Travel restrictions and self-isolation (quarantine) rules have been implemented across the UK since the start of the coronavirus pandemic in March 2020, in order to reduce the spread of COVID-19 and protect the health of the public.

Since 15th February 2021, travellers arriving directly into Scotland from any country outside the Common Travel Area (UK, Ireland, Isle of Man and Channel Islands) must quarantine for ten days and have a valid Managed Quarantine Facility booked prior to their departure, unless they have an exemption. More detailed information for travellers arriving in Scotland is available on the Scottish Government website.

The rules between each of the UK four nation countries vary, and travellers should follow the rules both for the UK nation they will be arriving into and their home nation. Further information for travellers arriving into England, Wales and Northern Ireland is available.

The Foreign, Commonwealth & Development Office (FCDO) provides guidance on travelling abroad, including the latest information on COVID-19 and other non-COVID-19 risks such as safety and security, entry requirements, and travel warnings. This guidance is being kept under constant review and may change at short notice.

Country specific COVID-19 risk

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. This risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country and is regularly reviewed.

From 4 March 2021, the COVID-19 risk for UK travellers has been increased in Norway.

Advice for travellers

Before planning or booking international travel, travellers should consider if their journey is essential and legally permitted.  The following sources should be consulted both prior to travel and during the trip, as guidance may change at short notice: 

• the FCDO 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 fitfortravel COVID-19 health considerations for travel page
• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• requirements for COVID-19 testing at their destination prior to return to the UK

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the 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, 15 February 2021

The Democratic Republic of the Congo (DRC) and Guinea have declared new outbreaks of Ebola virus disease (EVD).

The DRC confirmed a new case in North Kivu Province on 7 February 2021. As of 1 March 2021, there have been 11 confirmed cases and four deaths reported by the DRC Ministry of Health, with all confirmed cases reported so far located in the North Kivu province.

Health authorities in Guinea declared an Ebola outbreak in N’Zérékoré region on 14 February 2021, which is the first time EVD has been reported in Guinea since the end of the 2014 to 2016 West Africa Ebola outbreak. The Ministry of Health of Guinea have reported that, as of 2 March 2021, there have been 13 confirmed cases and four probable cases associated with this outbreak.

The World Health Organization (WHO) is supporting Guinea with surveillance, infection prevention and control of health facilities, local community engagement and Ebola vaccine procurement.

Advice for travellers 

• EVD is a type of viral haemorrhagic fever (VHF) and the risk to travellers becoming infected or developing EBV is extremely low. 
• Travellers to known Ebola outbreak areas must be made aware of the risk of infection and transmission routes of Ebola virus. 
• Medical personnel travelling to work in an outbreak region must follow strict infection prevention control guidance. 
• Travellers returning from an Ebola outbreak area should seek rapid medical attention by contacting NHS 24 (Scotland) or NHS 111 (rest of UK) for advice prior to attending UK medical facilities if they develop fever and have: 
  • returned to the UK within 21 days from a region or area with a known outbreak of EBV 
  • contacted individuals infected with a VHF

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

Sources: TRAVAX, 5 March 2021 and TRAVAX, 5 March 2021

The World Health Organization (WHO) has published a series of products on human T-lymphotropic virus type 1 (HTLV-1), aimed at drawing attention to the virus through a global public health approach. The HTLV-1 technical report, fact sheet and meeting report have been published following consultations undertaken by the WHO with member states and partners over the past year.

HTLV-1 is a retrovirus which causes a chronic lifelong infection in humans, with transmission occurring through breast feeding, sexual contact and blood transfusions and is similar to the HIV virus. HTLV-1 causes a range of clinical syndromes, with the most common being adult T-cell leukaemia (ATL) and HTLV-1 associated myelopathy or total spastic paraparesis (HAM/TSP). As of 2012, estimates suggest between five to ten million people worldwide are living with HTLV-1 infection, with prevalence being particularly high in parts of Japan, Australia and the Pacific islands.

Source: WHO, 3 March 2021

From November 2019 to January 2021, the US Centers for Disease Control and Prevention (CDC) reported nine cases of extensively drug-resistant (XDR) Salmonella typhi (S. typhi) infections, with no link to international travel. Annually in the USA, there are approximately 350 diagnosed cases of typhoid fever.

Advice for travellers

Typhoid is an illness caused by infection with the bacteria S. typhi, and is spread by consuming food and drink that has been contaminated with human faeces or urine (faecal-oral route). As with all illnesses spread by the faecal-oral route, travellers are advised that the following food and water precautions should be taken: 

• Avoid consumption of potentially contaminated drinks. 
• Ensure food is uncontaminated and cooked thoroughly. 
• Practice personal hygiene when eating and drinking, such as washing hands prior to eating and using clean plates, cups and utensils.

When to consider vaccination

Typhoid vaccination recommendations are country-specific and are available on the individual country pages on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

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

Source: TRAVAX, 4 March 2021

The European Centre for Disease Prevention and Control (ECDC) has published an overview of avian influenza for the period December 2020 to February 2021. Between 8 December 2020 and 23 February 2021, 1,022 highly pathogenic avian influenza (HPAI) virus detections were reported in 25 EU/EEA countries and the UK, in poultry, wild and captive birds.

In major findings from the overview: 

• France had the greatest number of detections, with 442 outbreaks in poultry, mostly located in the Landes region and affecting the foie gras production industry, and six wild bird detections. 
• Germany reported 207 detections in wild birds and 50 poultry outbreaks. 
• Denmark reported 63 detections in wild birds and one poultry outbreak. 
• Poland reported 37 poultry outbreaks and 24 wild bird detections.

Seven human cases due to A(H5N8) HPAI virus have been reported from Russia, in all cases poultry workers with mild or no symptoms (see 55/0902), while five human cases due to A(H5N6) HPAI and 10 cases due to A(H9N2) LPAI viruses have been reported from China.

The risk to the general population as well as travel-related imported human cases is assessed as very low and the risk to occupationally exposed people is assessed as low. Any human infections with avian influenza viruses are notifiable within 24 hours through the Early Warning and Response System (EWRS) and the International Health Regulations (IHR) notification system.

Source: ECDC, 26 February 2021

The European Centre for Disease Prevention and Control (ECDC) has published its annual epidemiological report for Q fever in 2019.

For 2019, 1,069 cases of Q fever were reported in the EU/EEA, 958 (90%) of which were confirmed. The EU/EEA notification rate for 2019 was 0.2 cases per 100,000 of the population.

Source: ECDC, 26 February 2021

The European Food Safety Authority (EFSA) has published surveillance strategies that will help countries affected by African swine fever (ASF), determining when the virus stopped circulating among their wild boar populations, and developing exit strategies from ASF for these countries.

The publication recommends that such an exit strategy comprises of two phases, these being a period of routine surveillance of wild boar (the screening phase) followed by a shorter period of intense surveillance (the confirmation phase).

Modelling has demonstrated that: 

• the accuracy of the approach rises in line with the number of wild boar carcasses collected and tested 
• lengthening the monitoring period increases the chances of verifying that the ASF virus is no longer circulating 
• the use of active surveillance based on hunting has limited impact on the effectiveness of the exit strategy

The publication gives practical examples of how to apply the exit strategy to both large and small affected areas, and also recommends the minimum monitoring periods needed to make the strategy effective.

Source: EFSA. 3 March 2021