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Travel Health News Digest (27 August 2013 - 2 September 2013)

Advice for pilgrims visiting Mecca, Saudi Arabia (Hajj)

Pilgrims are advised to note the followings:

  1. Vaccination against meningitis

  2. The Saudi Arabia government requires all pilgrims on entry to produce a certificate of vaccination against the meningococcal disease using the quadrivalent vaccine (serogroups A, C, W135 and Y). The certificate should be not more than 3 years and not less than 10 days before arrival.

     

  3. Vaccination against seasonal influenza

  4. The Saudi Ministry of Health recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the Kingdom of Saudi Arabia, particularly those at increased risk of severe influenza diseases, including pregnant women, children under 5 years, the elderly, and individuals with underlying health conditions such as HIV/AIDS, asthma, and chronic heart or lung diseases.

     

  5. Be Vigilant against Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

  6. Travellers should take note of MERS-CoV (formerly known as novel coronavirus). Most of the cases reported to date originated or returned from the Middle East and subsequently became ill. The most common symptoms observed include fever, cough, and breathing difficulties. Approximately half of the patients have died.

    In view of the severity and possibility of spread of the illness among human through close contact, if you are travelling to the Middle East for vacation or pilgrimage, please observe personal and environmental hygiene strictly at all times such as avoiding undercooked meats, raw fruits and vegetables, unless they have been peeled, or unsafe water. Travellers should also avoid direct contact with animals, birds, poultry or sick people during the journey and should wear face masks in crowded places.

    Pilgrims should be reminded that pre-existing major medical conditions can increase the likelihood of medical problems, including MERS-CoV infection, during travel; thus, pilgrims should consult a health care provider before travelling to review the risk and assess whether making the pilgrimage is medically advisable. For further advice from the Saudi Ministry of Health, please see ( http://www.moh.gov.sa/en/Hajj/Pages/HealthRegulations.aspx )

    Travellers who develop symptoms during travel or up to 14 days after their return from affected areas should put on face masks, seek medical attention and inform doctor of their travel history. Before departure, if you feel unwell, such as having fever, sore throat, muscle pain or cough, you are advised to seek medical attention and delay the trip until recovery. For further information on MERS, please visit Centre for Health Protection (CHP) website (http://www.chp.gov.hk)。

     

  7. Other infectious diseases

  8. Updating immunization against vaccine-preventable diseases in all travellers is strongly recommended. With the recent resurgence of measles and rubella cases, special attention is needed for both of these vaccines to avoid widespread outbreaks with this virus during Hajj and Umra this year.

    Men are required to shave their heads after Hajj, and unclean blades can transmit disease. Male pilgrims should go to officially designated centers to be shaved, where barbers are licensed and use disposable, single-use blades.

     

  9. Food hygiene

  10. Fresh food carried by visitors and pilgrims are banned and not allowed into the country. Only properly canned food in very small amount which is enough for one person to the end of his or her trip is allowed. In addition, diarrhea is common during Hajj, so eat only food that is cooked and served hot and drink only beverages from sealed containers.

     

  11. Injury

  12. Try to avoid the most densely congested areas and always be aware of the location of emergency exits. Pilgrims can perform rituals during non-peak hours to avoid crowds.

     

  13. Heat stroke

  14. Temperatures in Mecca can exceed 37.8 ºC (100°F) in October. Heat exhaustion and heatstroke are leading causes of illness during Hajj. Pilgrims should drink plenty of water (bottled), wear sunscreen, rest, and seek shade as much as possible. Symptoms of heat-related illness can include profuse sweating, chills, headache, dizziness or confusion, and nausea. Travelers who develop these symptoms should move to a cool area and seek medical attention.

     

  15. Observe personal and environmental hygiene strictly at all times. For more information, please read the section on Travel Health Advice.
  16.  

(Source: World Health Organization, Centers for Disease Control and Prevention & Ministry of Hajj, Kingdom of Saudi Arabia)

 

Take precautions against dengue fever when travelling abroad

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 Guangdong province in China, Brazil, Costa Rica, Columbia, Paraguay and the Dominican Republic this year. 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
 North, Central & South


1,403,440


World Health Organization, 8 August 2013

Australia

1,143

World Health Organization, 21 August 2013

Cambodia

12,419

World Health Organization, 21 August 2013

China
  Guangdong province
  (Zhongshan)


63


Department of Health of Guangdong Province, 22 July 2013

India
  Maharashtra


727


ProMED-mail, 7 July 2013

Indonesia
  East Jakarta

1,826

ProMED-mail 1 July 2013

Lao PDR

34,783

World Health Organization, 21 August 2013

Malaysia

16,586

World Health Organization, 21 August 2013

Myanmar

6,448

ProMED-mail 1 July 2013

New Caledonia

10,510

World Health Organization, 21 August 2013

Pakistan
  Sindh


549


ProMED-mail, 11 August 2013

Philippines

76,354

World Health Organization, 21 August 2013

Singapore

15,097

Singapore National Environment Agency, 28 August 2013

Solomon Island

6,591

World Health Organization, 7 August 2013

Sri Lanka

20,216

ProMED-mail, 11 August 2013

Taiwan

217

CDC, ROC (Taiwan), 5 August 2013

Thailand

81,763

ProMED-mail, 5 August 2013

Vietnam

18,934

World Health Organization, 21 August 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 bed nets 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 nets 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.

 

Qatar: Middle East Respiratory Syndrome

WHO has been informed of an additional two laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus infection in Qatar. This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 104, including 49 deaths.

(Source: World Health Organization 29 August 2013)

 

Kyrgyzstan: Plague

In Kyrgyzstan, a 15-year-old boy was killed by bubonic plague.

(Source: ProMED-mail 29 August 2013)

 

Kingdom of Saudi Arabia: Middle East Respiratory Syndrome [Update]

The Ministry of Health in Saudi Arabia has notified WHO of an additional eight laboratory-confirmed cases of Middle East Respiratory Syndrome. Additionally, a previously laboratory-confirmed case from the United Arab Emirates has died.

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 102, including 49 deaths.

(Source: World Health Organization 28 August 2013)

 

Australia: E.coli Infection

In Queensland, Australia, 9 people have been confirmed to have become ill from E. Coli  infection in August 2013.

(Source: ProMED-mail 28 August 2013)

 

Russia: Crimean-Congo Haemorrhagic Fever [Update]

In the Rostov region of Russia, 38 cases of Crimean-Congo Haemorrhagic Fever have been recorded and 2 of whom have died.

(Source: ProMED-mail 27 August 2013)

 

Uganda: Crimean-Congo Haemorrhagic Fever

Ministry of Health of Uganda reported on 21 August 2013 that a 27-year-old woman in Kampala had died after contracting Crimean-Congo Haemorrhagic Fever. The woman was suspected to have contracted the disease from her husband who also suffered from Crimean-Congo Haemorrhagic Fever while in South Sudan and had recently returned to Uganda, where he is receiving additional treatment.

(Source: ProMED-mail 26 August 2013)

 

USA: Cryptosporidiosis

An outbreak of Cryptosporidiosis with 528 probable and confirmed cases was reported in Iowa, USA since 1 June 2013.

(Source: ProMED-mail 26 August 2013)

 

Dominican Republic: Cholera

On 23 August 2013, health authorities of Dominican Republic confirmed a cholera outbreak in San Cristobal and 23 people have been hospitalised this week due to the disease.

(Source: ProMED-mail 26 August 2013)

 

India: Japanese Encephalitis [Update]

Gorakhpur district of Uttar Pradesh of India has been affected by Japanese encephalitis. Almost 100 deaths have been reported in August in 2013.

(Source: ProMED-mail 25 August 2013)

 

Thailand: Hand, Foot and Mouth Disease

In Thailand, over 27 000 cases of Hand, Foot and Mouth Disease have been found in 2013.

(Source: ProMED-mail 23 August 2013)

 

USA: Listeriosis [Update]

A multistate outbreak of listeriosis was reported in USA and five states namely Illinois, Indiana, Minnesota, Ohio and Texas were involved. Six cases including one death were reported. This outbreak was likely to be related to cheese.

(Source: Centres for Disease Control and Prevention 22 August 2013)

 

 

Last revision date: 30 August 2013