On 4 July 2020, the Foreign & Commonwealth Office (FCO) updated its global advisory against all but essential travel, exempting some countries that no longer pose an unacceptably high risk for British travellers against coronavirus (COVID-19).

The fitfortravel (for the general public) and TRAVAX (for health professionals) country pages have been updated to include a COVID-19 country specific risk-rating, with every country being identified as high, moderate or low risk and each rating accompanied by appropriate travel advice. This information will be listed in the ‘Alerts’ section on each country page of fitfortravel and the 'Emerging Health Risks' section of every TRAVAX country page. The risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country, and will be regularly reviewed. However, as the global spread of COVID-19 can change at any time, travellers are advised to consider the advice below before planning international travel.

Advice for travellers

Before planning and/or booking international travel, please check: 

• the Foreign & Commonwealth Office (FCO) website, for country specific Travel Advisory Notices regarding travel and entry restrictions, and review the local medical care available at your destination 
• the COVID-19 risk-rating at your destination, which will be listed in the ‘Alerts’ section of all fitfortravel country pages and the ‘Emerging Health Risks’ section of all TRAVAX country pages 
• the TRAVAX travel insurance page, as such insurance should be considered essential 
• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• physical distancing and hygiene measures in the country you are visiting

All travellers are encouraged to peruse the fitfortravel COVID-19 health considerations for travel page.

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the general public) websites.

Information on COVID-19 for the general public is available on the NHS Inform (Scotland) and the NHS.UK (rest of the UK) websites.

Information and resources on COVID-19 for health professionals is available on the Health Protection Scotland (HPS) (Scotland) and Public Health England (PHE) (rest of the UK) websites.

Source: TRAVAX, 7 July 2020

On 12 July 2020, the Ministry of Health for the Democratic Republic of the Congo (DRC) reported another death from Ebola virus disease (EVD) in the north of the country. The outbreak was first reported in Equateur Province on 1 June 2020, and currently affects six health zones in the province. Since the beginning of the outbreak, there have been 49 recorded cases, including 20 deaths.

Advice for travellers

When Ebola outbreaks occur, generally the risk of travellers becoming infected or developing EVD is extremely low.

Travellers returning from an EVD outbreak area should seek rapid medical attention if they develop flu-like symptoms, such as fever, headache, diarrhoea or general malaise, within 21 days after return. They should call NHS24 (Scotland) or NHS111 (England and Wales) or contact their GP by telephone. While EVD infection is unlikely, the returning traveller should mention any potential exposure to the virus including dates and itinerary of travel.

Further information and advice is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 15 July 2020

The European Centre for Disease Prevention and Control (ECDC) has published its annual zoonotic influenza epidemiological report for 2019.

The key findings of the report are: 

• no human cases of avian influenza were reported in the EU/EEA 
• one human A(H5N1) and another A(H7N9) infection were reported from mainland China 
• sporadic human cases of avian influenza A(H5N6) and A(H9N2) were reported 
• outbreaks and detections of highly pathogenic avian influenza viruses such as A(H5N1), A(H5N2), AH(H5N5), A(H5N6) or A(H5N8) continued to affect poultry, wild and captured birds worldwide, while influenza virus A(H1N1)v of swine origin caused two human cases, one in the USA and one in China

Source: ECDC, 13 July 2020

The European Centre for Disease Prevention and Control (ECDC) has published a threat assessment brief concerning Eurasian avian-like A(H1N1) swine influenza viruses. The 2009 pandemic was the latest of several pandemics caused by a swine-origin influenza virus.

The ECDC assessment reports that a study conducted between 2011 and 2018 in China, based on surveillance data in pigs, identified an emerging genotype 4 (G4) reassortant Eurasian avian-like (EA) A(H1N1) swine influenza virus, which contains internal genes from the human A(H1N1)pdm09 and North American triple-reassortant (TR) lineage-derived internal genes. This virus demonstrated the ability to replicate in human epithelial cells, and can spread through respiratory droplets between ferrets. Antisera against seasonal human A(H1N1)pdm09 virus showed poor reactivity with G4 viruses. In the same study, a subsequent serosurvey found that 10% (35/338) of swine farm workers tested positive for this G4 EA A(H1N1) virus, with a higher proportion being among people aged between 18 and 35 years of age.

Source: ECDC, 13 July 2020

According to data collected by the World Health Organization (WHO) and UNICEF, there has been a substantial decline in the number of children receiving vaccines around the world.  This is due to disruptions in the delivery and uptake of immunisation services caused by the COVID-19 pandemic.

The latest data on vaccine coverage estimates from the WHO and UNICEF shows that improvements  made in recent times, such as the expansion of the HPV vaccine to 106 countries, and greater protection for children against more diseases, are in danger of lapsing. For example, preliminary data for the first four months of 2020 points to a substantial drop in the number of children completing three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3). This is the first time in 28 years that a worldwide reduction may be seen in DTP3 coverage, the marker for immunisation coverage within and across countries.

Source: WHO, 15 July 2020

Some nutrients are regulated under different legal frameworks for use in products such as food additives and pesticides. The European Food Safety Authority (EFSA) has launched a draft approach for public consultation, which aims to integrate and harmonise how EFSA’s scientists assess the intake of these substances. 

Intake of nutrients is generally positive and, in many cases, essential for human and animal health, but an excessive intake of some nutrients could raise health concerns. Risk assessors set Health-Based Guidance Values (HBGVs), a threshold value to indicate how much of a substance, including nutrients, is safe for people and animals. Decision-makers use the HBGVs to help them determine how much of a substance is permitted in regulated products, such as food additives and pesticides.

The draft approach aims to harmonise assessments of the intake of these nutrients, the potentially hazardous properties of excessive intakes, and the overall risks for consumers. The public consultation runs from 15 July to 15 September 2020, and interested parties are invited to submit written comments using the electronic template provided.

Source: EFSA, 15 July 2020