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SOUTH AFRICA: CHANGES TO YELLOW FEVER VACCINATION CERTIFICATION REQUIREMENTS
5th July
The  South African Authorities have announced that they are about to make changes to their requirements for Yellow Fever Vaccination Certification which will affect travellers to and from the RSA. Proof of Yellow Fever vaccination will be required for all travellers over 1 year old entering South Africa from

This includes travellers who are travelling through these countries, even if they are spending a short time at an airport. Travellers are advised to make sure of requirements for their specific itinerary before travelling. Further details will be posted on Travel Updates as they become available.


CHOLERA - HAITI & DOMINICAN REPUBLIC
21st June
The cholera outbreak from November last year (see below) continues and the Pan American Health Organisation has reported that there have been 324,299 cases as of the end of May, with 5,342 deaths. Most of these are in Haiti, but there has also been a marked increase in the popular holiday destination of the Dominican Republic. Whilst there were 191 cases in 2010, there have now been 1,329 cases to the end of May, with only for of the Republic’s 31 provinces having escaped the disease.

The risk to travellers is still assessed as low, and only one related case has been reported in the UK from a traveller to the Domincan Republic. Travellers are advised to take extra care partcularly with water and shellfish. The authorities are not recommending the cholera vaccine routinely, but advising those who may be travelling to infected regions or areas with limited access to safe drinking water to have the vaccine.
The vaccine is available at any medicentre.


E-COLI OUTBREAK - UPDATE
11th June
Please click here for the update


JAPANESE EARTHQUAKE - UPDATE

North Eastern Japan 31 May

The FCO continues to advise against all but essential travel to north east Japan and to Tokyo. They are also advising British nationals in Tokyo and the area to the north to consider leaving the area due to the developing and uncertain situation at the Fukushima nuclear power plant. There have been no reports so far of infectious disease as a result of the disaster, but people are advised to take particular care with water and food hygiene. For detailed information, please see
http://www.nathnac.org/travel/news/japanearthquake_150311.htm


MOSQUITO-BORNE DISEASES - AUSTRALIA
31 May

There has been a marked increase in mosquito-borne diseases in several states in Australia, including Ross River virus, Barmah Forest virus, Murray Valley encephalitis and Kunjin virus. This is due to recent heavy rainfall. Travellers are urged to take especial care in their usual mosquito precautions in all sub tropical areas.


EBOLA IN UGANDA
26th May
A single confirmed fatal case of Ebola has been reported to the World Health Organisation by the Ugandan authorities. The last outbreak was in 2008, also in Uganda, where 180 people became infected. Travellers are advised only in terms of information at this stage, as the likelihood of contracting the disease is considered to be minimal.


JAPANESE EARTHQUAKE
North Eastern Japan
12 March

Following the devastating earthquake and tsunami which struck North Eastern Japan on the 11th, the Foreign Office, along with  and the equivalent governmental organisations of other nations, is advising against all travel to Tokyo and the North East of Japan unless it is absolutely necessary. For further advice and information, please see:
http://www.fco.gov.uk/en/news/latest-news/?view=News&id=563992782
for details of contacts, helplines and updates, and also
http://www.fco.gov.uk/en/travel-and-living-abroad/travel-advice-by-country/asia-oceania/japan/  for the very latest information from the FCO.

RABIES
BALI, INDONESIA 26 Feb

There have been over 190 cases of human rabies reported in Bali in an outbreak that has been going on over the last two years. With Bali being such a popular travel destination, it is worth reminding people of preventative measures to be taken against the disease.

It is transmitted via a bite or via a lick from an animal to an open wound - no matter how inconsequential. One should avoid contact with animals unless you are absolutely sure they are safe. If you are considering a longer stay, it is advisable to have a vaccination. Should you be bitten or have a wound licked, you should wash the wound very thoroughly as soon as possible. Treatment following a bite is essential, even if you have been vaccinated. Often, a flight back to Australia, the UK or a similarly well-equipped country is necessary. Good travel insurance with medical evacuation is therefore also essential. Remember that Rabies is almost always fatal.  


NZ EARTHQUAKE
Christchurch 22 Feb
Travellers should be aware that the damage caused by the earthquake is extensive, and that public services, healthcare, electricity supply and communications are expected to be disrupted for some time. There is also danger from weakened structures throughout the Canterbury region. If you are travelling to the area, you are advised to contact the Foreign & Commonwealth Office for the latest information.

YELLOW FEVER
Uganda 10th Feb
There has been an outbreak of Yellow Fever in northern Uganda, with over 225 cases and 53 deaths confirmed. Travellers to this area are strongly urged to have a Yellow Fever vaccination and should be aware that many countries require a certificate of vaccination  if travelling from areas where YF is endemic.

INFLUENZA
UK and the West, 5th Jan

The UK, Western Europe and North America are all undergoing a major seasonal outbreak of influenza and so called ‘swine flu’. Though infection rates are high, it has not reached epidemic proportions.

Travellers and residents are urged to get vaccinated, especially  the high-risk groups of the elderly, children, those who are pregnant and people with an underlying condition which weakens their immune system.
All residents and travellers are asked to ‘catch it, kill it and bin it’ and to ensure they wash their hands frequently, ideally using a disinfectant preparation.


TYPHOID
PHILLIPINES 20 Dec

Contaminated water systems are believed to be behind an outbreak of Typhoid in the Phillipines’ Cebu province. Some 320 cases had been reported as of December 17th.
Travellers are advised to take especial precautions over food, watrer and personal hygiene. Typhoid vaccinations are available at all Medicentres for those travelling to the Phillipines.


Typhoid is a serious disease caused by bacteria that are transmitted via food and water contaminated with faeces from an infected person. The symptoms of typhoid are fever, chills, headache, malaise, myalgia, anorexia, nausea and abdominal pain. Diarrhoea often occurs in the initial stages of the illness.

CHOLERA
HAITI, DOMINICAN REPUBLIC Nov 20
The cholera outbreak following the earthquake in Haiti has been well publicised and the problem is escalating, according to the OCHA with almost 17,000 cases reported and over 1,000 deaths. Those travelling to Haiti should seek specific advice outside the scope of this service.
DOMINICAN REPUBLIC
Health Officials in the Dominican Republic are monitoring the situation closely along the border with Haiti and have issued advice on hygiene and safe water practice to the indigenous population living near the border or trading with Haiti.  The cholera vaccine is not being advised at this time, however travellers are requested to monitor the situation. Only two cases of cholera have been reported as of November 26th.
Robert Curley wrote in his Caribbean Travel Blog:









XIX COMMONWEALTH GAMES
NEW DELHI, INDIA Sept 27

The Commonwealth Games are scheduled to take place in New Delhi from October 3rd to 14th. Travellers are reminded that it is important to take proper precautions before departure.
You should ensure that you are up to date with the British Schedule of vaccination which includes Measles, Mumps and Rubella (MMR), as well as Tetanus, Diptheria and Polio. These vaccinations are available at any Medicentre.
The Indian Government has also reported that there have been consistent infections of Dengue Fever this year, and travellers should take especial care to avoid insect bites during both the day and night. There is no vaccine for Dengue Fever.
Please check the latest information from NaTHNaC and the Foreign and Commonwealth Office.


WEST NILE VIRUS
GREECE, HUNGARY, ROMANIA & RUSSIA September 6th

The incidence of West Nile Virus (WNV) is increasing amongst animals in the Mediterranean basin and has now been reported in humans. The risk to travellers is very low and people are advised to take normal measures for the avoidance of mosquito bites.
Most infections are asymptomatic (no symptoms) and less than 20% of infected people will show symptoms of mild fever, headache and rash. In very rare cases, the infection can lead to meningitis and/or encephalitis. People over 50 are most at risk, and there is no vaccine.   

TRICHINELLOSIS
ARGENTINA August 31st
There has been a marked increase in the incidence of Trichinellosis in the provinces of La Pampa, Buenos Aires, Mendoza, Santa Fe, San Luis and Cordoba, and travellers are reminded to ensure that all meat products have been thoroughly cooked, especially pigs. Undercooked or raw meat should be avoided completely.
Trichinellosis is caused by a parasite which migrates from the stomach to muscles and organs via the blood stream, and can prove fatal.


SALMONELLA OUTBREAK
USA August 27th

The US Centre for Disease Control and Prevention is reporting a substantial increase in infections of a strain of Salmonella  in a number of US states. The outbreak appears to be linked with the distribution of hens eggs and a number of distribution companies are conducting checks.
In the meantime and as a precautionary measure, travellers are advised not to buy eggs under the brand names of Lucerne, Albertson, Mountain Dairy, Ralph’s, Boomsma’s, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms and Kemps. NaTHNaC is advising travellers to avoid restaurant dishes made raw, undercooked or unpasteurised eggs.
Most people make a full recovery from a Salmonella infection and it is not considered life-threatening, although it is extremely unpleasant.


WILDFIRE AND SMOG

RUSSIA August 7th
The Foreign Office has advised “against all travel to specific regions of Russia, and against all but essential travel to other specific regions of Russia" because of the dense smog caused by wildfires arising from the unprecedented heatwave. Many countries have evacuated non-essential diplomatic staff. The fires from the peat bogs and forests across a huge swathe of Russia have been raging for 12 days, and the smoke is mixing with pollutants to pose a significant risk, especially to those suffering from any respiratory condition. Carbon monoxide levels are at 7 times the maximum allowable concentrations. A state of emergency has been declared in seven of the worst-hit regions - Mari El, Mordovia, Vladimir, Voronezh, Moscow, Nizhny Novgorod and Ryazan.


FLOODS IN PAKISTAN
Azzad Jammu, Kashmir, Baluchistan, Gilgit Baltistan, Kyber-Pakhtunkwa (KP), and Punjab 5th August

It is estimated that over a million people have been displaced by the flooding in Pakistan, and the infrastructure in the regions listed above has been badly disrupted, and in some areas no longer exists. There is a significant health risk to anyone travelling to Pakistan, and the FCO is advising against all travel to specific regions of Pakistan and against all but essential travel to other specific regions of Pakistan, including Lahore. Please check the FCO site for the latest update.


FLOODS & LANDSLIDES
CHINA 27 July

There is a significantly increased risk of food and waterborne diseases in all 27 provinces affected by the torrential rain, floods and landslides suffered during July and which are continuing [as of July 27th]. Some tributaries of the Yangtze are at record levels and a peak is expected on the morning of July 28th.

Whilst there are no travel restrictions in place, travellers are urged to ensure they are completely up-to-date with all required vaccines and to check with the FCO and Nathnac sites for the latest bulletins and information.


WHOOPING COUGH
CALIFORNIA 16 July
There has been a five-fold increase in whooping cough in the USA, with most cases being reported amongst infants. Those visiting California are urged to ensure their DTP vaccine is current.


LEPTOSPIROSIS
ARGENTINA 14 July

Over 300 cases of Leptospirosis have been reported so far this year in the provinces of Santa Fe, Entre Rios and Buenos Aires, including six in the city itself. The infection is spread through contact with infected animals or contact with soil or water containing their urine. It is an extremely unpleasant illness and its severe form, known in Britain as Weil’s Disease, is serious and often fatal.


RISK TO TRAVELLERS
The risk is assessed as low, but advice includes ensuring cuts and grazes are cleaned and treated as a matter of urgency, and taking great care if exposed to areas containing rubbish or an environment where rats have been seen. There is no vaccine against this disease.


HAND, FOOT & MOUTH DISEASE (HFMD):
CHINA, JAPAN, SINGAPORE 14 June
This is a common disease which affects young children (generally under 5) in temperate regions, and outbreaks are associated primarily with schools and nurseries. It is usually mild, and rarely leads to serious complications. It is however very unpleasant for the child, with symptoms such as fever, a sore throat, general malaise and rashes on the soles of the feet and the hands. Painful lesions in the throat are also common.
The HFMD ‘season’ is the summer months, when especial attention to personal hygiene should be observed for those with younger children. There is no vaccination available to protect against HFMD.


TROPICAL STORM AGATHA: CENTRAL AMERICA 3rd June
Guatemala, El Salvador, Honduras and Nicaragua are all badly affected by flooding and landslides caused by record levels of rain. A state of emergency has been declared by the governments of Guatemala, El Salvador and Honduras, and travellers are advised accordingly. Healthcare provision in these countries is under a great deal of strain, and the flooding has made travel in some areas extremely difficult. Sanitation and the quality of drinking water are also affected. Medicentre advise that you check with NaTHNAC and the FCO if you are planning on travelling to this region.  


SOUTH AFRICA: RIFT VALLEY FEVER 10 May
An outbreak of Rift Valley Fever (RVF) was reported in February of this year in animals in Free State Province. Since then, some 172 human cases have been reported, with 15 deaths. NaTHNaC reports that some German tourists had contracted the disease, though the cases have not been serious and did not require hospitalisation.


RISK TO TRAVELLERS
The risk to travellers is assessed as low, however all travellers to the region should take particular care with their insect bite avoidance measures and use insect repellant.


AUSTRALIA: MOSQUITO-BORNE DISEASE ADVICE 7 May

The ‘wet’ season in the tropical north of Australia can bring an increased risk of mosquito-borne disease, and the health departments of several states have issued alerts to this effect. Risk diseases include Dengue fever, Barmah Forest virus, Kunjin virus, Murray Valley encephalitis and Ross River virus.


RISK TO TRAVELLERS

The risk to travellers is assessed as low, however all travellers to the region should take particular care with their insect bite avoidance measures.


BUENOS AIRES: SAINT LOUIS ENCEPHALITIS 30 March

The Argentinian Authorities have reported 40 cases of Saint Louis Encephalitis throughout the country, of which two have been confirmed in the capital. Further cases are under investigation in Buenos Aires, Entre Rios, Santa Fe, Chaco, Catamarca and Cordoba.

The Pan American Health Organisation recommends careful personal protection to

reduce the risk of mosquito bites.


DISEASE
Saint Louis Encephalitis (SLEV) is transmitted to people through mosquito bites.
Symptoms range from general fever through to severe meningoencephalitis. Symptoms include headache and nausea, fever, dizziness and general lethargy. If it progresses to meningoencephalitis, it can be fatal, with heightened risk for the young and the elderly.


RISK TO TRAVELLERS
The risk to travellers is assessed as low. There is no vaccination against SLEV, so one should take particular care in the prevention of insect bites, especially if outdoors for extend periods.


EGYPT: AVIAN INFLUENZA ('Bird Flu') 27 March

The Egyptian Ministry of Health has reported 16 cases of avian influenza (H5N1) in seven Governates throughout the country. Of these, four had proved fatal at the time of writing. All the people infected are known to have had direct contact with domestic poultry prior to presenting symptoms.


DISEASE
Avian Influenza is a serious disease which was first shown to have crossed the 'species barrier' from birds to humans in 1997. So far, it has been restricted to people who have close contact with domestic fowl, but there is a concern that the virus could mutate and become pandemic. Humans have no resistance to the disease.

The symptoms are similar to those of 'normal' influenza, though more severe.  


RISK TO TRAVELLERS
The risk to travellers is assessed as low. There is no risk from eating properly prepared meat or eggs. There is no current vaccine against H5N1, although there have recently been promising results from tests conducted in both the UK and Hungary.


This is our roundup of the latest health news for travellers as of
July 5th  2011.

Please note that this is a general overview only, and should not be relied upon as a definitive update. Travellers are urged to make specific checks concerning their destination or itinerary.
We recommend the NaTHNaC Outbreak Surveillance Service in this regard.


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Yes, there has been a major outbreak of the deadly disease in neighbouring Haiti. But most tourist destinations in the Dominican Republic are quite distant from Haiti -- Bavaro and Punta Cana, for example are literally on the other end of the island of Hispanola. Also, cholera is only spread by ingesting contaminated food or water, so direct transmission from person to person isn't a concern. Finally, the public-health authorities in the Dominican Republic -- who have one of the better prevention systems in the region -- are on high alert because of the situation in Haiti.