Diphtheria, Bangladesh, Indonesia – March 2019


International travellers are reminded to keep their routine vaccinations up to date following a large number of cases of diphtheria reported in recent months in several locations around the world. Some cases have been reported in South America but the most intense transmission is currently occurring in Bangladesh and Indonesia. The situation in Bangladesh has been exacerbated by the influx of a large number of refugees from Myanmar. The government of Indonesia is planning to vaccinate almost 2 million children to manage the outbreak in that nation.


Diphtheria is a serious and potentially fatal bacterial infection that affects the mucous membranes of the throat  and heartand nose with initial flu-like symptoms but can aggravate to fever, swallowing difficulties, hoarseness, enlarged lymph nodes, coughing, and shortness of breath; while in some patients, the disease may affect the skin, leading to ulcers. The bacteria also produces a toxin which may damage the heart. Several effective vaccines are available from our clinic.


Cholera, Yemen – March 2019


A severe cholera epidemic has devastated the Middle Eastern nation of Yemen which has been in the grip of conflict for several years. Cholera is a severe diarrhoeal illness which can become a major risk after natural disasters or during military conflict. Almost 250,000 cases of cholera have been identified and 1,500 deaths have occurred. Almost all provinces have been affected by the epidemic. About one quarter of all children who have been diagnosed with cholera in this outbreak have died from this illness. Two thirds of the entire population of Yemen are in need of urgent humanitarian aid. Less than 45% of hospitals are operational. Although an effective vaccine for cholera is available from our clinic all non-essential travel to Yemen should be avoided at this time.


Yellow fever, South America, Africa – March 2019


Authorities in areas of Brazil and Bolivia are attempting to contain outbreaks of yellow fever which developed in recent months. Yellow fever is a severe viral haemorragic fever transmitted by the bite of a moquito. The illness can be prevented by vaccination. The current outbreaks centred on the regions of Minas Gerais and Espritu Santo in Brazil and Cochabamba in Bolivia where several hundred cases have been reported and numerous deaths have occurred. Efforts are underway to control the outbreak with mosquito control measures and mass vaccination. Some surrounding countries have also recently reported cases including Peru, Columbia.


There has been considerable yellow fever activity in Africa in recent months. In Nigeria (Edo state) more than 100 cases of suspected yellow fever have been reported. Several cases of yellow fever have also recently been reported in Central and West Africa in recent months with majority reported in Democratic Republic of Congo and in Liberia.


Ebola virus, Democratic Republic Congo – March 2019


Travallers should avoid non-essential viaits to provinces of North Kivu and Ituri in Democratic Republic of Congo at the present time due to an ongoing outbreak of the severe haemorrhagic fever Ebola virus. Almost 900 cases of the often fatal disease have been diagnosed in the region and over 500 deaths have been attributed to Ebola during the current outbreak.


Dengue Fever update – March 2019


During the last few months, dengue fever cases have been reported in a number of regions around the globe. High dengue activity is occuring in Sri Lanka, India (multiple states), Pakistan (Punjab, Sindh), Myanmar, Philippines, Mexico, Columbia, Brazil, Bolivia Jamaica, New Caledonia and several areas in West Africa and Palau at the present time.


Dengue fever is common in many tropical areas of the world that are frequently visited by travellers. The illness is often transmitted in urban areas. Those affected may develop a severe flu-like illness with a characteristic rash. No vaccine is available however the illness risk may be reduced by minimising the number of mosquito bites in affected regions. Anti malaria tablets do not protect against dengue fever. Travellers are advised to dress appropriately and use high quality insect repellants if required. Although rarely fatal, the illness may be severe or prolonged in some individuals and in children. Complications may arise.


All visitors to dengue fever regions are advised to minimise the risk of mosquito bites and seek medical attention if ill. Asprin must NOT be used.


Measles , various countries – March 2019


Travellers are advised to consider an update of measles vaccination due to several cases being reported in some countries around the world. Recent outbreak of this highly infectious disease have been reported in Philippines where 13,000 cases and over 200 deaths have been reported. Cases of measles have also been reported in Japan, Australia, Ukraine, Belarus, Turkey and Switzerland. Typical symptoms of measles include fever, sore eyes, dry cough and a characteristic rash. Significant  measles outbreaks have occurred in several continents in recent years.


Polio, PNG – March 2019


Cases of Polio are continuing to emerge in Papua New Guinea after an outbreak of the illness was identified in June 2018. PNG was declared polio free in 2000 but a cluster of cases has recently been diagnosed. Other countries recently reporting cases include Nigeria, Niger, Somalia, Pakistan and Afghanistan. The virus, which mainly affects children, causes paralysis of varying degrees of seriousness. Polio virus spreads through faecal-oral contamination, multiplies in the intestines, and then affects the central nervous system. There is no cure for polio, which can only be controlled by vaccinations in childhood.


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