Current Travel Health News

In USA, 2 cases of tularemia were confirmed in Lincoln County of Nebraska. So far, 8 cases had been confirmed in Nebraska in 2013.

In India, an outbreak of leptospirosis was suspected in Vadodara of Gujarat, affecting nearly 150 people.

Dengue fever is an endemic disease in most Southeast Asian countries including Singapore, Malaysia, Indonesia, Laos, Thailand, Cambodia, Vietnam and the Philippines. Travellers visiting these places are advised to protect themselves against mosquitoes all year round.

The recent dengue fever activity in Asia has been more severe than that of last year. Various popular tourist attractions among Hong Kong people including Thailand, Singapore, Taiwan and Indonesia, observed recent persistent increase in the number of dengue fever cases. Other neighbouring Asian countries such as Laos, Cambodia, Vietnam, Malaysia, the Philippines, Pakistan and India, also recorded rising dengue fever activities.

Outbreaks of dengue fever were observed in Brazil, Costa Rica, Columbia, Paraguay and the Dominican Republic in the first quarter this year. Peru detected its first local dengue fever case. It was expected that dengue fever activities will continue to rise in coming months in Central America, Mexico and the Caribbean.

Travellers planning to travel in these areas should take precautions against the disease.

Cumulative reported number of dengue cases in 2013 *

	Cumulative reported no. of cases in 2013	Source of information and date of report
America   Central & South	868,653	World Health Organization, 21 June 2013
Australia	841	Australian Government, Department of Health and Ageing, 28 June 2013
Cambodia	4,464	World Health Organization, 26 June 2013
India   Mysore   Bangalore	224 163	ProMED-mail, 24 June 2013 ProMED-mail, 24 June 2013
Lao PDR	10,159	World Health Organization, 26 June 2013
Malaysia	11,485	World Health Organization, 26 June 2013
New Caledonia	10,318	World Health Organization, 26 June 2013
Pakistan   Sindh	303	ProMED-mail, 24 June 2013
Philippines	37,895	World Health Organization, 26 June 2013
Singapore	11,443	Singapore National Environment Agency, 28 June 2013
Solomon Island	6,217	World Health Organization,, 26 June 2013
Taiwan	137	CDC, ROC (Taiwan), 25 June 2013
Thailand   Northeastern region   Bangkok	3,544 4,374	ProMED-mail, 24 June 2013 ProMED-mail, 24 June 2013
Vietnam	13,903	World Health Organization, 26 June 2013

Remark:
* Dengue reporting systems vary by country.

Travellers should stay vigilant against dengue fever and adopt the following personal preventive measures against mosquito bite:

*	Always wear long-sleeved clothing and trousers;
*	Stay in air-conditioned residence or places with mosquito screens;
*	If mosquito screen or air-conditioning is absent, aerosol insecticide and bednets are advised;
*	Use insect repellents containing DEET on exposed skin and clothing;
*	Use insect repellents containing DEET apart from applying sunscreen while staying in beaches;
*	Carry a portable bed net and apply permethrin on it as well as to clothes if travelling to rural areas where dengue fever is prevalent.

Travellers returning from areas where dengue fever is prevalent should seek medical advice as soon as possible if they feel unwell and provide travel details to their doctors.

As of 28 June, 11,443 dengue fever cases with 3 deaths were recorded in Singapore.

The number of dengue fever cases in Singapore is 6 times higher for the same period of this year compared to last year. As of 27 June, 11,343 cases with 3 deaths were recorded.

The Department of Health (DH) is closely monitoring seven additional cases of Middle East Respiratory Syndrome reported to the World Health Organization (WHO) by the Kingdom of Saudi Arabia (KSA).

According to the WHO, four cases have been detected among contacts of confirmed cases. They range in age from seven to 15 years, and all were asymptomatic. Two further asymptomatic cases have been recorded among female health-care workers. The seventh case involved a 50-year-old female in the Eastern Region. She is currently hospitalised with pulmonary disease and her condition is considered stable.

In addition, the KSA health authority has announced the death of a 32-year-old male patient who was previously reported by the WHO on June 23.

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 77, including 40 deaths.

As of 11 June, 4,464 dengue fever cases were recorded.

As of 15 June, 11,485 dengue fever cases were recorded.

As of 20 May, 13.903 dengue fever cases were recorded.

As of 22 June, 10,318 dengue fever cases were recorded. The number 52 times higher for the same period of this year compared to last year.

As of 19 June, 6,217 dengue fever cases were recorded.

As of end of May 2013, there have been 868,653 cases of dengue fever, 8,406 cases of severe dengue and 346 deaths in Central and South America. In the first semester of 2013, outbreaks of dengue were registered in Brazil, Costa Rica, Colombia, Paraguay and the Dominican Republic. In places like Peru, cases were registered where there had previously not been locally acquired dengue cases.

The number of dengue fever cases in lower northeastern provinces of Thailand is 4 times higher in the first 5 months of this year compared to last year. From 1 January to 31 May 2013, 3544 cases were recorded. In its capital city, Bangkok, 4374 cases were reported during the past 6 months.

Increasing number of dengue fever cases was also noted in Pakistan, India, Singapore and Philippines. In Sindh province of Pakistan, 303 cases were reported so far this year and the municipality that was most affected was Karachi. In India, Mysore and Bangalore were mostly affected with 224 cases and 163 cases reported respectively since January 2013. In Singapore, as of 20 June 2013, 10 258 cases were reported while in Philippines, as of 8 June 2013, 42 207 cases were reported.

Moreover, the number of cases in the Laos was 6,377 as of 31 May 2013, about seven times that compared with the same period in 2012. The recent trends in Cambodia, Vietnam and Malaysia have also indicated increase in dengue fever cases.

For travelers who planned to visit countries in Asia, they should stay viligant against dengue fever and adopt the following personal preventive measures against mosquito bite:

• Wear long-sleeved shirts and trousers;
• Rest in air-conditioned or well-screened rooms;
• Use aerosol insecticide indoor and use bednets if sleeping areas are not air-conditioned or screened.
• Use insect repellents containing DEET on exposed skin and clothings;
• If travelling in endemic rural areas, carry a portable bed net and apply permethrin on it as well as to clothes.

H7N7 avian influenza virus infection was reported in Niedersachsen, Germany. Of 13,406 susceptible birds, 400 were affected and all were destroyed.

A norovirus outbreak was reported in Yellowstone and Grand Teton National Parks and areas outside the national parks in Montana. To date, over 100 suspected cases of norovirus among employees in Yellowstone and about 50 suspected cases among employees in Grand Teton were reported while 50 visitors also went to medical clinics within Yellowstone with symptoms of gastrointestinal illness.