Travel health update
A flurry of updated guidance documents and reports were published as 2016 came to a close. Jane Chiodini updates you on a number of these to kick off a new series of updates for 2017
NEW MALARIA GUIDELINES
Guidelines for malaria prevention in travellers from the UK: 2016 was published by Public Health England last month.1 NaTHNaC summarised the changes, which include greater emphasis being placed on mosquito bite prevention; some of the drug information in section 4.2 has been reordered; clarification that there has been no change to the ACMP’s view that mefloquine remains a valuable option for some travellers, following an appropriate risk assessment. The section on India in the country tables has been expanded on page 39. Remember when you access the document you can easily skip to the page or section you want by clicking within the index of the electronic document. Among the best new features are a number of new malaria maps which have been provided by NaTHNaC, and which are located in Appendix 4. These maps also contain the recommended malaria chemoprophylactic drugs. A comprehensive review of the country recommendations and significant changes are likely to appear in the next guidelines, which are expected in early 2017.
JAPANESE ENCEPHALITIS
While I made mention in the December Update of the new rapid schedule for Japanese encephalitis immunisation, on days 0 and 7 for the 18 – 65 year old age group, an update to the Green Book Chapter 20 also states that although not licensed for this age group, the rapid schedule can be used for travellers aged 12 – 18 years, in circumstances where there is insufficient time to complete the standard schedule prior to travel.2 With both schedules, primary immunisation should ideally be completed at least one week prior to potential exposure to Japanese encephalitis virus. While the summary of product characteristics for the vaccine recommends a second booster 10 years after the first booster dose in the 18 – 65 year-old age group, prior to potential exposure to JEV, this has not yet been included in the GB chapter. However, this information is on NaTHNaC.3
TRAVEL HEALTH GUIDANCE FOR SCHOOLS
Produced by the Travel and International Health Team within TRAVAX, the third edition of this useful guidance has now been published.4 This comprehensive publication, 43 pages in total, includes information on all travel related topics most relevant for school trips as such activity becomes more adventurous than ever before. Such topics include schistosomiasis, rabies and travel at high altitude. There is also a list of useful suppliers of travel health equipment. Perhaps put the link on your surgery website and ensure when seeing such travellers, you provide the link to this document not only for them to read but to take back to their schools to heighten awareness of this excellent resource.
ABTA TRAVEL TRENDS REPORT 2017
An annual publication which is both visually attractive and easy to read gives us perhaps some idea of destinations we may be advising on for this year.5 The report states 24% of those in the research for the report were likely to spend more on a holiday this year, and 26% say they are very likely to visit a country they’ve never been to before, compared with 18% who said this last year. Predicted top destinations that travellers that we are more likely to see for vaccines and advice include Chile, Croatia, Kerala, South Africa and Vietnam. For the 13% who were planning a river cruise, while many are within Europe, further afield the Nile and the Zambezi are popular destinations.
LAUNCH OF FGM AND TRAVEL HEALTH GUIDANCE
This guidance document and the helpful A4 poster published by the RCN mentioned in previous editions of Practice Nurse are now available to download from the RCN website,6 but are also accessible through my updated FGM page.7
RESOURCES
1. Public Health England. Guidelines for malaria prevention in travellers from the UK,2016
2. The Green Book Chapter 20: Japanese encephalitis
3. NaTHNaC. Japanese encephalitis.
4. TRAVAX. Travel health guidance for schools, 3rd edition.
5. ABTA Travel Trends report 2017. http://abta.com/assets/uploads/general/ABTA_Travel_Trends_Report_2017.pdf
6. RCN. Female genital mutilation: RCN guidance for travel health services.
7. Jane Chiodini http://www.janechiodini.co.uk/news/help/fgm
