Healix International, the global travel risk management and international medical and security assistance provider, has set out the big health challenges the company believes businesses sending employees abroad may face in 2019.
"Diseases that tend to be more associated with far-off regions remain top of the list of concerns – including Ebola, the Zika virus and Malaria. But employers also need to be mindful of the risks of some diseases that are just as common at home. For example, measles and mumps can present serious risks and both remain prevalent thanks to the fact that many parents shun the MMR vaccine. Employers therefore need to ensure that they're monitoring all health risks when posting staff abroad."
Ebola continues to be a high risk in Democratic Republic of Congo
As the number of cases of Ebola in the Democratic Republic of Congo approaches 800, and fatalities almost 400, it is clear that this outbreak is far from over.
Now established as the second largest Ebola epidemic in history, further infections are to be expected far into 2019. A particular challenge in trying to bring these outbreaks under control is the resistance of local communities to accept the guidance of healthcare professionals. The on-going militia activity in the region is also a major factor, halting vaccination and quarantine efforts, as well as causing the withdrawal of some healthcare experts many hundreds of miles away from Ebola-affected cities. If other epicentres of disease are established in neighbouring countries to DRC, as is feared, control of the epidemic will take much longer to establish.
Zika predictions for India and the Americas
Zika is likely to be widely reported in 2019, if not for new epidemics, then for the delayed consequences of past infection - only now receiving attention. Around 6% of babies infected in the womb will have profound neurological deformities resulting in microcephaly, the abnormally small head seen in many images of babies from Brazil during the 2016 epidemic. But what has only recently come to light, is that of those born with a normal appearance, a further 8% of babies can have developmental delay, movement problems, or even seizures.
It has also been predicted that in 2019 it is likely that further outbreaks will continue in India and its population of 1.3 billion.
Poorer tropical countries face potential increases in malaria cases
Although malaria cases are still counted in the hundreds of millions each year, deaths from this mosquito-borne disease have decreased by around 30% over the last decade. However, over the past year, epidemics of malaria have occurred in countries facing particular economic hardships including Venezuela and Angola. A reduction in mosquito prevention programmes, or simply a failure in basic hygienic measures such as refuse collection both lead to increase the environments permissive for mosquito propagation.
Middle East Respiratory Syndrome a threat for workers
The Middle East Respiratory Syndrome (MERS), is the severe respiratory infection that first produced a handful of cases in 2012. Since then over 2,000 individuals have been infected, mostly in Saudi Arabia and often caught directly from its animal host, the camel, after which the disease is particularly severe.
There is, however, also a risk to acquire the illness from MERS-infected patients, albeit the symptoms are generally milder - but this is not true for those who also have a chronic medical condition. Understanding employees' health before they are posted to this region is therefore important, particularly as a low level of new MERS infections persists in the Middle East, and will continue to do so into 2019.
Predictions for cholera in Africa
2018 saw many outbreaks of cholera. From Zimbabwe, Mozambique, and Niger, to Cameroon, Somalia, and the much-beset DRC, thousands of cases occurred, particularly in countries that have a compromised sanitation infrastructure. In 2019, further epidemics of cholera are sadly inevitable as countries continue to have unsafe water provision, compounded by times of particular hardship.
Poor take-up of MMR vaccine perpetuates measles and mumps
Both measles and mumps saw outbreaks in 2018 and this is very likely to continue in 2019. The uptake of the MMR vaccine is still poor in many regions, not least Europe which still suffers from misconceptions concerning vaccines. Despite the MMR vaccine being shown to be safe, over 14,000 cases of measles alone were confirmed in 2018. Employers should therefore monitor reports of outbreaks – particularly where pregnant employees are travelling abroad.
Pandemic planning essential for 2019
The possibility of a bird flu capable of infecting humans continues to concern health experts. In recent years the bird flu, H7N9, has produced a modest number of infections in China; most associated with bird farmers or those who have had direct contact with poultry. Transmissibility between humans is poor with H7N9, however, meaning that an epidemic (or its big brother, the pandemic - during which transmission to several countries occurs) is very unlikely to occur.
However, as over the last century pandemics of other viruses have regularly resulted, many think that a novel bird flu might be a candidate for the next large pandemic. Whether this will occur in 2019, or in a later year, the important issue is to ensure that an organisation has adequate pandemic planning – knowing what to do when an outbreak occurs, reducing the risk for businesses and their employees.
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