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Travel Health News Digest (30 July 2013 - 5 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.
  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


1,320,215


World Health Organization, 4 July 2013

Australia

954

World Health Organization, 24 July 2013

Cambodia

7,791

World Health Organization, 24 July 2013

China
  Guangdong province
  (Zhongshan)


63


Department of Health of Guangdong Province, 22 July 2013

India
  Maharashtra


727


ProMED-mail, 7 July 2013

Indonesia
  East Jakarta

1,826

ProMED-mail 1 July 2013

Lao PDR

23,657

World Health Organization, 24 July 2013

Malaysia

13,483

World Health Organization, 24 July 2013

Myanmar

6,448

ProMED-mail 1 July 2013

New Caledonia

10,452

World Health Organization, 24 July 2013

Pakistan
  Sindh


524


ProMED-mail, 29 July 2013

Philippines

45,037

World Health Organization, 24 July 2013

Singapore

13,868

Singapore National Environment Agency, 2 August 2013

Solomon Island

6,591

World Health Organization, 24 July 2013

Sri Lanka

15,777

ProMED-mail 1 July 2013

Taiwan

192

CDC, ROC (Taiwan), 22 July 2013

Thailand

73,000

ProMED-mail, 29 July 2013

Vietnam

18,934

World Health Organization, 24 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.

 

Taiwan: Rabies [Update]

In Taiwan, as of 4 August, 39 ferret-badgers were confirmed with rabies.

(Source: CDC, ROC (Taiwan) 5 August 2013)

 

Philippines: Chikungunya Fever

In Mountain province of Philippines has recorded 3 confirmed cases and another 50 suspected cases of Chikungunya Fever were reported.

(Source: ProMED-mail 4 August 2013)

 

Ghana: Malaria

Kumasi of Ghana recorded 172 538 cases of malaria in the 1st half of 2013 compared with155 734 cases in the same period in 2012.  

(Source: ProMED-mail 4 August 2013)

 

India: Influenza 

As of 26 July 2013, Delhi of India has recorded 1507 cases and 16 deaths of influenza H1N1 cases.

(Source: ProMED-mail 4 August 2013)

 

Mainland: Dengue fever [Update]

Three local cases of dengue fever were reported in Guangzhou Huanghuagang and Guihuagang Mainland.

(Source: Guangzhou Center for Disease Control and Prevention 2 August 2013)

 

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

The Department of Health (DH) isclosely monitoring three 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, the first patient is a 67-year-old woman with underlying illnesses who is from the KSA's capital. She became ill on July 25 and is currently hospitalised. She had no known exposure to animals or other confirmed cases. The other two female patients are health-care workers, respectively from southern KSA and the capital, who have mild symptoms and were exposed to previously confirmed cases.

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 94, including 46 deaths.

(Source: The Centre for Health Protection of the Department of Health 2 August 2013)

 

Somalia: Poliomyelitis [Update]

Somalia's Ministry of Health confirms there are now 94 cases of poliomyelitis in south-central Somalia.

(Source: ProMED-mail 1 August 2013)

 

 

Taiwan: Rabies [Update]

In Taiwan, as of 1 August, 21 ferret-badgers and 1 house shrew were confirmed with rabies.

(Source: CDC, ROC (Taiwan) 1 August 2013)

 

India: Japanese Encephalitis

An additional fatal case of Japanese encephalitis was reported in Gorakhpur, eastern Uttar Pradesh of India and this raised the death toll to 88 this year.

(Source: ProMED-mail 31 July 2013)

 

USA: Eastern Equine Encephalitis

A 70-year-old woman has tested positive for eastern equine encephalitis in clinch county, Georgia of USA.

(Source: ProMED-mail 31 July 2013)

 

Poland: Rubella [Update]

As of July 15, 2013, a total of 35,061 cases of rubella have been reported in Poland.

(Source: Centres for Disease Control and Prevention 26 July 2013)

 

Japan: Rubella [Update]

As of July 17, 2013, 12,832 rubella cases have been reported in Japan.

(Source: Centres for Disease Control and Prevention 26 July 2013)

 

Taiwan: Rabies [Update]

Another 5 ferret-badgers with rabies were confirmed on 28 July in Taiwan. In addition, World Organisation for Animal Health reported that the outbreak of rabies continues in Taiwan.

(Source: ProMED-mail 29 July 2013, World Organisation for Animal Health 30 July 2013)

 

India: Crimean-Congo Haemorrhagic Fever

In the Amreli District, Gujarat state, India, 6 human cases including 2 deaths of Crimean-Congo Haemorrhagic Fever were confirmed between 23 Jun 2013 and 10 Jul 2013. 

(Source: ProMED-mail 30 July 2013)

 

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

The Department of Health (DH) is closely monitoring an additional case of Middle East Respiratory Syndrome reported to the World Health Organization (WHO) by the Kingdom of Saudi Arabia (KSA).According to the WHO, the patient is an 83-year-old man who became ill on July 17 and is currently hospitalised.

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 91, including 46 deaths.

(Source: The Centre for Health Protection of the Department of Health 30 July 2013)

 

 

Last revision date: 5 August 2013