Travel health update

As we enter a new decade, Jane Chiodini reflects on some of the issues that general practice nurses involved in travel health service provision may encounterA new year and a new decade and I just wonder what will happen to travel in the next ten years? Tourists will probably have started going into space, and people will undoubtably be doing increasingly more adventurous activities if the images on Instagram are anything to go by – a great platform by the way to visually see what backpackers are experiencing! I’ve chosen four topics this month to reflect upon and update you on the current situation.

PROVISION OF A TRAVEL HEALTH SERVICE

Will this remain on the NHS – well the answer at the current time is I really don’t know! In October 2019 a report was published from NHS England entitled Interim findings of the Vaccinations and Immunisations Review – September 2019, found at https://www.england.nhs.uk/publication/interim-findings-of-the-vaccinations-and-immunisations-review-september-2019. Most of its content surrounds national immunisation programmes and management thereof, but it also stated a purpose was to consider whether to extend the list of chargeable vaccines. A number of organisations were involved in the review, which it reported would continue for the remainder of the year. Travel vaccinations were to be included in the second half, so there were no details in interim report. I understand that review has now happened for travel and a decision made, but that the information is still embargoed. Rumours are rife, however, but until we do know for certain then no change in the way we deliver a travel service in primary care should happen, unless the practice formally opts out. See my FAQs on the subject for more detail https://www.janechiodini.co.uk/help/faqs/faq-3-providing-nhs-travel-service/

MEASLES

I would very much hope that control of measles will not be an issue in 2020. With a current outbreak affecting a number of the Pacific Islands, new entry requirements have been introduced for certain destinations, including American Samoa, Solomon Islands, Republic of Marshall Islands and Tokelau. These may require some travellers to demonstrate history of vaccination or immunity to measles. Make sure you always check the country-specific information on TravelHealthPro or TRAVAX for the latest details, and which will give links to more details from the WHO as well. And remember it remains important to ensure our travellers all have a record of two doses of MMR vaccine. If they need updating, then in England, Immform stock can be used. I blogged about this subject last year – see http://janechiodini.blogspot.com/2019/05/mmr-and-travel.html

POLIO

Will polio finally be eradicated over the next ten years? It would be wonderful if this was achieved. The subject remains a World Health Organization Public Health Emergency of International Concern (PHEIC) with the latest committee meeting (the 23rd) held last month. TravelHealthPro publish the findings every three months and to see the history and updates on the current situation go to https://travelhealthpro.org.uk/search?s=polio&ge_srch= . Malaysia and the Phlippines have been added to the country list of Afghanistan, Pakistan, Indonesia, Myanmar and Nigeria who all require a certificate requirement for polio vaccination, under the International Health Regulations, if visiting for longer than four weeks. If this is the case, then an International Certificate of Vaccination or Prophylaxis (ICVP) will be required as evidence of vaccination against polio in the preceding 12 months. This subject continues to cause some confusion in general practice – who can you provide vaccine to, and who do you need to direct to a private travel clinic to receive the vaccine and ICVP? I wrote a new blog about this last month, found at http://janechiodini.blogspot.com/2019/12/polio-update.html

LGBQT

Will travel by this population group to many countries become more acceptable in the coming decade because the receiving countries are showing greater tolerance? I certainly hope so. In December 2019 the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA) published an updated map of sexual orientation laws in the world, covering criminalisation of consensual same-sex sexual acts between adults to protection against discrimination based on sexual orientation at https://ilga.org/maps-sexual-orientation-laws.