WHO / Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)

WHO /  The Ministry of Health of Saudi Arabia has issued the following requirements and recommendations for entry visas for the Hajj and Umra seasons in 2012.

 

Yellow Fever

In accordance with the International Health Regulations 2005, all travellers arriving from countries or areas at risk of yellow fever must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days previously and not more than 10 years before arrival at the border. In the absence of such a certificate, the individual will be placed under strict surveillance for 6 days from the date of vaccination or the last date of potential exposure to infection, whichever is earlier.

Meningococcal meningitis

 

For all arrivals

Visitors from all over the world arriving for the purpose of Umra or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and not less than 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor’s country of origin should ensure that adults and children over the age of 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.

For arrivals from countries in the African meningitis belt, namely Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and Sudan.In addition to the above stated requirements, chemoprophylaxis will be administered at port of entry to all arrivals from these countries to lower the carriers rate among them. Adults will receive ciprofloxacin tablets(500 mg), children will receive rifampicin, and pregnant women will receive ceftriaxone injections.

Poliomyelitis

All travellers arriving from polio-endemic countries and re-established transmission countries, namely Afghanistan, Angola, Chad, the Democratic Republic of Congo, Nigeria and Pakistan, regardless of age and vaccination status, should receive 1 dose of oral poliovirus vaccine (OPV). Proof of OPV vaccination at least 6 weeks prior departure is required to apply for entry visa for Saudi Arabia. These travellers will also receive 1 dose of OPV at borders points on arrival in Saudi Arabia. The same requirements are valid for travellers from recently endemic countries at high risk of reimportation of poliovirus, i.e. India.

All visitors aged under 15 years travelling to Saudi Arabia from countries with imported cases of poliomyelitis or circulating vaccine-derived polioviruses (see list below) in the past 12 months (as of mid-February 2012) should be vaccinated against poliomyelitis with the OPV or inactivated poliovirus vaccine (IPV). Proof of OPV or IPV vaccination is required 6 weeks prior the application for entry visa. Irrespective of previous immunization history, all visitors under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points.

 

Polio cases related to wild poliovirus importation or to circulating vaccine-derived poliovirus have been registered during the past 12 months in the following countries: China, Central African Republic, Côte d’Ivoire, Kenya, Mali, Niger, Somalia and Yemen.

 

Seasonal influenza

 

The Ministry of Health of Saudi Arabia recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the kingdom of Saudi Arabia, particularly those at increased risk of severe complications (e.g. the elderly over 65 years of age, people with pre-existing medical conditions such as people with chronic respiratory or heart diseases, hepatic or renal failure, neuromuscular or metabolic  diseases including diabetes or immunocompromised conditions due to various reasons such as HIV infection or immunosuppressive therapy). Pregnant women can also be considered for vaccination.

In Saudi Arabia, seasonal influenza vaccine is recommended for internal pilgrims, particularly those with pre-existing health conditions, and all health staff working in the Hajj premises.

 

International outbreaks response

 

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 this year Hajj and Umra.

Preparation for international travel provides opportunity to review the immunization status of travellers. Incompletely immunized travellers can be offered routine vaccinations recommended in national immunization schedules (these usually include diphtheria, tetanus, pertussis, polio, measles and mumps), in addition to those needed for the specific travel (e.g. meningococcal vaccination for Hajj).

In InternationalTravel and Health 2012, WHO recommends that travelers ensure immunity against measles by having at least 2 doses of vaccine and against rubella by 1 dose of vaccine.

 

Source; WHO / Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)

Cholera in Cuba, an update by CDC

Center for Disease Control and Prevention: Outbreak notice: Update: August 22, 2012

The Cuban Ministry of Health has confirmed the first cholera outbreak in Cuba in more than a century. As of July 31, 2012, 236 confirmed cases and 3 deaths have been reported in the cities of Manzanillo, Bayamo, Yara, and Campechuela Niquero in Granma Province.

Currently, cases are limited to Granma Province, mostly in Manzanillo. According to the Cuban Ministry of Public Health, control measures have been implemented, including public awareness campaigns and efforts to ensure safe drinking water and to improve environmental sanitation. The Pan American Health Organization (PAHO)  is also closely monitoring this situation.

What Is Cholera?

Cholera is a bacterial disease that can cause diarrhea and dehydration. Cholera is most often spread through eating contaminated food or drinking contaminated water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food may be contaminated by water containing cholera bacteria or by being handled by a person ill with cholera.

How Can Travelers Protect Themselves?

Most travelers are not at high risk of getting cholera. However, travelers to an area with a known outbreak should take steps to avoid getting sick. (See below.) The vaccine to prevent cholera is not available in the United States.

Travelers can prevent cholera by following these 5 basic steps:

Drink and use safe water.*

• Bottled water with unbroken seals and canned or bottled carbonated beverages are safe to drink and use.
• Use safe water to brush your teeth, wash and prepare food, and make ice.
• Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

*Piped water sources, drinks sold in cups or bags, or ice may not be safe. All drinking water and water used to make ice should be boiled or treated with chlorine.

To be sure water is safe to drink and use:

• Boil it or treat it with water purification tablets, a chlorine product, or household bleach.
• Bring your water to a complete boil for at least 1 minute.
• To treat your water, use water purification tablets—brought with you from the United States or a locally available treatment product—and follow the instructions.
• If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking.
• Always store your treated water in a clean, covered container.

Wash your hands often with soap and safe water.*

• Before eating or preparing food
• Before feeding your children
• After using the bathroom
• After changing diapers
• After taking care of someone ill with diarrhea

* If no soap is available, use an alcohol-based hand sanitizer containing at least 60% alcohol.

Use toilets; do not defecate in any body of water.

• Use toilets, latrines, or other sanitation systems, such as chemical toilets, to dispose of feces.
• Wash hands with soap and safe water after using the bathroom.
• Clean toilets and surfaces contaminated with feces by using a solution of 1 part household bleach to 9 parts water.

Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables.*

• Boil it, cook it, peel it, or leave it.
• Be sure to cook shellfish (such as crabs and crayfish) until they are very hot all the way through.
• Do not bring perishable seafood back to the United States.

*Avoid raw foods other than fruits and vegetables you have peeled yourself.

Clean up safely—in the kitchen and in places where the family bathes and washes clothes

• Wash yourself, your children, diapers, and clothes at least 30 meters away from drinking water sources.

Clinician Information:

Clinicians should obtain a travel history from their patients. Cholera infection is most often asymptomatic or results in mild gastroenteritis.

Severe cholera is characterized by acute, profuse watery diarrhea, described as “rice-water stools” and often vomiting, leading to volume depletion.

Cholera is confirmed through culture of a stool specimen or rectal swab. Cary-Blair medium is ideal for transport, and the selective thiosulfate-citrate-bile salts agar is ideal for isolation and identification. Rehydration is the best treatment. Oral rehydration salts are used, and intravenous fluids are used when necessary

Source: CDC / Cholera in Cuba, update August 22, 2012

Preventing Mosquito Bites - Simple ways of preventing Yellow Fever & other mosquito borne diseases

How Can Yellow Fever Be Prevented?

Advise all persons, especially unvaccinated persons traveling to yellow fever risk areas, to practice strict mosquito-bite prevention measures. Such measures include the following:
•         Staying in air-conditioned or well-screened quarters
•         Minimizing exposed skin by wearing long-sleeved shirts and long pants
•         Using insect repellent containing DEET or picaridin
•         Applying permethrin-containing repellents to clothing
•         Sleeping under bed nets when air-conditioned or well-screened bedrooms are not available
•         Avoiding areas where mosquitoes breed
•         Helping to eliminate mosquito breeding sites
Source

WHO / Ebola outbreak in Kibaale district of Western Uganda

World Health Organization: Global Alert and Response (GAR): July 29, 2012

 

The Ministry of Health (MoH) of Uganda has notified WHO of an outbreak of Ebola haemorrhagic fever in Kibaale district in the western part of the country.

A total of 20 cases, including 14 deaths have been reported since the beginning of July 2012. The index case was identified in a family from Nyanswiga village, Nyamarunda sub-county of Kibaale district, where nine of the deaths were recorded. The deceased include a clinical officer who attended to a patient, and her four month-old child. Nine of the 14 deaths have occurred in a single household.

Laboratory confirmation was done by the Uganda Virus Research Institute in Entebbe.

 

The MoH is working with stakeholders and partners to control the outbreak. Response plans at the national and district levels are being finalised. A national task force coordinated by the MoH has been re-activated at the MOH headquarters and holds daily meetings. In Kibaale a district task force has been formed to better coordinate field response. The neighbouring districts have been put on high alert about the outbreak and to step up surveillance.

 

The MoH has advised the public to take measures to avert the spread of the disease and to report any suspected patient to the nearest health unit.

 

WHO does not recommend that any travel or trade restrictions are applied to Uganda.

 

Source: WHO / GAR / Ebola in Uganda