Travel health update
Jane Chiodini MSc(Travel Med), RGN, RM, FFTM RCPS(Glasg)
Jane Chiodini MSc(Travel Med), RGN, RM, FFTM RCPS(Glasg)
Risks of malaria in the Indian subcontinent; latest edition of the Faculty of Travel Medicine magazine, Emporiatrics; Civil Aviation Authority guidance on assessing fitness to fly; EMC app provides mobile access to SPCs
UK MALARIA STATISTICS
Figures for travellers returning to the UK with malaria published by the Health Protection Agency last month (April) reported a 5% decrease in overall numbers in 2011 to 1,677. However, cases among travellers returning from the Indian-subcontinent increased by 22%, from 274 cases in 2010 to 334 cases in 2011. The increase in cases was largely due to Plasmodium vivax malaria acquired in Pakistan. While the most common and most dangerous type of malaria responsible for the disease in returning UK travellers is Plasmodium falciparum, vivax malaria is the more common species in India and Pakistan. Of the eight deaths reported in 2011, six were falciparum malaria acquired in Africa, but two were vivax malaria acquired in India. The report suggested travellers may not be aware of the risk of malaria in the Indian subcontinent . The lifecycle of both Plasmodium vivax and Plasmodium ovale means parasites can remain dormant in the liver due to the presence of hypnozoites, which may develop many months later. This is why we advise travellers to look out for symptoms of malaria not only in the first three months after return especially, but also for up to a year later. Advice given pre travel on the ABCD of malaria prevention is always essential: be Aware, use Bite avoidance measures, take Chemoprophylaxis and seek prompt Diagnosis if you develop a fever during or after travel. For more details of the report go to http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2012PressReleases/120425Malaria/
EMPORIATRICS SPRING /SUMMER 2012
Our 6-monthly magazine from the Faculty of Travel Medicine is now published. This edition includes interesting articles on 'Travellers' Diarrhoea' and also 'Travel and Sexual Health'. The latter includes a one page leaflet which you could photocopy and use with your travellers. For an electronic copy of the publication, please just e mail or download it from the 'blog' area of my website.
FLYING GUIDELINES
As I write this, having had a laparoscopic cholecystectomy as a day case just 3 days ago, I'm astonished at the difference in recovery made by the technology to this procedure. In my day as a Ward Sister, patients would be in hospital for 10 days recovering! The carbon dioxide used during the procedure was interesting post operatively, and got me thinking about 'fitness to fly'!
The Civil Aviation Authority published their 'Assessing fitness to fly' guidelines in March 2012. This update from the previous version in 2008, remains concise and comprehensive but includes a new section on psychiatric conditions and includes some useful and interesting links to further resources. For further details go to http://www.caa.co.uk/docs/923/Fitness_To_Fly%20-%20March%202012.pdf
Also remember, 'Health Information for Overseas Travel' commonly known as 'The Yellow Book' has a good section on this topic on pages 26-28. For details to obtain this publication go to http://www.nathnac.org/yellow_book/YBmainpage.htm and also www.spmsd.co.uk
SUMMARIES OF PRODUCT CHARACTERISTICS
One of my favourite websites for work is the Electronic Medicines Compendium www.medicines.org.uk where one can search for many 'Summary of Product Characteristics' (SPCs) and also 'Patient Information Leaflets' (PILs), so essential to be aware of when immunising. The EMC has now produced an app 'Medicines Compendium UK 2012' for both iOS and Android devices, which I'm sorely tempted to buy! Those of you who prefer to simply access the information at home or at work could go EMC website, or as I've recently found, TRAVAX has neatly included links to all the travel vaccine SPCs from one page which is so helpful for subscribers! Login to www.travax.nhs.uk, go to Vaccination Practice on left hand menu, then to 'Further information' then to 'SPC vaccines' and click the 'Yes' on the chart of the SPC you desire!