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Travel Health News

Travel Health News Digest (13 August 2013 - 19 August 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.

(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

 North, Central & South


World Health Organization, 28 July 2013



World Health Organization, 7 August 2013



World Health Organization, 7 August 2013

  Guangdong province


Department of Health of Guangdong Province, 22 July 2013



ProMED-mail, 7 July 2013

  East Jakarta


ProMED-mail 1 July 2013



World Health Organization, 7 August 2013



World Health Organization, 7 August 2013



ProMED-mail 1 July 2013

New Caledonia


World Health Organization, 7 August 2013



ProMED-mail, 5 August 2013



World Health Organization, 7 August 2013



Singapore National Environment Agency, 8 August 2013

Solomon Island


World Health Organization, 7 August 2013

Sri Lanka


ProMED-mail 1 July 2013



CDC, ROC (Taiwan), 5 August 2013



ProMED-mail, 5 August 2013



World Health Organization, 7 August 2013

* 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.


Italy: Avian Influenza, poultry

An outbreak of Avian Influenza caused by highly pathogenic (H7) virus affecting thousands of birds was reported on a farm in Emilia-Romagna, Italy.

(Source: World Organisation for Animal Health 15 August 2013)


Israel: Poliomyelitis, environmental samples [Update]

Wild poliovirus type 1 (WPV1) has been isolated in 67 sewage samples from 24 sampling sites in Israel, collected from 3 February 2013 to 4 August 2013. WPV1 has also been isolated in stool samples from 27 healthy children (all under the age of nine years) and one adult, who had been fully immunized for their age. No cases of paralytic polio have been reported.

(Source: World Health Organization 15 August 2013)


Italy: E.coli Infection

In Italy, 8 children and an adult patient were hospitalized after developing Hemolytic Uremic Syndrome (HUS) between 1 and 14 August 2013. Most HUS cases are secondary to Shiga toxin-producing Escherichia coli infection.

(Source: ProMED-mail 15 August 2013)


USA: West Nile Virus [Update]

As of 13 August 2013, a total of 174 cases of West Nile virus disease infection, including seven deaths, have been reported in USA.

(Source: Centers for Disease Control and Prevention 13 August 2013)


USA: Plague

On 12 August 2013, the New Mexico Department of Health in USA confirmed a case of plague in a 15-year-old boy from Torrance County who is currently hospitalized in stable condition. This is the first human case of plague in New Mexico in 2013.

(Source: ProMED-mail 13 August 2013)


Bangladesh: Anthrax

5 new cases of anthrax have been reported in the 1st week of August 2013 in Meherpur district, bringing the total number of reported cases in Bangladesh this year to 175.

(Source: ProMED-mail 14 August 2013)


Afghanistan: Cholera

A cholera outbreak which was detected in north east Afghanistan has caused 1492 cases and 1 death.

(Source: ProMED-mail 14 August 2013)


Singapore: Chikungunya Fever [Update]

Close to 500 people has been infected by Chikungunya virus in Singapore in 2013.
(Source: ProMED-mail 13 August 2013)


Cambodia: Avian Influenza, human

Two more new human cases of Avian Influenza H5N1 have been confirmed in Cambodia, bringing the number of cases to 16 in 2013. The two cases were from north western Battambang Province and Southern Kandal Province respectively.

(Source: ProMED-mail 13 August 2013)


Taiwan: Rabies [Update]

In Taiwan, as of 12 August, there were 78 cases of confirmed rabies cases in animals.

(Source: ProMED-mail 12 August 2013)


USA: E.coli Infection

In Arizona, USA, 52 people have been confirmed to have become ill from E. Coli O157 infection after eating at a Mexican food restaurant.

(Source: ProMED-mail 10 August 2013)


Netherlands: Measles

In Netherlands, as of 8 August 2013, the number of confirmed cases of measles in the Dutch Bible Belt outbreak has reached 921.

(Source: ProMED-mail 10 August 2013)


USA: Cyclosporiasis [Update]

As of 8 August 2013, 514 cases of Cyclospora infection have been reported from the following 17 states: Arkansas, Connecticut, Florida, Georgia, Iowa, Illinois, Kansas, Louisiana, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New York, Ohio, Texas, and Wisconsin, USA.

(Source: Centres for Disease Control and Prevention 9 August 2013)



Last revision date: 17 August 2013