Bangladesh

Media sources have reported 25 cases (1 death) of anthrax from Rajshahi (W), June 17. Outbreaks were reported from Rajshahi and Sirajganj province (C) in 2016.

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

Sudan

Health officials have reported over 16,100 cases (265 deaths) of 'acute watery diarrhoea'/cholera from 11 states, Aug 16-Jun 17. White Nile and Blue Nile States in the southeast have recorded the highest number of cases.

Yemen

The WHO has reported over 91,400 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-Jun 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.

Pakistan

4 deaths from Crimean-Congo haemorrhagic fever have been confirmed in Khyber Pakhtunkhwa, Jun 17. 11 cases have been reported countrywide, Jan-Apr 17. 90 cases were reported, Jan-Sept 16. The risk is thought to be highest in Balochistan, Khyber Pakhtunkhwa, Punjab and Sindh.

Crimean-Congo haemorrhagic fever is an unpleasant viral disease which is fatal in 20-35% of cases. It is usually transmitted by infected tick bites or direct contact with the blood of infected individuals. Take steps to avoid tick bites by covering exposed skin and using an effective repellent.

Sri Lanka

Dengue fever is a continuing problem with over 55,300 suspected cases reported, Jan-Jun 17. Colombo (W), Gampaha (W) and Galle (SW), Jaffna (N), Trincomalee (NE) and Kalutara (SW) districts are most affected. Nearly 50,000 cases (77 deaths) were recorded during 2016.

Peru

Dengue fever is a continuing problem, with nearly 45,000 probable cases (54 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.

Chile

Health authorities have reported 14 cases (3 deaths) from Hantavirus in the Bio Bio region (C), Jan-Jun 17. 13 confirmed cases (3 deaths) have been reported in Los Lagos region (C), May 17. 2 Swiss tourists were diagnosed with Hantavirus after travelling along the Pacific Coast of South America visiting Ecuador, Argentina and Chile, Nov 16. An average of 57 cases (20 deaths) are reported annually in Chile.

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 but it would be wise to avoid rodent infested areas.

India

A confirmed case of Japanese encephalitis has been reported from Odisha (E), Jun 17. 1 confirmed death has been reported, suspected to have been contracted in Bihar (NE), Apr 17. 2 confirmed cases were reported in Pune (W), Dec 16. At least 119 deaths from encephalitis were reported in Odisha, Oct-Nov 16. About 1/3 were confirmed as Japanese encephalitis whilst the rest were acute encephalitis syndrome (AES). A study has shown many cases of AES in Bihar (NE) to be linked to excessive lychee consumption. The majority of reported cases countrywide are from Uttar Pradesh, West Bengal, Assam, Odisha, Jharkand and Tamil Nadu.

Thailand

Japanese encephalitis has been confirmed in an Australian tourist 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.

Colombia

Media sources have reported 56 cases of visceral leishmaniasis in Tibú, North Santander (NE), Jun 17. 4 cases (1 death) have been reported in Neiva (C), Apr 17. Leishmaniasis in endemic in Colombia and is one of the countries with the highest transmission of the disease.

Leishmaniasis is a parasitic disease spread by infected sand flies that bite between dusk and dawn. The disease occurs in three forms of varying severity affecting the skin and/or internal organs.  Treatment can be prolonged with skin ulcers taking a long time to heal. Travellers should avoid sand fly bites by using effective repellents and sleeping under insecticide treated bed nets.

Indonesia

Health officials have reported 58 cases (8 deaths) from leptospirosis in Yogyakarta, Java, Jan-Jun 17.

Leptospirosis is transmitted by contact with the urine of infected animals usually in water. Outbreaks often occur after natural disasters and flooding. About 10% of those infected progress onto a severe form known as Weil’s disease which can involve multiple organs. Avoid swimming or wading in potentially contaminated fresh water. It is treated with antibiotics.

Italy

Health officials have reported over 2,300 cases of measles, with the majority of cases in Piedmont (N), Lazio (C), Lombardy (N) Tuscany (C) and Abruzzo (E), Jan-Jun 17. Mandatory vaccinations have been introduced for children under 6 going to nursery schools. 844 cases were reported in 2016.

Romania

Over 6,400 confirmed cases (26 deaths) of measles have been recorded, Sep 16-Feb 17. West Region is most affected. 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.

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.

Nigeria

The outbreak of meningitis continues, with over 14,400 suspected cases reported (1,115 deaths) in 25 states, Dec 16-Jun 17. Zamfara State (NW), Sokoto State (NW) and Katsina State (N) report the largest number of cases. Neisseria meningitides serotype C accounts for 68% of confirmed cases. 515 cases (27 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. 

Australia

Media sources have reported 648 cases of pertussis in South Australia, Jan-Jun 17.

Pertussis (Whooping cough) is a highly infectious bacterial infection which affects the respiratory tract. Pertussis vaccines are given as part of the childhood immunisation schedule of many countries.

USA

Health authorities have recorded a case of human plague in New Mexico, Jun 17. The USA experiences an average of 10-15 cases per year of human plague.

Plague is spread from animals, usually through flea bites or by handling infected animals. Rarely the disease is spread by close contact with an infected person or swallowing infected materials. Most travellers are at low risk with outbreaks mainly occur in areas of poor housing and sanitation. Infected persons usually start with flu-like symptoms. Prompt antibiotic treatment is required to prevent serious illness or death.

USA

2 cases of Powassan virus (POW) have been reported in Maine, Jun 17. A 5 month old baby from eastern Connecticut contracted the virus, Nov 16. Governmental agency reports state that there have been 65 cases in the USA 2013-2015. Most cases have occurred in the north east and Great Lakes region.

Powassan virus (POW) is transmitted to humans by infected ticks. Signs and symptoms of infection can include fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur. There is no specific treatment, but people with severe POW virus illnesses often need to be hospitalized. Take steps to avoid tick bites.

Brazil

Media sources have reported a human death from rabies following a vampire bat bite in Bahia (E), Mar 17. A death was reported following a bite from a vampire bat in the state of Ceara (NE), Nov 16. Neither case sought medical attention following the bites.

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.