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Travel Health News Digest (5 November 2013 - 11 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

1,452

World Health Organization, 30 October 2013

Brazil

1,446,660

World Health Organization, 5 November 2013

Cambodia

15,193

World Health Organization, 30 October 2013

China
  Guangdong province


753


Department of Health of Guangdong Province, 15 October 2013

India

55,063

Ministry of Health & Family Welfare, India, 28 October 2013

Lao PDR

43,279

World Health Organization, 30 October 2013

Malaysia

23,829

World Health Organization, 30 October 2013

Mexico

184,406

World Health Organization, 5 November 2013

New Caledonia

10,537

World Health Organization, 30 October 2013

Philippines

138,055

World Health Organization, 30 October 2013

Singapore

19,420

Singapore National Environment Agency, 8 November 2013

Sri Lanka

26,857

Ministry of Health, Sri Lanka, 8 November 2013

Taiwan

493

CDC, ROC (Taiwan), 11 November 2013

Thailand

139,681

Ministry of Public Health, Thailand, 4 November 2013

Vietnam

44,085

World Health Organization, 30 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.

 

Qatar: Middle East Respiratory Syndrome

The Department of Health (DH) is closely monitoring an additional case of Middle East Respiratory Syndrome reported to the World Health Organization (WHO) by Qatar. According to the WHO, the male patient aged 48 with underlying illnesses became ill on October 25 and was admitted to hospital on October 31. He is currently in critical condition. Preliminary investigations revealed that he frequently visited animal barns. He described no recent travel history or contact with previously confirmed patients.

This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 151, including 64 deaths.

(Source: The Centre for Health Protection of the Department of Health 11 November 2013)

 

Cambodia: Avian Influenza, human

The Ministry of Health of the Kingdom of Cambodia reported the 24th human case of Avian Influenza H5N1 in 2013. The 24th case was a 10-year-old boy from southern Kampot province.

(Source: ProMED-mail 9 November 2013)

 

Spain: Middle East Respiratory Syndrome

The Ministry of Health, Social Services and Equality of Spain has notified the detection of a laboratory confirmed imported case of the Middle East Respiratory Syndrome. The patient was a woman who recently returned from Saudi Arabia after attending the Hajj pilgrimage in October. She was currently hospitalized in stable condition.

(Source: Ministry of Health, Spain 6 November 2013)

 

Sudan: Yellow Fever

According to the Sudanese federal Ministry of Health, between 3 Oct and 2 Nov 2013, a total of 20 suspected cases of Yellow Fever, including 7 deaths, were reported in Sudan.

(Source: ProMED-mail 6 November 2013)

 

Mainland: Avian Influenza, human

The Centre for Health Protection (CHP) of the Department of Health (DH) has been notified by the National Health and Family Planning Commission (NHFPC) of an additional human case of avian influenza A(H7N9) in Zhejiang affecting a woman aged 64. The patient became ill on October 30 and is currently receiving treatment in hospital in critical condition. Her sample tested positive for the avian influenza A(H7N9) virus upon testing by the relevant health authority of Zhejiang and the case was subsequently confirmed.

To date, a total of 138 human cases of avian influenza A(H7N9) have been laboratory confirmed in the Mainland, including Zhejiang (49 cases), Shanghai (33 cases), Jiangsu (28 cases), Jiangxi (six cases), Fujian (five cases), Anhui (four cases), Henan (four cases), Shandong (two cases), Hunan (two cases), Beijing (two cases), Guangdong (two cases) and Hebei (one case).

(Source: The Centre for Health Protection of the Department of Health 6 November 2013)

 

Cambodia: Avian Influenza, human

The Ministry of Health of the Kingdom of Cambodia reported the 23rd human case of Avian Influenza H5N1 in 2013. The 23rd case was a 2-year-old girl fromSvay Chrum village, Borng Bort Kandal commune, Bakane district, Pursat province.

(Source: World Health Organization 5 November 2013)

 

Mainland: Avian Influenza, human

The Centre for Health Protection (CHP) of the Department of Health (DH) has been notified by the Health and Family Planning Commission of Guangdong Province of a confirmed human case of avian influenza A(H7N9) on November 5 affecting a 3-year-old boy in Dongguan, Guangdong Province. The patient is currently receiving treatment under isolation in hospital. He presented with minor symptoms without fever and is now in stable condition. His sample tested positive for the avian influenza A(H7N9) virus by the relevant health authority of Guangdong Province and the diagnosis was confirmed today. Seven close contacts of the patient have been put under medical surveillance by the relevant health authority of Guangdong Province. Three of them developed influenza-like symptoms but none of them tested positive for avian influenza A(H7N9).

To date, a total of 137 human cases of avian influenza A(H7N9) have been laboratory confirmed in the Mainland, including Zhejiang (48 cases), Shanghai (33 cases), Jiangsu (28 cases), Jiangxi (six cases), Fujian (five cases), Anhui (four cases), Henan (four cases), Shandong (two cases), Hunan (two cases), Beijing (two cases), Guangdong (two cases) and Hebei (one case).

(Source: The Centre for Health Protection of the Department of Health 5 November 2013)

 

Nigeria: Cholera [Update]

On 31 October 2013, a total of 1 623 cholera infection cases have been reported in Nigeria and 86 patients died from the infection.

(Source: ProMED-mail 4 November 2013)

 

Kingdom of Saudi Arabia: Middle East Respiratory Syndrome

WHO has been informed of an additional laboratory-confirmed case of Middle East Respiratory Syndrome in Saudi Arabia. This brings the latest global number of confirmed cases of Middle East Respiratory Syndrome to 150, including 64 deaths.

(Source: World Health Organization 4 November 2013)

 

 

Last revision date: 11 November 2013