is a reminder that many measles outbreaks occur when travellers become infected while overseas and then spread the virus when they return to Australia, New Zealand or their home country. Measles is highly contagious and causes severe illness. Travellers should know their measles immune-status. Unless there is a history of confirmed measles in the past, or documentation of having had two doses of measles-containing vaccine, measles vaccination is recommended for all travellers, providing there are no contra-indications to having the vaccine.
Yellow Fever Cases in Brazil
In February 2015 two cases of yellow fever were confirmed related to travel or residence in Alto Paraiso. One case was fatal. Travellers are reminded to check if yellow fever vaccination is required for their travel. See travel health reports for further information.
Trichinellosis Outbreak in Argentina
In February 2015, authorities advised of large number of people have been affected by the roundworm Trichinella spiralis in Pehaujo Municipality, Buenos Aires province, after eating sausages from a butcher shop in Pehaujo. This infection can cause severe illness in humans. See travel health reports for further information.
Typhoons in South East Asia December 2014
With recent typhoons there has been flooding in a number of countries including Indonesia, Malaysia and Thailand. This increases the risk of outbreaks of diseases such as those related to contaminated water e.g. diarrhoeal diseases (including cholera) and leptospirosis. When flooding is extensive, outbreaks may occur in urban areas as well as rural areas. See travel health reports for further information.
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. See travel health reports for further information.
Legionnaires Disease in Portugal
In November 2014, health authorities advised of Portugal's largest ever outbreak of Legionnaires Disease in Lisbon. See travel health reports for further information.
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. See travel health reports for further information.
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. See travel health reports for further information.
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. 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. See health reports for further information.
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. See health reports for further information.
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. See health reports for further information.
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. See health reports and website for further information.
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. See travel health reports for further information.
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. See our travel health reports for additional details.
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. See our travel health reports for additional details.
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. See travel health reports for further information and advice.
Brazil FIFA World Cup 2014 & Yellow Fever Vaccination
Subscribers are advised to check our Fact Sheet Section for extra guidance when advising travellers going to the FIFA World Cup 2014
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. See health reports for additional details.
MERS-CoV Case Dies in Malaysia
In April 2014, a man died from MERS-CoV infection following a trip to Saudi Arabia. See our Fact Sheet and travel health reports for more detail.
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. See health reports for additional details.
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. See health reports for further information.
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. See health reports for additional information.
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. See health reports for additional details.
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. See health reports for additional details.
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. See health reports for additional details.
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. See our website health reports for more information.
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. See our health reports for more detail.
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. See our website health reports for more detail.
Novel Corona Virus Infection Proposed Name is MERS-CoV
A Qatari traveller returned from Saudi and developed an acute respiratory illness and kidney failure in September 2012. The illness was caused by a novel coronavirus. Illnesses caused by coronaviruses vary from the common cold to severe illness like SARS. Cases continue to be reported from a number of countries in the Middle East. In May 2013, the proposed name for the virus is Middle East Respiratory Syndrome Coronavirus (MERS-CoV). See Fact Sheets and Travel Health Reports.
Measles in United Kingdom
A large measles vaccination campaign was commenced in the UK in April 2013 following an outbreak of measles that started in Wales. Travellers are advised to know their measles immune status and, providing there are no contraindications, be vaccinated if not immune. See Travel Health Reports for further information.
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. See Travel Health Reports for further information.
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. See Travel Health Report for further information.
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. See Fact Sheets and Travel Health Reports.
Novel Corona Virus Infection
A Qatari traveller returned from Saudi and developed an acute respiratory illness and kidney failure in September 2012. The illness was caused by a novel Corona virus. Illnesses caused by Corona viruses vary from the common cold to severe illness like SARS. Cases continue to be reported. See Fact Sheets and Travel Health Reports.
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. See Fact Sheets and Travel Health Reports.
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, diarrhoea and generalised symptoms. Symptoms usually occur a few weeks after exposure but tests may not become abnormal until over a month after exposure. See Travel Health Advisor Travel Health Reports for more information.
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. See Fact Sheets and Travel Health Reports.or further information.
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. See Fact Sheets and Travel Health Reports for further information.
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 - See Fact Sheets and Travel Health Reports for updates.
Chad Poliomyelitis Outbreak
Since 2007 there has been an ongoing outbreak of poliomyelitis in Chad. Cases are still being reported in Chad in 2011. This and previous outbreaks have been associated in the past with spread to other countries, including spread into Sudan between 2004 and 2006. See the personalised Travel Health Reports.for further information.
Philippines and Schistosomiasis (Bilharzia)
A recent outbreak of schistosomiasis in a Leyte town is a reminder that schistosomiasis is still endemic in parts of Philippines. See the personalised Travel Health Reports.for further information.
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. See the personalised Travel Health Reports for further information.
More Chikungunya Cases Diagnosed in New Caledonia
Chikungunya cases continue to be detected in New Caledonia, as at 25 May 2011. This discovery follows on from the announcement by health authorities on Friday 25th February 2011 of the first case of acute chikungunya virus infection in New Caledonia, in a person travelling from Indonesia. Authorities advise the local population to be stringent with eliminating mosquito breeding sites. See the personalised Travel Health Reports and Fact Sheets for further information.
Australia Torres Strait Islands Malaria Outbreak
Malaria cases have been reported on Saibai and Dauan in the Torres Strait, leading authorities to limit travel between Papua New Guinea and the Torres Strait Islands effective as of 28 March 2011. Travel that is covered by the Torres Strait Treaty will not be affected. Seven cases of malaria have been diagnosed on Saibai Island, with the last case diagnosed on 10 April 2011. The risk of spread of malaria to the mainland of Australia is low. Antimosquito measures are recommended for travellers to the region. See the personalised Travel Health Reports and Fact Sheets for further information.
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 l
