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.

It should be noted that the risk rating for Austria, Hong Kong, Luxembourg and Spain was upgraded in the week commencing 27 July 2020, reflecting an increase of cases in these countries.

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 
• the fitfortravel COVID-19 health considerations for travel page 
• physical distancing and hygiene measures in the country you are visiting

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

During the West Nile virus transmission season, which usually runs from June to November, the European Centre for Disease Prevention and Control (ECDC) monitors the occurrence of infection in the EU/EEA and EU neighbouring countries.

Between 17 and 23 July 2020, EU member states reported six human cases, all in Greece. All cases were reported in areas that have been affected during previous transmission seasons. No human cases were reported from EU neighbouring countries. As of 23 July 2020, no outbreaks among equids or birds have been reported.

Sources: ECDC, 24 July 2020 and ECDC, 24 July 2020

According to new estimates from the World Health Organization (WHO), the proportion of children under the age of five who are chronically infected with hepatitis B (HBV) dropped to just under 1% in 2019. This figure is down from around 5% in the pre-vaccine era, the period between the 1980s and the early 2000s, and marks the achievement of one of the milestone targets to eliminate viral hepatitis in the UN’s Sustainable Development Goals (SDGs).

The WHO is calling for further action to build on this achievement through intensified efforts to prevent mother-to-child transmission of HBV. Their recommendations include the testing of pregnant women and the provision of antiviral prophylaxis to those who need it, and maintaining and expanding access to hepatitis B immunization and birth dose vaccine.

Globally, more than 250 million people are living with chronic HBV infection. Infants are especially vulnerable and around 90% of children infected with HBV in their first year of life become chronic HBV carriers. HBV attacks the liver and claims the lives of nearly 900,000 people each year.

Source: WHO, 27 July 2020

Excessive consumption of salt, more than around 5g per day, may raise blood pressure, which is a major risk factor in cardiovascular diseases such as heart disease and stroke. The World Health Organization (WHO) report that many countries in Europe have initiated national salt reduction strategies, including public awareness campaigns, reformulation and front-of-pack nutrition labelling. However, despite these ongoing efforts, surveillance data indicate that salt intake still exceeds the limits recommended to protect health.

The WHO Regional Office for Europe has produced a country support package, which aims to support the development of effective national salt reduction programmes and surveillance collection. Countries throughout the region can use this document to either accelerate existing efforts to reduce salt intake, or begin new policies and interventions.

Source: WHO European Region, July 2020

The European Food Safety Authority (EFSA) has analysed the available scientific evidence on bee mortality, as part of its ongoing review of the guidance for assessing risks to bees from pesticides. Their report is based on the largest systematic collection of evidence on mortality rates ever carried out, and covers three bee groups, honey bees, bumble bees and solitary bees.

The EFSA report aims to strengthen existing knowledge by adopting a more systematic approach than used previously, and widening the scope of the analysis beyond mortality of forager bees.

The main sources of information were a systematic literature review and a survey of beekeepers from several EU countries. Following consultations and workshops involving risk managers from member states and the European Commission, EFSA’s working group has also proposed four possible approaches to defining the specific protection goals (SPGs) that will be used in the guidance review. Risk managers will now decide which approach EFSA should use.

Source: EFSA, 28 July 2020

A report published by the Food Standards Agency (FSA) has found it is not possible to compare foodborne disease rates effectively between countries. This is due to the hugely different methodologies and recording systems employed. Researchers compared the ways different countries estimate how many people suffer from food poisoning each year, in an effort to determine whether these rates can be reliably compared.

The study, commissioned by the FSA and carried out by Public Health England (PHE), uncovered three broad approaches used globally: 

• Prospective cohort studies – a sample population is recruited in advance, then report weekly on any symptoms of illness and submit samples so specific causes can be determined. 
• Surveillance pyramid studies – an estimation of the number of cases missed through under-diagnosis and under-reporting, by using multipliers to extrapolate from laboratory confirmed illnesses. 
• Retrospective cross-sectional surveys – a representative sample of the population is contacted and asked about their symptoms in the recent past.

Countries need to calculate foodborne disease estimates due to under-reporting, as not everyone who suffers from infectious intestinal disease will seek medical help and those who do will not always get a confirmed diagnosis. The data can then inform a country’s own food policy and prioritisation of resources.

Researchers concluded that the UK is using the most accurate approach available (prospective cohort studies).

Source: FSA, 30 July 2020