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Latest health alerts for international travelers

EARTHQUAKE RELIEF in HAITI

02/08/2010 11:58 PM

SWINE FLU in WORLDWIDE PANDEMIC

02/08/2010 11:58 PM

Jan '10- The Pandemic Level is currently a 6 out of 6. Worldwide more than 208 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1, including at least 12,220 deaths. The numbers above are the last reported. Many countries have stopped reporting individual numbers of cases. The pandemic (H1N1) 2009 influenza virus outbreak remains moderate and its effects are probably closer to those of 1957 and 1968 than the far more deadly 1918 version, the World Health Organization (WHO) said on Monday [17 Jan 2010]. Due to the circulation of 2009 H1N1 influenza in the United States and many other countries, airport staff in some foreign countries may check the health of arriving passengers. If you are sick with symptoms of flu-like illness, you should not travel. In other countries that are conducting entry screening for 2009 H1N1 flu, travelers may be checked for fever and other symptoms of 2009 H1N1 flu, and their travel may be delayed. Consult the embassy of the country, or countries, in your travel itinerary for information about entry screening procedures. Because these outbreak-related delays, which could include several days of quarantine, may affect planned activities and lead to unexpected costs, CDC strongly recommends that travelers consider purchasing travel insurance. China's Health Ministry has urged vulnerable groups to H1N1 vaccinations or limit travel during the upcoming Chinese Lunar New Year holiday due to the spread of the pandemic A (H1N1) virus. "Pregnant women, children, the elderly, obese people, and those with chronic diseases should avoid public travel during the peak period of Spring Festival travel. This year's travel period extends from 30 Jan 2010 to 10 Mar 2010. The Ministry also urged for prevention measures to be stepped up, including wearing face masks, frequently washing hands and getting early medical checkups for coughs and other flu symptoms, it said. The Ministry announced it had recorded 659 swine flu deaths in China in 2009, nearly all of them in the last 2 months of the year, and warned that the danger of mass outbreaks still existed in certain areas. Swine Influenza is a respiratory disease of pigs caused by type A Influenza Viruses. There is no evidence to show that swine flu can be transmitted through food. Eating properly handled and cooked pork and pork products is safe. Travelers should receive an H1N1 vaccine.

AVIAN INFLUENZA in CHINA, EGYPT, GERMANY, INDONESIA, NEPAL, VIETNAM

02/08/2010 11:58 PM

Jan '10- In Cambodia 9 cases and 7 deaths have been confirmed to date. In China 7 cases and 4 deaths were confirmed in 2009 according to WHO. The Centre for Health Protection (CHP) of the Department of Health is investigating a case of influenza A (H9N2) infection -- a mild form of avian influenza -- involving a 35-month-old girl. This is the 7th time that H9 viruses were found in humans in Hong Kong. Five females and a male were confirmed to have suffered from H9 infection in 1999, 2003, 2007, 2008 and 2009. Influenza A (H9) is an avian influenza virus which has been isolated from ducks and chickens for many years. Infection in humans is rare and appears to present as a mild disease. In Egypt the number of cases reported since the beginning of 2006 is 94, so far 27 have been fatal. In 2009 alone 39 cases and 4 deaths were reported to WHO. In Indonesia 162 cases have been confirmed to date. In Vietnam 112 cases have been confirmed to date, 57 have been fatal. Out of these, 5 cases and 5 deaths were reported in 2009. Avian influenza viruses do not normally infect humans. However, there have been instances of certain highly pathogenic strains causing severe respiratory disease in humans. In most cases, the people infected had been in close contact with infected poultry or with objects contaminated by their faeces.

MALARIA in DOMINICAN REPUBLIC, GEORGIA, INDIA, KENYA, SOUTH AFRICA

02/08/2010 11:58 PM

Jan '10- The Dominican Republic continues to have cases among both the local and tourist population (Punta Cana). In November 09 The Institute of Parasitology announced that 6 tropical malaria cases have been registered in [the Republic of] Georgia. Although autochthonous cases continue to be reported, malaria rates in Georgia and surrounding countries have decreased considerably since 1999. With the exeption of Russia, all of the countries which border Georgia had reported higher rates in recent years. In Mizoram India an estimated 119 people died in a malaria outbreak between January and October last year [2009]. State health department officials said the increase in number of deaths is due to the fact that malaria patients approached the hospitals and health centers too late. Malaria transmission has increased on Mount Kenya. In the past 20 years, the average temperature on the mountain has risen by 2-degrees Centigrade, allowing the disease to crop up in the higher altitude areas, with the local population having no or little immunity to the disease. The change in temperature is being blamed on emissions from human activity, rather than climatic changes due to natural causes. Rising temperatures on the slopes of Mount Kenya have put an extra 4 million people at risk of malaria, as the disease creeps into the higher altitude areas. Confirmed cases of malaria continue to rise in Limpopo South Africa. More that 947 people have been diagnosed with the mosquito-borne disease since the start of the rainy season, and numbers are expected to soar. Tropical malaria manifests with flu-like symptoms and high fever. The CDC is recommending prophylactic antimalarial medications as well as mosquito repellents containing DEET on exposed skin and Permethrin on outer clothing, mosquito netting and bedding.

CHOLERA in AFGHANISTAN, ANGOLA, DEMOCRATIC REPUBLIC OF THE CONGO, ETHIOPIA, IRAQ, KENYA, MALAYSIA, MOZAMBIQUE, NAMIBIA, NEPAL, NIGER, NIGERIA, PAPUA NEW GUINEA, SENEGAL, SOUTH AFRICA, SUDAN, ZAMBIA, ZIMBABWE

02/08/2010 11:58 PM

Jan '10- In Afghanistan at least 673 cases and 28 deaths have been reported since July 2009. Angola has had 4500 cases with 150 deaths confirmed to date. The D.R. of Congo reports 5483 cases and 120 deaths to date. In Ethiopia cholera is expanding and killing hundreds of people in West Arsi, East Shewa, West Hararghe and North Shewa and Arsi zones. Iraq reports 892 cases and 11 deaths to date. A cholera epidemic is sweeping across Kenya following severe droughts this year; officials are calling it "one of the worst outbreaks in a decade." Just in one months time period 4,700 cases and 119 deaths were reported. The cholera outbreak in Terengganu Malaysia is reported to have become more serious. Health officials also anticipate the number of confirmed cholera patients in the state to increase over the next 2 weeks following the heavy downpours, which were expected in most of the East Coast states. Mozambique has had 250 cases and 53 deaths confirmed to date. Namibia reports 2168 cases with 13 deaths to date. Nepal had 301 deaths last year [2009]. Niger has had 13,276 cases with 6 deaths reported to date. In Nigeria 169 deaths have been reported in the past 3 months (end of 2009). The cholera outbreak in Papua New Guinea's Madang is still worsening with more than 300 people now being treated for the illness. Senegal has had 2231 cases with 12 deaths reported to date. South Africa reports 720 cases with 22 deaths to date. Sudan reports over 6000 cases and over 44 deaths to date. Zambia declares 1224 cases with 42 deaths to date. Zimbabwe has reported a cholera epidemic that killed more than 4000 people between August 2008 and July 2009. Follow the food and water precautions covered in the travel consultation.

YELLOW FEVER in ARGENTINA, BRAZIL, CAMEROON, CENTRAL AFRICAN REPUBLIC, COTE D'IVOIRE, ECUADOR, LIBERIA, PARAGUAY, PERU, SUDAN, TANZANIA, TRINIDAD AND TOBAGO, VENEZUELA

02/08/2010 11:58 PM

Jan '10- In Brazil, At least 4 cases of yellow fever were confirmed in Rio Grande do Sul in 2009. In Sao Paulo state, 25 cases and 9 deaths were reported in 2009. The Ministry of Health in the Central African Republic [CAR] reported 4 suspected cases of yellow fever [YF], including 3 deaths. With these events since 2008, the Central African Republic is now considered to be at high risk of further outbreaks. In Cote d'Ivoire's northern province of Ordienne local health officials have reported 37 suspected cases and a total 21 deaths in an outbreak of yellow fever since the disease was detected in November 2009. The WHO and Ivorian authorities have declared an epidemic in the Denguele region (in the far north, bordering on Mali) with 36 suspected cases (12 are confirmed) with 19 deaths. Guinea reported a case of yellow fever to WHO. The case occurred in the prefecture of Mandiana belonging to the Kankan region in the east of the country, near the border with Cote d'Ivoire. Cote d'Ivoire has recently conducted an outbreak response in the border health districts of Minignan and Madinani. In Liberia the total number of confirmed cases was 2 including 1 death in 2009. In Venezuela the Minister of People's Power for Health made a call to residents of Guarico state, and especially the inhabitants of the Roscio, Ortiz, Monagas, Guaribe and Chaguaramas municipalities, to get yellow fever vaccination due to the presumed presence of YF in the area. Yellow Fever is a mosquito born disease found in Sub-Saharan Africa and the Amazon region of South America. This disease can be prevented with vaccination. Anyone traveling to a yellow fever zone needs to be protected, so get vaccinated! The CDC recommends a Yellow Fever vaccine in the following areas; Amazon Basin, Morana-Santiago, Napo, Orellana, Pastaza, Sucumbios, and Zamora-Chinchipe and Tanzania.

DENGUE FEVER in ARGENTINA, ARUBA, AUSTRALIA, BARBADOS, BRAZIL, CAMBODIA, GUADELOUPE, HONDURAS, INDIA, INDONESIA, MALAYSIA, MEXICO, SAINT MARTIN, SAINT BARTHELEMY, USA, VENEZUELA, VIETNAM, SRI LANKA

02/08/2010 11:58 PM

Jan '10- In Key West Florida USA 20 cases of locally transmitted dengue were confirmed in 2009. In Argentina 10,375 people contracted the dengue virus in 6 provinces in 2009. In Aruba 612 suspected cases have been reported (2009). In Cairns Australia 900 cases were reported in 2009. Health Officials are concerned because people are contracting dengue from infected dengue mosquitoes in areas with no known link to earlier generations of transmission. In Barbados one death was reported from co-infection with pandemic influenza and dengue-3 in 2009. In the Brazilian state of Bahia (in northeast) 226,500 cases and 51 deaths were reported in 2009. In the state of Mato Grosso (Brazil) 1346 cases of the disease, 26 of them reported as serious dengue cases, have been reported so far this year (2010). To date, 4 deaths have been reported but not yet confirmed. Brazil reports, on average, more than 2000 new cases a day. In Cambodia 11,652 cases and 37 deaths were reported in 2009. In Guadeloupe there was a rapid rise in the large number of cases clinically suggestive of dengue virus infections during the 1st week of Jan (2010). With about 260 cases it far surpasses the maximum level expected for the period. In Honduras 400 cases were reported in 2009. In India (Gujarat) the total number of patients being treated for dengue fever was 55 with 1 death reported [2009]. In Goa India 49 cases and 1 death have been reported [2009]. In Indonesia (East Kalimantan) 2 people have died, and 176 others have been treated in hospitals since December 2009. Health officials state that the dengue outbreak was already out of control. Health officials in East Java Indonesia, have recorded a total of 141 cases of dengue fever in the 1st 11 days of the new year [2010] and say the number may increase in the coming weeks. Usually, the number peaks between January and February at the height of the wet season. In Malaysia more people in the state were afflicted with dengue fever between last year (2009) and 2 Jan (2010), according to a statement from the state health department. 4579 cases were reported during the period, compared with 1527 cases in 2008. In 2009, Jalisco Mexico reported a total of 4697 cases, of which 776 are the DHF form of the disease. In Saint Martin and Saint Barthelemy the dengue epidemic continues. Saint Martin confirmed 123 cases identified since early December [2009]. In Venezuela 729 cases have been confirmed to date. At the beginning of last year [2009] between 2-3 cases were reported, and now, on average, we receive 20-30 dengue patients per week. According to the Health Ministry, Vietnam had more than 77,000 cases and 58 deaths confirmed last year(2009). In Sri Lanka 25,606 cases and 249 deaths were reported in 2009. Dengue fever causes the same symptoms as flu and other kinds of fever in the first 3 days and then developing in critical conditions such as hemorrhage, vomiting, or faster heartbeats.

JAPANESE ENCEPHALITIS in AUSTRALIA, BANGLADESH, CAMBODIA, CHINA, INDIA, INDONESIA, KOREA, LAOS, MALAYSIA, MYANMAR, NEPAL, PAPUA NEW GUINEA, PHILIPPINES, SINGAPORE, SRI LANKA, TAIWAN, THAILAND, VIETNAM

02/08/2010 11:58 PM

Jan '10- According to the CDC, japanese encephalitis is the leading cause of viral encephalitis in Asia with 30-50,000 cases reported annually. In the Uttar Pradesh state of India there were around 4000 cases of Japanese encephalitis and acute encephalitis syndrome reported last year (2009) and 567 deaths. Local Authorities reported that japanese encephalitis claimed as many as 30 lives in India's northern state of Bihar last year [2009]. In Assam Japanese Encephalitis has killed 78 people in 8 districts of eastern Assam since April [2009]. According to the Government of India, 109 AES cases were reported from July-August 2009. Of these, 33 were JE cases, of which 10 adults and 5 children (all unvaccinated) died. According the the CDC, countries which have had major epidemics in the past, but which have controlled the disease primarily by vaccination, include China, Korea, Japan, Taiwan and Thailand. Other countries that still have periodic epidemics include Viet Nam, Cambodia, Myanmar, India, Nepal, and Malaysia. Travelers are encouraged to consider JE vaccination prior to travel and to use mosquito repellents containing DEET on exposed skin and Permethrin on outer clothing.

MEASLES in ANGOLA, AUSTRALIA, BOSNIA, BURKINA FASO, ENGLAND, IRELAND, NAMIBIA, NIGERIA, NEW ZEALAND, ZIMBABWE

02/08/2010 11:58 PM

Jan '10- In Angola at least 99 cases of measles were diagnosed in the districts of Kwanhama, Cahama, and Coroca in the southern province of Cunene between July 2009 and Aug 2009. In Burkina Faso a measles outbreak infected more than 19000 people, with 150 deaths reported between January 2009 and April 2009. This is 10 times more than the number of infections reported any year since 1997. Victoria, Australia experienced its largest measles outbreak in years in February 2009. There were 12 cases total reported. There were only 2 in the whole of 2008. Health authorities are now trying to contact 84 people exposed to measles by a baby who flew from London to Christchurch via Auckland. The baby arrived in Auckland on Air New Zealand flight NZ1 on Mon 7 Dec 2009, before travelling to Christchurch on flight NZ509. "These passengers, or their family members, who have symptoms suggestive of measles are advised to immediately seek advice from a doctor," Dr Novak said (Auckland Regional Public Health Service medical officer of health). "Call ahead to alert your doctor or practice nurse about the possibility of measles as this will allow them to arrange to assess you safely without infecting others. People who suspect they may have measles should avoid contact with young children and pregnant women." In England HPA officials said 99 cases had been reported last year [2009], and more than 100 suspected cases were being investigated. The agency said there were only 17 cases reported in 2008. Health Chiefs warn this is the biggest measles outbreaks in years. In Ireland since January 2009, over 60 cases of measles have been reported nationally, 12 of whom were hospitalized. This compares with a total of 55 for all of 2008. In Namibia, 5 months after the 1st case of measles was reported in the Kunene Region the number of affected patients has risen to 1081. Health authorities have confirmed the number of fatalities has increased to 13. The number of patients has significantly dropped from previous months; new cases are still coming, but at slower rates. In Nigeria 25 deaths, including children and teenagers, have been confirmed despite claims by the Bayelsa State Government that it has curtailed the recent outbreak of measles from spreading to neighbouring communities. In Western Bosnia 161 cases were reported as of May 2009. The infected were not vaccinated against measles. In South Africa, Western Cape health authorities say they are on high alert after receiving reports that nearly 250 people around the province have contracted measles in the past 5 months. In Eastern Cape there were 50 suspected measles infections reported by mid-January [2010]. More than 100 cases of measles had been reported in Cape Town since October [2009]. In Zimbabwe 10 infants have died of measles since the beginning of this year, this included mostly children from the Apostolic Sect religion, who are against immunization. The measles outbreak comes hard on the heels of another one in Manicaland last December 2009 which claimed the lives of 22 infants. Also in Zimbabwe an estimated 1052 suspected cases have been reported countrywide although confirmed cases number only 161. At least 41 people have died from the disease, according to WHO and the Ministry of Health. This is a huge leap from the 340 suspected cases reported by WHO in Dec 2009. Most cases involved members of registered religious groups that refuse conventional medical treatments. Vaccination with MMR is recommended at least 2 weeks prior to traveling to these regions. It is recommended that you receive an adult booster if you haven't had measles and you have only had your childhood immunizations.

MENINGITIS in BRAZIL, INDIA, NIGERIA, RUSSIA, SUDAN, UGANDA, USA

02/08/2010 11:58 PM

Jan '10- For those traveling to Saudi Arabia for the Hajj Meningococcal vaccine is required for entry. In Bahia Brazil 2218 cases and 138 deaths were reported to the Directorate of Health Information by the Secretary of Health of the State as of 10 Dec 2009. The Ministry of Health of the Federal Republic of Nigeria has reported 5323 suspected cases, including 333 deaths. In India, at least 257 people have died in the north eastern states of Tripura, Meghalaya, and Mizoram. A recent outbreak of meningitis in Southern Sudan has infected more than 11,786 people, killing 704. In Russia an outbreak of serous meningitis [acute meningitis with secondary external hydrocephalus/viral meningitis] has occured in the Chelyabinsk Oblast. This disease is most dangerous for small children. Since the beginning of this year [2009] 200 preschool children have fallen ill with this disease. Vaccination prior to travel is recommended for travelers to these areas.

MUMPS in CANADA, MACEDONIA(FYROM), MOLDOVA, UNITED KINGDOM, USA

02/08/2010 11:58 PM

Jan '10- Israel is in the midst of a mumps outbreak. Over the past 4 months some 600 cases of mumps have been reported in the Jerusalem district and over 850 nationally in Israel. In England there were 315 confirmed cases in Greater Manchester in 2009, compared with 36 in 2008. Across Cumbria and Lancashire the number rose from 97 to 341 confirmed cases and in Merseyside and Cheshire the numbers rose to 304 from 111. People aged under 25 are being urged to have the MMR vaccine; the age group makes up 73 per cent of all cases reported in 2009. In Macedonia-FYROM (Former Yugoslav Republic of Macedonia) there were 234 cases of mumps reported, including 50 who were hospitalized, 20 with a complication of orchitis and 18 with meningitis, in January 2009 alone. Canada reports 200+ cases in the Fraser Valley, mostly among a religious group that refuses vaccinations. A mumps outbreak in Brooklyn NY that has lasted for months has prompted health officials to issue a multistate mumps outbreak alert, warning health care providers in New York, New Jersey, and Connecticut to be aware of the problem. New York City is dealing with nearly 600 confirmed and suspected cases. As of late October [2009], there were 79 confirmed cases in Brooklyn, 40 cases in Lakewood, New Jersey, and 15 cases in Quebec, primarily in Montreal, according to CDC. Mumps is caused by a virus that usually spreads through saliva and can infect many parts of the body, especially the salivary glands. It can lead to inflammation and swelling of the brain and other organs. It can cause deafness and leave men sterile. It is recommended that you receive an adult booster if you haven't had mumps and you have only had your childhood immunizations.

POLIO in AFGHANISTAN, CAMEROON, HAITI, INDIA, NAMIBIA, NIGER, NIGERIA, PAKISTAN, SUDAN, ANGOLA, GUINEA, CHAD, TOGO, BENIN, BURKINA FASO, UGANDA, MALI, CONGO, COTE D'IVOIRE, KENYA

02/08/2010 11:58 PM

Jan '10- Volunteers traveling to Haiti to help with earthquake relief efforts should be aware and properly protected against diseases that arise after a disaster. The potential new mass of displaced persons could create crowded, unsanitary conditions that facilitate the spread of diseases such as Polio. Vaccination is recommended. New Guideline: Saudi Arabia now requires proof of current vaccination for all persons less than 15 years of age entering the country, including travelers for Hajj and Umrah. Adults should receive a one-time polio booster and all children should be current with their vaccinations prior to traveling. In Afghanistan 1 case has been reported so far this year [2010]. The total number of cases for 2009 was 38. In Angola 29 cases were confirmed last year [2009]. In Kenya there were 18 cases total last year [2009]. In Burkina Faso 15 cases were confirmed last year [2009]. In Benin 21 cases were confirmed in 2009. In Chad 66 cases were confirmed in 2009. In Cote d'Ivoire 27 cases were confirmed in 2009. In Guinea 41 confirmed cases were reported for 2009. In India 724 cases were confirmed for 2009. In Liberia 11 cases were confirmed in 2009. In Nigeria 388 confirmed cases were reported last year. In Pakistan a 9-month-old child is the 1st polio case this year (2010). In Uganda 8 cases were confirmed last year[2009].

RABIES in ANGOLA, BRAZIL, CHINA, INDIA, INDONESIA, RUSSIA, USA, VIETNAM

02/08/2010 11:58 PM

Jan '10- A possibly rabid raccoon is being hunted on Wilmington's East Side [Delaware] after 2 people and a dog were bitten in separate attacks. The bites were reported blocks from the Wilmington police station, New Castle County Courthouse and train station. The animal had not been captured as of Wednesday [27 Jan 2010]. In Maryland USA a 6 week old calf at a farm that does educational programs for middle and elementary school children has tested positive for rabies. The Maryland Department of Health and Mental Hygiene (DHMH) said that the calf is at the Hard Bargain Farm in Prince George's County. Almost 400 animals in Maryland were diagnosed with rabies last year (2009). Luanda Angola experienced a very serious rabies outbreak that killed 93 children as of March 2009. The animal health authorities in Angola have made significant and effective efforts to vaccinate over 111,000 animals (dogs, cats and monkeys). According to the Ministry of Health, China is one of the countries most threatened by rabies. In recent years, averages of more than 2400 people in China have died from rabies infections annually. More than 40 million people in the Chinese mainland are attacked by animals annually. The number was calculated from the amount of rabies vaccine administered every year. A Brazilian boy died despite treatment(in January 2009), this brings the numbers of patients to at least 3 who received treatment and died. Indonesia (Bali) reports 25 deaths due to bites from wild dogs since the outbreak started in 2008. Tourists must be aware that any dog or cat or monkey bite in Bali is a potential rabies exposure that needs to be treated under WHO post exposure guidelines. In addition, there is a shortage of vaccine. Consequently, travelers to Bali should vaccinate prior to departure per WHO/CDC protocol. Otherwise, if bitten, they will need to fly home, or to an Asian center such as Bangkok, Singapore, or Hong Kong to get proper post-exposure treatment. In Israel a total of 56 cases of rabies were reported this year [2009], the vast majority in the north of the country. In each of the past 3 years, there were 9 to 12 cases of the disease. In 1997, 3 people in Israel died of rabies, the last time the disease was fatal to humans in the country. Health officials say that about 10,000 feral dogs live in Moscows streets, including fighting dogs. Sterilization and other methods have yet to bring the situation under control. So far this year [2010] at least 14 people in Moscow have been biten by a rabid dog, who has since been euthanised by the local veterinary service. In late December 2009, Vietnam reports 81 dead in '08 and 5.9 million exposure cases over the past ten years. Travelers to these areas should consider the pre-exposure rabies prophylaxis vaccination series. World wide there are approximately 55,000 deaths per year.

HAND, FOOT AND MOUTH DISEASE in CHINA, SINGAPORE, VIETNAM

02/08/2010 11:58 PM

Jan '10- Authorities in China said the disease has sickened about 54,713 people and killed 19 children across the country this year. Over 90 percent of the patients are under the age of 5. Authorities in Singapore have reported 5471 cases of HFMD infections this year. Typically, Singapore experiences annual peaks of HFMD from March to May. In Vietnam since the beginning of 2009 to 11 Sep 2009, there had been 60 patients under treatment for HFMD. Approximately 54 out of 60 children (90 percent) were in serious condition. The disease usually begins with a fever, poor appetite, malaise (feeling vaguely unwell), and often with a sore throat. One or 2 days after fever onset, painful sores usually develop in the mouth. They begin as small red spots that blister and then become ulcers. The sores are usually located on the tongue, gum and inside of the cheeks. A non-itchy rash develops over 1-2 days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually located on the palms of the hands and soles of the feet; it may also appear on the buttocks or genitalia. A person with HFMD may have only the rash or only the mouth sores.

TYPHOID FEVER in HAITI, CANADA, INDIA, PAKISTAN, UGANDA

02/08/2010 11:58 PM

Jan '10- Volunteers traveling to Haiti to help with earthquake relief efforts should be aware and properly protected against diseases that arise after a disaster. With water supplies being stalled and contaminated, the risk of waterborne disease outbreaks like typhoid and cholera are increased. Vaccination is recommended. In Nepal 40 Israeli travelers who were traveling in the [Russian] Far East became ill with Typhoid Fever. The source of the outbreak is unknown at this time. Pakistan currently experience 1000 cases of Typhoid Fever per 100,000 of population per year. Uganda reports 90 cases with 20 dead in the Kasese area since July '08. The Centre for Health Protection urges travelers to Indonesia to guard against typhoid fever due rising cases of the disease in people arriving from the country recently. Travelers are encouraged by local health officials to get the Typhoid vaccine prior to traveling to these and other endemic regions and to exercise food and water precautions.

LASSA FEVER in CENTRAL AFRICAN REPUBLIC, GUINEAM LIBERIA, NIGERIA, SIERRA LEONE, UNITED KINGDOM

02/08/2010 11:58 PM

Jan '10- In Nigeria more than 55 people have died so far from the Lassa Fever epidemic between January 2008 and February 2009. More than 51 million Nigerians are at risk, with the annual number of illnesses estimated at 3 million and with the number of deaths estimated at about 58, 330. The WHO said over 93 cases of the virus (infection) has been confirmed in the capital Abuja and neighboring Nassarawa state since December 2008. The disease has already claimed 8 lives in 3 weeks. Around 8 in 10 people infected with Lassa Fever develop mild or no symptoms, but in 20 percent of cases people will have severe illness. Symptoms include, fever, headache, sore throat, a cough, nausea, vomiting, diarrhea, and muscle pain. Around 2 percent of all patients die from the illness and death rates are particularly high in women in their final months of pregnancy. A common complication of Lassa Fever is deafness. Lassa Fever is a zoonotic disease, meaning that humans become infected by contact with infected animals. Animals commonly known as the "multimammate rat" are the carriers of the virus. Animals infected with Lassa virus do not become ill, but they can shed the virus in their excreta (urine and feces).

HEPATITIS B in INDIA

02/08/2010 11:58 PM

Jan '10- Health Officials declare one of the worst epidemics to have struck Gujarat India. There were 92 deaths reported, most between 15 and 45 years old. In the Sabarkantha district cases climbed to 43 with the report of 5 new deaths. Meanwhile, state health department launched a mass vaccination drive in Modana town in February 2009. According to district health officials, 6 new cases of hepatitis have been registered from Modasa town and nearby villages to date. The officials said that people of all ages had queued up since morning to get themselves vaccinated.

BUBONIC PLAGUE in LIBYA, USA

02/08/2010 11:58 PM

Jan '10- An 8 year old boy from New Mexico has died and his 10 year old sister was hospitalized after both contracting the bubonic plague, the first recorded human plague cases in the USA so far in 2009. Since then New Mexico has reported a total of 5 cases. The CDC says an average of 10 to 15 persons contract the plague each year in the USA. Modern antibiotics are an effective treatment. In Libya, authorities have reported an outbreak of bubonic plague in the Mediterranean coastal town of Tubruq, approx. 16 to 18 cases have been reported including 1 death. Globally the WHO reports about 1000 to 3000 plague cases each year, with most in the last 5 years occurring in Madagascar, Mozambique, Uganda, and the Dem. Republic of the Congo. Plague is generally transmitted through animals, including rodents and rabbits. The typical sign of the most common form of human plague is a swollen and very tender lymph gland, accompanied by pain. Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2 to 6 days after being infected.

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