Travel Health Service Year 2009

Travel Health News Digest (27 September 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 20 September 2009, there have been more than 300,000 laboratory confirmed cases of pandemic influenza H1N1, 3917 deaths, in 191 countries and territories reported to WHO.

In the temperate regions of the northern hemisphere, influenza-like-illness (ILI) activity continues to increase in many areas. In North America, the United States has reported continued increase in activity above the seasonal baseline for the last 2 to 3 weeks, primarily in the southeast but now also appearing in the upper midwest and the northeast. In Europe, the United Kingdom is reporting regional increase in ILI activity in Northern Ireland and Scotland. The Netherlands, France, Ireland and Israel are reporting rates above the seasonal baseline. In Japan, influenza activity continues to be slightly above the seasonal epidemic threshold. The increase in ILI activity has been accompanied by increase in laboratory isolations of pandemic influenza H1N1 2009 in most of these areas.

In the tropical regions of the Americas and Asia, influenza activity remains variable. In parts of India, Bangladesh and Cambodia, influenza transmission continues to be active, while other countries in the Southeast Asia have been recently reporting declining transmission (Indonesia, Singapore and Thailand). Although most countries in the tropical regions of the Americas are still reporting regional to widespread geographic spread of influenza activity, there is no consistent pattern in the trend of respiratory diseases. Peru and Mexico have reported an increasing trend in some areas, while most others are reporting an unchanged or decreasing trend (most notably Bolivia, Venezuela and Brazil).
In the temperate regions of the southern hemisphere, influenza transmission has largely returned to baseline (Chile, Argentina, and New Zealand) or is continuing to decline (Australia and South Africa).

(Source: World Health Organization 25 September 2009)

Vietnam: Hand, Foot and Mouth Disease

As of 11 September, 60 children cases of Hand, Foot and Mouth Disease were reported in Vietnam. Most of the cases were in serious condition and the outbreak was due to Enterovirus 71. Last year, there were about 3 000 children cases including at least 10 deaths in the whole country.

(Source: ProMED-mail 20 September 2009)

Egypt: Avian Influenza, human

Egypt announced 2 new human cases of H5N1 Avian Influenza virus infection. The first case was a 13-yesr-old boy from Alexandria governorate. The second case was a 14-month-old girl from Behira governorate. Both of them were hospitalized and given Tamiflu. They are in a stable condition. Investigations into the source of infection indicated that both cases had contact with dead or sick poultry. Up till now, there were 87 cases with 27 deaths in Egypt.

(Source: World Health Organization 24 September 2009)

Afghanistan: Cholera [update 1]

Afghanistan reported outbreaks of Cholera in the capital Kabul and 10 provinces across the country. There were at least 673 cases of the disease countrywide with 28 deaths reported.

(Source: ProMED-mail 21 September 2009)

Bangladesh: Avian Influenza, poultry

In Bangladesh, an outbreak of Avian Influenza which killed 53 birds was reported in a farm in Chittagong.

(Source: World Organisation for Animal Health 20 September 2009)

Maldives: Chikungunya Fever

Two travellers from Germany were diagnosed Chikungunya Fever after returning home from a 10-day trip in Maldives.

(Source: ProMED-mail 22 September 2009)

United Kingdom: Escherichia coli O157 infection [update 1]

The recent outbreak of Escherichia coli O157 infection has affected 67 persons who had history of visiting the Gladstone Farm in Surrey of the United Kingdom since early August this year. A total of 8 children were currently being treated in hospital. The source of the infection was apparently from the farm animals. Health authorities reminded parents to follow strict hand washing with their families when visiting farms.

(Source: ProMED-mail 21& 23 September 2009)

Netherlands: Q fever [update]

In the Netherlands, 2 145 cases of Q fever with 5 deaths were reported in the country so far this year.

[Editor's note: Q fever is a disease that is usually passed from sick farm animals to humans. People can become sick with Q fever 2-5 weeks after being exposed to the disease. Usual symptoms include high fever, chills, severe headache, muscle pain, bone pain, and weakness. Pneumonia occurs in about half of the cases. Travellers should avoid visiting farms in affected areas, and should drink only boiled water or pasteurized dairy products.]

(Source: ProMED-mail 27 September 2009)

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