Travel health update

August is traditionally the ‘silly season’ but there has been plenty going on, especially relating to malaria. Jane Chiodini has also been busy updating her tools and resources

MALARIA

Interactive maps

I’ve mentioned interactive maps before, such as the CDC’s interactive map for Brazil and the yellow fever risk (https://wwwnc.cdc.gov/travel/notices/alert/yellow-fever-brazil). The concept of this feature means you can search the Google map for a specific destination to find out if there is disease activity there, so you can give appropriate advice – and you can also zoom in on the destination to see more. NaTHNaC have now used this feature for three malaria maps on the TravelHealthPro website, for India, Brazil and Bolivia. Knowing this technology is now available could make our malaria consultations so much easier, especially for specific destinations where there isn’t a risk of malaria throughout the whole country. Go to https://travelhealthpro.org.uk/countries and look up one of these countries to see for yourself and click on the interactive map feature. It’s best viewed on the whole screen – but full details are explained below the map itself so be sure to read this section.

Malaria advice

The Public Health England Malaria Reference Laboratory has provided a service for healthcare professionals for queries about complex patient scenarios for many years. In the early days it was a telephone service and then it went to fax. Now you can email your query instead. A risk assessment form must be completed electronically, and is then emailed to the advice service. A reply will be sent back within three working days. For more information about this and other interesting resources go to https://www.gov.uk/government/collections/malaria-reference-laboratory-mrl and for this specific service scroll down to the bottom of the page to Malaria: risk assessment form.

South Africa update

NaTHNaC posted an update to the risk of malaria in South Africa at the end of August at https://travelhealthpro.org.uk/news/345/south-africa--malaria-updated-risk-areas-and-advice. The South African authorities have reviewed the risk areas for malaria transmission, resulting in changes to guidance for UK travellers. NaTHNaC has included information about the risk areas as follows: North-eastern Kwazulu-Natal, low altitude areas of Mpumalanga (note expanded area of risk) and low altitude areas of Limpopo (note expanded area of risk). A link is provided to the South African guidance - the map to be used is found on page 13 http://www.nicd.ac.za/wp-content/uploads/2017/09/National-Guidelines-for-Malaria-amended-August-2018-Draft-map.pdf This means you should not currently refer to the South Africa map in the UK malaria guidelines to assess the risk when your travellers are going to this destination, and the NaTHNaC map in question has been removed from its website.

UPDATED TOOLS

Vaccine chart

Because the Green Book chapters for Japanese encephalitis and rabies have both been updated recently, I’ve updated my vaccine chart with the new information. It’s an increasing challenge to fit all the detail in to a two-page chart, but I display it deliberately in this format to make it a useful tool. Please make sure though that you always use it in conjunction with other resources available as detailed at the beginning of the chart. To obtain it, go to Item 3 at https://www.janechiodini.co.uk/tools/.

FGM risk assessment

I’ve made a small adjustment to the travel risk assessment form also found on my ‘Tools’ page at Item 1 (see link above). A question has been included right at the beginning to ascertain the original country of origin of the traveller. This was done in response to a new e-learning tool being developed in relation to travel health and FGM (more news on that soon I hope). Knowing the country of origin could be a useful indicator of risk if that country has a high percentage of risk for FGM, as illustrated on the RCN map (see page 2) at https://www.rcn.org.uk/professional-development/publications/pub-005784.

Rabies boosters

Just as the August Practice Nurse travel health update was being published, PHE published a special edition Vaccine Update for rabies which provided additional useful information. This included further advice in relation to boosting a traveller. I subsequently wrote a blog about it to help you further so please go to http://janechiodini.blogspot.com/2018/08/rabies-vaccine-for-travellers.html for updated information.