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Travel Health News Digest (3 September 2013 - 9 September 2013)

Advice for pilgrims visiting Mecca, Saudi Arabia (Hajj)

Pilgrims are advised to note the followings:

  1. Vaccination against meningitis

  2. The Saudi Arabia government requires all pilgrims on entry to produce a certificate of vaccination against the meningococcal disease using the quadrivalent vaccine (serogroups A, C, W135 and Y). The certificate should be not more than 3 years and not less than 10 days before arrival.

     

  3. Vaccination against seasonal influenza

  4. The Saudi Ministry of Health recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the Kingdom of Saudi Arabia, particularly those at increased risk of severe influenza diseases, including pregnant women, children under 5 years, the elderly, and individuals with underlying health conditions such as HIV/AIDS, asthma, and chronic heart or lung diseases.

     

  5. Be Vigilant against Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

  6. Travellers should take note of MERS-CoV (formerly known as novel coronavirus). Most of the cases reported to date originated or returned from the Middle East and subsequently became ill. The most common symptoms observed include fever, cough, and breathing difficulties. Approximately half of the patients have died.

    In view of the severity and possibility of spread of the illness among human through close contact, if you are travelling to the Middle East for vacation or pilgrimage, please observe personal and environmental hygiene strictly at all times such as avoiding undercooked meats, raw fruits and vegetables, unless they have been peeled, or unsafe water. Travellers should also avoid direct contact with animals, birds, poultry or sick people during the journey and should wear face masks in crowded places.

    Pilgrims should be reminded that pre-existing major medical conditions can increase the likelihood of medical problems, including MERS-CoV infection, during travel; thus, pilgrims should consult a health care provider before travelling to review the risk and assess whether making the pilgrimage is medically advisable. For further advice from the Saudi Ministry of Health, please see ( http://www.moh.gov.sa/en/Hajj/Pages/HealthRegulations.aspx )

    Travellers who develop symptoms during travel or up to 14 days after their return from affected areas should put on face masks, seek medical attention and inform doctor of their travel history. Before departure, if you feel unwell, such as having fever, sore throat, muscle pain or cough, you are advised to seek medical attention and delay the trip until recovery. For further information on MERS, please visit Centre for Health Protection (CHP) website (http://www.chp.gov.hk)。

     

  7. Other infectious diseases

  8. Updating immunization against vaccine-preventable diseases in all travellers is strongly recommended. With the recent resurgence of measles and rubella cases, special attention is needed for both of these vaccines to avoid widespread outbreaks with this virus during Hajj and Umra this year.

    Men are required to shave their heads after Hajj, and unclean blades can transmit disease. Male pilgrims should go to officially designated centers to be shaved, where barbers are licensed and use disposable, single-use blades.

     

  9. Food hygiene

  10. Fresh food carried by visitors and pilgrims are banned and not allowed into the country. Only properly canned food in very small amount which is enough for one person to the end of his or her trip is allowed. In addition, diarrhea is common during Hajj, so eat only food that is cooked and served hot and drink only beverages from sealed containers.

     

  11. Injury

  12. Try to avoid the most densely congested areas and always be aware of the location of emergency exits. Pilgrims can perform rituals during non-peak hours to avoid crowds.

     

  13. Heat stroke

  14. Temperatures in Mecca can exceed 37.8 ºC (100°F) in October. Heat exhaustion and heatstroke are leading causes of illness during Hajj. Pilgrims should drink plenty of water (bottled), wear sunscreen, rest, and seek shade as much as possible. Symptoms of heat-related illness can include profuse sweating, chills, headache, dizziness or confusion, and nausea. Travelers who develop these symptoms should move to a cool area and seek medical attention.

     

  15. Observe personal and environmental hygiene strictly at all times. For more information, please read the section on Travel Health Advice.
  16.  

(Source: World Health Organization, Centers for Disease Control and Prevention & Ministry of Hajj, Kingdom of Saudi Arabia)

 

Take precautions against dengue fever when travelling abroad

Dengue fever is an endemic disease in most Southeast Asian countries including Singapore, Malaysia, Indonesia, Laos, Thailand, Cambodia, Vietnam and the Philippines. Travellers visiting these places are advised to protect themselves against mosquitoes all year round.

The recent dengue fever activity in Asia has been more severe than that of last year. Various popular tourist attractions among Hong Kong people including Thailand, Singapore, Taiwan and Indonesia, observed recent persistent increase in the number of dengue fever cases. Other neighbouring Asian countries such as Laos, Cambodia, Vietnam, Malaysia, the Philippines, Pakistan and India, also recorded rising dengue fever activities.

Outbreaks of dengue fever were observed in Guangdong province in China, Brazil, Costa Rica, Columbia, Paraguay and the Dominican Republic this year. It was expected that dengue fever activities will continue to rise in coming months in Central America, Mexico and the Caribbean.

Travellers planning to travel in these areas should take precautions against the disease.

Cumulative reported number of dengue cases in 2013 *

 

Cumulative reported no. of cases in 2013

Source of information and
date of report

America
 North, Central & South


1,489,833


World Health Organization, 5 September 2013

Australia

1,246

World Health Organization, 4 September 2013

Cambodia

12,943

World Health Organization, 4 September 2013

China
  Guangdong province
  (Zhongshan)


63


Department of Health of Guangdong Province, 22 July 2013

India
  Maharashtra


1,500


ProMED-mail, 8 September 2013

Indonesia
  East Jakarta

1,826

ProMED-mail 1 July 2013

Lao PDR

38,272

World Health Organization, 4 September 2013

Malaysia

18,099

World Health Organization, 4 September 2013

Myanmar

6,448

ProMED-mail 1 July 2013

New Caledonia

10,527

World Health Organization, 4 September 2013

Pakistan
  Sindh


1,056


ProMED-mail, 8 September 2013

Philippines

96,717

World Health Organization, 4 September 2013

Singapore

15,701

Singapore National Environment Agency, 8 September 2013

Solomon Island

6,733

World Health Organization, 4 September 2013

Sri Lanka

20,216

ProMED-mail, 11 August 2013

Taiwan

282

CDC, ROC (Taiwan), 8 September 2013

Thailand

81,763

ProMED-mail, 5 August 2013

Vietnam

25,335

World Health Organization, 4 September 2013

Remark:
* Dengue reporting systems vary by country.

Travellers should stay vigilant against dengue fever and adopt the following personal preventive measures against mosquito bite:

* Always wear long-sleeved clothing and trousers;
* Stay in air-conditioned residence or places with mosquito screens;
* If mosquito screen or air-conditioning is absent, aerosol insecticide and bed nets are advised;
* Use insect repellents containing DEET on exposed skin and clothing;
* Use insect repellents containing DEET apart from applying sunscreen while staying in beaches;
* Carry a portable bed nets and apply permethrin on it as well as to clothes if travelling to rural areas where dengue fever is prevalent.

Travellers returning from areas where dengue fever is prevalent should seek medical advice as soon as possible if they feel unwell and provide travel details to their doctors.

 

Peru: Anthrax

A farmer raising livestock in Huaraz of Peru is in serious condition after contracting anthrax. This is the second case reported in the area.

(Source: ProMED-mail 8 September 2013)

 

Kingdom of Saudi Arabia: Middle East Respiratory Syndrome [Update]

The Department of Health is closely monitoring four additional cases of Middle East Respiratory Syndrome Saudi Arabia reported to the World Health Organisation. Two of the cases involve healthcare workers at the same hospital in Riyadh; a 41-year-old woman and a 30-year-old man. The woman fell ill on August 15 and died in late August. The man developed severe pneumonia on September 1, and is in critical condition. The third case is a 79-year-old woman from eastern Saudi Arabia, who was a contact of a previously confirmed case. She fell ill on August 21 and died on September 2. The last case is a 47-year-old man from eastern Saudi Arabia who had a chronic illness, and is a contact of a previously confirmed case. He became ill on August 23 and is currently in critical condition. This brings the latest global number of confirmed cases of the disease to 114, including 54 deaths.

(Source: The Centre for Health Protection of the Department of Health 8 September 2013)

 

Tunisia: Middle East Respiratory Syndrome [Update]

The Department of Health is monitoring an additional Middle East Respiratory Syndrome case Tunisia reported to the World Health Organisation. The case involves a 66-year-old man who became ill on May 1 and died on May 10. His daughter and son tested positive for the disease in May.

(Source: The Centre for Health Protection of the Department of Health 7 September 2013)

 

Qatar: Middle East Respiratory Syndrome [Update]

The Department of Health is monitoring an additional Middle East Respiratory Syndrome case Qatar reported to the World Health Organisation. The case involves a 56-year-old woman with underlying illnesses who became ill on August 18, and died on August 31.

(Source: The Centre for Health Protection of the Department of Health 7 September 2013)

 

Cambodia: Avian Influenza, human

The Ministry of Health of the Kingdom of Cambodia reported the eighteenth human case of Avian Influenza H5N1 in 2013. The 18th case was a 15-month-old boy from Phnom Penh municipality.

(Source: World Health Organization 5 September 2013)

 

Poland: Rubella [Update]

As of August 31, 2013, a total of 36,440 cases of rubella have been reported in Poland.

(Source: Centres for Disease Control and Prevention 4 September 2013)

 

Japan: Rubella [Update]

As of August 21, 2013, 13,747 rubella cases have been reported in Japan.

(Source: Centres for Disease Control and Prevention 4 September 2013)

 

Guinea: Cholera

In the prefecture of Kouroussa in Upper Guinea, 27 cholera cases including 8 deaths have been reported.

(Source: ProMED-mail 3 September 2013)

 

Guinea-Bissau: Cholera

As of late July 2013, 225 cholera cases including 21 deaths were reported in Tombali region of  Guinea-Bissau. A total of 700 cases of cholera have been reported in the country so far.

(Source: ProMED-mail 3 September 2013)

 

Pakistan: Cholera

A cholera outbreak was detected in Kurram Agency, Pakistan. Since 12 August 2013, 2 people have died while 320 others were affected.

(Source: ProMED-mail 3 September 2013)

 

Australia: E.coli Infection

Queensland Health of Australia is continuing to investigate an outbreak of enterohemorrhagic Shiga toxin-producing E. coli (EHEC) in Brisbane. So far, 32 confirmed cases were reported while 5 people have been hospitalized.

(Source: ProMED-mail 3 September 2013)

 

Italy: Avian Influenza, human

The National Institute of Health of Italy had recorded a positive diagnosis for H7N7 Avian Influenza in a person suffering from conjunctivitis and occupationally exposed to sick birds belonging to the farms in the region of Emilia Romagna.

(Source: Ministry of Health, Italy 2 September 2013)

 

Kingdom of Saudi Arabia: Middle East Respiratory Syndrome [Update]

The Department of Health is closely monitoring four additional cases of Middle East Respiratory Syndrome reported to the World Health Organization (WHO) by the Kingdom of Saudi Arabia (KSA).

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 108, including 50 deaths.

(Source: The Centre for Health Protection of the Department of Health 31 August 2013)

 

USA: Cyclosporiasis [Update]

As of 29 August 2013, 636 cases of Cyclospora infection have been reported from the following 23 states: Arkansas, California, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Louisiana, Michigan, Minnesota, Missouri, Nebraska, New Jersey, New Hampshire, New York, Ohio, South Dakota, Tennessee, Texas, Virginia, Wisconsin, and Wyoming, USA.

(Source: Centres for Disease Control and Prevention 30 August 2013)

 

 

Last revision date: 12 September 2013