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Travel Health News

Travel Health News Digest (23 July 2013 - 29 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.

    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. 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

 North, Central & South


World Health Organization, 4 July 2013



World Health Organization, 24 July 2013



World Health Organization, 24 July 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, 24 July 2013



World Health Organization, 24 July 2013



ProMED-mail 1 July 2013

New Caledonia


World Health Organization, 24 July 2013



ProMED-mail, 15 July 2013



World Health Organization, 24 July 2013



Singapore National Environment Agency, 25 July 2013

Solomon Island


World Health Organization, 24 July 2013

Sri Lanka


ProMED-mail 1 July 2013



CDC, ROC (Taiwan), 22 July 2013



ProMED-mail, 15 July 2013



World Health Organization, 24 July 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 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.


Philippines: Chikungunya Fever

In Ilocos Norte province of Philippines, 200 suspected cases of Chikungunya Fever were reported.

(Source: ProMED-mail 28 July 2013)


Russia: Measles

During the first 6 months of 2013, a total of 136 cases of measles were recorded in Moscow of Russia.

(Source: ProMED-mail 28 July 2013)


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

The Ministry of Health of the Kingdom of Saudi Arabia (KSA) announced one additional case of Middle East Respiratory Syndrome in Asir.


(Source: ProMED-mail 27 July 2013)


Canada: Legionnaires' Disease

A total of 16 cases of Legionnaires' disease were recorded in Toronto, Canada in a 6 week period and the number of cases was more than expected.

(Source: ProMED-mail 26 July 2013)


Taiwan: Rabies

In Taiwan, a person who lived in Donghe Township of Taitung County was bitten by a wild ferret-badger on 22 July 2013. The animal died later and was tested positive for rabies.

(Source: World Organisation for Animal Health 24 July 2013)


Mainland: Dengue fever

An outbreak of dengue fever was detected in Zhongshan, Guangdong province in Mainland. As of 21 July, 63 cases have been reported.

(Source: Department of Health of Guangdong Province 22 July 2013)


India: Japanese Encephalitis

In June 2013, 2 people were diagnosed with Japanese Encephalitis in Kokrajhar, India. In view of this, the district health department has stepped up surveillance.

(Source: ProMED-mail 23 July 2013)


Democratic Republic of the Congo: Yellow Fever

Since mid June this year, 13 cases of suspected yellow fever have been registered in Bandundu province of Democratic Republic of the Congo.

(Source: ProMED-mail 23 July 2013)


Italy: Botulism

More than 50 people in Italy suffered from Botulism after consuming jarred pesto contaminated with botulism bacteria and 12 people have been hospitalized.

[Editor's note: Foodborne Botulism is caused by ingestion of preformed toxins, which are produced by Clostridium botulinum, presented in the contaminated food. The features of the illness include marked fatique, weakness, blurred vision, dry mouth, difficulty in swallowing and speaking. Vomiting, constipation or diarrhoea may occur. Paralysis of breathing muscles can cause stopping of breathing and death.]

(Source: ProMED-mail 23 July 2013)


Somalia: Poliomyelitis

Twenty new cases of poliomyelitis were reported this week in Somalia and that brings the total number of cases in the Horn of Africa to 73.

(Source: ProMED-mail 23 July 2013)


Russia: Tickborne Encephalitis

A total of 18 cases of tickborne encephalitis have been reported in Russia and another 26 people are under observation as suspected cases of tickborne encephalitis virus infection.

[Editor's Note: Tickborne encephalitis is a viral infection. It is transmitted by the bite of infective ticks or by consumption of unpasteurized dairy products from infected goats, sheep, or cows. Incubation period ranges from 7-14 days. Symptoms include fever, vomiting and paralysis. Mortality rate is about 15-20%. Travellers should adopt measures similar to anti-mosquito measures to avoid tick bite and avoid consumption of unpasteurised milk.]

(Source: ProMED-mail 23 July 2013)


USA: Legionnaires' Disease

A Legionnaires' disease outbreak was reported in the Milwaukee area of USA and 31 people in the area have been affected since 1 June.

(Source: ProMED-mail 23 July 2013)


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

The Department of Health is closely monitoring two additional cases of Middle East Respiratory Syndrome reported to the World Health Organization (WHO) by the Kingdom of Saudi Arabia (KSA). According to the WHO, both cases are currently in critical condition and the patients are hospitalised in Intensive Care Units. The first case is a 41-year-old man who was admitted to hospital with symptoms on 15 July. The second patient is a 59-year-old woman who developed symptoms on 11 July. Both patients have underlying medical conditions, but neither patient has had contact with confirmed cases or animals. This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 90, including 45 deaths.

(Source: The Centre for Health Protection of the Department of Health 22 July 2013)


Philippines: Chikungunya Fever

In Negros Occidental province of Philippines, 56 cases of Chikungunya Fever were reported.
An outbreak of Chikungunya Fever was also detected in Camarines Norte province of Philippines with 300 cases recorded. The Chikungunya Fever outbreak in South Cotabato province of Philippines continues.

(Source: Promed Mail 19 & 20 July 2013)


Indonesia: Rabies

A dog infected with rabies bit five people in Gianyar regency, Bali of Indonesia.

(Source: Promed Mail 20 July 2013)


Global: Measles

Measles incidence in the Bedfordshire, Gloucestershire and Lancashire of United Kingdom continued at elevated levels during the early months of 2013.

In Pakistan, as many as 882 measles cases have been reported in the first 6 months in 2013.

In Canada, so far in 2013, nearly 30 cases of measles were identified in Alberta, British Columbia, Ontario, Quebec, New Brunswick and Prince Edward Island. The number is high, considering at this point in 2012, 6 cases had been reported.

(Source: Promed Mail 21 July 2013)



Last revision date: 31 July 2013