Travel Health News
Nomad Travel Health News is edited by Karen Hoy, Lead Nurse, Nomad Travel Clinics, Bishops Stortford
Visit one of our clinics for a 10 minute travel vaccination consultation with a specialist travel health medical professional for £20 or free when you pay for any travel vaccination. Contact your nearest Nomad Travel Clinic for details.
25th August 2010
Japanese Encephalitis in India
Japanese encephalitis has claimed the lives of 2 children in Gorakhpur (Uttar Pradesh), taking the toll in the viral infection in the district to 149 this year. Over 100 people suffering from acute encephalitis syndrome are being treated at various hospitals in Gorakhpur.
Advice to Travellers
Japanese B Encephalitis is spread through the bite of an infected mosquito. It is most common in rural farming areas of Asia. Most infections have few symptoms and may not be recognised but severe cases can lead to meningitis, inflammation of the brain and can be fatal. Risks to travellers are generally very low but vaccination should be considered by people intending to spend a significant length of time in rural areas, particularly during outbreaks. Vaccination involves a course of 2 or 3 injections given over a month period. Bite avoidance is essential.
Rabies Peru
Rabid vampire bats have attacked more than 500 people in Peru's Amazon. The attacks occurred in the village of Urakusa, in north eastern Peru, where the indigenous Aguaruna tribe lives. At least 4 people are believed to have succumbed to rabies as a result. Medical supplies and vaccines to treat those infected with rabies have been sent to the tribe.
Advice to travellers
Travellers to remote north Eastern areas of Peru should be aware of the risk of Rabies and lack of availability of post exposure treatment which would be needed following a potentially rabid injury.
Travellers are advised to consider pre travel Rabies vaccine, this consists of a course of 3 vaccines administered over the course of 21 to28 days; this removes the need for Rabies Immunoglobulin in the event of an injury. Animal contact should be avoided wherever possible and in the event of contact with animal saliva any wound should be thoroughly washed with soap and water and Iodine or Alcohol applied. Medical advice should be sought as soon as possible even if vaccinated with a full course of Rabies vaccine.
Tick Borne Encephalitis Russia
12,490 people have sustained tick bites in the Tyumen oblast region of Russia since the beginning of this year, including 59 cases during the past week. There have been 345 suspected cases of tick-borne encephalitis.
As of Thu 12 Aug 2010, the number of confirmed cases of TBE was 81, Whereas during the same period last year, only 45 cases were recorded. None of the cases had been immunised against Tick borne encephalitis, and 26 percent of cases received emergency immune globulin treatment. The regional laboratory which carries out surveys on ticks has reported that this year, 5.4 percent of ticks are carrying TBE virus, and 15.2 percent are carrying Borellia (the causative agent of Lyme disease).
Advice to travellers
Travellers planning to visit the affected region should consider vaccination. Vaccination is advised for persons likely to be exposed to lots of tick bites e.g. if camping, walking, staying in rural forested areas for long periods. Travellers should also avoid bites by covering up with long clothing treated with premethrin and wearing DEET on exposed skin. All ticks should be removed immediately with tweezers –ensuring head and body removed. Vaccination involves 2 injections given over a 1-3 month period with a booster 5-12 months later.
Dengue – Yemen
2000 suspected, and 309 confirmed cases of Dengue fever have been reported in Shabwa Governate. Marshes resulting from rain and the leakage of sewage are the main causes for the spread of mosquitoes that are transmitting the epidemic, according to the heath official.
Advice to travellers
Dengue fever is spread by daytime biting mosquitoes normally from sunrise to sunset and is more common in urban areas. There is no vaccine available and therefore insect bite avoidance is essential.
Dengue – Nicaragua / Guatemala / Costa Rica
Nicaragua- at least 5 000 cases of dengue fever have been confirmed So far this year.
Guatemala – At least 13 deaths and almost 7 000 cases of dengue fever have been recorded this year.
Costa Rica – At least 21,200 dengue fever cases have been recorded this year.
Advice to travellers
Dengue fever is spread by daytime biting mosquitoes normally from sunrise to sunset and is more common in urban areas. There is no vaccine available and therefore insect bite avoidance is essential.
Cholera - Laos
216 individuals from 14 villages in Attapeau province have been affected by an outbreak of cholera in Southern Laos. Officials from the Health Department say that the outbreak began on 5 July 2010, and affected; the province that borders Cambodia and Vietnam.
Advice to travellers
Precautions should be taken to ensure good food, water and personal hygiene. Hand washing is very important and the use of an alcohol based hand gel is recommended where soap and water are not readily available. If planning to visit for a long time, they could consider vaccination. Vaccination involves 2 drinks given 1-6 weeks apart.
China - Dysentery
An outbreak of dysentery has been reported from Zhouqu county, Gannan Tibetan Autonomous Prefecture of Gansu province in the remote northwest of China. This follows on from the recent flooding and landslides that destroyed the infrastructure of the area resulting in a lack of safe drinking water and access to medical supplies.
Advice to travellers
Travellers to the affected area should take precautions to ensure good food, water and personal hygiene. Hand washing is very important and the use of an alcohol based hand gel is recommended where soap and water are not readily available.
3rd August 2010
Flooding in Pakistan
Heavy rains at the end of July in Pakistan have resulted in flash flooding which is widespread throughout the country. Many people have died and many more are injured and missing or have been evacuated from their homes. Rescue work is ongoing in affected areas.
Advice to travellers
The Foreign and Commonwealth Office(FCO) is advising against travel to some areas of Pakistan. Travellers should check the FCO website for updates on the latest advice.
Anyone intending to travel to Pakistan should seek comprehensive advice regarding travel vaccinations and anti malarial tablets well before travel, however, short notice travelers should still consult a travel health professional as it is always possible to give some vaccines whatever the length of time before travel and most Malaria tablets can be started 1 to 2 days before travel. It’s never too late to seek advice.
27th July 2010
Advice to travellers
Mumbai is usually considered to be a low risk area for Malaria so mosquito bite avoidance is advised rather than anti malarial medication at the present time. Use of mosquito repellants, insecticidal clothing treatments and mosquito nets is advised along with covering up exposed skin. Malaria carrying mosquitoes generally bite between dusk and dawn.
Any traveller visiting this area should seek prompt medical advice in the event of developing a fever or flu like illness.
The ongoing situation is being monitored and the current advice could change, travellers are advised to consult a travel health professional prior to travel.
23 July 2010
12th July 2010
Polio in Tajikistan
An outbreak of Polio is currently affecting The Republic of Tajikistan. This is the first importation of Polio in the World Health organization European Region since it was declared Polio free in 2002.
Polio is a disease which is most often spread by contact with food and water contaminated by the faeces of an infected person. It mainly affects children but any unimmunised individual may be at risk regardless of age.
Advice to travellers
A full course of Polio vaccine is advised for anyone previously unimmunised and boosters doses every 10 years for previously vaccinated travellers to areas of risk. Precautions should be taken to ensure good food, water and personal hygiene. Hand washing is very important and the use of an alchohol based hand gel is recommended where soap and water are not readily available.
6 July 2010
Malaria in Thailand
Thailand is a very popular destination for travellers including many young people and backpackers. There have recently been reports of a high number of Malaria cases in the Southern Province of Ranong. This area is on the border with Myanmar and is considered a high risk area for Malaria. Cases usually increase during the wet season.
Advice to travellers
Travellers to high risk Malarial zones are advised to take appropriate anti malarial medication before entering the malarial area, whilst there and for the prescribed length of time after leaving the area. It is important to take precautions against mosquito bites by frequent applications of insect repellant containing at least 50% Deet, covering up exposed skin and sleeping under mosquito nets impregnated with insecticide such as Permethrin, malaria mosquitos are active between dusk and dawn.
Any traveller returning from an area where there is a risk of Malaria who develops a fever or flu like illness within a year of travel should inform their medical professional that they have been in a Malaria zone. Malaria can then be excluded or treatment commenced.
8 June 2010
Tropical storm in Central America
A severe tropical storm, Agatha, has hit Central America in the last few days affecting areas from Guatemala to Nicaragua. This has caused widespread flooding and landslides resulting in the destruction of many communities. The countries affected are Guatemala, El Salvador, Honduras and Nicaragua.
Advice to travellers
Travellers should check with the Foreign and Commonwealth for the latest travel advice.
Cholera in India
There has been a recent outbreak of Cholera in Southern India affecting Theni District, Tamil Nadu. There have been confirmed cases some resulting in some fatalities among the local population.
Advice to travellers
Travellers visiting affected areas should take care to ensure the safety of their drinking water supply especially if mixing closely with the local population. There are a number of effective ways to purify water, consult your travel health specialist.
There is a vaccine against Cholera consisting of two doses of oral vaccine given at least two weeks apart.
Lyme Disease in Russia
There has been an increase in cases of Lyme Disease in Russia. Lyme Disease is spread by the bite of an infected tick. A high number of cases have been recorded in Moscow, however most of these cases have acquired infection outside the city.
Advice to travellers
There is no vaccine against Lyme Disease. Travellers visiting forests, rural areas and parkland should try to prevent tick bites by using insect repellants and also clothing treatments containing insecticide such as Permethrin.
Care should be taken to cover up exposed areas of skin by tucking trousers in to socks for example. Any ticks should be removed as soon as possible by prizing off with tweezers hooked around the mouthparts, take care not to squeeze the body of the tick.
Rabies in Angola
Rabies is a major problem throughout many parts of the world. There have been a number of deaths from Rabies across Angola recently, a mass vaccination programme for animals is currently underway.
Advice to travellers
Travellers should remain aware of the risk of Rabies which , if untreated with post exposure measures, is almost invariably fatal. Children are at particular risk as they may not report an injury. The infection is passed to humans via the saliva of infected mammals ( most commonly dogs) from a bite, scratch or lick on an open wound.
Following any suspect injury unimmunized individuals should seek medical help as soon as possible. Any wound should be cleaned thoroughly with hot soapy water and antiseptic or alcohol applied on top. A dose of Human Rabies Immunoglobulin may be required followed by five doses of vaccine, Human Rabies Immunoglobulin may not be readily available in developing countries.
A safe, effective vaccine against Rabies is available consisting of three doses of vaccine given over the course of 21 to 28 days.
3 June 2010
FIFA World Cup in South Africa – Top tactics for football fans
Health
Make sure you have any vaccinations and travel advice in good time before you travel to South Africa. Consult your travel health professional before you go.
Remember, not all diseases can be prevented by vaccines, HIV/AIDS for example, don’t put yourself at risk.
Travel Insurance
Not having travel insurance could leave you with medical bills of thousands of pounds. Make sure your insurance covers you for all eventualities including your personal possessions.
Entry requirements
Although you do not need a visa to enter South Africa unless planning to stay for longer than 90 days, make sure your passport is valid for at least 30 days from your return travel date and that it has at least 2 blank pages. It is a good idea to photocopy your documents or scan them into your computer.
Road safety
Be careful when driving hire cars. Remember that the local rules of the road will differ from the UK. At four way intersections for example, the car arriving first will have right of way and traffic lights are often only situated on the opposite side of a junction.
South African Laws and Customs
There are different laws And policing procedures in South Africa, racist and xenophobic material will not be tolerated for example.
Fans deemed to be too intoxicated with alcohol may be refused entry to the stadium. It can be illegal to drink alcohol anywhere outside of designated areas.
Watch this space for more top tactics
27th May 2010
Yellow Fever and travellers to South Africa for the FIFA world cup
All travellers going to South Africa via Nairobi in Kenya are required under International Health Regulations (2005) to have a valid International Certificate of Vaccination against YELLOW FEVER disease. This certificate must be shown on entry to South Africa. Failure to provide proof of vaccination or a medical exemption certificate may result in refusal of entry or vaccination at the Airport. A Yellow Fever certificate is not necessary for travellers flying direct to South Africa.
Advice to travellers - Although there is no Yellow Fever disease in South Africa, Kenya is considered by The World Health Organisation to be a country with risk of Yellow Fever.
There are issues surrounding Yellow Fever vaccination and it may not be suitable for certain people, for example, the elderly, those with illness or medication which affects the immune system, those with severe egg allergy and pregnant women.
Travellers should discuss Yellow Fever vaccine requirements with their GP or travel health specialist. An important point to remember is that the vaccination certificate is not valid until 10 days after vaccination.
Measles in France
French authorities are reporting an increase in the number of Measles cases in France during 2010. The outbreak is particularly affecting Lille and the Bordeaux region in south west France.
The Department of Health has issued advice to UK travellers intending to visit France this summer.
Advice to travellers
Travellers to France should ensure that children have had the recommended two doses of MMR vaccine as per the UK childhood vaccination schedule. MMR vaccine is usually given at age 12 to 15 months and again at pre- school age around 4 to 5 years. Adults who have not had the disease and are unimmunised should consider having MMR vaccine, two doses are required for adequate protection given 1 month apart.
Rabies in Bali
The current Rabies epidemic in Bali is continuing, there have been a considerable number of deaths among the local population of the island, which is one of Asia’s top tourist destinations. According to government sources 30,000 dog bites have been reported in the first half of this year alone. This is a very serious problem due to the lack of availability of Human Rabies vaccine and Rabies immunoglobulin in Bali.
Rabies kills approximately 55,000 people annually, mostly children, 60% of these cases occur in Asia.
Following treatment after contact with saliva from a rabid animal death can usually be prevented but once symptoms appear death is inevitable.
A third of the island’s estimated 600,000 dogs have been euthanized since the outbreak began which has not solved the problem. There is an ongoing dog vaccination programme but 70% of the dog population needs to be vaccinated to effectively control the spread of the Rabies virus and currently only 20% have been reached.
Advice to travellers
Travellers to Bali should be aware of the significant risk of Rabies and lack of availability of post exposure treatment which would be needed following a potentially rabid injury.
Travellers are advised to consider pre travel Rabies vaccine, this consists of a course of 3 vaccines administered over the course of 21 to28 days, this removes the need for Rabies Immunoglobulin in the event of an injury.
Animal contact should be avoided wherever possible and in the event of contact with animal saliva any wound should be thoroughly washed with soap and water and Iodine or Alcohol applied. Medical advice should be sought as soon as possible even if vaccinated with a full course of Rabies vaccine.
Malaria in India
Malaria has become a continuing problem in Mumbai, in the last fortnight almost 9000 cases of Malaria have been reported, the highest number for 4 years.
Central Mumbai is worst affected and the increase is being blamed on the high number of construction sites in the area which are good breeding sites for mosquitoes, especially during the Monsoon season.
Health officials are planning to carry out anti larvae treatment of the mosquito breeding areas to try to reduce their number.
Rabies in India
A report has come in from India regarding a group of 15 people who were injured by a stray cow whilst standing at a bus stop in Goa. The cow was in a distressed state and was found to be suffering from Rabies at post mortem. It was subsequently discovered that the cow had previously been bitten by a Rabid dog. All the injured individuals were given post exposure Rabies treatment.
This case serves as a good example that despite popular belief, it is not just dogs and cats who can cause a rabid injury.
Advice to travellers
Travellers should be aware that Rabies is endemic in India, including Goa, and care should be taken to protect themselves from this terrible disease. A safe and effective vaccine is available consisting of 3 doses over the course of 21 to 28 days. Having the vaccine pre travel removes the need for Rabies Immunoglobulin, which is not always readily available, however medical advice should always be sought as soon as possible in the event of an injury even when fully vaccinated.
Japanese Encephalitis in India
A recent outbreak of Japanese Encephalitis has been confirmed in India. This is a serious disease spread by mosquito bites and is common in many countries in Asia and the Far East.
The disease is prevalent in areas where rice growing and pig farming are common, although urban outbreaks do occasionally occur. Cases usually increase during the wet season.
Advice to travellers
Vaccination is recommended for travellers to areas where this disease occurs if staying for long periods or making frequent trips to risk areas.
The vaccine for adults consists of 2 doses over the course of 28 days, the schedule for children is different so please consult your Travel Health Professional in plenty of time.
Travellers should also take precautions to avoid insect bites by using insect repellant containing 50% DEET, using mosquito nets, insecticidal clothing treatments and covering up exposed skin.