Travel health update

While we have been preoccupied with COVID-19, the threat of other diseases has not gone away – and indeed, disruptions in prevention and treatment strategies as a result of the pandemic have increased the threat and prevalence of some conditions

A number of vector borne diseases have been reported recently, which could impact travellers although for some, risk will be low. However, it is still important to be aware of them and know about prevention to advise your travellers when appropriate.A new website has been developed by the London School of Hygiene and Tropical Medicine. Going to the website at https://globalvectorhub.lshtm.ac.uk/ you will initially see a rotating globe which pinpoints recent reports of a variety of vector borne diseases. This website is still in development, but already contains some good information and I found the resources section really interesting. So here is an update on some of the recent reports or outbreaks.

MALARIA

The World Health Organization (WHO) states that there were about 241 million cases of malaria in 2020, with an estimated 627,000 deaths globally. This represents about 14 million more cases in 2020 compared with 2019, and 69,000 more deaths. Approximately two thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment during the COVID-19 pandemic in 87 countries of the world. The WHO African Region accounted for 94% of all malaria cases and deaths in 2019 – for more details see https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2020 I recently updated my e learning course taking a learner through the UK malaria guidelines, at https://www.janechiodini.co.uk/education/malaria-course/. Bite prevention advice resources are available at https://www.janechiodini.co.uk/help/bite-prevention/

JAPANESE ENCEPHALITIS

A posting on TravelHealthPro (16 March 2022) informed us there have been 18 confirmed human cases of Japanese Encephalitis (JE) in Australia, in the states of New South Wales (6), Queensland (1) South Australia (4) and Victoria (7), including two deaths – one in New South Wales and one in Victoria – see https://travelhealthpro.org.uk/news/622/japanese-encephalitis-in-australia. Prior to this JE had existed on this continent, but only in the tip of Queensland. A vaccination programme has begun for those at high risk in mainland Australia, Torres Strait Islands and Tiwi Islands. https://www.health.gov.au/resources/publications/cdna-advice-regarding-vaccination-against-japanese-encephalitis-virus. While you would not necessarily recommend JE vaccine to your travellers visiting Australia, it is important to be aware of the news, prevention advice and check the country specific information for Australia for further news. Details about JE can be found at https://travelhealthpro.org.uk/factsheet/55/japanese-encephalitis

YELLOW FEVER

Over the past few months, WHO has reported outbreaks of yellow fever (YF) occurring in a large geographic area in the West and Central regions of Africa. According to WHO, the upward trend of cases and outbreaks is indication of ongoing intense YF virus transmission in the region and represents a persistent and growing risk to all unvaccinated people living or visiting YF risk countries. The YF vaccination coverage in this area is not sufficient to provide herd immunity and prevent outbreaks. Since mid February 2022, NaTHNaC have reported outbreaks in Chad, Ghana, Uganda, Kenya and Nigeria including a number of deaths. See https://travelhealthpro.org.uk/outbreaks-search?period=6&coun=All&dis=194. Many UK travellers continue to visit friends and relatives and it is important to raise awareness of this risk, advise on yellow fever vaccine and mosquito bite prevention.

CRIMEAN-CONGO HAEMORRHAGIC FEVER

Crimean-Congo haemorrhagic fever (CCHF) is a tick borne virus primarily transmitted to people from ticks and livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons. CCHF is endemic throughout Africa, Asia, the Middle East, Eastern and Southwestern Europe. We do not have the types of ticks to transmit CCHF in the UK. However, the UK Health Security Agency has confirmed a case of CCHF in England, in a woman who had recently travelled to Central Asia. This is only the third case imported into the UK with the others reported in 2012 and 2014. The risk to the majority of those travelling to areas where CCHF is known or presumed to occur is very low, if tick bite avoidance measures are followed. There is no licensed human CCHF vaccine available in the UK. NaTHNaC provide a good insect and tick bite avoidance factsheet at https://travelhealthpro.org.uk/factsheet/38/insect-and-tick-bite-avoidance and FitforTravel provides an information sheet on CCHF at https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/crimean-congo-haemorrhagic-fever