Travel health update

In this month's update: Ebola - advice for practices and travellers; Oral typhoid vaccine; Yellow fever, polio and International Certificate(s) of Vaccination or Prophylaxis; Malaria Matters - e-learning 

EBOLA UPDATE

Ebola remains – understandably – high profile in the news and increasing volumes of resources have become available. Public Health England has published a webpage, which includes a very important guidance document entitled ‘Ebola virus disease: managing patients who require assessment in primary care’. This is important as our practices may well be a first contact for travellers returning from high risk destinations. The document describes the process that should happen in a primary care setting and this needs to be brought to the attention of all clinical staff enabling an individual practice process to be discussed. With the risk of malaria and currently Middle East Respiratory Syndrome - Coronavirus (MERS CoV) also important in returning travellers, reception staff also need to be aware of the important role they would play. A public awareness poster is also available within these resources:see https://www.gov.uk/government/collections/ebola-virus-disease-clinical-management-and-guidance. Sensible advice for our travellers is available at: http://www.nhs.uk/Conditions/ebola-virus/Pages/Travel.aspx

ORAL TYPHOID VACCINE

The ‘Green Book’ chapter for typhoid has been updated. The main change relates to the oral typhoid vaccine Ty21a (or Vivotif). An optimal immune response may not occur unless all three vaccine capsules in the course are completed and protection commences about seven to ten days after the third dose of the course. A booster of three doses is now recommended every three years instead of the previous recommendation of annual boosters for those travelling intermittently to a typhoid endemic area. See http://tinyurl.com/brnvh9y

YELLOW FEVER, POLIO AND ICVP

Proof of polio vaccination has currently to be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) for travel of trips longer than 4 weeks to the polio exporting countries. At the current time these are Cameroon, Equatorial Guinea, Pakistan and the Syrian Arab Republic. For some travellers this means there will be a need to have an ICVP for two different diseases, one for polio and a separate ICVP for yellow fever. In NaTHNaC’s opinion, writing more than one disease in the appropriate section of the ICVP could result in the certificate being challenged and is not therefore recommended. The FAQ document at https://www.nathnac.org/pro/documents/FAQ_polio_icvp.pdf has been updated to reflect this advice.

MALARIA MATTERS

This is an e-learning course based on ‘Guidelines for malaria prevention in travellers from the UK 2014’ which I have recently finished updating and working with an e learning developer to produce. The course comprises 5 modules of learning, with assessment questions throughout, which if passed results in a certificate of completion. The course uses a variety of learning materials including videos and simulated case studies, fully referenced and includes useful resources that can be downloaded during the course. Completion for someone new to the subject is estimated at 6 hours of learning. The course is currently free of charge but please only consider undertaking it if you plan to complete. A limited number of people can undertake the training each month. If you register then fail to finish, you may have deprived someone else of the opportunity. For more details see http://www.janechiodini.co.uk/education/malaria/

EHIC UPDATE

The NHS Choices website page for the European Health Insurance Card (EHIC) at http://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/about-the-ehic.aspx was updated towards the end of September. I discovered a smartphone app for the EHIC which provides a portable guide on how to use the EHIC in 24 different languages. New EHIC rules came into place in July 2014. You can no longer be reimbursed for co-payments once you go back to the UK. A link to the EHIC Facebook page provides a great facility for travellers who may have queries. From there, I found a new FCO video entitled ‘Moving to Spain? Think about healthcare!’ In this situation the EHIC will not provide cover, the person moving must register for healthcare on arrival.

See http://tinyurl.com/nwy9lv5.