According to Hong Kong's Department of Health and local health authorities, more than 30 cases of dengue fever per week (a significant increase over average incidence) are being reported in Guangdong Province. More than 390 cases have been reported since April 2019. High transmission early in the year usually heralds much worse-than-usual case numbers during the typhoon season. Travelers should observe daytime insect precautions.
Sudan: Significant Measles Increase
According to WHO's regional office, more than 1,100 cases of measles (a significant increase over average incidence) were reported from January through March 2019. True incidence is unknown because local surveillance and diagnostics are limited. Shoreland continues to make the following recommendations for travelers: All individuals ≥ 12 months of age born in 1957 or later (1970 or later in Canada and the U.K.; 1966 or later in Australia) without history of disease or of 2 countable doses of live vaccine at any time during their lives should complete a lifetime total of 2 doses of MMR vaccine (spaced by at least 28 days). All infants aged 6-11 months should receive 1 dose of MMR vaccine. All those born before 1970 (in Canada) without evidence of immunity or previous vaccination with 1 countable dose of measles-containing vaccine need 1 dose of MMR vaccine.
Tanzania: Advisory Due to High Terrorist Threat in Dar es Salaam
According to the U.S. Embassy in Dar es Salaam, unsubstantiated rumors are circulating of a possible terrorist attack in the Masaki area of Dar es Salaam, at the Serena Hotel, and at the Slipway Shopping Center on the Msasani Peninsula. Nevertheless, extreme vigilance is recommended. Travelers should maintain a high level of security awareness, follow the advice of local authorities, and monitor the situation through local media and embassy communications.
Singapore: Significant Dengue Increase
According to Singapore's Ministry of Health, more than 270 locally acquired cases of dengue fever per week (a significant increase over average incidence) are being reported throughout the country. More than 40 clusters are occurring, but no significant clusters have been reported in popular areas in the downtown core frequented by usual business travelers. Approximately 3,500 cases (mainly serotype 2) have been reported since January 2019. The outbreak has yet to peak. Travelers should observe daytime insect precautions.
Angola: Significant Measles Increase, Mainly in Lunda Sul Province
According to WHO's regional office and press sources, more than 100 cases of measles per week (a significant increase over average incidence) are being reported, mainly in Saurimo, Lunda Sul Province. More than 1,300 cases (including > 750 confirmed) have been reported since January 2019 (primarily in unvaccinated children) throughout most of the country, mainly in Saurimo, Lunda Sul Province as well as in Luau, Moxico Province. The outbreak has yet to peak. Shoreland continues to make the following recommendations for travelers: All individuals ≥ 12 months of age born in 1957 or later (1970 or later in Canada and the U.K.; 1966 or later in Australia) without history of disease or of 2 countable doses of live vaccine at any time during their lives should complete a lifetime total of 2 doses of MMR vaccine (spaced by at least 28 days). All infants aged 6-11 months should receive 1 dose of MMR vaccine. All those born before 1970 (in Canada) without evidence of immunity or previous vaccination with 1 countable dose of measles-containing vaccine need 1 dose of MMR vaccine.
Singapore: Imported Monkeypox Case
According to Singapore's Ministry of Health, 1 confirmed, imported case of monkeypox was reported on May 9, 2019. The case, a Nigerian resident, arrived in Singapore from Nigeria on April 28, developed symptoms on April 30, and was admitted directly from his hotel to Tan Tock Seng Hospital on May 7 by ambulance. Twenty-three close contacts identified by detailed contact tracing have been offered smallpox vaccination (which protects against monkeypox) and have been quarantined. All health care workers in contact with the patient have used appropriate personal protection. One close contact has left Singapore, and his home country has been notified. Risk in the community is negligible. Human-to-human transmission is uncommon and limited to close contacts.
Maldives: Significant Chikungunya Increase
According to Maldives' Ministry of Health and press sources, more than 300 locally acquired cases of chikungunya fever per month (a significant increase over average incidence) are being reported throughout the country, mainly in North Central, South Central, and Upper South provinces. More than 830 cases have been reported since January 2019. The outbreak has yet to peak. Travelers should observe daytime insect precautions.
Sri Lanka: Multiple Bombings in Cities of Colombo, Batticaloa, and Negombo
On April 21, 2019, a coordinated series of bombings, attributed to a known terrorist organization, occurred in the cities of Colombo, Batticaloa, and Negombo, targeting several churches and luxury hotels popular with tourists. At least 350 casualties (including > 35 foreigners) and more than 500 injuries occurred. A nationwide state of emergency is in effect, and curfews may be imposed at short notice. Airports are operational, with increased security measures and access restrictions; passengers departing Bandaranaike International Airport must produce tickets and passports at checkpoints en route. Disruption to mobile and internet services should be expected. Further attacks are possible and extreme vigilance is recommended. Travelers should avoid the affected areas, follow the advice of local authorities, and monitor the situation through local media and embassy communications.
Japan: Significant Measles Increase, Mainly in Tokyo and 2 Prefectures
According to Japan's Ministry of Health, approximately 35 cases of measles per week are occurring, mainly in Mie and Osaka prefectures. More than 145 cases, a significant increase over average incidence, have occurred since January 1, 2019, in 19 of 47 prefectures, mainly in Mie (> 45 cases) and Osaka (> 40 cases) prefectures, as well as in the Greater Tokyo Area (> 10 cases). Shoreland continues to make the following recommendations for travelers: All individuals ≥ 12 months of age born in 1957 or later (1970 or later in Canada and the U.K.; 1966 or later in Australia) without history of disease or of 2 countable doses of live vaccine at any time during their lives should complete a lifetime total of 2 doses of MMR vaccine (spaced by at least 28 days). All infants aged 6-11 months should receive 1 dose of MMR vaccine. All those born before 1970 (in Canada) without evidence of immunity or previous vaccination with 1 countable dose of measles-containing vaccine need 1 dose of MMR vaccine.
Egypt: Attack in Giza
On December 28, 2018, a tourist bus triggered a roadside bomb near the Giza pyramids, resulting in 3 tourist casualties and 11 injuries. A heightened terrorist threat exists throughout the country. Targets may include public places, tourist sites, and major events. Enhanced security measures, especially in public buildings and gatherings, major events, and transport hubs, should be expected. Travelers should follow the advice of local authorities and monitor the situation through local media and embassy communications.
