Travel Vaccine Breaking News

The World Health Organization (WHO) reported yesterday a surge of dengue cases started in the People's Republic of Bangladesh in June 2022.

The high incidence of dengue cases this year occurs in the context of an unusual amount of rainfall.

The current outbreak is unusual in its scale and seasonality, stated the WHO on November 28, 2022.

Currently, all eight divisions in Bangladesh are reporting dengue cases and fatalities.

The most affected division is Dhaka, accounting for 70.6% of cases (34,071) and 60.4% of fatalities.

The largest dengue outbreak in Bangladesh occurred in 2019.

Dhaka city the largest city in Bangladesh, with about ten million residents. Bangladesh tourism statistics for 2020 showed a 44% decline from 2019.

Dengue is a disease caused by a virus spread through mosquito bites.

The disease can take up to two weeks to develop, with illness generally lasting less than a week.

In this region, two dengue vaccines are authorized: Dengvaxia and Qdenga.

To notify travelers of their dengue health risks, the U.S. CDC issued a Level 1 Dengue Alert in Asia and the Pacific Islands on September 6, 2022.

Other dengue outbreak news is posted at Vax-Before-Travel.com/Dengue.

Following a series of consultations with global experts, the World Health Organization (WHO) announced today it would begin using the preferred term “mpox” as a synonym for monkeypox.

In August 2022, a group convened by WHO agreed on new names for monkeypox virus variants as part of ongoing efforts to align the terms of the Mpox disease, virus, and variants – or clades.

The consensus was reached to refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II).

Additionally, it was agreed that Clade II consists of two subclades, IIa and IIb.

Human monkeypox was given its name in 1970 after the virus that causes the disease was discovered in 1958. 

Furthermore, the overall risk of Mpox infection is assessed as moderate for men (MSM) and low for the broader population. 

Mpox vaccine news is posted at PrecisionVaccinatins.com/Monkeypox.

Since the onset of the latest cholera outbreak, UNICEF reported about 90% of confirmed cholera cases in Haiti had been reported in areas most affected by the country's nutrition crisis.

Children suffering from severe acute malnutrition are more vulnerable to cholera and at least three times more at risk of dying from the disease.

After more than three years with no cases, national authorities reported a cholera outbreak in October 2022.

As of November 21, 2022, Haiti's Ministry of Health reported 924 confirmed cholera cases, over 10,600 suspected cases, and 188 related fatalities.

"In Haiti, the vicious cycle between malnutrition and cholera can be broken," said Manuel Fontaine, Director of the Office of Emergency Programmes, in a press release on November 23, 2022.

"Simple, affordable, and effective treatment can save Haitian children's lives, as long as we reach the most vulnerable families before it's too late."

Cholera is an acute diarrhoeal disease that can kill within hours if left untreated.

Currently, there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral®, ShanChol™, and Euvichol®, mainly used for travelers. 

All three OCVs require two doses for complete protection and are not available in the U.S.

The U.S. FDA has approved Vaxchora®, a live attenuated recombinant V. cholerae O1 Inaba Vaccine Strain CVD 103-HgR. 

It is recommended for adult travelers, and the European Medicine Agency recommends it for children who visit an area of active cholera transmission.

In addition to cholera, the U.S. CDC suggests various travel vaccines, such as yellow fever and measles, before visiting Haiti.

The Victoria Department of Health recently reported the fifth measles patient related to overseas travelers since January 2022.

The three new cases confirmed on November 17, 2022, were within one family. Two of the cases were infectious during a return flight from Singapore to Melbourne, Australia.

There are two public exposure sites in Victoria linked to these measles cases.

The government urges those who attended these sites to seek medical care if they develop symptoms, to wear a mask, and to call ahead to ensure they can be isolated from others.

"Measles is a highly infectious viral disease that spreads quickly with close contact, especially in those who are not fully vaccinated. Young children and adults with weakened immune systems are the most at risk of serious illness," commented Victoria's Deputy Chief Health Officer, Associate Professor Deborah Friedman, in a press release.

On September 13, 2022, Australia's NSW Health confirmed its first local case of measles since February 2020. This person developed symptoms after returning from Sydney.

“Our progress towards measles and rubella elimination in the Western Pacific must not be reversed,” commented Dr. Huong Tran, Director of Programmes for Disease Control in the WHO Western Pacific Region, in September 2022.

Measles is a highly contagious disease, spread by the droplets from when an infected person coughs and sneezes. Symptoms include a red rash and fever. In some people, it can be severe.

Measles is prevented by vaccination, says the Australian government.

The U.S. CDC suggests confirming measles immunity for most people visiting Australia, as well as Japanese encephalitis in parts of eastern and southeastern Australia. 

The Ministry of Health for the Republic of Uganda and WHO published an updated Situation Report that indicates the Sudan Ebolavirus (SUDV) outbreak has been reduced.

As of November 24, 2022, the weekly number of confirmed SUDV cases reported has decreased for the third consecutive week after peaking in late October 2022.

Recently, one newly affected district has been reported (Jinja), leading to a total of nine districts in Uganda that have reported confirmed SVD cases.

In addition to the six surrounding countries assessed to be at-risk, five additional countries are now included: the Central African Republic, Ethiopia, Somalia, Sudan, and Djibouti.

These countries have important population movements to and from Uganda. 

Since the outbreak declaration on September 20, 2022, a total of 141 confirmed cases and 55 confirmed deaths (39%) from Ebola disease caused by the SUDV have been reported.

Overall, 19 cases with seven deaths occurred among healthcare workers.

On November 4, 2022, the WHO revised the risk assessment for this event from high to very high at the national level and from low to high at the regional level, while the risk remained low at the global level.

As of November 25, 2022, the U.S. CDC maintains an Alert - Level 2, Practice Enhanced Precautions notice regarding the SUDV outbreak.

Furthermore, while three SUDV vaccine candidates are scheduled to conduct human clinical trials in 2022, the U.S. FDA has not approved any SUDV vaccine or therapeutic.

Additional SUDV outbreak news is posted at Vax-Before-Travel.com/Ebola.

The U.S. Department of State reissued after a periodic review of the Travel Advisory for the Kingdom of Thailand. The Level 1 Exercise Normal Precautions notice says visitors should exercise normal precautions in Thailand as some areas have an increased risk of civil unrest.

On November 23, 2022, the State Department stated visitors should reconsider traveling to the southernmost provinces of Yala, Pattani, Narathiwat, and Songkhla.

These areas have reported periodic violence directed mostly at Thai government interests.

The U.S. government has limited ability to provide emergency services to U.S. citizens in these provinces as U.S. government employees must obtain special authorization to travel to these provinces.

If you travel to Thailand, the State Department suggests enrolling in the Smart Traveler Program to receive Alerts and make it easier to locate in case of an emergency.   

The U.S. Embassy in Bangkok is located at 120/22 Wireless Road, Bangkok, Thailand 10330, +66-2-205-4000, remains one of the world's largest and comprises several dozen sections and agencies. The mission of the U.S. Embassy is to serve and protect U.S. citizens while in Thailand.

 In 2021, the number of tourist arrivals in Thailand amounted to only around 427,000, drastically decreasing from the previous years when about 39 million people visited.

The Kingdom is located in Southeast Asia, at the center of the Indochinese Peninsula.

From a health perspective, the U.S. CDC suggests several travel vaccinations, such as yellow fever, polio, and measles, before visiting Thailand.

The World Health Organization (WHO) has formally confirmed that the U.K. has a ‘circulating’ vaccine-derived poliovirus type 2 (VDPV2) based on detecting the same isolate for more than 60 days.

And evidence that the virus detected in London is genetically linked to the poliovirus detected in Israel and the U.S.

An average of 1 to 3 poliovirus isolates per year have been detected from U.K. sewage samples in recent years.

However, these have all been single detections that are unrelated to each other.

In this instance, the isolates identified are genetically related, which has prompted the need to investigate the extent of transmission of this virus in Northeast London.

The most likely scenario is that a recently vaccinated individual entered the U.K. before February 2022 from a country where the oral polio vaccine (OPV) has been used for supplementary immunization campaigns.

The UKHSA confirmed on November 14, 2022, the environmental surveillance had been expanded to assess the extent of VDPV2 transmission in and outside of London.

The U.K. stated it is committed to global polio eradication, and achieving this is maintaining high vaccine coverage (95%) in the routine childhood immunization program.

Primary care colleagues and school-aged immunization providers should opportunistically check that patients are up to date with their polio-containing vaccines and provide catch-up vaccination to anyone who is un/under-vaccinated.

While the U.K. stopped using OPV in 2004, several countries, including Pakistan, Afghanistan, and Nigeria have continued to use OPV-containing type 2 virus for outbreak control.

Since 2000, the U.S. has offered the IPV vaccine.

To alert international travelers to this new polio risk, the U.S. CDC included the U.K. in the updated Alert - Level 2, Practice Enhanced Precautions notice on November 18, 2022.

Other polio outbreak news is posted at Vax-Before-Travel.com/Polio.