May 1, 2006
International travel can expose Canadians to traditional childhood infectious diseases such as polio, measles, mumps, rubella, tetanus, and diphtheria that, while are no longer common in Canada, are common in many other countries in the world.
Canadians travelling internationally should ensure that their routine childhood immunizations are up to date before travelling, regardless of their destination. The Public Health Agency of Canada recommends that Canadians travelling internationally consult a physician or travel medicine clinic 6 to 8 weeks prior to departure for an individual risk assessment to determine their individual health risks and their need for primary and/or booster immunization. For comprehensive information on the recommended immunization schedules for infants, children and adults in Canada, readers are referred to the Canadian Immunization Guide [link to: http://www.phac-aspc.gc.ca/publicat/cig-gci/index.html] prepared by the National Advisory Committee on Immunization.
The Importance of Keeping Childhood Immunizations Up-to-Date
Due to the high percentage of Canadians who are immunized through our national childhood immunization program and as a result of Canada’s high level of sanitation, Canadians, even if not fully immunized themselves, are protected in large part from these infectious diseases. To maintain this situation, and because small localized outbreaks may occur at any time, Canadians must remain diligent with respect to keeping their routine immunizations up to date.
Prevention of infection through immunization is a lifelong process. As we age, our vaccine-acquired immunity against some of the above noted illnesses may decrease. As a result, additional vaccination may be recommended to boost one’s immunity.
It is important to note that public health infrastructure initiatives such as national immunization programs vary around the world and, in many countries, may not be as developed or as successful as here in Canada.
When travelling to an area where childhood illnesses may be of special concern, an alternative or accelerated childhood immunization schedule may be recommended for small children, based on an individual risk assessment.
International Reports of Traditional Childhood Infectious Diseases
The Public Health Agency of Canada is aware of the following official reports of epidemic and outbreak activity of polio, measles, mumps, rubella, tetanus, and diphtheria, as reported by the referenced international sources. Travellers who visit areas where epidemics of traditional childhood diseases occur regularly should be aware that outbreaks can occur at any time.
Country and Source of information
Date
Disease
Synopsis
U.S.
[CDC]
April 21, 2006
Measles
Region(s)
United States : Multi-state: Iowa, Kansas, Nebraska, and Illinois
Period
December 2005 to April 19, 2006
Incidence
Iowa : 975 confirmed, probable, and suspect reports of mumps cases in 66 of 99 counties .
Kansas : 147 reports of confirmed and probable mumps cases in 31 of 105 counties.
Nebraska : 109 reports of suspected mumps cases in 18 of 93 counties.
Illinois : 72 reports of mumps cases, 35 of which have been confirmed.
Additional Details
The Centers for Disease Control and Prevention ( CDC) has confirmed the strain in this outbreak as genotype G.
See - Public Health Agency of Canada Travel Health Advisory
Germany Update
[ Eurosurveillance]
April 13, 2006
Measles
Region(s)
Federal state of Nordrhein-Westfalen, Germany
Period
January to April 12, 2006.
Incidence
660 cases
Additional Details
the overwhelming majority of the patients (>90%) have not been vaccinated
U.S.
[CDC]
April 13, 2006
Measles
Region(s)
United States : State of Iowa
Period
December 2005 and April 10, 2006
Incidence
515 confirmed, probable, and suspect cases of mumps
Additional Details
See - Public Health Agency of Canada Travel Health Advisory
Spain
[Eurosurveillance]
April 3, 2006
Measles
Region(s)
Madrid , Spain.
Period
January 26 - March 16, 2006
Incidence
59 cases; 50 of which have been laboratory confirmed
49 of the cases were in unvaccinated patients.
Additional Details
Genotype B3 confirmed in samples from 13 patients.
Denmark and Sweden
[Eurosurveillance]
April 3, 2006
Measles
Region(s)
Øresund region of Denmark and Sweden:
Denmark : Zealand, mostly in the greater Copenhagen area.
Sweden : Western part of Skåne
Period
Denmark : late-January to March 11, 2006
Sweden : February 3 to March 15, 2006
Incidence
Øresund Region: 18 Cases
Denmark : Nine cases -all nine Danish cases were in unvaccinated patients and were confirmed serologically.
Sweden : Nine cases - all nine Swedish patients were also unvaccinated
Additional Details
Denmark : The measles virus was has been identified as genotype B3, in seven of the patients.
Sweden : The measles virus was has been identified as genotype B3 with a sequencing pattern identical to the Danish ones, in one patient.
Venezuela
[PAHO]
March 27, 2006
Measles
Region(s)
Venezuela : State of Miranda and the capital district of Caracas
Period
Late-February to March 27, 2006
Incidence
12 laboratory confirmed cases
Additional Details
Somalia
[WHO]
March 24, 2006
Polio
Region(s)
Lower Juba - southern Somalia
Mudug - northeastern Somalia
Period
N/A
Incidence
Two new cases
Additional Details
N/A
Germany
[Eurosurveillance]
March 23, 2006
Measles
Region(s)
Germany
Western Germany - Nordrhein Westfalen,
Southern Germany - Baden Wuerttemberg
Period
Nordrhein Westfalen : Between mid-January and March 23, 2006
Baden Wuerttemberg : early-January to March 17, 2006
Incidence
Nordrhein Westfalen : 246 cases of measles were notified in the federal region of Nordrhein Westfalen – most of them in patients aged 10-19 years. Of these cases, 107 have been laboratory confirmed. This is more than 20 times the number reported during the same period in 2005. Over 90% of the patients had not been vaccinated against measles, or vaccinated incompletely (only one dose).
Baden Wuerttemberg : 58 measles cases have been reported, most of them in patients aged 1-9 years. Nine cases were laboratory confirmed, and seven cases have been found to be caused by measles genotype B3. None of the patients had been immunised. The patients belong to a social group where measles vaccination is viewed as unnecessary.
Additional Details
N/A
England and Wales
[CDRweekly]
March 23, 2006
Measles
Region(s)
England and Wales - cases have occurred in all regions apart from the North East.
Period
January to mid-March (epidemiological weeks 1 to 11)
Incidence
72 cases of measles have been confirmed. Ages of cases have ranged from under one to 35 years.
Additional Details
Only two of the cases had received one dose of measles, mumps, and rubella (MMR) vaccine and three others had been vaccinated with single measles vaccine.
Bangladesh
[WHO]
March 16, 2006
Polio
Region(s)
Bangladesh : Chandpur district of Chittagong division
Period
January
Incidence
One case confirmed in a nine year-old girl
Additional Details
The virus is closely related to viruses from western Uttar Pradesh in India.
Ukraine
[Eurosurveillance]
March 09, 2006
Measles
Region(s)
Ukraine : All 27 administrative territories of the country are now reporting cases. All but five of these territories have reported at least 100 cases each.
Period
February 2005 to the end of February 2006.
Incidence
19 673 cases; 17 281 (88%) occurred during January and February 2006.
Additional Details
Measles cases from the current outbreak in Ukraine have been imported into Belarus (2 cases), the Russian Federation (9 cases), Spain (1 case) and the United States (2 cases). Measles virus of D6 genotype has been identified from cases in Ukraine and from imported cases.
Greece
[Eurosurveillance]
February 23, 2006
Measles
Region(s)
Greece : Cases were reported from 14 of the 52 districts of Greece
Period
September 2005 to February 2006
Incidence
171 cases of measles were reported, of which 53 (31%) have been laboratory confirmed. 159/171 patients (93%) are from northern Greece
Additional Details
Of 110 patients with known vaccination status, 98 (89%) were unvaccinated for measles and 12 (11%) had had one dose of measles-containing vaccine.
[Information for Travellers]
[Information for Travel Medicine Professionals]
