Ethiopia

Over 33,000 cases (776 deaths) of acute watery diarrhoea/ cholera have been reported from 6 regions, with Somali region (C) most affected, Jan-May 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.

Kenya

Media sources have reported 5 deaths from cholera in Nairobi County, May 17. An outbreak was reported in Lamu, Tana River Counties (S), Jan 17. At least 15,000 cases were reported from 30 counties during 2016.

Yemen

The WHO has reported over 50,000 suspected cases of cholera in 19 provinces, with Al Hudaydah (W), Al Bayda (SW), Hajjah (NW), Sana'a (W) and Ta'izz (SW) Governates most affected, Oct 16-May 17.

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.

Côte d’Ivoire (Ivory Coast)

34 cases of dengue fever have been reported in Abijan, Apr-May 17.

Malaysia

Over 34,000 cases (83 deaths) of dengue fever have been reported, Jan-May 17. This is a decrease compared with 2016. Selangor (SW), Perak (W), Kuala Lumpur and Putrajaya are most affected. Over 101,000 cases (237 deaths) were reported during 2016.

Peru

Dengue fever is a continuing problem, with over 28,300 probable cases (34 deaths), Jan-May 17. Regions most affected: Piura (NW), La Libertad (NW), Ica (W), Lambayeque (NW), Ayacucho (C), Ucayali (E), Cusco (C) and Ancash (W). Over 31,800 probable cases (41 deaths) were reported 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.

Democratic Republic of the Congo

Health authorities have reported 34 suspected cases (4 deaths) of Ebola virus disease in Likati Health Zone (N), Apr-May 17.

Ebola is a serious viral infection which is often fatal causing excess bleeding and organ failure. It is spread by direct contact with infected blood or bodily fluids of infected people or animals. Outbreaks have been linked to contact with infected bush meat or fruit bat saliva.

Panama

Health officials have reported 3 cases of Hantavirus in Los Santos province (S),

Feb-May 17. 5 cases of Hantavirus were reported in 2016.

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 to travellers is low.

India

187 cases (11 deaths) of Kyasanur Forest Disease have been reported from Sindhudurg district, Maharashtra (W), Jan-May 17. 48 cases (4 deaths) have been reported in Shimoga district, Karnataka (SW) and 9 deaths in Goa (W), Jan-Apr 17. At least 277 cases (3 deaths) were reported during 2016.

Kyasanur Forest Disease is an unpleasant viral disease transmitted by tick bites or direct contact with infected animals such as monkeys. It can cause fever and encephalitis. Take steps to avoid tick bites. A local vaccine is sometimes used in affected areas.

South Africa

Health authorities have reported an increase in malaria cases in Mopani and Vhembe Districts in Limpopo province (N) and Bushbuckridge area in Mpumalanga Province (N), May 17.

Malaria is a serious and sometimes fatal disease common in many tropical countries. It is spread by the bite of infected mosquitoes which bite between dusk and dawn. Symptoms can vary and include fever and a flu-like illness. More serious forms can be fatal and progress to organ failure and coma within 24 hours of symptoms first appearing.

Niger

The UN has reported over 3,000 cases (179 deaths) of meningitis, Jan-May 17. 1,540 cases (114 deaths) were reported, Jan-Jul 16.

Meningococcal meningitis is a bacterial infection affecting the brain usually spread by respiratory droplets (coughing/sneezing). Highest infection rates usually occur during the dry season in the ‘meningitis belt’ of sub-Saharan Africa. The risk is highest for long-stay travellers and those mixing closely with the local population. There are a number of different strains of meningococcal meningitis and the vaccine used for traveller purposes contains 4 of these (A, C, W135 and Y). This vaccination is mandatory for pilgrims travelling to Hajj or Umrah in Saudi Arabia. 

Latvia

2 suspected cases of tick-borne encephalitis have been reported, May 17.

Tick-borne encephalitis is a viral disease spread by the bite of infected ticks and less commonly through the consumption of unpasteurised dairy products. Symptoms include flu-like illness and neurological problems. It occurs across many parts of Europe and Asia. Ticks are found in forest clearings, long grass and hedgerows and are most active in the spring and summer months. Travellers to rural areas (e.g. hikers, campers, agricultural/forestry workers) should consider vaccination.

Tanzania

African trypanosomiasis has been confirmed in a traveller from the Netherlands who had spent time in Mwanza (N) and Dar-Es-Salaam (E), May 17.

African trypanosomiasis (Sleeping Sickness) is spread by the bite of the tsetse fly. These are large black flies which are found in rural areas and are active during the daytime. They are attracted to moving objects (e.g. safari vehicles) and dark colours. They are not particularly affected by insect repellents, and can bite through lightweight clothing. A skin ulcer may occur at the site of the bite and swollen lymph nodes may appear. The disease can progress to affect the brain, causing confusion and poor coordination. The disease is fatal if left untreated.

Brazil

Health authorities reported the first confirmed cases of Zika virus in Brazil in May 15. Since then over 223,000 suspected cases and 11 deaths have been recorded,

May 17. 7,911 cases were reported Jan-Apr 17 compared with over 170,000 in the same period in 2016 and the emergency was declared over, May 17. Nationally over 2,500 confirmed cases of microcephaly (a birth defect causing babies to be born with small heads) have been reported.

Zika virus (ZIKV) is transmitted by daytime biting mosquitoes and is similar to dengue fever. Symptoms include rash, conjunctivitis, muscle or joint pain. Neurological complications have been reported. There is consensus that ZIKV infection during pregnancy may cause some birth defects such as microcephaly. There is a low risk of sexual transmission of the disease. Countries/territories/areas with active or past Zika transmission have now been classified into 4 risk categories: high, moderate, low and very low, based on the current and potential epidemiological situation. These categories ensure travel advice is appropriate and proportionate to the defined ZIKV transmission risk.  See current national advice from Public Health England for more details, including that for pregnant travellers, who are advised to postpone non-essential travel to high risk countries and also regarding condom use for preventing sexual transmission of the disease. https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance