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Industry alert as deadly diseases make a comeback

February 6, 2018 Headline News No Comments Email Email

With the Rio carnival due to start at the end of the week, authorities in Brazil are battling a yellow fever outbreak that has seen the city of São Paulo close its city gardens and zoo – while elsewhere in the world, mumps and drug-resistant typhoid are keeping doctors busy.

The World Health Organisation (WHO) recommends that travellers to Brazil’s São Paulo state get a yellow fever vaccination before visiting. São Paulo’s Inhotim art park, a big tourist drawcard, is demanding that visitors show proof of vaccination to be allowed entry.

WHO says that 20 people in Brazil have died of yellow fever recently and 145 suspected cases are under investigation.

“In recent weeks, the number of confirmed human cases of yellow fever has tripled in Brazil, mainly in the states of São Paulo and Minas Gerais,” WHO states.

“Confirmed cases were notified in the states of São Paulo (20 cases, including 11 deaths), Rio de Janeiro (three cases, including one death), and Minas Gerais (11 cases, including seven deaths), and in the Federal District (one fatal case).”

Much of Brazil is considered at risk for yellow fever and the country last year recorded its worst outbreak in decades of the mosquito-borne disease, with the fever spreading into regions not previously at risk. More than 770 people were infected and more than 250 died.

The International Travel Vaccination Centre (ITVC) advises: “For tourists travelling to Brazil for the annual Carnival which gets under way on Feb 9th, the recommendation for YF [yellow fever] vaccination has been extended from previously identified at-risk areas to include the City as well as the state of São Paulo.”

ITVC sounds a reassuring note: “While it can be severe, yellow fever infection is very rare in Australian travellers. However, under the International Health Regulations (IHR), proof of vaccination may be required of any traveller entering or leaving an area at risk of yellow fever transmission.”

Yellow fever is a viral disease whose symptoms include fever, chills, loss of appetite, nausea, muscle pains (particularly in the back) and severe headaches. Symptoms typically improve within five days – however in about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing characteristic yellow skin and eyes. Once infected, no specific measures are effective against the virus. Death occurs in up to half of those who get severe disease.

Doctor administering a typhoid vaccination at a school in San Augustine County, Texas, 1943

MEANWHILE, an outbreak of typhoid fever confirmed in Zimbabwe last October continues raging in the capital, Harare, with about 2450 suspected and confirmed cases. The outbreak is mainly in the western and southern districts of Harare, with Mbare and Kuwadzana being the areas most affected.

Typhoid is also spreading in Hyderabad (capital of the southern Indian state of Telangana) where the outbreak has been dubbed the “world’s first outbreak of drug-resistant typhoid”. An emergency vaccination drive is underway to protect children from the lethal bacterial disease.

“Typhoid cases resistant to third-generation antibiotic Ceftriaxone have been reported from different areas of Hyderabad, but so far we’re unable to find its source,” Health Services Sindh Director General Dr Muhammad Akhlaq Khan told The News in Pakistan.

Symptoms of typhoid may be mild or severe and may include prolonged fever, severe headache, malaise, constipation or diarrhoea, rose-coloured spots on the torso and an enlarged spleen. Most people recover fully over several weeks, although disease can be fatal if untreated.

In New Zealand, meanwhile, the Auckland-centred mumps outbreak, which has so far caused nearly 90 hospitalisations, could continue well into 2018, the Auckland Regional Public Health Service (ARPHS) warns.

Almost 1100 confirmed and probable mumps cases in Auckland have been reported since the beginning of last year, ARPHS states. That includes 88 hospitalisations, mostly due to inflammation of the testicles (orchitis), ARPHS clinical director Julia Peters told New Zealand Doctor magazine.

Mumps symptoms in adults are often more severe than in children, and while about a third of people have mild or no symptoms, complications may include meningitis (15%), pancreatitis (4%), permanent deafness, and testicular inflammation which can occasionally result in infertility.

Written by Peter Needham

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