Yemen

Media sources have reported over 200,000 suspected cases of cholera in 20 provinces, with Al Hudaydah (W), Al Bayda (SW), Hajjah (NW), Sana'a (W) and Ta'izz (SW) Governates most affected, Oct 16-Jun 17. 1,310 deaths have been recorded, Apr-Jun 17.

Ethiopia

Over 35,600 cases (780 deaths) of acute watery diarrhoea/cholera have been reported from 6 regions, with Somali region (C) most affected, Jan-Jun 17. A UN report has estimated 2,000 deaths since Nov 16. At least 12,000 people were affected by outbreaks across the country, Jul-Aug 16.

Somalia

The number of cases of acute watery diarrhoea/cholera continues to increase with over 51,000 cases (782 deaths) reported in many regions, Jan-Jun 17. Banadir (Wadajir), Luq (Gedo), Dusamareb, Galadud, Baidoa (Bay) and Bunhodle Ayn (Puntland) regions in the south are most affected. Large outbreaks were recorded during 2016 with at least 15,600 cases (548 deaths).

Zanzibar

At least 180 cases (1 death) of cholera have been reported on Zanzibar, Jun 17. Treatment camps have been opened in West-Unguja and North-Unguja regions. Large outbreaks of cholera were recorded during 2016.

Tanzania

Cholera cases continue with nearly 30,000 cases reported, Jan-Jun 17. A large outbreak which began in Dar es Salaam spread to at least 23 regions during 2016. At least 23,000 cases were recorded.

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.

Ukraine

There have been 62 cases (9 deaths) of botulism reported in Ukraine, Apr-Jun 17. Almost all these cases are associated with the consumption of dried fish. Reports state that there is a shortage of anti-botulism serum in the country.

Botulism is caused by a toxin usually acquired after ingesting contaminated food, often from home canning. Initial symptoms consist of blurred vision, difficulty swallowing and speaking progressing to generalised paralysis.

Bahamas

Health authorities have recorded 240 cases of conjunctivitis, May-Jun 17. This is an increase compared to 2016.

Brazil

Health authorities have recorded 172 cases of conjunctivitis in Humaita, Amazonas State, May-Jun 17.

Dominican Republic

Health authorities have recorded over 66,600 cases of conjunctivitis, May-Jun 17. This represents a large increase compared to 2016. Distrito Nacional, San Cristobal, Santiago and Santo Domingo are most affected.

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.

Naura

964 cases (3 deaths) of dengue fever have been reported, Jan-May 17.

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.

Chile

Media sources have reported an outbreak of hepatitis A affecting 74 people in Antofagasta region (NW), Jun 17. The outbreak has been linked to food from local street vendors.

Marshall Islands

Health authorities have reported 171 cases of hepatitis A, with most cases in the capital Majuro, Sep 16-May 17.

Hepatitis A is a viral infection which affects the liver and occasionally causes severe disease. It is usually spread by contaminated food and water. Symptoms include fever, digestive disturbance and jaundice. Effective hepatitis A vaccines are available and can be given on their own or in combination with hepatitis B or typhoid.

Niger

Health authorities have reported an outbreak of hepatitis E in Diffa region (SE), with 876 cases (34 deaths), Dec 16-Jun 17.

Hepatitis E infection affects the liver and is usually transmitted through contaminated food and water in areas with poor sanitation. Symptoms include fever, fatigue and jaundice.  It is especially dangerous in the latter stages of pregnancy when fatality rates can reach 20%. There is currently no vaccine.

Taiwan

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

Thailand

An Australian tourist has died from Japanese encephalitis after contracting the disease on a 13 day holiday to Phuket, Jun 17.

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.

UAE

At least 65 cases of Legionnaires' disease have been reported in European travellers returning from Dubai, Oct 16-Jun 17. The source of the infection is unknown.

Legionnaires’ disease is a bacterial infection which can cause a life-threatening pneumonia. Outbreaks are often associated with communal water facilities such spas, showers and cooling towers.

Ukraine

735 cases of measles have been recorded across 15 regions, Jan-Jun 17.

Measles is a viral infection which causes a red blotchy rash and occasionally more serious disease. 2 doses of the MMR vaccine are recommended to provide protection against the disease. The travel consultation is good opportunity to ensure that all travellers are in-date with their primary vaccinations.

Saudi Arabia

The Saudi Ministry of Health has reported an increase in cases of Middle East respiratory syndrome coronavirus (MERS-CoV), Jun 17. 1,667 cases (673 deaths) have been reported since 2012.

MERS-CoV is a viral infection which affects the respiratory system and can be fatal. Human to human transmission has been reported including amongst healthcare workers. There is evidence that camels/bats may also transmit the disease. Travellers returning from the Middle East who develop a significant respiratory illness with fever and cough should seek medical advice. There are no travel restrictions.

Marshall Islands

Over 1,000 cases of mumps have been recorded, Jan-Jun 17. A vaccination campaign has been commenced.

Mumps is a viral disease which causes painful swelling of the salivary glands. 2 doses of the MMR vaccine are recommended but protection against the disease sometimes wanes over time.

Syria

Health authorities have confirmed 17 cases of vaccine-derived poliovirus from Deir Al Zour and Raqua governates (E), Jun 17. Additional cases of acute flaccid paralysis have been reported in the same region. An emergency vaccination campaign is planned.

Afghanistan

Afghanistan is one of the few countries still reporting polio cases. 4 cases have been reported, the most recent from Helmand province (S), Jan-Apr 17. 13 cases were reported from Paktika, Kabul, Kandahar, Kunar & Helmand Provinces in 2016.

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.

Bolivia

Media sources have reported a death from yellow fever in a youth who travelled frequently to Villa Tunari (Cochabamba, central), Jun 17. The WHO reported a case in an unvaccinated tourist visiting Caranavi (W), Jan 17.

Yellow fever is a viral disease, found in tropical regions of Africa and the Americas. It principally affects humans and monkeys, and is transmitted by the bite of an infected mosquito. The risk is highest in rural areas. 15-25% of those infected will develop severe disease with organ failure, jaundice and bleeding. An effective vaccine is available but may not be suitable for everyone. International regulations are in place to prevent the spread of the disease and as such the vaccine must be administered in a registered ‘Yellow Fever Centre’ and a certificate of vaccination issued.