Travel Health Service Year 2009

Travel Health News Digest (9 November 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 1 November 2009, worldwide more than 199 countries and overseas territories/communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 6000 deaths.

Intense and persistent influenza transmission continues to be reported in North America without evidence of a peak in activity. The proportion of sentinel physician visits due to influenza-like-illness (ILI)(8%) has exceeded levels seen over the past 6 influenza seasons; 42% of respiratory samples tested were positive for influenza and 100% of subtyped influenza A viruses were pandemic H1N1 2009. Rates of ILI, proportions of respiratory samples testing positive for influenza, and numbers of outbreaks in educational settings continue to increase sharply in Canada as activity spreads eastward. Significantly more cases of pandemic H1N1 have been recorded in Mexico since September than were observed during the initial springtime epidemic.

In Europe and Central and Western Asia, pandemic influenza activity continues to increase across many countries, signalling an unusually early start to the winter influenza season. Active circulation of virus marked by high proportions of sentinel respiratory samples testing positive for influenza has been reported in Belgium (69%), Ireland (55%), Netherlands (51%), Norway (66%), Spain (46%), Sweden (33%), the United Kingdom (Northern Ireland:81%), and Germany (27%). In addition, there is evidence of increasing and active transmission of pandemic influenza virus across Northern and Eastern Europe (including Ukraine and Belarus), and eastern Russia. In Western Asia and the Eastern Mediterranean Region, increasing activity has been reported in Oman and Afghanistan.

In East Asia, intense and increasing influenza activity continues to be reported in Mongolia. In China, after an earlier wave of mixed influenza activity (seasonal H3N2 and pandemic H1N1), pandemic H1N1 influenza activity now predominates and is increasing. Sharp increases in pandemic influenza activity continue to be reported throughout Japan with highest rates of illness being reported on the northern island.

Active influenza transmission and increasing levels of respiratory diseases continues to be reported in parts of the Caribbean, including in Cuba, Haiti, and other Caribbean Epidemiology Centre (CAREC) countries. Most other countries in the tropical region of Central and South America continue to report declining influenza activity. With the exception of Nepal, Sri Lanka, and Cambodia, overall transmission continues to decline in most but not all parts of tropical South and Southeast Asia. Influenza virus isolates from sub-Saharan Africa are predominantly pandemic H1N1 virus but some seasonal H3N2 has been detected even in recent weeks. Unconfirmed media reports from the area indicate that disease activity has increased in recent weeks.

Since the new pandemic H1N1 2009 virus emerged, infections in different species of susceptible animals (pig, turkey, ferret, and cat) have been reported. Limited evidence suggests that these infections occurred following direct transmission of the virus from infected humans. These isolated events have had no impact on the dynamics of the pandemic, which is spreading readily via human-to-human transmission. As human infections become increasingly widespread, transmission of the virus from humans to other animals is likely to occur with greater frequency. Unless the epidemiology of the pandemic changes, these will continue to pose no special risks to human health.

(Source: World Health Organization 6 November 2009)

Ukraine: Pandemic Influenza (H1N1) 2009

As of 3 November, more than 250 000 cases of influenza-like illness and 70 deaths from acute respiratory illness were reported in Ukraine. Regions in western Ukraine continue to show highest rates of acute respiratory illness/influenza-like illness. The level of activity in the Kyiv area is also increasing rapidly. Laboratory testing has confirmed pandemic H1N1 influenza virus in samples taken from patients in two of the most affected regions.

(Source: World Health Organization 3 November 2009)

Vietnam: Avian Influenza, poultry

In Vietnam, outbreaks of Avian Influenza affecting 9 farms and killed hundreds of poultries were reported in Dien Bien province.

(Source: ProMED-mail 3 November 2009)

Vietnam: Dengue Fever

Up to now, more than 74 242 cases of Dengue Fever with 58 deaths were reported in Vietnam.

(Source: ProMED-mail 2 November 2009)

Australia: Hepatitis A

Health authorities in Victoria, Australia reported a further 23 cases of Hepatitis A in the past week. So far this year there had been 200 notifications of Hepatitis A, compared to 74 at the same time last year. More than two thirds of the cases recalled eating semi-dried tomatoes. The authority continues to work with the manufacturers and suppliers of semi-dried tomatoes to try to identify the source. The greatest risk would appear to be at restaurants and cafes, where semi-dried tomatoes are served in foods such as salads and sandwiches.

(Source: ProMED-mail 4 November 2009)

Australia: Pertussis

In South Australia, there were almost 3 500 reports of Pertussis this year, compared with 859 at the same time in 2008 and 318 in 2007. The patients this year were mainly babies.

(Source: ProMED-mail 7 November 2009)

Netherlands: Q fever, human and animals

In the Netherlands, 80 out of the 360 goat farms were suspected to be affected by Q fever. As of 29 October, there were 2 126 confirmed human cases, 110 probable cases of Q fever and 6 deaths. The country had 1 000 and 168 cases of the disease in 2008 and 2007 respectively.

(Source: ProMED-mail 7 November 2009)

Peru: Rabies

In Peru, 5 deaths due to suspected Rabies transmitted by the bite of bats were reported in Loreto.

(Source: ProMED-mail 6 November 2009)

Sudan: Leishmaniasis

There was an outbreak of visceral Leishmaniasis in southern Sudan. Jonglei State was the most affected area with 275 cases of the disease. There were also 66 cases of visceral Leishmaniasis in the neighbouring Upper Nile State.

(Source: ProMED-mail 7 November 2009)

Yemen: Dengue Fever

In Yemen, an outbreak of Dengue Fever with at least 350 confirmed cases and 1 000 suspected cases was reported in Taiz city.

(Source: ProMED-mail 2 November 2009)

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