Travel health update

Ten years ago this month I started writing this column – well it’s been quite a journey and fun to do! I work closely with the Editor, Mandy Galloway, who does a really rapid turnaround – probably one of the greatest buzzes of all. Discussions about final edits have occasionally happened in some weird and wonderful places as I’ve been travelling for work. We hope you enjoy this edition.

NOVEL CORONAVIRUS (COVID-19)

The development of this new disease has been rapid. As I write, the new coronavirus has been declared a Public Health Emergency of International Concern, the first cases have been identified in the UK and the news has been full of reports of the ongoing situation. So this is one time the latest information probably won’t be found on this page but I thought I would use the opportunity to signpost you to very useful resources. The World Health Organization (WHO) has put out a great information video at https://www.youtube.com/watch?v=mOV1aBVYKGA and the BBC has produced a helpful visual guide to the outbreak at https://www.bbc.co.uk/news/world-51235105. WHO publishes a daily update at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

Regarding the many global resources, but particularly the UK based ones that we need to follow (including guidance for primary care), I wrote a blog on 31 January and will do my best to ensure the links are current and working, so go to http://janechiodini.blogspot.com/2020/01/novel-coronavirus-2019-ncov.html for more information. I’ve also been posting regular items on my FaceBook page at https://www.facebook.com/TravelHealthTraining

YELLOW FEVER

NaTHNaC posted a news item towards the end of January about a new PHE document Guidance in the event of yellow fever vaccination in travellers with a contraindication or report of a yellow fever vaccine associated serious adverse event. Because of the potential risk of vaccine being occasionally administered inadvertently to travellers with a contraindication, and the fact there is no clear national or international consensus on the management of such cases, the purpose and scope of this document is to provide guidance and describe recommended immediate actions. As well as outlining contraindications to yellow fever vaccine and describing potential serious adverse events, the guidance explains how reporting is to be managed, provides a flowchart of action required and describes roles and responsibilities of those involved when actioning the protocol for care of any patients who may have incorrectly received vaccine. This is an important aspect of care for all those involved in the administration or management of yellow fever vaccine. See https://nathnacyfzone.org.uk/factsheet/59/management-and-reporting-of-adverse-events and https://www.janechiodini.co.uk/help/yellow-fever/

NEW PGDs

If you work in England, new PGDs for combined hepatitis A and typhoid, injectable monovalent typhoid, MMR and PCV were posted on the PHE website on 28 January. The PGDs will be valid from 1 March 2020 and they will need to be signed off by your organisation that has legal authority to authorise PGDs (on page 4), but this is just to alert you to the fact they should be in the pipeline for your signature and use in the surgery. Again within the PGD for Typhim Vi, which is licensed from 2 years of age, it states that the vaccine may be administered off-label to children between the age of 12 months and 2 years if the risk of typhoid fever is considered to be high, in accordance with the recommendations in Chapter 33 of the ‘Green Book’ and NaTHNaC. See the PGD collection at https://www.gov.uk/government/collections/immunisation-patient-group-direction-pgd

EHIC

It has happened, we’ve left the European Union, but the European Health Insurance Card (EHIC) is still valid for use through 2020. The NHS EHIC webpage explains what will happen beyond January 2021: pensioners, students, frontier workers (someone who lives in one state and works in another) and EU nationals living in the UK before 31 December 2020 will still be able to access healthcare for visits that begin after 1 January 2021. Presumably negotiations will take place during the transition period to decide exactly how this will work in the future for everyone. https://www.nhs.uk/using-the-nhs/healthcare-abroad/apply-for-a-free-ehic-european-health-insurance-card/