India

Media sources have reported 7 cases of anthrax in Odisha (E), Jun 17. A previous outbreak was reported from the same area, Mar 17. Andhra Pradesh (E), Odisha (E) and Jharkhand (E) reported cases in 2016.

Bangladesh

Media sources have reported 25 cases (1 death) of anthrax from Sirajganj (C) and 18 cases from Pabna (W), in Rajshahi Division, June 17. Outbreaks were reported from the same region in 2016.

Anthrax is a bacterial infection which can affect the skin, lungs and gastro-intestinal tract. It is generally transmitted via infected livestock. Ensure that all meat is well cooked and from a safe source.

Panama

774 suspected cases of chikungunya have been reported, Jan-Jun 17. 6 confirmed cases were reported in 2016.

Chikungunya (CHIK) is a viral infection spread by day-time biting mosquitoes. Symptoms may include fever and muscle/joint pain. Some people experience persistent joint pain and fatigue lasting weeks or months.

Kenya

An outbreak of 90 cases of cholera has been reported from Turkana County (NW) and 243 cases (6 deaths) from Garissa County (SE) and 6 other counties, Jun 17. Media sources have reported 146 cases of cholera (4 deaths) from Nairobi, Mombasa and Vihiga, May 17. At least 15,000 cases were reported from 30 counties during 2016.

Cholera is a bacterial infection usually spread through contaminated food and water in areas with poor sanitation. The risk is highest for those with limited access to safe water and medical care such as aid workers and travellers to remote areas with reported outbreaks. Symptoms include watery diarrhoea and dehydration. An oral vaccine is available for those at particular risk.

Guadeloupe

Health authorities have reported a large outbreak of conjunctivitis, with 500-600 cases reported per week, May-Jun 17.

Martinique

An outbreak of conjunctivitis has been reported, with 150-200 cases being recorded per week, May-Jun 17.

Viral conjunctivitis is highly contagious and causes red, sore, inflamed eyes and may be accompanied by a discharge. Wash hands frequently, avoid rubbing eyes and sharing towels.

Iran

Media sources have reported 33 cases (3 deaths) of Crimean-Congo haemorrhagic fever, Jun 17. Cases are reported every year, with Sistan and Baluchistan (SE), Isfahan (C), Fars (S), Tehran (N), Khorasan (NE) and Khuzestan (W) provinces reporting the highest numbers.

Crimean Congo haemorrhagic fever is an unpleasant viral disease which can be fatal. It is usually transmitted by infected tick bites or direct contact with the blood of infected individuals. Travellers should take steps to avoid bites by covering exposed skin and using an effective repellent.

Myanmar

Dengue fever is a continuing problem throughout Myanmar, with over 1,400 cases

(9 deaths) reported in Yangon (S) and 400 cases in Rakhine State (W), Jan-Jun 17. Over 9,800 cases were recorded during 2016.

Dengue fever is a viral infection spread by day-time biting mosquitoes. It is widespread across over 110 countries with large outbreaks reported in many regions including South East Asia and South/Central America. Dengue fever commonly causes flu-like symptoms including fever, joint pain and rash. Severe forms of the disease are rare in travellers but can lead to excessive bleeding and organ failure.

Germany

Health authorities have reported an increase in Hantavirus cases in Baden-Württemberg (SW), with 441 reported, Jan-Jun 17.

Hantavirus is a viral disease which is primarily transmitted by contact with infected rodent excreta. The infection usually affects the lungs and kidneys. The risk is low but it would be wise to avoid rodent infested areas.

Taiwan

2 cases of Japanese encephalitis have been reported from Tainan and Kaohsiung in the south west, Jun 17. 23 cases were reported in 2016.

Japanese encephalitis is a viral infection affecting the nervous system spread by mosquitoes. There is no treatment and around a third of those who develop encephalitis will die. It is found in parts of Asia, particularly in rural areas where there are rice fields and pig farms. The risk is highest during the rainy season. Vaccination should be considered for long stay or rural travellers.

Syria

Health authorities have confirmed 2 cases of vaccine-derived poliovirus from Deir Al Zour Governate (E), Jun 17. 58 cases of acute flaccid paralysis have been reported in the same region. 11 have tested negative for the vaccine virus, further results are awaited. An emergency vaccination campaign is planned.

Polio is a viral infection which can sometimes cause long term paralysis. It is usually spread by contaminated food and water in areas with poor sanitation. Polio has been successfully eliminated from many countries. Vaccination is part of the standard UK immunisation schedule and boosters are given in combination with tetanus and diphtheria.

Vietnam

12 human rabies deaths have been reported nationwide, Jan-Apr 17. 91 deaths were recorded across 28 cities/provinces during 2016. On average 400,000 people are bitten by cats and dogs in the country each year with the northern mountainous regions considered high risk for rabies.

Rabies is a viral infection spread by the saliva of infected animals. Human cases are usually due to dog bites but any mammals can be infected. Rabies is fatal once symptoms begin. Pre-exposure vaccinations are recommended for long-stay travellers; those remote from medical help (>24 hours) and animal handlers. All travellers must know how to treat a wound and seek prompt post-exposure vaccines if bitten/scratched.

USA

Media sources have reported the death of a 2 year old in Indiana from Rocky Mountain spotted fever, Jun 17. North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri report most cases annually.

Rocky Mountain spotted fever is a serious rickettsial disease spread by infected ticks and reported in the Americas. It causes fever, headaches, rash, muscle pain and may be fatal if not treated with antibiotics promptly. Take steps to avoid tick bites.

Nepal

2 cases of scrub typhus have been reported from Rolpa and Bara District, Feb-Jun 17. 707 cases (14 deaths) were reported from 47 different districts of the country, Jul-Dec 16.  The number of cases increased following the earthquake in 2015. The majority of cases are from Chitwan district (C) and Kailali (W).

Scrub typhus is an illness caused by a Rickettsia bacteria that is spread by mites on rodents. Symptoms vary but often include headache, fever and rashes. Travellers should minimize exposure by avoiding rodents and using insect repellents.

Venezuela

Health authorities have reported 142 suspected cases (21 deaths) of Venezuelan haemorrhagic fever during 2016. The majority of the cases were recorded in Barinas state (NW).

Venezuelan haemorrhagic fever is transmitted by contact with saliva, blood or urine from rodents and reported exclusively in Venezuela. Symptoms include fever and malaise followed by haemorrhagic manifestations and convulsions. There is no vaccine or treatment.