The World Health Organization (WHO) has reported on phase two of an oral vaccination campaign against cholera taking place from 3-8 July 2019 in the four central provinces of the Democratic Republic of the Congo (DRC), Kasaï, Kasaï Oriental, Lomami and Sankuru. The second dose of vaccine confers lasting immunity against cholera, and is being targeted at 1,235,972 people over one year of age.

The vaccination campaign was launched to contain a serious epidemic, which resulted in 9,154 presumed cases and 458 deaths, with a case-fatality rate of 5% in the Kasaï region between January and December 2018. The DRC reported a cumulative total of 29,304 suspected cholera cases in 2018 and more than 930 deaths, with a case-fatality rate of 3.17%. From 1 January to 9 June 2019, at least 12,247 suspected cases of cholera and 279 deaths, with a case-fatality rate of 2.2%, has been reported.

The campaign is organized by the Ministry of Health with technical, logistic and financial support from the WHO, Gavi the Vaccine Alliance, and the Global Task Force on Cholera Control (GTFCC).

Further information relating to cholera can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: WHO Africa, 3 July 2019

An outbreak of cholera in the Ugandan Bududa district on the border with Kenya, with 11 cases noted so far, has been reported by the World Health Organization (WHO).

Travellers to the region are advised to only consume safe food and water. Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables.

Good personal hygiene is essential, particularly frequent hand washing, especially prior to eating and after visiting the bathroom. 

A vaccine is available to protect against cholera, but as the risk to most travellers is very low, it is only recommended for:

• Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks are likely. 
• Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible.

Further information relating to cholera can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Sources: TRAVAX and fitfortravel (both 4 July 2019)

The European Centre for Disease Prevention and Control (ECDC) has published a rapid risk assessment for the hajj, which will take place between 9 and 14 August 2019. 

The risk of infection with communicable diseases for EU/EEA citizens during the 2019 hajj is considered low, due to vaccination requirements for travelling to Makkah (Mecca) and the Saudi Arabian preparedness plans for health hazards during and after the hajj.

The risk of communicable disease outbreaks at mass gathering events is greatest for food- and waterborne diseases and respiratory diseases. Outbreaks of MERS-CoV continue to be reported from the Arabian Peninsula, specifically from Saudi Arabia, which implies that there is a risk of importation of cases to Europe after the hajj.

The risk of vaccine-preventable and vector-borne diseases is considered low if preventive measures are applied. Health Protection Scotland (HPS) previously published information for travellers to Saudi Arabia for the hajj pilgrimage in 2019 (see current note 53/2505).

Source: ECDC, 2 July 2019

Research published in Eurosurveillance focuses on a newly identified tick-borne pathogen, Alongshan virus (ALSV) in Ixodes ricinus ticks, which are common across the European continent. ALSV is a segmented Jingmen virus group flavivirus, which was recently associated with human disease in China. Although screening of sera from Finnish patients suspected for tick-borne encephalitis virus (TBEV) revealed no human cases, the presence of ALSV in common European ticks is considered worthy of further investigation on its role as a human pathogen.

Source: Eurosurveillance, 4 July 2019

The Scottish Environment Protection Agency (SEPA) has announced that planned controlled flaring at the Mossmorran Fife Ethylene Plant started on 4 July 2019. Because of community concerns, SEPA has deployed monitoring equipment to capture air quality data once flaring begins so that local impacts are assessed, while SEPA officers will be on site during the controlled flaring to make an initial assessment of noise and other impacts.

SEPA will provide an update on the initial findings of the air quality monitoring once data has been collated and analysed.

Source: SEPA, 3 July 2019

World Population Day was first observed on 11 July 1990. The annual observation of this event seeks to maintain awareness of population issues, including their relationship to the environment and development.

Current estimates indicate that roughly 83 million people are being added to the world’s population every year and the global population is expected to reach 8.6 billion in 2030, 9.8 billion in 2050 and 11.2 billion in 2100.

Source: United Nations, 11 July 2019

The World Meteorological Organization (WMO) reports that many regions in mainland Europe are experiencing a heatwave caused by warm air masses, and Saharan dust arriving from Africa. Spain was the first country to be affected by intense heat, which gradually spread to France, Austria, Germany and Switzerland.

Travellers are advised that heat acclimatisation takes time and that some simple adaptations can be undertaken to reduce risk of heat related illness:

• limit physical exertion until acclimatised 
• maintain adequate hydration 
• if urine becomes dark increase fluid intake, as this is a good indicator of hydration status 
• wear light and airy clothing 
• a hand held personal fan may prove invaluable when it is not possible to escape the heat 
• avoid heat exposure during the hottest part of the day 
• take advantage of air-conditioning and shade where possible

Further advice relating to heat can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Sources: TRAVAX and fitfortravel (both 3 July 2019)