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Welcome to Travel Health Advisor

MASTA (ANZ) has undergone a name change and is now known as Travel Health Advisor.

Our website address is http://www.travelhealthadvisor.com.au and all subscribers can continue to log in using their existing user name and password.

Travel Health Advisor provides professional travel health advice to doctors, pharmacists, pathologists, corporations, government departments and travel agents. This advice is available immediately online to subscribers.

The Medical Director of Travel Health Advisor is A/Prof. Bernie Hudson MBBS (Hons).DTPH.FACTM.FAFPHM.FRACP.FRCPA. He is an Associate Professor in the School of Public Health, Tropical Medicine & Rehabilitation Sciences at James Cook University, Townsville, Queensland, and a specialist Clinical Microbiologist and Infectious Diseases Physician, who holds specialist qualifications in pathology (microbiology), internal medicine (infectious diseases), public health and tropical medicine. He also holds a position as Clinical Senior Lecturer in Infectious Diseases at Sydney University. Bernie Hudson is a pioneer of travel health in Australia, having been, since its inception in 1988, the Medical Director of Medical Advisory Services for Travellers Abroad MASTA (ANZ), now known in Australia and New Zealand as Travel Health Advisor.

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Our partner

mosiguard

MOSIGUARD TESTIMONIALS

Medical
Hi,
I am a GP in WA. We went to South America two years ago and decided to try Mosi Guard. Well i was so impressed. Pleasant to wear, the most effective repellent I have ever used.
We had other tourists with all the usual repellants asking us for some and finding it so effective. I hope you never take it off the market. Great product.
Yours sincerely,
Dr Philip Snowball MBBS, MRCP
Children
"I am the Director of a preschool in Sydney where we foster a love of nature and children engaging in outdoor play. But sometimes outdoor play involves mosquitoes! A few years ago I searched the internet to find a natural product that we would be able to apply to children's skin on a daily basis that actually repelled mosquitoes. I found Mosi-guard! Mosi-guard allows our children to play bite free anywhere in our outdoor environment. For children who have in the past experienced allergic reactions to mosquito bites it has been a lifesaver! A number of parents now take a bottle of Mosi-guard home with them after approaching us to find out what we use. From our experience, i could not recommend Mosi-guard more highly to anyone who wants an effective repellent minus the chemicals !"
Pam Lawton
Director
St. George's Preschool Eastwood. NSW.
Travellers
"My partner and i recently travelled to South America and spend a lot of time in the Bolivian jungles and also Mexican Jungles. We were adamant to use a natural alternative to repelling mosquitos, ticks and all the other creepy crawlies in the jungle so we tried Mosi-Guard. We were utterly surprised at how well it worked. The hundreds of mosquitos that continually surrounded us, didn’t dare go near our skin, same as the ticks. It works so powerfully, smells so fresh and i would like to thank you for such an impressive product. We met many other travellers who had skin conditions and even burns from using DEET, and i am so glad i found Mosi-Guard. Thank You! I would like to leave this testimony and please feel free to use it on any website!
Kind Regards,
Melody and Brad

See the Mosiguard Website for more information about:

  • what is Mosiguard?
  • how to avoid being bitten
  • insects and diseases
  • questions
  • stockists

News

CDC - Zika Virus Does Cause Microcephaly and Brain Defects in Foetus

In April 2016, the USA CDC (Centers for Disease Control and Prevention), following publication of an article in the New England Journal of Medicine that reviewed the available evidence, issued a statement that concluded, after careful review of existing evidence, Zika virus infection in pregnancy is a cause of microcephaly and other severe foetal brain defects. See our travel health reports and Zika Virus Fact Sheet for further information and advice.

Correct Information on Insect Repellents

In view of the concerns about Zika virus and other mosquito-borne infections, and in response to queries from subscribers, we advise the following:

Of the personal insect repellents on the market in Australia, the peak USA public health body, the Centers for Disease Control & Prevention (CDC), advises that the only repellents that are effective enough to recommend are those that contain adequate amounts of the following:

deet (available in multiple brands in Australia)

picaridin or icaridin (available in multiple brands in Australia)

oil of lemon eucalyptus (OLE) or PMD (the only product available in Australia is Mosiguard)

An evidence-based review of insect repellents (Goodyer LI et al Journal of Travel Medicine 2010*) advises that there are only 3 active ingredients in insect repellents that provide enough protection (when in appropriate product concentrations) to be recommended. They are those listed above.

The CDC advice has been available for almost 10 years. A review on 1 February 2016 of health department websites in Australia reveals that there is only one federal, state or territory health department (South Australia) that even mentions PMD/OLE as a personal insect repellent choice. Many travel health clinics and other authorities also are failing to provide the same up to date information as provided by the South Australia State Health website.

When providing advice, rather than just referring to the active constituent as PMD, it is advisable that it be referred to as extract of lemon eucalyptus, and that the concentration must be 30% or greater (i.e. greater than 300g/kg). This would assist members of the public in selecting the effective products that contain the correct active ingredient and the correct concentration.

*Goodyer LI et al. Expert Review of the Evidence Base for Arthropod Bite Avoidance. DOI: 10.1111/j.1708-8305.2010.00402.x. Journal of Travel Medicine 2010; Volume 17 (Issue 3): 182–192

Chikungunya in Argentina

Chikungunya cases have now been detected in Argentina. The first cases were detected throughout January and February 2016. Prevention is by protection against mosquito bites as for dengue and Zika. See travel health reports and our Fact Sheets for further information.

Yellow Fever in Angola

In February 2016, it is reported that, because of ongoing cases of yellow fever, especially in Luanda Province (but also other provinces), Angolan authorities are aiming to vaccinate over 1.5 million persons in a mass vaccination campaign. Travellers to Angola should be in date for yellow fever vaccination unless there are contraindications. For persons who are unable to have yellow fever vaccination, travel to Angola should be avoided. See travel health reports and our Fact Sheets for further information.

Zika Virus Infection - more countries affected

In January 2016 it was confirmed that Zika virus infections acquired locally have now occurred in Haiti, St Martin and Guadeloupe in the Caribbean. In March 2016, locally acquired infections were reported in Cuba and Dominica. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports and our Fact Sheets for further information.

Zika Virus Infection in Puerto Rico

Zika virus infections acquired locally have been reported from Puerto Rico for the first time ever in late December 2015. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports and our Fact Sheets for further information.

Zika Virus Infection in Colombia and Suriname

Zika virus infections acquired locally have been reported from Colombia and Suriname for the first time ever in 2015. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports for further information.

Dengue in Egypt

In November 2015, an outbreak of fever involving over 250 cases in October 2015 in Dayrout District (Assiut Governorate), was confirmed as dengue. See travel health reports for further information.

Scrub typhus in Nepal

In 2015 (October) authorities reported an increase in cases of scrub typhus, with a number of deaths, in a number of districts in Nepal. This infection caused by the bacteria Orientia tsutsugamushi is transmitted by mite bites. Treatment is with doxycycline. Prevention is by bite avoidance measures including effective personal insect repellents. See travel health reports for further information.

Cholera in Iraq

In 2015 (September) a significant outbreak commenced. The outbreak is thought to be related to a contaminated water source. Cholera is transmitted by contaminated food and water. Outbreaks tend to occur in areas with poor sanitation. An oral cholera vaccine is available for those at risk. See travel health reports and our Fact Sheet on cholera and the vaccine (Dukoral).

Trichinellosis Outbreak in Argentina

In September 2015, authorities reported a large outbreak of trichinellosis in Bahia Blanca, with over 100 cases including children. Trichinellosis is caused by the roundworm Trichinella spiralis. A large outbreak was also reported in February 2015 (see below) in Pehaujo Municipality, Buenos Aires province, after eating sausages from a butcher shop in Pehaujo. This infection can cause severe illness in humans. See travel health reports for further information.

Cholera in Tanzania

In 2015 (July) a significant outbreak commenced with cases reported into September and occurring in Kigoma region, thence Dar es Salaam region, Iringa, Morogoro and Pwani (Coast). The outbreak was continuing into October-November 2015, involving Dar es Salaam, Dodoma, Geita, Iringa, Kigoma, Kilimanjaro, Mara, Morogoro, Mwanza, Pwani, Shinyaga, Singida and Zanzibar.Cholera outbreaks occur commonly throughout Tanzania. Cholera is transmitted by contaminated food and water. Outbreaks tend to occur in areas with poor sanitation. An oral cholera vaccine is available for those at risk. See travel health reports and our Fact Sheet on cholera and the vaccine (Dukoral).

Parvovirus not Chikungunya Case in Spain and France

In July 2015, authorities advised of a case of Chikungunya virus in a 60 year old male from Gardia Valencia with no history of travel to an endemic area. The patient was diagnosed in Spain but had travelled to France. Subsequent testing could not confirm Chikungunya. The illness may have been caused by Parvovirus. Nevertheless, travellers are reminded that ill travellers may introduce infections into their home country on return.

Poliovirus in Madagascar

In July 2015, authorities advised of at least 8 cases of flaccid paralysis caused by a vaccine-derived poliovirus strain, linked to a strain from a case notified in September 2014. Travellers should be fully immunised against polio. See individual travel health reports and our Fact Sheet on Polio.

MERS-CoV in Thailand

In June 2015, Thailand notified its first case of MERS-CoV (Middle East Respiratory Syndrome Coronavirus) in a male who travelled from Oman to Bangkok. This case is unrelated to the ongoing outbreak that recently commenced in South Korea that was also following return of an infected traveller to South Korea from the Middle East. See individual travel health reports and our Fact Sheet on MERS-CoV.

MERS-CoV in South Korea

A large outbreak of MERS-CoV (Middle East Respiratory Syndrome Coronavirus) commenced in South Korea following return of an infected traveller to South Korea from the Middle East. A related case also occurred in China (after travel from South Korea to Hong Kong SAR and mainland China) . See individual travel health reports and our Fact Sheet on MERS-CoV.

Measles in Chile
A number of measles cases were notified in Santiago in May 2015. Travellers should know their measles immune-status. Unless there is a history of confirmed measles in the past, or of having had two measles vaccinations, measles vaccination is recommended for all travellers, providing there are no contra-indications to having the vaccine.

Zika Virus Infection in Brazil
Zika virus infections acquired locally have been reported from Brazil for the first time ever in 2015. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) than those seen with dengue. Prevention is by protection against mosquito bites as for dengue.

Zika Virus Infection in Vanuatu

Zika virus infections were reported from Vanuatu in May 2015. Zika virus is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See travel health reports for additional details.

Ebola Virus Case in Italian Healthcare Worker in Rome
An Italian healthcare worker who contracted Ebola Virus Disease (EVD) in Sierra Leone was confirmed by laboratory diagnosis in May 2015 and hospitalised in Rome. See health reports and website for further information.

Typhoid in Uganda
A typhoid outbreak was reported in the Ugandan capital Kampala, commencing early 2015, ongoing as at April 2015 and with spread to other parts of Uganda. Contaminated water and juices were thought to be significant sources. See our travel health reports for futher information.

Measles Outbreak in USA - Reminder to Travellers
The current (2014-2015) measles outbreak in USA is a reminder that many measles outbreaks occur when travellers become infected while overseas and then spread the virus when they return to Australia, New Zealand or their home country. Measles is highly contagious and causes severe illness. Travellers should know their measles immune-status. Unless there is a history of confirmed measles in the past, or documentation of having had two doses of measles-containing vaccine, measles vaccination is recommended for all travellers, providing there are no contra-indications to having the vaccine.

Yellow Fever Cases in Brazil
In February 2015 two cases of yellow fever were confirmed related to travel or residence in Alto Paraiso. One case was fatal. Travellers are reminded to check if yellow fever vaccination is required for their travel. See travel health reports for further information.

Trichinellosis Outbreak in Argentina
In February 2015, authorities advised of large number of people have been affected by the roundworm Trichinella spiralis in Pehaujo Municipality, Buenos Aires province, after eating sausages from a butcher shop in Pehaujo. This infection can cause severe illness in humans. See travel health reports for further information.

Typhoons in South East Asia December 2014
With recent typhoons there has been flooding in a number of countries including Indonesia, Malaysia and Thailand. This increases the risk of outbreaks of diseases such as those related to contaminated water e.g. diarrhoeal diseases (including cholera) and leptospirosis. When flooding is extensive, outbreaks may occur in urban areas as well as rural areas. See travel health reports for further information.

Bubonic Plague in Madagascar
In August through November 2014 inclusive, a significant outbreak of bubonic plague has occurred in Madagascar with cases in the capital Antananarivo. Fatality rate has been 30% to date. See travel health reports for further information.

Legionnaires Disease in Portugal
In November 2014, health authorities advised of Portugal's largest ever outbreak of Legionnaires Disease in Lisbon. See travel health reports for further information.

Ebola Virus Disease Case in Mali
In October 2014, health authorities advised that tests confirmed the death of a 2 year old girl in Kayes was due to Ebola Virus Disease (EVD). The child developed EVD in Guinea and travelled to Kayes where she was hospitalised and died. With WHO, health authorities have implemented contact tracing and other measures. See travel health reports for further information.

Leptospirosis in Popular Recreational Park Malaysia
In October 2014, health authorities temporarily closed the Jeram Toi waterfall and recreational park in Negeri Sembilan State (western Malaysia) after 4 teenage children became ill with leptospirosis after swimming at the park. See travel health reports for further information.

Chikungunya in Tahiti (French Polynesia)
In October 2014,authorities advised the first ever cases of Chikungunya virus infection have been reported in Tahiti. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue and zika virus infections also seen in French Polynesia, all of which are transmitted by mosquito bite. See health reports for further information.

Ebola Cases (Suspected) in Addis Ababa (Ethiopia) Hospitals
In October 2014, four (4) cases of suspected EVD were reported to be hospitalised in Kenya's northern neighbour, Ethiopia (in Addis Ababa hospitals), related to persons travelling from areas affected by the ongoing outbreak in West Africa. As Kenya and Ethiopia are hubs for travellers in Africa, authorities have marked Kenya and Ethiopia as high risk countries for importation of Ebola Virus Disease (EVD) cases. See health reports for further information.

Marburg Virus Case in Kampala Uganda
A healthcare worker in Kampala died in September 2014 from Marburg Virus Disease (MVD), which is caused by Marburg virus a filovirus from the same family as Ebola. Authorities have implemented surveillance and contact tracing measures. See health reports for further information.

Ebola Virus Case in Spanish Healthcare Worker in Madrid
A healthcare worker in Madrid who contracted Ebola Virus Disease (EVD) from a patient who arrived from Sierra Leone in September 2014 is the first case of person-to-person transmission of Ebola described outside of Africa. See health reports and website for further information.

Ebola Virus Death in USA
Following the death in Dallas Texas of a Liberian national of Ebola Virus Disease (EVD) in October 2014, travellers should be aware that authorities have advised of increased screening measures at five international airports in USA (Atlanta, JFK, Newark, O'Hare and Dulles).

Enterovirus (EV-D68) in USA and Canada
In September 2014, an Enterovirus (EV-D68) infection has been notified with cases in 12 states (Alabama, Colorado, Illinois, Indiana, Kansas, Kentucky, Louisana, Missouri, New York, Oklahoma, Pennsylvania) and likely in other states, and also in Canada: Toronto (Ontario), Alberta, British Columbia and likely other provinces. Symptoms include fever, runny nose, cough, body and muscle aches. There have been cases of paralysis with polio-like illness. See travel health reports for further information.

Chikungunya Virus Infection in Samoa and American Samoa
In July 2014, local transmission of chikungunya virus infection was reported for the first time in Samoa and American Samoa. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue virus infection, both of which are transmitted by mosquito bite. The concern is that the infection is now becoming widespread in the South Pacific Islands. See our travel health reports for additional details.

Ebola Virus in Democratic Republic of Congo
In August 2014, the seventh recorded outbreak of Ebola Virus Disease (EVD) was reported from DRC and continues through September 2014. It is unrelated to the outbreak described below. The index case was a pregnant woman who butchered a bush animal that had been killed and given to her by her husband. She subsequently died, as did health care workers who cared for her as well as relatives and persons who helped with funeral activities. See our travel health reports for additional details.

Ebola Virus in West Africa

Since the outbreak of Ebola commenced in early 2014, there has been, by end August 2014, over 3000 cases of Ebola virus disease (EVD) with over 1500 deaths. The outbreak continues through August. Quarantine zones have been set up in areas of high transmission, including some cities. The affected countries (Guinea, Liberia, Nigeria and Sierra Leone) continue to report new cases. A case (fatal) hospitalised in Lagos, Nigeria, travelled to Nigeria from Liberia via Lome (Togo) and Accra (Ghana) while unwell with EVD. See travel health reports for further information and advice.

Brazil FIFA World Cup 2014 & Yellow Fever Vaccination

Subscribers are advised to check our Fact Sheet Section for extra guidance when advising travellers going to the FIFA World Cup 2014

Chikungunya Virus Infection in Tonga

In April 2014, local transmission of chikungunya virus infection was reported for the first time in Tonga. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue virus infection, both of which are transmitted by mosquito bite. The concern is that the infection will become widespread in other South Pacific Islands. See health reports for additional details.

MERS-CoV Case Dies in Malaysia

In April 2014, a man died from MERS-CoV infection following a trip to Saudi Arabia. See our Fact Sheet and travel health reports for more detail.

Zika Virus Infection in Cook Islands

Zika virus infections were reported from Cook Islands in March 2014. This virus was likely introduced from French Polynesia where it has been causing outbreaks. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See health reports for additional details.

Polio in Iraq

In March 2014, the first case of polio since 2000 was confirmed in a 6 month old boy who developed paralysis in the previous month. He had not been immunised against polio. Laboratory tests indicate the poliovirus was similar to the strain causing the ongoing Middle East outbreak. See health reports for further information.

Ebola Outbreak in Guinea

In February 2014, an outbreak of hemorrhagic fever later identified as Ebola, occurred in Southern Guinea and is continuing through March and likely April. Ebola is a virus infection that has a high case fatality rate (up to 90% but may be as low as 25%) and can be spread by direct contact with infected blood/secretions. Patients with Ebola may cross the border to enter Sierra Leone and Liberia for medical care. See health reports for additional information.

Zika Virus Infection in Easter Island

Zika virus infections were reported from Easter Island in March 2014. This virus was likely introduced from French Polynesia where it has been causing outbreaks. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See health reports for additional details.

Zika Virus Infection in French Polynesia & New Caledonia

Zika virus infection has been reported from New Caledonia. Cases have also been described from Tahiti. Zika virus is a virus that is transmitted by mosquito bites. Symptoms are similar (but usually milder) to those seen with dengue. Prevention is by protection against mosquito bites as for dengue. See health reports for additional details.

Chikungunya Virus Infection in Caribbean

In December 2013, local transmission of chikungunya virus infection was described for the first time in the Caribbean. The cases were detected on the island of Saint Martin. Chikungunya virus infection causes high fever, headache and joint pains. It is rarely fatal but needs to be distinguished from dengue virus infection, both of which are transmitted by mosquito bite. The concern that the infection will spread to other Caribbean islands has proven well-founded with cases now being reported from other Caribbean islands. See health reports for additional details.

Measles in Travellers

Measles transmission occurs in many overseas destinations including tropical countries. Measles cases in returned travellers can lead to outbreaks in their home country upon return. Travellers have returned from some popular destinations in recent times (e.g. Bali) and have subsequently been diagnosed as having measles. Travellers should know their measles immune-status and check with their doctor to determine whether they require measles vaccination. See our website health reports for more information.

Japanese Encephalitis in Brunei Darussalam

Japanese Encephalitis cases were reported in Brunei in October 2013, with cases reported from Belait, Tutong and Brunei-Muara Districts. This mosquito borne virus infection has never previously been reported from Brunei. See our health reports for more detail.

Cholera cases in Mexico

An outbreak of cholera in October 2013 has led to cases in the states of Hidalgo, Mexico, San Luis Potosi, Vera Cruz and Distrito Federal. Government authorities are on alert. The strain of cholera is similar to that circulating in Cuba, Haiti, Dominican Republic in recent years. See our website health reports for more detail.

Novel Corona Virus Infection Proposed Name is MERS-CoV

A Qatari traveller returned from Saudi and developed an acute respiratory illness and kidney failure in September 2012. The illness was caused by a novel coronavirus. Illnesses caused by coronaviruses vary from the common cold to severe illness like SARS. Cases continue to be reported from a number of countries in the Middle East. In May 2013, the proposed name for the virus is Middle East Respiratory Syndrome Coronavirus (MERS-CoV). See Fact Sheets and Travel Health Reports.

Measles in United Kingdom

A large measles vaccination campaign was commenced in the UK in April 2013 following an outbreak of measles that started in Wales. Travellers are advised to know their measles immune status and, providing there are no contraindications, be vaccinated if not immune. See Travel Health Reports for further information.

Influenza A (H7N9) in China

On 31 March 2013 China notified three laboratory confirmed cases of Influenza A (H7N9) and since then a number of cases have been notified with over 100 cases notified as at late April 2013. See Travel Health Reports for further information.

Liver Fluke in Travellers Returning from Bali

A recent report advises of 6 travellers diagnosed with liver fluke (Fasciola) infection that was acquired in Bali. Initially some travellers were diagnosed with liver cancer and one had major surgery for that. Infectious diseases consultation led to the diagnosis. The most likely mode of acquisition was from eating fresh or under cooked water plants including watercress salad. See Travel Health Report for further information.

Chikungunya in Papua New Guinea

Outbreaks of dengue fever and Chikungunya, both transmitted by mosquitoes, have been reported in recent years, with the first recorded outbreaks of Chikungunya being in 2012, the first descriptions coming from West Sepik (Sundaun) Province. Both virus infections are transmitted by daytime biting mosquitoes so travellers should take steps to avoid mosquito bites. See Fact Sheets and Travel Health Reports.

Novel Corona Virus Infection

A Qatari traveller returned from Saudi and developed an acute respiratory illness and kidney failure in September 2012. The illness was caused by a novel Corona virus. Illnesses caused by Corona viruses vary from the common cold to severe illness like SARS. Cases continue to be reported. See Fact Sheets and Travel Health Reports.

Contaminated acai juice risk for Chagas Disease

A recent outbreak of American trypanosomiasis (Chagas Disease) was reported from Para state Brazil. Contaminated fruit juices made from berries of acai and bacaba palms are thought to be the source. Eating contaminated food and drink was discovered to be a way of acquiring the disease in 2005. Adequate preparation of acai is required to avoid contamination. See Fact Sheets and Travel Health Reports.

Unusual parasitic illness in travellers returning from Malaysia

An unusual parasitic illness called Sarcocystis has been described in a few French travellers returning from Tioman Island in the middle of 2011. This illness causes a variety of symptoms, most prominent being fever, muscle pain, abdominal pain, diarrhoea and generalised symptoms. Symptoms usually occur a few weeks after exposure but tests may not become abnormal until over a month after exposure. See Travel Health Advisor Travel Health Reports for more information.

Ebola virus outbreak confirmed in Uganda & New Outbreak DRC

In July 2012 an outbreak of Ebola virus infection was confirmed in western Uganda (Kibaale District) with at least 20 cases (14 deaths) by late July. As at mid-August there have been 24 probable and confirmed cases cases (16 deaths). An isolation facility in Mulago Hospital is available. Ebola virus outbreaks occur episodically in Uganda. Risk for travellers is low but all travellers to Uganda should be on alert until the outbreak is contained. On 17 August 2012, WHO was notified of an Ebola outbreak in Democratic Republc of Congo (10 suspected cases and 6 deaths). See Travel Health Reports for further information and updates.

Sleeping Sickness in Tourists

Two European travellers have became unwell from Sleeping Sickness (Human African Trypanosomiasis or HAT) following visits to Masai Mara National Reserve in Kenya. This has focused attention on a parasitic illness (fatal if untreated) that most travellers to Africa rarely consider, until they get bitten by the insect that transmits the infection – the tsetse fly (Glossina species). WHO reports that, from 2000 to 2010 inclusive, there have been 94 cases of HAT reported in countries outside the endemic area. By far the largest percentage of these reported cases of East African Sleeping Sickness (caused by the parasite Trypanosoma brucei rhodesiense) has been in tourists, who have often acquired it while on short trips especially to the Serengeti (Tanzania), but also to rural areas and game parks in Kenya, Malawi, Tanzania, Uganda and Zambia. A case from Zimbabwe was in a park ranger. See Fact Sheets and Travel Health Reports.or further information.

Greece and Malaria Cases

Malaria cases (P.vivax) are still occurring in Greece with at least 11 more locally acquired cases reported since June 2012. Originally, by October 2011, locally acquired P.vivax malaria cases were described from Evrotas (Lakonia District), Eastern Attiki, Evia, Viotia, Larissa, with most cases being from rural areas of Evrotas. Since then cases have been documented from other towns. While malaria cases have been described in persons entering Greece from malaria endemic areas, some cases have been acquired by persons who have not travelled to a malaria area, indicating that they acquired malaria in Greece. Travellers are advised to be vigilant with anti-mosquito measures and consider malaria in cases of fever. See Fact Sheets and Travel Health Reports for further information.

South Africa & Yellow Fever Requirements for Travel from Zambia

In the past there has been some debate as to whether the western provinces of Zambia are included in the yellow fever endemic zone. World Health Organisation advises that it is not. However some maps from other (usually older) sources include this region within the endemic zone. Since the Yellow Fever outbreak in Uganda, East African and other African countries have been on high alert. South Africa authorities proclaimed that will be requiring a valid Yellow Fever Vaccination Certificate from all persons travelling from Zambia to South Africa from 1 July 2011, unless there is a medical contraindication. See the personalised Travel Health Advisor Health Report for further information. This requirement was reversed on 21 July 2011 but appears to have been reinstated effective from 1 October 2011 - See Fact Sheets and Travel Health Reports for updates.

Chad Poliomyelitis Outbreak

Since 2007 there has been an ongoing outbreak of poliomyelitis in Chad. Cases are still being reported in Chad in 2011. This and previous outbreaks have been associated in the past with spread to other countries, including spread into Sudan between 2004 and 2006. See the personalised Travel Health Reports.for further information.

Philippines and Schistosomiasis (Bilharzia)

A recent outbreak of schistosomiasis in a Leyte town is a reminder that schistosomiasis is still endemic in parts of Philippines. See the personalised Travel Health Reports.for further information.

Germany Severe Illness caused by E.coli - Cases in other EU Countries

In May 2011, authorities were alerted to a number of cases of Hemolytic Uremic Syndrome (HUS), a severe kidney disorder, occurring in Hamburg. Cases have snce been identified in other parts of Germany including Bavaria and now cases have been reported from other EU countries including Denmark, France, Netherlands, Sweden, Switzerland, UK. HUS usually follows a gastroenteritis-like illness caused by a toxin-producing strain of E.coli, in this case EHEC strain 0104:H4. Most cases in Europe appear related to the outbreak in Germany where over 20 deaths and over 2000 cases have occurred. Cases have also occurred in North American travellers returning from Europe. See the personalised Travel Health Reports for further information.

More Chikungunya Cases Diagnosed in New Caledonia

Chikungunya cases continue to be detected in New Caledonia, as at 25 May 2011. This discovery follows on from the announcement by health authorities on Friday 25th February 2011 of the first case of acute chikungunya virus infection in New Caledonia, in a person travelling from Indonesia. Authorities advise the local population to be stringent with eliminating mosquito breeding sites. See the personalised Travel Health Reports and Fact Sheets for further information.

Australia Torres Strait Islands Malaria Outbreak

Malaria cases have been reported on Saibai and Dauan in the Torres Strait, leading authorities to limit travel between Papua New Guinea and the Torres Strait Islands effective as of 28 March 2011. Travel that is covered by the Torres Strait Treaty will not be affected. Seven cases of malaria have been diagnosed on Saibai Island, with the last case diagnosed on 10 April 2011. The risk of spread of malaria to the mainland of Australia is low. Antimosquito measures are recommended for travellers to the region. See the personalised Travel Health Reports and Fact Sheets for further information.

Hepatitis E in France from Uncooked Pig Liver Sausages

An outbreak of Hepatitis E has been reported in the first quarter of 2011 from Marseille in south eastern France, with most cases occurring from the end of February 2011. Of the initial 11 cases, 10 were males. Cases are thought to have been associated with consumption of uncooked pig liver sausages. Hepatitis E is a virus infection which has an incubation period of 2-9 weeks. With diagnosed illness there is a reported mortality rate of 1-4%. Infected pigs (because virus replicates in their liver) are a reservoir for the virus. Following this discovery, health authorities now require that producers label pig liver sausages with a warning advising the sausages must be cooked thoroughly. See the personalised Travel Health Reports and Fact Sheets for further information.

Malaria in Swaziland

April 2011, health authorities advise of a malaria outbreak in the Sidvwashini region of Northern Hhohho and surrounding areas of Masutaneni, Ngonini and Nya-katfo. It is thought cases relate to travellers infected with malaria returning from neighbouring malaria countries. Local transmission in Swaziland is thereafter likely due to the presence of Anopheline mosquitoes in Swaziland. See the personalised Travel Health Reports and Fact Sheets for further information.

Legionnaires' Disease Outbreak in Dundee Scotland

As at 25 March 2011, health authorities advise of more than 60 persons having an illness thought to be Legionnaires' Disease after suspected exposure to the Legionella bacterium at the Landmark Dundee four star hotel. The hotel's leisure centre is the focus of public health investigations. See the personalised Travel Health Reports and Fact Sheets for further information.

East Africa on Yellow Fever Alert

The Yellow Fever outbreak in Uganda has placed health authorities in Kenya and Tanzania on alert. Travellers should be aware that immigration authorities will be checking Yellow Fever vaccination status upon entry into both Kenya and Tanzania, with the possibility that travellers without a valid Yellow Fever Vaccination Certificate may be vaccinated "on the spot" upon entering Tanzania or Kenya. Reports indicate that authorities are requesting valid Yellow Fever vaccination certificates for entry into Zanzibar. See the personalised Travel Health Reports and Fact Sheets for further information.

Ackee Fruit Poisoning in Jamaica

Health authorities, February 2011, advise of an increase in deaths and sickness in Jamaica in the last 3 months from ackee fruit poisoning. Ackee is a fruit related to the lychee and longan. It is widely used in local cuisine. Illness is caused by a substance in the fruit (especially unripe fruit) called hypoglycin which cause dangerously low blood glucose and an illness associated with abdominal pain, diarrhea and often severe vomiting. There are no reports of travellers being affected to date but travellers should be aware to report any episodes of severe gastroenteritis or drowsiness. See the personalised Travel Health Reports and Fact Sheets for further information.

Australia Floods Cyclones & Disease Risk including Dengue

Following the floods & cyclone in Queensland a number of reports are filtering through about disease risks and outbreaks. The following diseases can potentially increase due to damage and disruption caused, problems with safe water and population movements and during clean up, but risk for some like mosquito borne diseases may not impact until after the recovery period : diarrhoeal diseases, illnesses related to injury like serious skin and soft tissue infections, or leptospirosis, an infection caused by bacteria often found in water contaminated by urine from rats and cattle in particular. There is expected to be an increase in cases of dengue. This unpleasant viral disease can cause fever, rash and joint pains. Rarely, it can be fatal. There is no specific cure. Treatment is given to relieve symptoms. In dengue especially one should avoid the use of aspirin and other anti-inflammatory medications as they may aggravate bleeding tendencies caused by the disease. Use paracetamol instead. Dengue virus is transmitted by daytime biting mosquitoes so travellers should take steps to avoid mosquito bites. See Travel Health Advisor Fact Sheet. Outbreaks of dengue fever, a viral illness transmitted by mosquitoes, have been reported in recent years. Cases of dengue fever have been reported in North Queensland in recent years including popular tourist spots like Cairns, Port Douglas, Townsville and other parts of Far North Queensland. Cases are often highest during and after the rainy/monsoon season.Cases have been detected following the floods and cyclone in Innisfail (February 2011). See the personalised Travel Health Reports and Fact Sheets for further information.

Ivory Coast (Cote D'Ivoire)

A Yellow Fever outbreak was notified on 3 January 2011 in the north of Cote D'Ivoire. As of January 2011, more than 60 cases (more than 20 deaths) have occurred in 12 districts in Beoumi and Katiola districts (central region) and Worodougou region (north) of the country. There is concern about spread to other parts of the country. Health authorities wil be implementing a mass vaccination program against Yellow Fever, proposed start date is 22 January 2011, in Beoumi, Katiola, Makono & Seguela districts. Travellers are reminded to be in date for Yellow Fever vaccination for travel to Cote D'Ivoire and other Yellow Fever endemic countries. See the personalised Travel Health Reports and Fact Sheets for further information.

Bali & Legionnaire's Disease

West Australian health authorities reported two cases of severe pneumonia caused by Legionnaires' Disease in travellers returning from Bali. At that stage (August 30 2010) it was not certain where they were exposed to the bacteria. Since then, by January 2011, further cases have been reported in travellers returning to Western Australia and Victoria. 11 cases have been notified in total to date. Of 10 cases, 9 have stayed at the same hotel in Kuta Beach (The Ramayama Resort & Spa) but most had also visited the same local shopping centre. Legionnaires' Disease is caused by a bacterium that is spread in aerosols (very small water particles) often from heated or warm water such as seen with hot tubs, jacuzzis and water misting devices. See the personalised Travel Health Reports and Fact Sheets for further information.

Uganda Outbreak Confirmed as Yellow Fever

An illness that commenced in northern Uganda in early November 2010 has been confirmed as Yellow Fever. As of January 2011, more than 200 cases (more than 50 deaths) have occurred in 12 districts in northern Uganda. There is concern about spread to other parts fo the country. Health authorities wil be implementing a mass vaccination program against Yellow Fever, proposed start date is 22 January 2011. Travellers are reminded to be in date for Yellow Fever vaccination for travel to Uganda and other Yellow Fever endemic countries. See the personalised Travel Health Reports and Fact Sheets for further information.

Hong Kong Raises Bird Flu Level to "Serious" after Bird Flu - Avian A/(H5N1) Influenza Case Detected

As at 17 November 2010, China Health Authorities advise of a case of H5N1 in Hong Kong that was detected in a 59 year old female who is thought to have acquired the infection while travelling in mainland China where she visited a poultry market. The last case in China was in Hubei Province in June 2010, where the patient died but no other human cases were reported. See the personalised Travel Health Reports and Fact Sheets for further information.

Cholera in Papua New Guinea

As of 30 November 2010, the large outbreak of cholera that commenced in Daru in Western Province in October 2010 has spread to mainland areas of Western Province. Travel from Daru to Australian Torres Strait Islands is being restricted by Australian authorities to prevent spread. Since September 2009, when the first outbreak of cholera was confirmed in Morobe Province, cholera has spread to other parts of PNG. Vaccination is recommended for humanitarian & aid workers & persons in close contact with local populations, but be aware that safe food & water precautions are paramount in cholera prevention. See the personalised Travel Health Reports and Fact Sheets for further information.

Cholera in Haiti

The cause of the disease outbreak in the central rural region of Artibonite was confirmed as cholera and, as of 12 November 2010, the outbreak had spread to other parts of Haiti including the capital, Port au Prince, and one of the main offshore islands (La Gonave). At 30 November 2010, the outbreak was widespread with over 70,000 cases and almost 2,000 deaths having been reported since the outbreak was first detected in mid-October 2010. Vaccination is recommended for humanitarian & aid workers & persons in close contact with local populations, but be aware that safe food & water precautions are paramount in cholera prevention. See the personalised Travel Health Reports and Fact Sheets for further information.

Cholera in Pakistan

Health authorities advise that flood affected provinces of Sindh, Punjab and Khyber Pakhtunkhwa reported laboratory-confirmed cases of cholera following the flooding. Vaccination is recommended for humanitarian & aid workers & persons in close contact with local populations, but be aware that safe food & water precautions are paramount in cholera prevention. See the personalised Travel Health Reports and Fact Sheets for further information.

Bird Flu Cases in Java (Indonesia)

Two recent laboratory confirmed cases have been notified from Java. Both died. One, in August 2010, a 35 year old male in West Jakarta likely contracted the infection from dead birds around his house. The other, in September 2010, a 40 year old female in Kota Depok, West Java, likely acquired the infection at a live bird market. Of 170 cases of H5N1 notified from Indonesia, 141 have been fatal. See the personalised Travel Health Reports and Fact Sheets for further information.

Chikungunya Outbreak in China (South Guangdong Province)

Local health authorities advise that, at 8 October 2010, just over 200 cases of Chikungunya virus infection have occurred in persons in Xinchun community (Dongguan City) in Wanjiang District. Almost 40 cases have been confirmed with serology tests. Chikungunya virus infection is spread by mosquitoes and causes illness with fever, body aches, rash and arthritis. It can be difficult to distinguish from Dengue without performing the specific blood tests. outbreaks usually occur in tropical areas of Africa, Asia and South East Asia. Prevention is by anti-mosquito measures. See the personalised Travel Health Reports and Fact Sheets for further information.

Rabies Outbreak in Bali

A rabies outbreak was identified in Bali and adjacent islands in mid-2008. The first incident involved a Flores man who was bitten by a dog apparently imported to Bali from Flores. He did not die from rabies until January 2009, but at least 5 deaths occurred before his death (4 in Ungasan and 1 in Kutuh, with 3 of these cases being children aged less than 5 years). Since then, by early October 2010, around 100 human deaths had been identified, with unofficial reports placing the number of deaths even higher than this figure. Rabid dogs have been found in and around popular tourist resorts. Deaths in humans living near tourist areas have been reported. Bali was previously regarded as free of rabies. This ongoing outbreak means that Bali is unlikely to be regarded as rabies-free for many years, if ever. Rabies is a viral infection usually spread by the saliva of infected animals. It is fatal once symptoms begin. Pre-exposure vaccination is recommended for long-stay travellers, those remote from medical help (>24 hours), and animal handlers. All travellers must seek prompt post-exposure vaccines if bitten/scratched. See the personalised Travel Health Reports and Fact Sheets for further information.

Cholera Outbreak Sweeping Through Central Africa

WHO advises that, at 3 October 2010, over 40,000 cholera cases (almost 2,000 deaths) have occurred in the region, with Cameroon, Chad, Niger & Nigeria being the countries most affected. Flooding with the rainy season, poor hygienic conditions and population movements have been blamed for the greater than usual number of cases. Food and water precautions are essential for prevention of cholera but an oral cholera vaccine (Dukoral) is available for travellers who are at risk. See the personalised Travel Health Reports and Fact Sheets for further information.

Yellow Fever in Senegal

On 20 September 2010, Senegal Health Authorities reported a susected case of Yellow Fever in Mbour health district (Thies region). This is about 50km from Dakar. The case was a 27 year old fisherman who was working in Gambia (Tandji). A second suspected case with the same exposure was also reported. This is just another reminder to travellers that West Africa is a high risk region for Yellow Fever. Prevention is by vaccination. See the personalised Travel Health Reports and Fact Sheets for further information.

Polio in Angola & Democratic Republic of the Congo

WHO advises that, at 8 September 2010, outbreaks of polio are continuing to occur in these two countries. The causative strain is the wild poliovirus type 1 (WPV1). The outbreak in Angola commenced in April 2007 and has spread to DR Congo. A case in Burundi in 2009 was linked to the same outbreak. WHO regards the polio situation in Central Africa as the greatest impediment to being able to eradicate polio from Africa. Previous problem areas have had no ongoing outbreaks eg West Africa (no cases since 1 May 2010) and Horn of Africa (no cases for more than 12 months), but continued surveillance is essential to ensure that new cases are not missed. Travellers to countries where polio still occurs, or to countries bordering on such countries, should be in date for polio vaccination. See the personalised Travel Health Reports and Fact Sheets for further information.

Pandemic Influenza A/H1N1 Vaccine

As of 30 September 2009, a vaccine that induces protective immunity against the pandemic Influenza A/H1N1 vaccine became available and is free. Australian health authorities advise that all travellers should be vaccinated with this influenza vaccine, or a seasonal influenza vaccine that contains the pandemic H1N1 vaccine strain, prior to travelling overseas, provided there are no contraindications. See the personalised Travel Health Reports and Fact Sheets for further information.