Travel health update
It’s been a very busy time in travel health over the last few months with many official guidance resources published. Dominance of the vaccine shortages has possibly overshadowed other news so here is a quick recap of some of the other things that have been happening
IMPORTED MALARIA DATA
Mid-August saw the publication of Public Health England’s Malaria imported into the United Kingdom:2016. Implications for those advising travellers.1 Imported malaria cases increased to 1,618, up by 15.6% from 2015. Just over 80% of them were due to P. falciparum, 55% of cases were reported in London, and there were six deaths. Where a reason for travel was known, 80% were visiting friends and relatives (VFR) and, where a history of chemoprophylaxis was known, 83% had not taken any antimalarial drugs. The updated Guidelines for malaria prevention 2017 are due for publication very soon. Clearly there is still much work to be done in terms of education on malaria prevention and this updated guidance will be a key document.
ZIKA PREVENTION ADVICE
Categories of global risk to UK travellers has been defined as high, medium and low with some high risk areas being downgraded to medium risk, and NaTHNaC guidance should be read in full.2 The key change in guidance for my travellers would be that for high and moderate risk areas, the sexual transmission advice now focuses the message on pregnant women, their partners and very importantly, couples who are planning pregnancy, as these individuals are at greatest risk. For non-essential travel, pregnant women should still postpone travel to high risk areas and consider postponing travel to a moderate risk area. Mosquito bite prevention remains essential, as does the use of condoms for the rest of the pregnancy. For those planning pregnancy, the same periods of waiting after return (8 weeks for a woman and 6 months for a man) apply. However, not having to abide by such strict restrictions if travellers are not in these categories will help in our consultations. Many of the guidance documents have been updated including the mosquito bite prevention advice leaflet. The collection can be accessed via www.janechiodini.co.uk/home/hot-news/
RABIES GUIDANCE
Advice for pre exposure immunisation (PrEP) for those at occupational risk of rabies or for post exposure assessment for potential treatment, are not directly ‘travel health’ topics but will be consultations you may need to address in general practice. All requests for Rabies PrEP for occupational groups now need to be directed to the RIGS service via email but have to be sent via an nhs.net e mail account. If this isn’t possible then the request must be encrypted.3 The August Vaccine Update had a good recap, on the information required to undertake a post exposure rabies risk assessment plus additional links.4
TRAVAX CHANGES
A new mobile responsive and bright looking website is being tested out on a Beta site just now alongside the usual website. I would urge you, if you are a TRAVAX user, to go into the new site and have a test before it is fully launched. It’s easy to use, very intuitive and the home page highlights key important topics of the moment. The ‘suitcase’ features have been enhanced, including a feature where you can personalise a message to your travellers when you send them information. https://travax-beta.scot.nhs.uk/login. TRAVAX has also republished its very helpful Schools Guidance document and this can be found on their site but also on fitfortravel on the school groups page or directly at www.fitfortravel.nhs.uk/media/670039/travel-health-guidance-for-schools-final-aug-2017_alt-2-.pdf
…And finally
I’ve also had my website (www.janechiodini.co.uk) updated to a mobile responsive version. I’ve changed very little of the format but like the new rotating images on the home page. This and all the topics in this update will be covered in more detail at my upcoming joint roadshows with the RCN as detailed opposite, and in response to demand, I’ve added a new independent date for 12 October in Edinburgh – see janechiodini.co.uk/education/update/. I hope to see you there!
References
1. Public Health England.]Malaria imported into the United Kingdom: 2016. Implications for those advising travellers. www.gov.uk/government/publications/malaria-in-the-uk-annual-report
2. NaTHNaC. Zika virus update, 2017. https://travelhealthpro.org.uk/news/4/zika-virus--update-and-advice-for-travellers
3. Public Health England. Rabies: guidelines for requesting pre-exposure prophylaxis, August 2017. www.gov.uk/government/publications/rabies-pre-exposure-prophylaxis-guidelines
4. Public Health England. Vaccine update Issue 269 August 2017. www.gov.uk/government/publications/vaccine-update-issue-269-august-2017