Current Travel Health News

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.

• 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, present yourself to the port health post staff stationed at all boundary control points 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.

As of 24 January 2010, worldwide more than 209 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 14711 deaths.

Although much of the temperate northern hemisphere passed a peak of fall and wintertime pandemic influenza activity between late October and late November 2009, virus transmission remains active in several later affected areas, particularly in North Africa, limited areas of eastern and southeastern Europe, and in parts of South and East Asia.

In North Africa, limited data suggests that pandemic influenza virus transmission remains active and geographically widespread, particularly in Morocco, Algeria, Libyan Arab Jamahiriya, and in Egypt, although most countries in the region appeared to have recently passed a peak of activity during December 2009 or January 2010. In west Asia, pandemic influenza activity continues be geographically regional to widespread, however activity levels have continued to decline or remain low since December 2009.

In South Asia, pandemic influenza activity remains active but geographically variable. Recent peaks in activity were noted during late December and early January 2010 in northern India, Nepal, and Sri Lanka. Influenza activity remained stable but elevated in western India, continued to decline substantially in northern India, and remained low overall in southern and eastern India. In Bangladesh, regional spread influenza activity and a low intensity of respiratory diseases activity was reported.

In East Asia, transmission of pandemic influenza virus remains active, however, overall activity continued to decline in most countries. An increasing trend in respiratory diseases with localized spread was reported for DPR Korea. In the Republic of Korea, transmission of pandemic influenza virus remains active (>20% respiratory specimens tested positive for pandemic H1N1), however, overall activity continue to decline since peaking during November 2009. In Japan, influenza activity continues to decline, however high levels of transmission persist on the southern island of Okinawa. In northern and southern China, pandemic virus isolations have declined substantially since peaking early to mid November 2009, however, in recent weeks detections of influenza type B viruses have increased.

In southeast Asia, transmission of pandemic influenza virus persists, but current activity levels are low. In Vietnam, influenza activity has declined substantially since peaking during October and November 2009. In Thailand, focal outbreaks of influenza were reported from a few provinces in northern and central parts of the country, however, overall ILI activity remains low.

In Europe, transmission of pandemic influenza virus remains geographically regional to widespread in the central, eastern, and southeastern parts of the continent, however, overall activity continues to decline in most places. Several countries (Austria, Albania, Bulgaria, Slovakia, and the Russian Federation) reported slight increases in the levels of ARI or ILI activity, however in most, levels remain well below recent peaks in activity. The overall rate of respiratory specimens testing positive for influenza (16%) continued to fall since peaking (45%) during early November 2009.

In the Americas, both in the tropical and northern temperate zones, overall pandemic influenza activity continued to decline or remain low in most places. Of note, detections of RSV have increased in a few countries in the Americas, which may partially account for elevated ILI activity in those areas, particularly among young children. In the US and Canada, pandemic influenza virus detections and the numbers of severe and fatal cases have decline substantially as rates of ILI have fallen below seasonal baselines. In Central America and Caribbean, pandemic influenza virus transmission persists but overall activity remains low or unchanged in most places.

In temperate regions of the southern hemisphere, sporadic cases of pandemic influenza continued to be reported without evidence of sustained community transmission.

Pandemic influenza (H1N1) 2009 virus continues to be the predominant virus circulating worldwide. Seasonal H3N2 and type B viruses are circulating at low levels in parts of Africa, east and Southeast Asia and are being detected only sporadically on other continents.

In Indonesia, an outbreak of H5N1 Avian Influenza which killed at least 1 176 chickens was reported in Lampung.

(Source: ProMED-mail 30 January 2010)

In Vietnam, outbreaks of H5N1 Avian Influenza killing more than 1 000 of birds were reported in Dien Bien province and Soc Trang province.

(Source: World Organisation for Animal Health 28 January 2010)

Since 23 January 2010, following heavy rainfall and flooding, major landslides have occurred in all provinces and departments of Cusco Region, Peru.  Train services from Cusco and Ollantaytambo to Machu Picchu Pueblo, the principle access point to Machu Picchu, have been suspended due to track damage.  One tourist from Argentina and two tour guides have been confirmed as killed on the Inca trail as a result of a landslide.

(Source: National Travel Health Network and Centre, UK 29 January 2010)

Egypt announced three new human cases of H5N1 Avian Influenza. The victims were a one-and-a-half-year-old child, a 3-year-old boy and a 45-year-old man from Ad Daqahliyah governorate, Assiut Governorate and Ash Sharqiyah respectively.  They were admitted to hospitals and in stable condition.  A total of 94 cases had been reported in Egypt including 27 deaths.

(Source: ProMED-mail 27 January 2010)

In Israel, an outbreak of highly pathogenic H5 Avian Influenza was reported at a henhouse containing about 43 000 hens in Kibbutz Ein Shemer.

(Source: ProMED-mail 27 January 2010)

In Israel, an outbreak of Mumps affecting about 1 450 people was reported in the country.  Out of which, Jerusalem reported about 600 cases.

(Source: ProMED-mail 26 January 2010)