Travel health update

This month Jane Chiodini brings us up to date on the measles outbreak in Europe, the yellow fever outbreak in Brazil and flags up a new app from the WHO to highlight World Malaria Day

MEASLES IN EUROPE

A recent NaTHNaC posting on TravelHealthPro informs us of the ongoing outbreak of measles in Europe with a total of 14,600 measles cases reported in 2017 alone, more than triple the number of cases reported in 2016 and 2015. The countries with the highest numbers are Romania (5,608), Italy (5,098), Greece (967), Germany (929) and France (518) and an additional 2,239 cases reported by the Romanian Institute of Public Health in 2017 have not been submitted to the European surveillance system (TESSy) yet. More details at https://travelhealthpro.org.uk/news/308/measles-in-europe-reminder. In the UK, two doses of MMR vaccine are needed for a person to be considered fully protected no matter what their age now, but this is especially important for travellers not only to Europe, but should also be considered for travel elsewhere as increased cases of measles have been reported internationally as well. If vaccine is required then ImmForm stock can be used in a GP surgery even if given for the purpose of travel, as you are also bringing your patient up to date for the National immunisation recommendations. There is a good publication, MMR for all: general advice leaflet at www.gov.uk/government/publications/mmr-for-all-general-leaflet. However, I couldn’t find one specifically for travel and importantly just now with a focus on Europe. So, in the meantime I’ve made a simple poster which may be helpful for your waiting rooms since travellers do not generally come to see us for travel to European destinations. See item 24 at www.janechiodini.co.uk/tools/

YELLOW FEVER

The yellow fever outbreak in Brazil continues with 723 confirmed cases and 237 deaths between July 2017 and end of February 2018. The disease has also affected unvaccinated travellers to Brazil with a total of 11 cases since the beginning of this year, some of them being fatal. These travellers visited Brazil from countries including the Netherlands, France, Argentina, Chile, Switzerland, Romania and England. The latest update on this can be found at https://travelhealthpro.org.uk/news/304/yellow-fever-cases-in-travellers-update but NaTHNaC also encourages access to their Outbreak Surveillance database at https://travelhealthpro.org.uk/outbreaks to make sure you’re up to data on the latest information. For the most recent yellow fever map of Brazil, NaTHNaC provides a link to the European Centre for Disease Prevention and Control (ECDC), which updates its data on the map regularly – see https://ecdc.europa.eu/ en/yellow-fever/threats-and-outbreaks/distribution-Brazil. Another useful map to be aware of for Brazil is found at https://wwwnc.cdc.gov/travel/notices/alert/yellow-fever-brazil. This is an interactive map from the CDC in the USA which allows you to zoom in on areas and has a search facility to find specific destinations.

I have just created a page of yellow fever resources on my website at www.janechiodini.co.uk/help/yellow-fever/. This is ONLY designed to link you to resources because I find when teaching, many people are unaware of the exact links to the information. It is not intended to provide any advice or education on the subject.

APPS FOR TRAVEL

I haven’t mentioned apps for a while but one of my favourite sources of travel medicine related apps is available from the World Health Organization. Each December the WHO publishes the World Malaria Report and for the first time this has been also provided in an app both for iOS (iPhone and iPad) and Android devices and is free of charge. If you’re familiar with the WHO Malaria Report, you’ll be aware of the wealth of data it provides to illustrate the state of this global problem. World Malaria Day is on 25 April this year and use of this app can significantly increase awareness of the ongoing importance of this disease – for details and access to the apps go to http://www.who.int/malaria/news/2018/launch-world-malaria-report-app/en/ . Also see http://www.who.int/malaria/media/en/ for links to some other excellent resources for malaria.