A Report from GeoSentinel

GeoSentinel is the global surveillance network of ISTM. The GeoSentinel Program includes issuance of periodic advisories to all our member clinics via electronic means.

An important outbreak of influenza A once again occurred this summer in travellers and tourist industry workers in Alaska and the Yukon Territory. Detailed information and background is available at http://www.hc-sc.gc.ca/hpb/lcdc/osh/yukak_e.html.

Acquisition appears to be primarily on land portions of combination land-then-cruise group tours. Last year an estimated 850 000 travellers, many elderly, from at least 45 countries visited Alaska during the May-September summer travel season. An estimated 40-50 000 cases of influenza like illness occurred during the Summer 1998 outbreak in the same locales and several elderly travellers died with complicating pneumonia.

Influenza is a year-round disease in the tropics. In addition, these summer outbreaks are occurring with increasing frequency, Nevertheless, influenza vaccine is not available from manufacturers during the summer months in the Northern Hemisphere. Elderly and high risk travellers should thus be counselled on the use of rimantidine or amantidine for prophylaxis or for standby treatment.

We suggest that ISTM members make efforts publicise this outbreak as well as the risk to travellers within their own communities. This is a high priority public health travel topic with wide mass appeal. It is a good opportunity to promote travel medicine in general and your own clinic in particular. For example, a “Tip Sheet” put out locally in Birmingham last Friday in collaboration with the UAB media relations department when this news broke on the above web pages, has already resulted in one newspaper item and several requests for interviews since.

David O Freedman, Phyllis Kozarsky, GeoSentinel Directors