Travel health update

Ostomy care for travellers; meningitis ACWY VAX update; PGD competency framework; Travel health conference

OSTOMY CARE FOR TRAVELLERS

Doing some research for one of my travellers recently I found resources to help advise those with a colostomy or ileostomy. By nature of the condition, air travel could pose a problem with gaseous expansion if the wrong food and fluids are consumed resulting in the need to empty the bag more frequently. Equipment for such a purpose would need to be carried at all times and prophylactic antibiotics may be something to consider for travel to areas considered higher risk for travellers’ diarrhoea. The Colostomy Association has a travel advice leaflet and details regarding insurance at http://tinyurl.com/nvcohtk . Stomawise is another useful website which provides advice, see http://www.stomawise.co.uk/lifestyle/travel-guide. This includes information about stoma supplies outside the UK and a travel certificate which can be supplied. This details facts in the event of being security checked, including that if a stoma needs to be examined then it should be done with a qualified medical practitioner in attendance and also explains that some bags are supported by a belt which will contain metal parts. An app is now also available with this certificate information on it available in eight different European languages – see http://www.stomawise.co.uk/lifestyle/ostomy-travel-certificate-app for more detail.

MENINGITIS ACWY VAX

The production of the quadrivalent polysaccharide vaccine, ACWY Vax, made by GSK is to be discontinued with supplies very limited from July 2014. With two conjugate vaccines (Menveo and Nimenrix) used in travellers to give protection against meningococcal strains A, C, W135 and Y, the June 2013 version of the ‘Green Book’ states ‘Men ACWY quadrivalent conjugate vaccine is preferred to the polysaccharide vaccine in all instances’. As a reminder, the ‘Green Book’ also includes information regarding asplenic travellers, those with splenic dysfunction or complement deficiency above the age of one, if they are travelling to an area that puts them at risk, they should be given a meningococcal ACWY conjugate vaccine. Those who previously received a meningococcal ACWY polysaccharide vaccine should also be vaccinated with the conjugate vaccine. These vaccines should be administered for such travellers as an NHS provision. The need for and timing of an ACWY conjugate vaccine has not yet been determined.

PGD COMPETENCY FRAMEWORK

A new competency framework document was published by NICE towards the end of January for health professionals using patient group directions. The intention is that the implementation of the guidance is the responsibility of the commissioners and providers. The framework is made up of 3 domains each containing three competency areas. The framework is intended to be a developmental tool to support individual health professionals and organisations, and it is hoped it may help identify training and competency needs; develop educational materials; establish a comprehensive and appropriate training programme; facilitate continuing professional development and inform the development of organisational systems and process. PGDs for travel vaccines continue to be a huge problem area in primary care and it will be interesting to see if this new guidance makes a difference. To see the document go to http://tinyurl.com/q7jbmlz

A RETURN TICKET

The RCN travel health forum conferences held in the first decade of the millennium have been sadly missed since 2010. I’m delighted to announce that I’m working with the RCN to hold a similar event on Saturday 13 September 2014 at RCN Headquarters. An exciting programme with eight excellent speakers (and me delivering a travel health update!) will include a variety of topics from malaria, bite prevention, sexual health, skin diseases in travellers, to accidents abroad, telemedicine in travel and a media doctor (one of twins) presenting on experiences in the tropics and beyond. For further details go to www.janechiodini.co.uk/education or www.rcn.org.uk/TH14