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Travel Health News Digest (29 October 2013 - 4 November 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

Australia

1,434

World Health Organization, 16 October 2013

Brazil

1,423,672

World Health Organization, 25 October 2013

Cambodia

15,193

World Health Organization, 16 October 2013

China
  Guangdong province


753


Department of Health of Guangdong Province, 15 October 2013

India

38,179

Ministry of Health & Family Welfare, India, 30 September 2013

Lao PDR

42,779

World Health Organization, 16 October 2013

Malaysia

23,829

World Health Organization, 16 October 2013

Mexico

162,008

World Health Organization, 25 October 2013

New Caledonia

10,536

World Health Organization, 16 October 2013

Philippines

138,055

World Health Organization, 16 October 2013

Singapore

19,013

Singapore National Environment Agency, 1 November 2013

Sri Lanka

26,270

Ministry of Health, Sri Lanka, 1 November 2013

Taiwan

465

CDC, ROC (Taiwan), 4 November 2013

Thailand

137,221

Ministry of Public Health, Thailand, 29 October 2013

Vietnam

44,085

World Health Organization, 16 October 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.

 

Russia: Measles

In Russia, 38 cases of measles have been registered during the last two months in the Chelyabinsk region while 27 cases of suspected measles, including 17 children were reported in the Stavropol Region in October 2013.

(Source: Pro-MED mail 3 November 2013)

 

South Sudan: Measles

Health officials in South Sudan have launched an emergency vaccination campaign against measles after 14 children died in a suspected outbreak of measles in Eastern Equatoria state over the past week.

(Source: Pro-MED mail 3 November 2013)

 

Brazil: Measles

A total of 114 cases of measles have been confirmed in Brazil since January 2013, 98 of them in Pernambuco, 7 in Paraiba, 5 in Sao Paulo, 2 in Mato Grosso, one in Santa Catarina, and one in the Federal District.

(Source: Pro-MED mail 3 November 2013)

 

USA: Plague

The New Mexico Department of Health in USA announced on 1 November 2013, a fatal case of plague in an 80-year-old man from Bernalillo County. This is the 4th human case of plague in New Mexico and in the USA in 2013.

(Source: Pro-MED mail 2 November 2013)

 

USA: Hantavirus Infection

The New Mexico Department of Health in USA has announced a fatal case of Hantavirus Pulmonary Syndrome (HPS) in a 73-year-old woman from Santa Fe County.

(Source: Pro-MED mail 1 November 2013)

 

Cambodia: Avian Influenza, human

The Ministry of Health of Cambodia has announced a new human case of H5N1 Avian Influenza on 30 October 2013. The case is a 6-year-old girl from Romdoul village, Romdoul commune, Phnom Preuk district.

(Source: Pro-MED mail 1 November 2013)

 

Singapore: Hand, Foot and Mouth Disease

The Ministry of Health of Singapore reported 1029 cases of Hand, Foot and Mouth Disease from 20 to 26 October 2013, more than 325 cases in the same period last year.

(Source: Ministry of Health, Singapore 30 October 2013) 

 

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

WHO has been informed of three additional laboratory-confirmed cases of Middle East Respiratory Syndromefrom Saudi Arabia. Globally, from September 2012 to date, WHO has been informed of a total of 149 laboratory-confirmed cases of infection with MERS-CoV, including 63 deaths.

(Source: World Health Organization 31 October 2013)

 

Oman: Middle East Respiratory Syndrome

WHO has been informed of first laboratory-confirmed case of Middle East Respiratory Syndrome in Oman.

(Source: World Health Organization 31 October 2013)

 

Syria: Poliomyelitis [Update]

Following reports of a cluster of 22 acute flaccid paralysis (AFP) cases on 17 October 2013 in the Syrian Arab Republic, wild poliovirus type 1 (WPV1) has been isolated from ten of the cases under investigation.

(Source: World Health Organization 29 October 2013)

 

Brunei: Japanese Encephalitis

According to the Ministry of Health in Brunei Darussalam, since 17 October 2013, a total of 12 patients with symptoms of Japanese encephalitis have been reported. Of these, 9 cases are from the Belait District, 2 from Tutong and one from Brunei-Muara.

(Source: Pro-MED mail 29 October 2013)

 

Qatar: Middle East Respiratory Syndrome

WHO has been informed of an additional laboratory-confirmed case of Middle East Respiratory Syndrome in Qatar. This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 145, including 62 deaths.

(Source: World Health Organization 29 October 2013)

 

India: Chikungunya Fever

As of October, 2013, 113 people have been confirmed to have become ill from Chikungunya Fever in India.

(Source: Centres for Disease Control and Prevention 29 October 2013)

 

 

Last revision date: 4 November 2013