TRAVEL HEALTH PROGRAM
DECEMBER 2017 NEWSLETTER

Check out our Healthy Travel Checklist video below- Now in French!

Healthy Travel Checklist Video - Now in French - Watch Now!

Outbreaks & Security Concerns

  • Thousands of people around the world celebrate Carnival every year and the dates vary by destination. People have fun at Carnival and Mardi Gras, but these festivities are also associated with health risks, primarily from crime, excessive drinking, unsafe food, risky sex, and heat-related illness. Travelers to Carnival should take simple precautions to stay safe and healthy.

Africa

  • Health officials in Cape Verde have reported a substantial increase in malaria in the capital city of Praia on São Tiago Island (also known as Santiago Island). CDC now recommends that travelers to the city of Praia on São Tiago Island take prescription medicine to prevent malaria before, during, and after their trip. 
  • Health officials in South Africa have reported limited cases of locally transmitted malaria in Gauteng Province, where Johannesburg and Pretoria are located. Local transmission means that mosquitoes in the area may have been infected with malaria and are spreading it to people. Malaria is not usually found in Gauteng Province, but rare outbreaks have been reported in the past. Because malaria is spread by mosquito bites, travelers to Gauteng Province should prevent mosquito bites. Ways include using insect repellent when outdoors, wearing protective clothing, and sleeping in an air-conditioned or well-screened room or under an insecticide-treated bed net. 
  • Cases of polio have been reported in Nigeria and the Democratic Republic of the Congo. The CDC recommends that all travelers to these countries be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.
  • A pneumonic and bubonic plague outbreak has been reported in Madagascar, including Antananarivo (the capital city and its suburbs) and Toamasina. CDC recommends that travelers to Madagascar should use insect repellent to prevent flea bites and avoid close contact with sick or dead animals. Travelers should also avoid close contact with ill people, especially those with cough or pneumonia. Plague can be prevented with antibiotics. Travelers who have had close contact with people with plague pneumonia or other high-risk exposures should immediately notify a health care provider. Exposed individuals may need to take antibiotics to prevent plague. During or after travel to Madagascar, travelers should be alert for symptoms of plague, and if they appear, seek medical care and inform the provider about their travel to Madagascar.
  • Check the World Map of Areas with Risk of Zika to find out about countries in Africa with risk of Zika. Refer to the Current Zika Virus Recommendations below on how to prevent Zika virus infection when traveling to these countries.

Asia

  • The 2018 Winter Olympics will take place in PyeongChang, South Korea, from February 9 to February 25, 2018. The Paralympic Games are scheduled for March 9 to March 18, 2018. Travelers to the Olympics or Paralympics should follow the CDC recommendations for health and safety.
  • The Year of the Dog begins on February 16, 2018, and many people will travel to Asia to celebrate the Lunar New Year. Those traveling for the Lunar New Year should take simple precautions to stay safe and healthy
  • The Malaysian state of Sarawak has declared parts of three divisions to be rabies infectious areas. Five human rabies cases and almost 800 cases of people being bitten by rabid animals have been reported in Serian, Sri Aman, and Kutching divisions as of July 2017. All five people infected with rabies have died. If travelers anticipate possible contact with animals such as dogs, cats, bats, or other carnivores, they should consider rabies vaccination before travel. Even if the pre-exposure rabies vaccine has been received, travelers should still get immediate medical treatment if bitten or scratched by an animal during travel.
  • Check the World Map of Areas with Risk of Zika to find out about countries in Asia with risk of Zika. Refer to the Current Zika Virus Recommendations below on how to prevent Zika virus infection when traveling to these countries.

Caribbean, Central and South America

  • In early 2017, the Brazilian Ministry of Health reported an outbreak of yellow fever, and subsequently the World Health Organization expanded the list of areas for which yellow fever vaccination is recommended for international travelers. The outbreak has ended. However, vaccination is still recommended for travelers to areas on this expanded list. Please note that these are temporary expanded recommendations. In addition to areas in Brazil where yellow fever vaccination has been recommended since before the outbreak, it is now also recommended for people who are traveling to or living in all of Espirito Santo State, all of Rio de Janeiro State, including the city of Rio de Janeiro, São Paulo State, with the exception of the urban area of the city of São Paulo and a number of cities in Bahia State. Travelers should consult with a yellow fever vaccine provider to determine if they should be vaccinated. Because of a shortage of yellow fever vaccine, travelers may need to contact a yellow fever provider well in advance of travel.
  • Hurricanes Irma and Maria have caused severe damage in a number of countries and territories, including Anguilla, Antigua and Barbuda, the Bahamas, the British Virgin Islands, Cuba, Dominica, the Dominican Republic, Guadeloupe, Haiti, Martinique, Puerto Rico, Saint Barthelemy, Saint Martin, Sint Maarten, Turks and Caicos, and the US Virgin Islands. The extent of destruction across these countries and territories varies, with many areas flooded and inaccessible. Significant damage from the hurricane has caused problems with water supplies, sanitation, food supply, electricity, transportation, shelter, communications, security, medical care, and mosquito control. US residents should postpone travel to severely affected areas because serious health and safety risks may be present and medical care may be limited or unavailable. Postponing travel to these areas would also prevent further straining already limited local resources. Those who must travel, including those who are traveling for humanitarian aid work, should adhere to recommendations for preventing illness and injury, avoiding bug bites, and following food and water safety precautions. 
  • Three recent natural disasters have caused severe damage, injuries, and deaths in Mexico. On September 7, 2017, an 8.1-magnitude earthquake struck the southwestern states of Oaxaca, Chiapas, and Tabasco, causing nearly 100 deaths. The next day, September 8, 2017, Category 1 Hurricane Katia made landfall on the eastern coast in Veracruz, causing a mudslide that resulted in several deaths. On September 19, a 7.1-magnitude earthquake struck the state of Puebla, about 75 miles from Mexico City. In addition to safety hazards caused by debris and unstable buildings, there may be problems with sanitation, food supply, electricity, transportation, shelter, communications, security, and medical care. US residents should postpone travel to severely affected areas. There are serious health and safety risks, medical care may not be available, and visitors could further strain limited local resources. Those who must travel, including those who are traveling for humanitarian aid work, should adhere to recommendations for preventing illness and injury, avoiding bug bites, and following food and water safety precautions. 
  • Check the World Map of Areas with Risk of Zika to find out about countries in the Caribbean, Central and South America with risk of Zika. Refer to the Current Zika Virus Recommendations below on how to prevent Zika virus infection when traveling to these countries.

Europe

  • Italy has reported limited local transmission of malaria in the town of Ginosa in the Apulia region. Local transmission means that mosquitoes in the area may have been infected with malaria and are spreading it to people. Italy had been declared free of malaria by the World Health Organization in 1970. However, the mosquitoes that transmit malaria are present. Travelers should take steps to avoid mosquito bites.
  • Health officials in ItalyFrance and Ukraine have reported an outbreak of measles. CDC recommends that all international travelers protect themselves by making sure they are appropriately vaccinated against measles. Getting measles vaccine is particularly important for infants 6-11 months of age (1 dose of measles vaccine) and children 1 year of age or older (2 doses of measles vaccine).
  • Three cases of Plasmodium vivax malaria have been reported in UK residents who traveled to Esentepe (also known as Agios Amvrosios) in the Kyrenia District in Northern Cyprus. Cyprus was certified as malaria-free in 1967, and since then, there have been no reports of malaria in Cyprus until now. However, the mosquitoes that spread malaria are found in the area. CDC recommends that travelers to Esentepe (Agios Amvrosios) take medicine to prevent malaria. Effective options include atovaquone-proguanil, chloroquine, doxycycline, mefloquine, and primaquine. 
  • The World Health Organization (WHO) has reported locally transmitted cases of chikungunya in three areas of Italy: Rome, the coastal area of Anzio (about 30 miles south of Rome), and the city of Latina (about 15 miles east of Anzio). Local transmission means that mosquitoes in those areas of Italy have been infected with chikungunya and are spreading it to people. Travelers should take steps to avoid mosquito bites.
Middle East
  • Cases of vaccine-derived polio have been reported in Syria. Most cases have been reported in Mayadeen District, in Dayr az Zawr Province. CDC recommends that all travelers to Syria be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.

Pacific Islands

  • Check the World Map of Areas with Risk of Zika to find out about Pacific Islands with risk of Zika. Refer to the Current Zika Virus Recommendations below on how to prevent Zika virus infection when traveling to these countries.

Traveler Health & Safety Tips

Heading Home Health Video - watch now

The CDC recommends all travelers:

  • Visit a health care provider, ideally, 4 to 6 weeks before their trip for personalized health advice, vaccines, and medications.
  • Avoid bites from mosquitoes and other bugs by using an insect repellent and wearing long-sleeved shirts, long pants, closed shoes, and hats as much as possible.
  • Stay safe around animals. Do not pet, handle, or feed unfamiliar animals, even pets.
  • Be safe on international roads. Avoid overcrowded buses and cars, always wear a seat belt, and wear a helmet when riding a bike or motorcycle.
  • Wash their hands often with soap and water and use a hand sanitizer, as needed.

Current Zika Virus Recommendations

  • Check the World Map of Areas with Risk of Zika before you travel.
  • The recommendations for travelers to areas with risk of Zika are:
  • CURRENT PREGNANCY:  Women who are pregnant (in any trimester) should not travel to areas with risk of Zika. Men who have traveled to an area with risk of Zika who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sexual intercourse for the duration of the pregnancy.
  • MOSQUITO AVOIDANCE:  Prevent mosquito bites while traveling to areas with Zika virus transmission, and for three weeks after returning to the U.S.
  • PLANNING PREGNANCY:  If you or your partner are trying to get pregnant, consider avoiding nonessential travel to areas with a CDC Zika travel notice. Women should wait at least eight weeks after travel before trying to get pregnant. Men should either consistently and correctly use condoms during sexual intercourse or not have sexual intercourse for at least six months after travel to an area with Zika virus transmission.
  • SYMPTOMS AFTER TRAVEL:  Zika virus testing should be offered to people with symptoms of Zika virus disease, including pregnant women and others who develop symptoms during or following travel.

Resources

This email distribution tool is supported by funding from grant U01CK000175 of the U.S. Centers for Disease Control and Prevention (CDC) to the Massachusetts General Hospital. The tool attempts to capture up-to-date notices and alerts at the time of posting; however, components of this information are constantly changing. By using this tool, you agree that the Massachusetts General Hospital and tool developers/supporters are not liable for any adverse outcomes, including those relating to travel.

 

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