Keeping up to date with seasonal matters like travel health can be a challenge. Dawn Gay looks at the latest travel trends and resources for pharmacy teams

Thousands of Muslims disperse after prayer at Masjid al-Haram mosque in Mecca, destination of the Hajj pilgrimage

 

Over a third of British holidaymakers are choosing new destinations, according to ABTA’s Travel Trends 2015 Report, making it increasingly difficult to stay abreast of global travel health requirements.

Michael Vibert, head of consular communications at the Foreign and Commonwealth Office (FCO), says: “With many travellers set to visit unfamiliar destinations and fit in as many activities as possible, it’s more important than ever to plan and prepare fully”.

Simple steps such as checking the FCO travel advice, taking out comprehensive travel insurance, and researching the country and health risks can help to ensure that a holiday is one to remember for all the right reasons.

ABTA spokesperson Sean Tipton says that pharmacists are ideally positioned to give travellers the correct advice about diseases that are causing concern. “The world is becoming increasingly a more accessible place and many consumers are concerned about reported outbreaks of ebola, malaria and dengue fever, so pharmacists may find them themselves in the position of having to update and increase their travel health knowledge extensively.”

We shouldn’t just be worrying about mosquitoes; diseases are caused by many other insects too

Hajj and Umrah

Around two million Muslims descend on Mecca every year for the annual Hajj pilgrimage, while the shorter Umrah pilgrimage can be undertaken at any time of year. This year, the Hajj takes place from September 21-26 and community pharmacists may be asked for vaccine advice. Pilgrims taking part in Hajj and Umrah must provide proof of vaccination against meningococcal meningitis ACW135Y to gain their entry visa for Saudi Arabia.

NaTHNaC publishes the latest vaccine information for health professionals advising about Hajj and Umrah on its website. Specific travel health advice concerning Saudi Arabia can be found on the FCO website at www.gov.uk/foreign- travel-advice.

Since Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012, the World Health Organisation has reported 971 laboratory confirmed cases (as of February 5) and around 356 deaths. But the WHO reports that cases in Saudi Arabia and UAE had decreased sharply by June 2014. WHO and NaTHNaC continue to publish outbreak news and summaries of the current situation.

Insect bites

It is important that pharmacists provide advice about malaria prophylaxis, but these days it's not the only serious disease caused by insect bites – and mosquitoes are not the only disease-carrying insects. Mr Tipton explains: “Malaria is one of the world’s most worrying health problems, responsible for thousands of deaths and serious illnesses each year. However, two less well-known diseases transmitted by mosquitoes are the chikungunya virus and dengue fever; these also cause unpleasant symptoms, which on occasion can be fatal.”

There is no vaccine to protect against dengue fever or chikungunya virus but travellers can reduce their risk of infection by practising strict insect bite avoidance. Travellers should wear appropriate clothing, use a DEET insect repellent and check the online Foreign Office travel advice and NaTHNaC website for the most up-to-date information.

Howard Carter, CEO of insect repellent brand incognito, predicts that many mosquito-borne diseases will be on the increase this year due to drug, pesticide and insecticide resistance, climate change, deteriorating health systems, armed conflict and natural disasters. He says: “We shouldn’t just be worrying about mosquitoes; diseases are caused by many other insects too, such as 20,000 different species of wasp, ticks, tsetse fly, hornets and fleas, all of which can all cause serious problems for humans.”

Anthisan Bite and Sting Cream has been a household holiday essential, soothing bites and stings, for over 50 years. But it now has a new sister product, Anthisan Citronella Patches. The self-adhesive strips release citronella fragrance to a 50cm radius over a 12-hour period to deter biting insects.

Incognito has significantly expanded its 100 per cent natural insect repellent range since 2012. The range now includes a roll- on (launched in May 2014), spray, soaps and hair and body wash that reduce attractiveness to insects and contain a citrus moisturiser. They have also added chemical insect sticks and organic java citronella oil, which can be diffused, dropped onto clothes, or diluted and applied to the skin.

Zap-Ease, a gadget for clicking on a bite to localise the poison and inhibit histamine release, was launched in 2014. The range is being backed by national PR and advertising campaigns and point of purchase support for pharmacists.

Ebola virus disease (EVD)

The current outbreak of EVD affects three West African countries – Guinea, Liberia and Sierra Leone. But while it remains a 'low threat' for people outside these countries, there have been calls for increased awareness among community pharmacists. The first UK case was reported on December 29 last year.

Chief medical officer Professor Dame Sally Davies wrote to health professionals in October, outlining an action plan. She wrote: “This message is to remind you of the need to remain vigilant for cases imported to the UK. The recently imported case in the USA has emphasised the importance of taking a full travel history when assessing relevant patients and ensuring that this information is subsequently acted on as part of any EVD clinical assessment."

The Royal Pharmaceutical Society followed suit with 'Ebola advice for community pharmacists', published in the same month, with a guidance letter for pharmacy staff encouraging them to download Public Health England/NHS posters and display them prominently for the public and pharmacy staff.

Countries affected by MERS-CoV

• Middle East: Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, United Arab Emirates and Yemen
• Africa: Algeria and Tunisia
• Europe: Austria, France, Germany, Greece, Italy, The Netherlands, Turkey, UK
• Asia: Malaysia and The Philippines
• North America: USA.
Source: WHO

EVD resources

• Royal Pharmaceutical Society: Ebola advice for pharmacists 
• Pharmacy information posters about ebola
• NaTHNac clinical updates
• The latest clinical management and guidance on the Public Health England website
• WHO information on the latest outbreaks of ebola