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Travel

Travel health

In the 12 months before August 2015 UK residents made 63.7 million visits abroad (Office for National Statistics 2015).

The main reason for travel is holidays, with Europe being the most popular destination. The UK Foreign and Commonwealth Office (FCO) provide advice for travellers, including safety and security issues in individual countries. Nurses should be aware of this advice.

Travel health medicine is a fast growing specialist area of practice. In the UK it is predominantly delivered by nurses. UK travellers of all ages are becoming more adventurous. Some present with illnesses at short notice and some have pre-existing medical conditions. Therefore the art of delivering accurate and current advice to travellers is becoming more complex.

Guidance from the RCN on Travel health nursing: career and competence development defines the standards of care expected for a competent registered nurse, experienced/proficient nurse and a senior practitioner/expert nurse delivering travel health services. 

The RCN is running a survey to gain your views and experience of this guidance document. Whether you have used the document or not, the survey is aimed at all nurses, doctors, pharmacists and other related health care professionals involved in travel health medicine. The results will help us to develop a revised version of the document in 2017. 

See: RCN Travel health competences survey to start our survey.

The survey closes at 11pm on Sunday 4 December 2016. Your responses are anonymous and it should take you no more than 15 minutes to complete. For additional information about the survey, please contact julian.russell@rcn.org.uk

The Faculty of Travel Medicine (FTM) of the Royal College of Physicians and Surgeons of Glasgow (RCPSG) has also produced a position paper, Protecting the health of travellers from the UK and Ireland which acknowledges that injury and illness sustained both during travel and on return, causes a considerable medical and economic burden. High quality pre travel advice can help to mitigate and reduce this risk. The report recognises that the lack of structure and delivery of travel medicine services in the UK and the absence of a formal training pathway to a recognised professional standard needs to be addressed.

Related RCN resources / publications

RCN Library subject guide: Travel Health

RCN public health resource: immunization

Malaria, a preventable but potentially fatal disease, remains an important issue for UK travellers. As a nurse advising travellers, you should make every contact count and use every opportunity to engage, especially with those in vulnerable groups likely to return home to visit family in their country of origin (VFRs).

Resources:

The UK Malaria Report 2015 provides current information on malaria cases imported into the United Kingdom (UK) in 2014

The World Health Organization (WHO) highlights World Malaria Day each year on 25 April

Public Health England (PHE) Advisory Committee on Malaria Prevention (ACMP) released an updated edition of Guidelines for Malaria Prevention in Travellers from the UK 2015 This is an essential tool for nurses advising travellers.

The APPG report on malaria and neglected tropical diseases acknowledges the work of the UK in supporting and strengthening health systems in countries where malaria is endemic and where neglected tropical diseases can be identified and treated.

Zika virus (ZIKV)

On 1 February 2016, the World Health Organisation (WHO) declared that the recent cluster of microcephaly cases and increase in neurological disorders and neonatal malformations reported from Brazil, constituted a Public Health Emergency of International Concern (PHEIC).

With information on Zika virus changing regularly NaTHNaC has posted information for travellers and health professionals. Nurses advising travellers should be aware of the most current information.

The World Health Organisation announces a public health emergency of international concern

Zika virus quick links

Based on epidemiological evidence NaTHNaC has updated information and advice for travellers in October 2016, see: Update and advice for travellers including pregnant women and those planning a pregnancy.

For historical and current epidemiology of the Zika virus infections, including cases in UK travellers, see: Zika virus: epidemiology and cases diagnosed in the UK.

See the RCOG statement and Q&A: Zika virus infection and pregnancy and the interim guidance.

The Royal College of Midwives have also provided guidance on the Zika Virus.

Further information is available from Public Health England:

Zika virus: advice for women returning from areas with active Zika virus transmission

HAIRS risk assessment: Qualitative assessment of the risk that Zika virus presents to the UK population

Health protection & guidance Zika virus


Yellow Fever

NaTHNaC (England Wales and Northern Ireland) and Health Protection Scotland's (HPS) TRAVAX (Scotland) are the designated State Parties for Yellow Fever provision in the UK under the WHO International Health Regulations (IHRs).

These parties have designed a mandatory training programme for designated Yellow Fever Vaccinating Centres (YFVCs). Information is on vaccination regularly updated and it is recommended that nurses remain up to date.

In July 2016, changes came into force regarding the International Health Regulations (IHR) and the duration of protection from the Yellow Fever vaccine. NaTHNaC has posted updated information and published a new HowTo guide on issuing the IHR yellow fever certificate: Getting to grips with the Yellow Fever certificate. This is also freely available on YouTube and iTunes.

NaTHNaC has updated clinical and administrative resources for healthcare professionals running or managing a YFVC, see: NaTHNaC launches the Yellow Fever Zone.

The conditions of Designation and Code of Practice for YFVC have been reviewed, revised and re-formatted.

See also: The NaTHNaC Training Portal.

CDC training the CDC Yellow Book and the World Health Organization's International Travel and Health 2016 updates all contain useful information for nurses on Yellow Fever. NHS Wales users can gain free access to TRAVAX resources via the NHS Wales website Health in Wales

As a nurse, you should stay alert to current information and the possibility of the risk of exposure to other diseases. For travellers returning ill from affected areas a full travel history should be taken before appropriate referral.

The Foreign & Commonwealth Office (FCO)

The FCO is a valuable source of advice for travellers and advisers and produces information on a variety of subjects.

The FCO provides useful pre-travel advice and and how to stay healthy and safe when abroad. See: Travel Aware - staying safe and healthy abroad.

Travel resources, courses and study days

Update from NaTHNaC

The National Travel Health Network and Centre (NaTHNaC) continue to update their website. Recent changes include:

Changes to the Country pages:

  • the ability to download each complete country page to enable viewing offline or printing a hard copy 
  • new antimalarial recommendations have been added for some countries
  • quick access to the country page index

Changes to the World overview:

  • quicker search results
  • multiple outbreaks or for a specific location
  • outbreaks with exact location data
  • search options by day, week, month, 6 month or year

Updated TravelHealthPro eBook:

  • all TravelHealthPro factsheets are contained in one eBook
  • opportunity to subscribe to email alerts for eBook updates

The Faculty of Travel Medicine at the Royal College of Physicians and Surgeons of Glasgow (RCPSG) offers lifelong learning, which includes educational courses and examinations to support travel health professionals throughout their careers. See: Travel medicine. Nurses can also join the FTM as Affiliate Members and benefit from access to publications and reduced fees for conferences.

Other organisations that offer online courses, include:

Forthcoming travel health conferences

Joint RCN and Travel Health Ltd Travel Health Roadshows

Jane Chiodini, Director of Travel Health Training Ltd, has linked with the RCN to provide education for health care professionals practising travel medicine. The roadshows are taking place in:

Stockport NHS Foundation Trust

Immunisation Conference for Health Care Workers 
Friday 2 December 2016

Faculty of Travel Medicine and Scottish Practice Nurse Association Study Day

This educational event is suitable for all healthcare professionals working in travel health
6 December 2016 
Royal College of Physicians and Surgeons of Glasgow 

Update in travel health

A one day course aimed at healthcare professionals already practising travel health. Led by Jane Chiodini 
10 March 2017
UCH Education Centre London

Joint Faculty of Travel Medicine and Royal Pharmaceutical Society Travel Medicine Symposium

This conference has been designed to address the knowledge and skills front-line professionals need to provide up-to-date, quality travel advice
18 March 2017 
RPS London

The International Society of Travel Medicine conference (CISTM15) 

14-18 May 2017 
Barcelona, Spain