This site is intended for Healthcare Professionals only

How to manage football fever

Conditions bookmark icon off

How to manage football fever

The ABTA Travel Trends Report 2014 predicts a big year for the travel industry, namely ‘sports tourism’, with the FIFA World Cup kicking off next month (June 12 to July 13). UK ‘staycations’ are still a popular choice, boosted by renewed national pride after the London 2012 Games and a couple of balmy British summers. But regular flights, new attractions and resorts, and tour operator expansion mean that Brits are booking more long haul trips. As well as Brazil, destinations from Mexico to the Caribbean and South East Asia are increasing in popularity.

With around 5,000 football fans expected to travel to Manaus in Brazil for England’s first game against Italy on June 14, pharmacists need to be on the ball with travel health advice. Travellers are advised to take malaria tablets and get vaccinated against yellow fever and other infectious diseases when travelling to this city in the heart of the Amazon rainforest.

The Foreign and Commonwealth Office (FCO) is already recommending that fans “check out the medical requirements for the destination well in advance”. And the National Travel Health Network and Centre (NaTHNaC) has added a health advice factsheet for travelling fans to its suite of travel resources at www.nathnac.org. Pharmacists can also get up-to-date advice on vaccines, malaria and other health issues on NaTHNaC’s country information web pages for Brazil.

Yellow fever latest

Last summer it was reported that worldwide supplies of the yellow fever vaccine, manufactured by Sanofi Pasteur MSD, were dwindling. This led to concerns that pharmacy yellow fever vaccine centres (YFVCs) would not be able to meet the demands of the World Cup exodus.

The reassuring news is that the single dose vaccine is back in production. Mary Gawthrop, NaTHNaC’s travel health nurse and spokesperson, reports: “There has been a yellow fever vaccine shortage, but NaTHNaC has now been informed by the manufacturer, Sanofi Pasteur MSD, that the single dose vaccine is back in stock. During the vaccine shortage, unlicensed yellow fever vaccine was imported, with permission, under a special licence from the Medicines and Healthcare products Regulatory Agency (MHRA).”

But that’s not all for yellow fever. Pharmacists should be aware of World Health Organisation (WHO) announcements in May 2013 regarding the ‘booster’ dose. Ms Gawthrop explains: “The World Health Organisation Strategic Advisory Group of Experts on immunisation announced that a ‘booster’ dose of yellow fever vaccine, 10 years after the first dose, is not necessary.” Yellow fever vaccination centres in England, Wales and Northern Ireland should continue to administer the vaccine according to current UK guidelines, undertaking an individual risk assessment and taking into account requirements for International Certificate of Vaccination or Prophylaxis. NaTHNaC is awaiting guidance from both WHO and the Joint Committee on Vaccination and Immunisation, and will post further information as this becomes available.

Pharmacies in England, Wales and Northern Ireland can register as designated YFVCs through NaTHNaC. As part of their application, pharmacists must attend NaTHNaC sponsored yellow fever training, which provides theoretical knowledge and an understanding of the disease and vaccination. More information about the training is available on the NaTHNaC website.

Travel clinics one year on

In-pharmacy travel clinics have proven an increasingly popular sideline for community pharmacists. Healthcare service providers like PharmaDoctor continue to equip pharmacists with training and patient group directions (PGDs) needed to supply travel vaccines and malaria prophylaxis.

PharmaDoctor now boasts around 250 ‘full’ travel clinics, which have proven to be profit- making, with returns of up to £70 per consultation. Managing director of PharmaDoctor Mike Bereza does the maths. “The average profit is £72 per consultation and each lasts between five to 10 minutes, or can be longer. Most of our established pharmacies are doing five to six consultations per day.”

PharmaDoctor also helps pharmacies become yellow fever centres via NaTHNaC.

“We liaise with pharmacists, help them fill out the forms and guide them through the whole process,” adds Mr Bereza.

PharmaDoctor now sells its package through third parties, like the NPA, which sources new clients. Leyla Hannbeck, head of pharmacy services at the NPA, explains: “The NPA is an agent delivering the travel clinic package and core PGD service to community pharmacists. We have a team of professionals at the NPA and we know what PGDs are robust. We make sure that PGDs are out there and are core to our pharmacists.”

“People are seeing the benefit of pharmacists being at the centre of a travel package. Travel clinics are best placed in the pharmaceutical environment. We want to see the pharmaceutical profession progress and pharmacists to be able to do what they do best. These services are the future,” she adds.

Travel health news from NaTHNaC

NaTHNaC’s travel health nurse Mary Gawthrop updates pharmacists with other developments in travel health.

Recognising chikungunya fever

NaTHNaC reports that this lesser known, ‘fluey’ illness spread by day-biting mosquitoes is becoming more prevalent at some popular holiday destinations. It is not a risk in the UK, but is present in parts of Africa, Asia and the Indian Ocean Islands. Since December 2013, cases have also been reported on many islands in the Caribbean. There is no vaccine or medication to prevent chikungunya fever, so pharmacists should advise travellers to reduce their risk by following insect bite avoidance measures, including applying insect repellents containing 50 per cent DEET frequently during the day.

India is declared polio-free

In January, the WHO announced that India, once the largest endemic reservoir of polio in the world, has been free of the wild polio virus for three years. NaTHNaC recommends that all travellers, independent of destination, should complete a primary vaccination course for polio according to the UK schedule. Travellers to countries reporting wild polio virus since January 2010, including travellers to India, should receive a booster dose of polio vaccine if they have not had a dose in the past 10 years.

Updated malaria guidelines

Pharmacists advising travellers on malaria prevention should make sure they are up-to-date with the latest guidelines. On August 22, 2013, Public Health England published updated guidelines on malaria prevention for travellers. These guidelines are for use by health professionals who advise travellers and can be accessed via Public Health England’s website at www.hpa.org.uk.

Middle East respiratory syndrome coronavirus (MERS-CoV)

A small number of cases of MERS-CoV have been reported in some countries in the Middle East and in travellers returning from the Middle East to France, Germany, Italy, Tunisia and the UK. This infection can cause severe illness. However, the risk of contracting MERS-CoV during travel is very low. A WHO report indicates that animals could be a possible source of infection; however the virus reservoir remains unknown. Travellers at high risk of severe disease due to MERS-CoV (such as immunosuppressed individuals and those with underlying respiratory or cardiac conditions) should avoid farms or barns where the virus is known to be potentially circulating. Any travellers visiting a farm or a barn should follow good general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals and ensuring good personal and food hygiene.” </box>

Brian Isaacs, a pharmacist, travel consultant and yellow fever co-ordinator at Barnet Travel Clinic, opened the travel clinic just over a year ago and holds around 20 consultations per week. He says: “It’s been a great success in so far as we are established in the local GP surgery and we provide travel vaccinations and anti-malarial advice. There’s a lot of training involved to keep up with individual diseases and making sure we fall within PGD categories.”

MASTA has provided a travel service since June 2011, training more than 350 pharmacists. MASTA travel nurses work alongside participating community pharmacies. Colin Watson, managing director at MASTA, explains: “The MASTA pharmacy travel health service uses a combination of a MASTA nurse conducting a telephone risk assessment and producing a vaccine plan for the traveller, who then chooses a participating pharmacy for the vaccines and anti-malarials to be administered by a pharmacist.” This allows a consistent and high-quality risk assessment to be delivered by a travel health trained nurse, while giving the flexibility of visiting a local pharmacy at a convenient time for vaccinations, says Mr Watson. It also avoids pharmacists getting involved in lengthy and sometimes complicated travel health risk assessments.

Travel health product update

A November 2013 survey conducted by Atomik Research on behalf of Nelsons found that two in 10 Brits blamed their car for most causes of family sickness.

Their travel sickness treatment Nelsons Travella contains a blend of seven homeopathic treatments. Brand manager Alessandra Godio says: “Nelsons Travella, a combination of several homeopathic remedies, helps bring relief from the unpleasant symptoms associated with travel sickness. It is suitable for all the family and is non-drowsy. As consumers are becoming increasingly open to exploring natural and homeopathic treatments on offer, we are confident that more consumers will try this product.”

Local pharmacists are seeing an increase in prevention rather than cures for tummy bugs and traveller’s diarrhoea with preventative products such probiotics and prebiotocs. Public Health England reports that as many as 60 per cent of travellers visiting low-income destinations are affected by traveller’s diarrhoea and around 50,000 instances are reported daily.

For Travelling Abroad, by Optibac Probiotics, contains the probiotocs L acidophilus and S boulardii. Jalal Janmohamed, director at OptiBac Probiotics, says: “There’s an increased awareness about natural supplements such as probiotics. People are also more open these days, perhaps largely thanks to the anonymity of the internet – and happy to share their experience of digestive upsets (and how to prevent them) on sites such as TripAdvisor. Probiotics are being recognised as a natural, safe and effective way of preventing stomach upsets when travelling abroad.”

Clasado’s Bimuno Travelaid pastilles contain the prebiotic galacto-oligosaccharides to prevent traveller’s diarrhoea, which can be taken seven days before travel and for the duration of the trip. Geoff Collins, Clasado’s head of consumer marketing, says: “Customers who travel provide an additional commercial opportunity for pharmacists through recommending suitable methods of protection and prevention. Such a high level of service will undoubtedly foster loyalty and recommendation to other prospective customers.”

Copy Link copy link button

Conditions

Share: