Dubai’s Emirates posts travel warning over killer Marburg virus
Travellers are advised to postpone trips unless absolutely necessary
Dubai’s Emirates has posted a travel warning on its website for customers travelling to Oman due to the confirmed break of the killer Marburg virus. The warning was issued by the Omani authorities to all airlines.
The advisory was issued on Thursday, stating that “those who have travelled from the impacted countries must isolate themselves and seek immediate assistance if they feel unwell within 21 days of travel.”
The warning was issued upon instruction by Oman authorities, advising travellers to postpone trips to countries affected by the Marburg virus and take precautions if the travel is urgent.
Oman’s travel advisory on Marburg virus outbreak
The issue statement reads, “Due to the confirmed outbreak of the Marburg virus in the Republic of Tanzania and Guinea, customers arriving in Oman, and who have travelled from the impacted countries must isolate themselves and seek immediate assistance if they feel unwell within 21 days of travel. The Oman authorities also advise travellers to postpone trips to countries affected by the Marburg virus and take precautions if the travel is urgent. Further details are available on the Oman Ministry of Health website.“
The Oman Ministry noted that note that efforts are being made to contain the outbreak in its current geographical scope.
Precautions to avoid the highly infectious disease, as per the Oman Ministry:
Avoid direct contact with patients with symptoms like fever, muscle ache, and skin rash, as well as avoid visiting areas affected by Marburg Virus Disease (MVD).
Avoid contact with blood and other body fluids, in general, from other people.
Avoid contact with fruit bats or visiting mines and caves inhabited by these bats.
Avoid contact with animals such as chimpanzees and gorillas.
Travelers who are infected with fever, chills, muscle pain, skin rash, sore throat, diarrhea, weakness, vomiting, stomach pain, or unprovoked bleeding from anywhere or bruising during or after travel (till 21 days) should isolate themselves from others and head to the nearest healthcare institution (emergencies departments in hospitals). They should disclose to medical staff whether they have traveled to the infected areas or contacted people with Marburg Virus Disease (MVD).
The Marburg Virus Disease (MVD) is highly infectious, with a fatality rate of around 60 percent to 80 percent.
Asbestos exposure, a hidden risk for budget tourists in Asia
We are just beginning to realise that exposure to asbestos is a hidden travel risk in Asia, particularly for those on a low budget who stay in cheap deteriorating buildings or next to demolition sites.
It’s a small but real risk.
Asbestos is a popular building material in many parts of Asia and given that it only takes a few fibres to cause a fatal cancer, tourists may unknowingly be facing a health risk.
The longer and higher the level of exposure, the greater the dose. This explains why asbestos workers are at higher risk of developing disease. But others get it too and some are totally disbelieving when they get the diagnosis because they can’t recall ever being exposed.
Although asbestos may be locked into insulation, floor tiles and coating, walls and roofing material, as buildings decay fibres can be freed.
These fibres can be 1000 times thinner than a human hair and can be inhaled without detection.
Some travel blogs suggest opting for new hotels and avoiding construction or renovation sites where fibres may be in the air, the soil or on nearby surfaces.
Professor Ken Takahashi, director of the Asbestos Diseases Research Institute (ADRI) says the travel risks have not previously been considered by researchers.
“But in the case of travel, one can assume that the exposure level is low and the duration of exposure is short. Therefore, the risk would be small,” he says.
“A practical recommendation would thus be to avoid going near places where asbestos may be obviously present, the most typical of which is asbestos factories or mines.
“Of course, presence of asbestos is not always obvious, such as in the case of exposure to buildings containing asbestos or exposure to asbestos-containing products.
“It then becomes a matter of practicality whether one should avoid travel in view of the small risk.
He strongly believes Australia has a responsibility to raise awareness of asbestos in Asia, provide education on protection against it and hopefully, help to get rid of it completely “for the sake of workers and residents of the country itself, much more than for the sake of travellers”.
He says more than 60 per cent of the world consumption of asbestos occurs in parts of Asia where commercial convenience and the need for development and housing outweigh public health concerns.
Causing persistent damage
While Japan and South Korea have banned it, China, India, Thailand, Indonesia and Vietnam are among the top 10 consumers in the world.
The small country of Laos has the highest per capita consumption of asbestos on the planet.
For almost 50 years, it has been known that inhaled asbestos fibres can cause cancer of the lungs or can pass through the lungs into a cell layer that surrounds all internal organs.
This layer is called the called the mesothelium and where malignant mesothelioma forms.
While the asbestos itself is chemically harmless, its long-pointed fibres lodge in the body and cause a series of micro-injuries.
As the body is unable to clear these fibres, they remain stuck and cause persistent damage to the tissue.
About 30 years ago, scientists observed that a single dose of asbestos fibres damages the mesothelium tissue.
Asbestos can also cause asbestosis, a non-malignant disease that results in irreversible lung damage, difficulty breathing, a cough and, in severe cases, an enlarged heart.
Australia should ‘share knowledge’
Professor Takahashi says Australia is the only country in the world that has a dedicated federal agency to deal with the legacy of the asbestos industry.
In other countries, if it is managed at all, it is done so within health, labour or environmental ministries.
“Australia should be taking a lead in the global effort to ban asbestos in developing countries that continue to use it at a very high level because it is cheap, widely available and has many advantageous characteristics.”
He says Australia should share its knowledge and technology about substitutes for asbestos within the Asian neighbourhood.
“These countries are hesitant to make the transition because they prioritise economy over health and added to that is the fact that there are many pro-asbestos lobbies trying to maintain the global trade.
“And there is corruption among officials of ministries of developing countries, so they are not fully motivated to make the transition.
“I believe Australia should assist these counties in developing their own expertise to detect the disease and also develop systems so that workers and consumers are not exposed to asbestos while they are using it.
“Until these countries stop the manufacture and export of products containing asbestos, Australia will have to deal with illegal imports for a long time.”
Occupational exposure
Professor Takahashi says this as the epidemic of asbestos-related disease in Australia has begun peaking.
Although Australia implemented a complete asbestos ban in 2003, classic asbestos cancer – mesothelioma – can take up to 40 years to develop, which means new cases will continue to occur and people will be dying from it for many years to come.
In the 1950s and 1960s, Australia had the world’s highest per capita rate of asbestos consumption. Today it has among the highest rates of mesothelioma.
In 2016, about 700 people – the great majority male – were newly diagnosed with this fatal disease.
Apart from those involved in mining or manufacturing asbestos, many more people have been affected because vast numbers of houses built before 1990 had materials containing asbestos.
Tradesmen, such as plumbers and electricians, working in such residential properties had a high degree of occupational exposure.
Mesothelioma has been characterised by nihilism in the past but an international research effort is making some inroads into the disease.
Last month, Swiss researchers unmasked an underlying mechanism that helps explain why asbestos causes cancer.
Detecting disease earlier
They say that until now, this cancer was “a black box” and they are hopeful their discovery may lead to detecting the disease much earlier in its development.
This may then lead to a means of slowing it.
They say over time the immune system can’t cope with the changes induced by the presence of the fibres.
“The immune system goes out of balance and is no longer strong enough to combat tumour formation,” said lead researcher Dr Emanuela Felley-Bosco, of the Swiss National Science Foundation.
Published in the journal Oncogene, the study proposes that immunotherapy, a treatment that triggers the body’s own immune system to fight disease, may work in this cancer.
Using mice, the researchers showed that micro-injuries caused by asbestos triggered an immune reaction.
Tissue-repair pathways were activated that promote cell proliferation and favoured the growth of tumours
The team also found an accumulation of mutations in RNA (a kind of working copy of DNA), which they thought weakened the tissue-repair immune response.
As a result, tumour formation was no longer effectively combated and cancer developed.
Immune imbalance
An analysis of data from a human gene bank revealed that human mesothelioma tumours also produce large amounts of the enzyme that causes the mutations in the RNA.
It’s hoped this will be useful in recognising early signs of inflammation and in developing a specific immunotherapy against mesothelial cancer.
A clinical study of immunotherapy at the advanced stage of this disease is under way at hospitals in Switzerland, Spain and Britain.
Dr Yuen Cheng, a molecular biologist at ADRI, says the Swiss research has taken the science of mesothelioma a step forward.
While it was known an immune imbalance occurred, the importance and the potential triggers for it were not known.
The Swiss have shown immune imbalance plays a major role and have provided list of genes that were previously not considered.
While these genes were found in the animal model, they were also found in mesothelioma tumours in human gene banks.
The problem is that the banks have samples from fewer than 100 tumours and hundreds of thousands are needed to confirm the finding.
“They’ve clearly shown a link, something different to what other researchers have done, but we don’t know for certain until we have done a large sample,” Dr Cheng says.
The next step, which is not difficult, is to confirm this in humans. If proved correct, it could be useful in the clinical setting.
*Jill Margo is an adjunct associate professor at The University of NSW.
University researchers warn that the virus now seems to be able to sustain itself outside marsupials.
Australia’s Ross River virus has the potential to become a global epidemic, similar to the Zika virus, researchers say.
It was previously thought that the mosquito-borne virus could only sustain itself among marsupials, which kept the disease endemic to Australia and Papua New Guinea.
But research fellow at the University of Adelaide Professor Philip Weinstein said he and his partners at the Australian National University (ANU) found the disease silently planting roots in the South Pacific.
“It’s really only in the last few years [it became apparent] when tourists returning to their home countries … were diagnosed with Ross River virus after travelling in the Pacific,” Professor Weinstein said.
“They’d never been to Australia or New Guinea. That’s when the little alarm bells started ringing that this was perhaps circulating outside Australia.”
Professor Weinstein said the new finding meant that even though there were no marsupials in the Pacific Islands, the virus was seemingly able to maintain itself there anyway.
He warned that if the virus could sustain itself in areas where there were no marsupials, “then it could sustain itself anywhere in the world”.
“That certainly means that it could be another global outbreak like Zika or Chikungunya a few years before that, another mosquito-borne virus that suddenly went global,” he said.
Professor Weinstein said all it could take was a “perfect storm” of a tourist carrying the virus, a set of animals who could harbour the virus, and the right conditions for mosquitos to bite those animals for an epidemic to take off.
In fact, he said, it was possible that was already happening.
“This has probably been chugging along quietly on different Pacific islands for a number of years, but because the symptoms are so general it’s not been identified as a Ross River Virus problem,” Professor Weinstein said.
In January alone 1,174 people were infected nationwide in Australia.
New South Wales Health authorities renew warnings for residents and holiday makers in the state’s Riverina region to protect themselves against mosquitoes after a fivefold increase in the number of Ross River virus infections compared to the average in previous years.
NSW Public Health Director Tracey Oakman said there were 34 cases of the virus in the Murrumbidgee Local Health District in December, five times the average for this time of year.
“The highest number of notifications have been in the 45- to 65-year-old age group and then the next age group most commonly notified is the 25- to 44-year-old age group,” she said.
The city of Griffith has been flagged as a hotspot for the virus, with seven cases reported in the region last month.
Ms Oakman also said a number of holiday makers in the Riverina who contracted the disease were unlikely to have been picked up in the latest figures.
“If we’ve got holiday makers that have been bitten and gone home, they’ll be recorded as having the virus from the postcode that they’re living in,” she said.
Ms Oakman said the numbers were concerning and she urged people to be vigilant, use quality mosquito repellents and wear long clothing.
How is the virus spread?
Ross River virus is spread among humans by the bite of certain types of infected female mosquitoes, which generally pick up the virus when feeding on the blood of infected animals.
Outbreaks can occur when local conditions of rainfall, tides and temperature promote mosquito breeding.
Tips to beat bites
Wear long, loose-fitting clothing
Use effective mosquito repellents containing DEET or picaridin
Control mosquitos with sprays or vaporising devices for inside use, including caravans
Install fly screens
Make sure mosquitos can’t breed by removing stagnant water every week
Empty children’s wading pools when not being used
Limit outdoor activity at dusk and dawn
Source: Department of Health
Ms Oakman said mosquito numbers had flourished after months of wet weather.
“That’s really concerning because we don’t normally see such a high level of Ross River virus in December.
“We normally get higher cases in February, March and April, the tail end of summer.
“Seeing them this early is a real concern,” she said.
Ms Oakman warned that wet conditions were likely to lead to even more people contracting the virus across the region in the coming months. She called on people who became infected to visit the doctor.
“The symptoms … joint aches and pains, headaches, fever, a chill and sometimes a rash,” she said.
“Sometimes the symptoms persist for weeks and even months.
“It’s quite a miserable time for someone who contracts it.”
