Travel health update

All about yellow fever; Future training for Yellow Fever Vaccine Centres; WHO news; Resources

I don’t usually cover Yellow Fever in this column because it is such a complicated issue, but there are lots of changes on the way, so I am devoting the entire page to this important topic.

ALL ABOUT YELLOW FEVER

Responsibility for administering Yellow Fever Vaccination Centres (YFVC) in England Wales and Northern Ireland is devolved to the National Travel Health Network and Centre (NaTHNaC) and for those in Scotland to Health Protection Scotland (HPS). Initial one day face-to-face training is required by both organisations to become registered and an update of training has always been a requirement every two years thereafter, to main registration status. How does this now happen?

FUTURE TRAINING OF YFVC

In Scotland update training is performed by either one person’s attendance at a full day face-to-face training session, or by completion of an online yellow fever training package accessed through the HPS website. This leads to a course made available from the Centers for Disease Control and Prevention (CDC), a United States of America health organisation. The training takes about 3 hours to complete and can be accessed as the ‘learner’ has available time, from any computer and numbers undertaking the training are not restricted. HPS publishes notes which must be read and these highlight any key differences between the two country perspectives – for example the vaccines used differ slightly. On completion the doctor who is registered as responsible for the YFVC must fill in a Confirmation of Completion form stating the name of the person who undertook the training, and confirm it was completed by the due date.

Centres in England, Wales and Northern Ireland administered by NaTHNaC will no longer be able to access face-to-face training for renewal of their YFVC registration. An online course will be available from September 2013. This will be self-directed learning with an exit test. All YFVC who were due to renew their registration during July, August and September are allowed to do so by 30 September 2013. New centres who attend the one day face-to-face yellow fever training will also have to complete an exit test from September this year. In addition, new YFVCs are advised to review the materials provided online prior to their training day – packs are no longer distributed on the day.

WHO NEWS

Press releases from the World Health Organization (WHO) at the end of May informed us that a single dose of yellow fever vaccine confers life-long immunity against yellow fever virus. However, while vaccine may be given for disease protection, it is also sometimes given so that an International Certificate of Vaccination or Prophylaxis may be provided. At present 20 countries require a valid ICVP as a condition of entry from all travellers. Other countries require an ICVP as a condition of entry only for travellers arriving from countries with risk of yellow fever transmission and/or for travellers having transited through the airport of a country with risk of yellow fever (YF) transmission. So although the news of long term protection is to be welcomed, until more is known, we continue to need to consider vaccination to issue an ICVP and each case needs to be assessed on an individual risk assessment basis.

RESOURCES

Useful resources are at www.nathnac.org, www.hps.scot.nhs.uk and www.travax.nhs.uk

Don’t forget if you are administered by NaTHNaC, then to access the protected area, you need your username which is your YFVC registration number, and your password, which is your customer registration payment reference number as it appears on the NaTHNaC invoice – ask your practice manager for this as it essential you review this area of the website regularly to keep up to date. NaTHNaC also provides a newsletter for healthcare professionals and yellow fever leaflet for travellers, found at http://www.nathnac.org/pro/Yellow_Fever_Vaccination_Centre_Information.htm

COMMENT

Yellow fever is now a complex topic and all nurses in travel health should have some knowledge on the subject even if only to refer appropriately to a YFVC. However, the RCN Competency document identifies that to administer yellow fever vaccine, a nurse should be experienced/proficient in travel health - not someone who is new to this field of practice and at the competent level – see page 20 at http://www.rcn.org.uk/__data/assets/pdf_file/0006/78747/003146.pdf