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Travel Health News Digest (16 July 2013 - 22 July 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. The Saudi Ministry of Health recommends that elderly (above 65 years of age) and those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes) and pilgrims with immune deficiency (congenital and acquired), malignancy and terminal illnesses, pregnant women and children (under 12) coming for Hajj and Umrah this year, to postpone the performance of the Hajj and Umrah for their own safety .The mode of transmission currently remains unknown though coronaviruses in general are typically spread like other respiratory infections such as influenza.

    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 Organisation, 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 Brazil, Costa Rica, Columbia, Paraguay and the Dominican Republic in the first quarter this year. Peru detected its first local dengue fever case. 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


1,320,215


World Health Organization, 4 July 2013

Australia

906

World Health Organization, 10 July 2013

Cambodia

6,797

World Health Organization, 10 July 2013

India
  Maharashtra


727


ProMED-mail, 7 July 2013

Indonesia
  East Jakarta

1,826

ProMED-mail 1 July 2013

Lao PDR

16,073

World Health Organization, 10 July 2013

Malaysia

12,143

World Health Organization, 10 July 2013

Myanmar

6,448

ProMED-mail 1 July 2013

New Caledonia

10,377

World Health Organization, 10 July 2013

Pakistan
  Sindh


432


ProMED-mail, 15 July 2013

Philippines

45,037

World Health Organization, 10 July 2013

Singapore

13,098

Singapore National Environment Agency, 16 July 2013

Solomon Island

6,313

World Health Organization, 10 July 2013

Sri Lanka

15,777

ProMED-mail 1 July 2013

Taiwan

182

CDC, ROC (Taiwan), 16 July 2013

Thailand

59,318

ProMED-mail, 15 July 2013

Vietnam

18,934

World Health Organization, 10 July 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 bednets 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 bednets 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.

 

Mainland: Avian Influenza, human

The Centre for Health Protection of the Department of Health has been notified by the National Health and Family Planning Commission an additional human case of avian influenza A(H7N9) in Hebei on 20 July affecting a 61-year-old woman. The patient developed cough and fever on 10 July and sought medical attention at a local hospital for further management on 13 July. She was transferred to a hospital in Beijing on 18 July and she is currently in critical condition. The patient's respiratory specimen tested positive for avian influenza A(H7N9) virus upon laboratory testing by the Beijing health authority.

As of 20 July, a total of 133 human cases of avian influenza A(H7N9) have been laboratory confirmed in the Mainland, including Zhejiang (46 cases), Shanghai (33 cases), Jiangsu (28 cases), Jiangxi (six cases), Fujian (five cases), Anhui (four cases), Henan (four cases), Shandong (two cases), Hunan (two cases), Beijing (two cases) and Hebei (one case).

(Source: The Centre for Health Protection of the Department of Health 20 July 2013)

 

Kingdom of Saudi Arabia, United Arab Emirates: Middle East Respiratory Syndrome

The Department of Health (DH) is closely monitoring six additional cases of Middle East Respiratory Syndrome reported to the World Health Organization (WHO) by the Kingdom of Saudi Arabia (KSA) (two cases) and the United Arab Emirates (UAE) (four cases). According to the WHO, both cases in the KSA are from the southern region. The first patient is a 26-year-old man who is a close contact with a previously confirmed case while the other one is a 42-year-old female health-care worker. They have mild symptoms and were not hospitalised. In the UAE, the four cases are health-care workers from two hospitals in the capital who took care of an earlier confirmed patient. They include a man aged 28 and a woman aged 30 who are both asymptomatic, and two women aged 30 and 40 who had mild upper respiratory symptoms and are in stable condition.

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 88, including 45 deaths.

(Source: The Centre for Health Protection of the Department of Health 19 July 2013)

 

Taiwan: Rabies

In Taiwan, rabies was found in 3 dead ferret-badgers in Yuchi and Lugu, Nantou County and in Gukeng, Yunlin County.

(Source: Taiwan Centers for Disease Control 16 July 2013)

 

New Zealand: Cryptosporidiosis

24 cases of cryptosporidiosis in Taranaki region, New Zealand were reported since the start of 2013 compared with none for the same period in 2012.

(Source: ProMED-mail 17 July 2013)

 

Tajikistan: Anthrax

8 anthrax cases were detected within the country, including 4 in Aini district, 2 in Panjakent district and 2 in Bobojonghafur district, he said.

(Source: ProMED-mail 17 July 2013)

 

Guinea-Bissau: Cholera

Since March 2013, 18 people from Tombali region in southern Guinea-Bissau have died of cholera infection.

(Source: ProMED-mail 16 July 2013)

 

India: Crimean-Congo Haemorrhagic Fever

Four fatal cases of Crimean-Congo hemorrhagic fever have been reported in Amreli district of India.

(Source: ProMED-mail 15 July 2013)

 

Philippines: Chikungunya Fever

An outbreak of Chikungunya Fever was detected in Nueva Ecija of Philippines with over 500 cases recorded.

(Source: ProMED-mail 15 July 2013)

 

USA: West Nile Virus

As of 9 July, a total of 14 cases of West Nile Virus disease including two deaths have been reported in USA.

(Source: Centers for Disease Control and Prevention 9 July 2013)

 

Israel: Poliomyelitis, environmental samples

Wild poliovirus type 1 (WPV1) has been isolated in 30 sewage samples in Israel. The samples were collected from 3 February 2013 to 30 June 2013. No cases of paralytic polio have been reported.

(Source: World Health Organisation 15 July 2013)

 

Somalia: Poliomyelitis

41 cases of Poliomyelitis have been reported from Somalia in 2013. These are the first wild poliovirus cases reported in Somalia since 2007.

(Source: Centers for Disease Control and Prevention U.S.A. 11 July 2013)

 

Kenya: Poliomyelitis

7 cases of Poliomyelitis have been reported from Kenya in 2013. These are the first wild poliovirus cases confirmed in Kenya since July 2011.

(Source: Centers for Disease Control and Prevention U.S.A. 11 July 2013)

 

 

Last revision date: 23 July 2013