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Germany

Alerts

Measles clusters across Europe


Created and/or Modified: Friday, August 18, 2017 21:52:39 GMT

Level: Notice
Location: Austria; Belgium; Bulgaria; Czech Republic; France; Germany; Hungary; Italy; Spain; Sweden; Switzerland; Ukraine; United Kingdom; Finland
Category: Measles

Latest update: increased cases in Austria, France, Germany and the United Kingdom. New measles cases continue to be reported in a number of countries including, Austria, Belgium, Bulgaria, Czech Republic, Finland, France, Germany, Hungary, Italy, Spain, Switzerland, Sweden and Ukraine. There have been a number of associated deaths. Portugal declared an end to the outbreak in mid-July 2017. Most cases have been in unvaccinated individuals. Measles is caused by a highly contagious virus that spreads from person-to-person via infectious droplets. Typical symptoms include fever, cough and a characteristic rash. Serious to fatal complications can occur - particularly when very young children, adults or pregnant women are infected. Travellers are advised to ensure they are immune to the disease.

Advice

Do the following:
  • Ensure you are immune to measles before travelling. People are immune if they've had the disease before or if they've had two doses of measles vaccine.
  • Keep young children and other people who are not immune to measles away from outbreak areas.
  • If you are unsure about your immunity and may have been exposed, or if you develop symptoms, seek medical attention. Call before visiting in person, so staff can protect themselves and other patients from this very contagious virus.

More detail

Clusters of measles cases have been reported in several countries across Europe, including a number of deaths. Since the beginning of the year, the following countries have all seen clusters with some experiencing large outbreaks: Austria (~80), Belgium (>300), Bulgaria (>165), Czech Republic (>135), Finland (10), France (>385), Germany (>825), Hungary (>50), Italy (>4,000), Spain (~145), Portugal (declared over with 31 total), Sweden (at least 15), Switzerland (>60), Ukraine (>735) and the United Kingdom (>950). There is a separate alert for Romania which has a very large outbreak. Most of the outbreaks are occurring in unvaccinated or incompletely vaccinated people. Some of the outbreaks have been linked to infected travellers, a few small clusters have occurred in healthcare settings. Surveillance activities and vaccination campaigns are ongoing. Imported cases linked to these outbreaks have been detected in other European countries, including Iceland and Slovakia.

For more information:
  • See the Disease and Prevention article "measles" on International SOS Country Guides.
  • Contact any International SOS assistance centre.




Increase in Hepatitis A


Created and/or Modified: Friday, August 04, 2017 22:52:38 GMT

Level: Advisory
Location: Austria; Belgium; Denmark; Finland; France; Germany; Ireland; Italy; Netherlands; Norway; Portugal; Slovenia; Spain; Sweden; United Kingdom; Greece; Latvia; Lithuania
Category: Hepatitis A

Latest update: increased cases reported in Latvia and Lithuania. Cases of hepatitis A has been reported in a number of countries including Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Lithuania, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden, and the United Kingdom. Most cases are in men who have sex with men. Hepatitis A is a viral infection of the liver, spread through the "faecal-oral" route, via direct person-to-person contact or contaminated food and water. Symptoms can take a month to appear and include fever, fatigue, abdominal pain, nausea, vomiting, dark urine and jaundice (yellow colour of the skin and eyes). Prevention is through vaccination and attention to hygiene.

Advice

Do the following:
  • If you have not previously been vaccinated against hepatitis A, see your doctor before departure and consider vaccination, especially if you are in the risk group.
  • If you have been in contact with someone with Hepatitis A, seek medical advice as you may be recommended vaccination.
  • Maintain a high level of personal hygiene, including during sexual activity.
  • Wash hands frequently, including before food preparation.

More detail

Since June 2016, there has been an increase in the number of hepatitis A cases recorded within the European region. At least 1,500 cases have been confirmed and over 2,600 probable or suspected cases have been reported in Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Lithuania, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden, and the United Kingdom. Spain and Italy are particularly affected. Most cases are in men who have sex with men however, other groups have also been affected. Case numbers are most likely greater than what is currently reported and many more cases are likely to occur. There is no suggestion of a food-borne outbreak.

Between June and September 2017, there are several national and international lesbian, gay, bisexual, and transgender (LGBT) pride festivals taking place. Public health authorities are urging travellers to take all necessary precautions to prevent infection, including seeing a travel health professional early due to a shortage of hepatitis A vaccine. Vaccination is also used to prevent disease in people who have had close contact with the virus.

What is Hepatitis A?

Hepatitis A is a viral disease that causes liver inflammation. The virus is present in the faeces of an infected person. It spreads through contaminated food and water, and is common in areas with poor sanitation. Person-to-person spread also occurs, when the virus is inadvertently transferred into the mouth, including during sexual activity. People at higher risk of infection include men who have sex with men, and injecting drug users. Symptoms begin on average 28 days after exposure (range 2 to 8 weeks), and include fever, chills, fatigue, abdominal pain, nausea, vomiting, dark urine and jaundice (yellow colour of the skin and eyes). Many infected people suffer only a mild illness. Most cases recover fully after four or more weeks. However for some, the disease can be severe, and occasionally is fatal. There is no specific treatment and cases are managed through supportive therapy. Prevention is through vaccination, attention to hygiene, and access to safe food and water.

For more information:

  • See "Hepatitis A" in the diseases and prevention dropdown on the International SOS country guides.
  • See the International SOS Country Guides for each country.
  • Contact any International SOS assistance centre.

Assessment

The outbreak has not yet peaked and more cases are expected.




 
 
 
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Travel security advice provided in this report represents the best judgment of AEA International Holdings Pte. Ltd. and Control Risks Group Holdings Ltd. Medical and health advice provided in this report represents the best judgment of AEA International Holdings Pte. Ltd. Advice in this report does not however provide a warranty of future results nor a guarantee against risk.

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