Travel Health Service Year 2009

Travel Health News Digest (7 December 2009)

Advice for Travellers Planning to Visit Human Swine Influenza Affected Areas

Human Swine Influenza (Influenza A / H1N1)

The World Health Organization has declared the human swine influenza (swine flu) outbreak a global pandemic. Confirmed cases of swine flu have been reported in many parts of the world, including Hong Kong.

Human-to-human transmission has occurred in the present swine flu outbreak. The symptoms of swine flu include fever, cough, sore throat, runny nose, muscle pain and headache. Some people infected with swine flu may also have vomiting and diarrhoea.

Advice

Strict adherence to personal and environmental hygiene is essential for prevention of swine flu. Department of Health reminds travellers to watch out for the latest developments in the swine flu outbreak when planning travel. Travellers should prepare adequate face masks and alcohol-based handrub and take the following precautionary measures:

During the trip: maintain good personal hygiene, wash hands or use handrub frequently and avoid contact with sick people.
Before returning: do not get on board an airplane when influenza-like symptoms develop. Put on a mask and seek medical attention where you are.
After returning: avoid going to crowded places and pay close attention to your health. Seek medical consultation from public clinics or hospitals right away if influenza-like symptoms appear.

The Government of the HKSAR requires each arriving passenger to complete a Health Declaration Form and return it to designated collection points.

Use of Anti-viral Drugs

According to interim testing result performed by Centers for Disease Control and Prevention, USA, human swine influenza virus is sensitive to two antiviral drugs, namely Oseltamivir (Tamiflu) and Zanamivir (Relenza). You should consult your doctor before taking these anti-viral drugs.

(Source: Department of Health, HKSAR, 22 June 2009)

Advice for Inbound Travellers/Returnees to Hong Kong on Prevention of Human Swine Influenza (Influenza A/H1N1)

Advice

The Hong Kong Special Administrative Region Government appeals to all inbound travellers/returnees to Hong Kong to observe the following:

While overseas, exercise good personal hygiene, e.g. observe hand hygiene and cough manners, and -
- pay attention to announcements from the local government
- follow local public health guidelines, including any movement restrictions and preventive recommendations
- avoid contact with sick people
Before returning, do not get on board an airplane when influenza-like symptoms develop. Put on a mask and seek medical attention where you are.
If you develop symptoms while on board, put on a mask and notify the crew right away. The crew will in turn follow established procedures and alert ground control. Port health team will board the airplane to assess and follow up on landing.
Upon landing, accurately and honestly complete the health declaration form; or present yourself to the port health post stationed at all border crossings if you have a health concern.
After returning, avoid going to crowded places and pay close attention to your health. Seek medical consultation from public clinics or hospitals right away if influenza-like symptoms appear.

(Source: Department of Health, HKSAR, 25 June 2009)

Worldwide: Pandemic Influenza (H1N1) 2009

As of 29 November 2009, worldwide more than 207 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 8 768 deaths.

In the temperate zone of the northern hemisphere, the early arriving winter influenza season continues to intensify across central Europe and in parts of central, eastern, and southern Asia. Disease activity has peaked and is declining in North America and has either recently peaked or is currently peaking in much of western and northern Europe.

In both Canada and the United States, influenza virus circulation remains active and geographically widespread, however, disease activity appears to have peaked in past 3 to 4 weeks. In the United States, deaths due to pneumonia and influenza continued to increase past the epidemic threshold for the past 8 weeks and cumulative rates of hospitalizations for the current influenza season have exceeded rates seen in recent seasons among all age groups except those aged ≥ 65.

In Europe, widespread and intense transmission of pandemic influenza virus continued to be observed across most of the continent. In western and northern Europe the peak of disease activity has passed in Belgium, Iceland, Ireland, Netherlands, Norway and parts of the United Kingdom (Northern Ireland, Wales); activity may be peaking or plateauing in Spain, Portugal, Italy, Sweden and Denmark. Influenza activity continues to increase in much of Central Europe in the region between the Baltic and Balkan countries and from Germany to Romania. In Eastern Europe, recent peaks or plateaus in disease activity have also been observed in Ukraine, Belarus, Bulgaria and the Republic of Moldova. In the Russian Federation, influenza activity remains active and intense in some regions, with an overall increasing trend. A moderate impact on the healthcare system has been reported in parts of Northern and Eastern Europe. Over 99% of subtyped influenza A viruses in Europe were pandemic H1N1 2009.

In Western and Central Asia, influenza transmission remains active. Disease activity continues to increase in Kazakhstan, Kyrgyzstan, Uzbekistan, Iran and Iraq, while activity may have peaked in Israel, Jordan, and Afghanistan.

In East Asia, increasing influenza-like-illness or respiratory disease activity has been reported in Southern China and Japan. A recent decline in activity has been observed in Northern China. In South and Southeast Asia, influenza activity continues to increase in the north-western parts of India, Nepal, Sri Lanka and Cambodia, while activity in the rest of region remain low.

In the tropical zone of Central and South America and the Caribbean, influenza transmission remains geographically widespread but overall disease activity has been declining except for focal areas of increasing activity in Jamaica, Venezuela and Ecuador.

In Africa, pandemic H1N1 2009 virus continues to be isolated from all parts of the continent, and there is evidence of continued co-circulation of pandemic (H1N1) 2009 and seasonal H3N2 viruses.

In the temperate region of the southern hemisphere, little pandemic influenza activity has been reported.

(Source: World Health Organization 4 December 2009)

Indonesia: Avian Influenza, human

In Indonesia, a suspected human case of Avian Influenza was reported in West Sumatra. The victim was a 37-year-old man who had contact with dead ducks before falling ill.

(Source: ProMED-mail 30 November 2009)

Vietnam: Avian Influenza, human

In Vietnam, the Ministry of Health reported a new suspected case of H5N1 Avian Influenza. The case was a 23-year-old man from Dien Bien Province. He developed symptoms on 18 November and died on 28 November. The victim had taken uncooked duck blood soup before falling ill.

(Source: ProMED-mail 1& 4 December 2009)

USA: Dengue Fever

In the USA, 20 local cases of Dengue Fever were reported in Key West, Florida.

(Source: ProMED-mail 1 December 2009)

Central African Republic: Yellow Fever

Central African Republic reported 4 suspected cases of Yellow Fever in the Prefecture of Ombella Mpoko and Prefecture of La Lobaye. Three of them died of the disease.

(Source: World Health Organisation 1 December 2009)

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