Travel health update

In this month's update: Rabies educational video; Advice for travellers to Saudi Arabia; Can I eat this? - new app for travellers

RABIES EDUCATIONAL VIDEO

As time gets increasingly pressurised within a travel consultation, the choice of advice we provide the traveller can be influenced by experience of what is and isn’t acceptable. The cost of a course of rabies vaccine is often considered as ‘unaffordable’ by some travellers and therefore the time and effort put in to educating on the topic can be limited. However, if there is contact with a warm blooded mammal in a rabies endemic area, the risk must be taken seriously and treatment given. If infection of the rabies virus occurs, then the outcome is almost always fatal. I feel travellers need to understand the risk, prevention measures and treatment pathways to make an informed choice prior to travel. I’ve therefore created a video to help you convey the message of rabies risk to your travellers – this is something they could even possibly be asked to view prior to or after an appointment to enable them to make an informed choice if travelling to an area and undertaking activities that puts them at higher risk. The video has been posted on YouTube but can also be accessed through my website under ‘tools to help’ at the bottom of the page http://www.janechiodini.co.uk/news/help/rabies/

POINTERS FOR TRAVEL TO SAUDI ARABIA

The Hajj pilgrimage for 2014 is estimated to fall in early October this year so many of you will be seeing travellers for advice in preparation for the event. A number of items related to this topic come to mind. GlaxoSmithKline (GSK) has now discontinued manufacture of ACWY Vax, the polysaccharide vaccines against the strains A, C, W135 and Y of meningococcal disease. Unless you have stock remaining in your surgery fridge, choice of vaccine in the future will only be the more effective and expensive conjugate vaccines (Menveo and Nimenrix). GSK provided information stating that although the current product information for ACWY Vax states an antibody persistence of at least 3 years, new data demonstrate a waning of antibody titres between one and two years after ACWY Vax. They suggested that individuals who remain at high risk of exposure to Neisseria meningitidis should be considered for revaccination earlier than currently recommended. See http://preview.tinyurl.com/p34bssf for further detail.

There has been an increase in reported infections with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) since 2014 primarily in the Middle East but mostly from the Kingdom of Saudi Arabia (KSA). MERS-CoV is a new subtype/strain of coronavirus, the transmission of which is not fully understood as yet. Most cases present with fever and cough that may progress to a severe pneumonia causing shortness of breath and breathing difficulties. In response to this international outbreak of disease, the Ministry of Health KSA recommends that elderly people, pregnant women, children, and those with chronic diseases (e.g. heart diseases, kidney diseases, respiratory diseases, nervous system disorders, diabetes, and immune deficiency) postpone trips for Umrah and the Hajj this year for their own safety. Public Health England has produced two very useful posters providing information and detailing symptoms to raise awareness in the travelling public both for before and after their trips to the Middle East. See http://preview.tinyurl.com/p69csmc for more details.

CAN I EAT THIS?

The Centers for Disease Control and Prevention (CDC) has produced a handy free of charge app, entitled ‘Can I eat this’? It provides a list of countries, illustrated by their nations’ flags and gives the user an option to select eating or drinking, then proceeds through a series of questions eventually resulting in advice as to whether that consumable would be safe to eat or drink, or not, with a red flashing cross or a green tick at the end of the decision making process. Foods for example considered are meat, dairy, fruits and vegetables, eggs and bread. It’s fun to use and could well engage children in the decision making process, providing invaluable education to the traveller, thus hopefully preventing a bout of travellers’ diarrhoea. The app is available in both IoS and Android format see http://wwwnc.cdc.gov/travel/page/apps-about.