Travel restrictions and self-isolation (quarantine) rules continue to be enforced in order to help reduce the global spread of COVID-19 and protect the health of the UK public. Within the UK, information on the easing of coronavirus restrictions has been published for Scotland, England, Wales and Northern Ireland.

A cautious approach to resuming international travel has been underway for people living in Scotland, England, Wales and Northern Ireland since late spring 2021. Travelling abroad carries a risk of bringing new cases and variants of COVID-19 back into the UK, therefore travellers are still advised to consider whether their trip abroad is necessary before booking travel. The Foreign, Commonwealth & Development Office (FCDO) continue to advise against non-essential international travel to some countries, and further advise against cruise ship travel.

A traffic light system which categorises countries on to a red, amber or green list, based on their COVID-19 risk, is in place for travellers arriving into the UK. It should be noted that the traffic light system does not indicate which countries are currently allowing UK travellers to enter their country.

Currently, anyone entering Scotland from countries on the international travel green list will not be required to quarantine on arrival, but will have to take a PCR test for COVID-19 and complete a passenger locator form. On 19 July 2021, Scotland, England and Wales updated their rules for returning to the UK from amber list countries, while Northern Ireland has also announced rule changes, to come into effect on 26 July 2021.

On return to the UK, travellers should be aware that testing and quarantine rules differ for Scotland, England, Wales and Northern Ireland. Prior to their journey, travellers must ensure they are able to comply with the rules appropriate to the UK nation they will be arriving in and reside in, if different.

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.

Advice for travellers

Prior to booking any international travel, travellers must first check if the country they are travelling to is currently accepting UK travellers. 

• Each country or territory on the FCDO foreign travel advice page provides up-to-date information on their entry rules, in response to coronavirus (COVID-19), under the ‘Entry Requirements’ section. 
• Travellers should be aware that some countries or territories may require proof of COVID-19 vaccination status for entry. Guidance for demonstrating COVID-19 vaccination status is available for those living in Scotland, England, Wales and Northern Ireland.

It is advised that travellers are aware of all travel restrictions, self-isolation rules and precautions they should take, in order to reduce their risk of exposure to coronavirus (COVID-19) before, during and after travel, as detailed on the fitfortravel website.

Sources: TRAVAX, 30 June 2021 and TRAVAX, 15 July 2021

In the first week of July, the European Centre for Disease Prevention and Control (ECDC) reported a case of West Nile virus (WNV) in La Spezia, north-west Italy, the first time a human case of WNV has been recorded in this province.

Advice for travellers 

• there is no vaccine against WNV 
• mosquito bite avoidance should be practiced at all times, especially during peak transmission times and when outbreaks are known to be occurring 
• medical advice should be sought if symptoms develop, following travel to a risk area 
• blood donors should note that if they have travelled to an area where WNV has been detected in the past four months, they may need to be tested for the virus before donating blood. The Scottish National Blood Transfusion Service can be contacted for further details

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

Source: TRAVAX, 12 July 2021

According to media reports, public health officials in Colorado, USA, have reported the death of a ten-year-old child from plague in the Durango area in early July 2021. This is the first death from plague in Colorado since 2015, however, the disease is known to be present in wildlife within the state.

The World Health Organization (WHO) reports a continuing outbreak of plague in the north-east of the Democratic Republic of the Congo (DRC). From 22 April to 13 June 2021, 37 suspected pneumonic plague cases, including 12 deaths, were recorded in Fataki health zone, Ituri province. Plague is endemic in Ituri province, but has not been seen in Fataki health zone for more than ten years. Plague also continues to be recorded in other parts of Ituri province this year.

Plague is a severe bacterial infection which spreads to humans mainly by the bite of infected fleas, or from close contact with infected animals.

Advice for travellers

Plague is rare in international travellers, with the risk highest in those who come into close contact with local wildlife, particularly rats or other rodents.

Travellers should be advised to: 

• practice good insect bite avoidance 
• avoid close contact with sick or dead animals 
• avoid crowded areas in regions where pneumonic plague has recently been reported 
• seek prompt medical attention if they develop symptoms and there is a risk they may have been exposed to plague

Further information and advice on plague is available on the TRAVAX website (for health professionals).

Sources: TRAVAX, 12 July 2021 and TRAVAX, 15 July 2021

On 4 July 2021, the World Health Organization (WHO) reported two cases of Lassa fever since May 2021 in Guinea. The first case, in Yomou prefecture, was confirmed on 8 May 2021 and the patient subsequently died. The second case, in Beyla prefecture, was confirmed at Nzérékoré Regional Hospital on 17 June 2021, and the patient died the same day. The sub-prefecture of Bheeta in Youmou prefecture is regarded as an active outbreak area, while Yomou-Centre, Péla, Yomou and Bignamou remain on alert.

In the week ending 8 July 2021, the Nigeria Centre for Disease Control reported that the transmission of Lassa fever in Nigeria continues, with three new cases reported from Edo and Ondo states. From 1 January to 8 July 2021, there have been 318 confirmed cases of Lassa fever in the country, including 63 deaths. 

Lassa fever is low risk to most travellers to Guinea and Nigeria, unless living in poor sanitary conditions in rural overcrowded areas. Health care workers in these regions are at risk if appropriate infection control measures are not followed. Travellers who develop symptoms after returning from affected areas should seek immediate medical advice.

Further information and advice on viral haemorrhagic fevers (VHF), including Lassa fever, is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Sources: TRAVAX, 12 July 2021 and TRAVAX, 12 July 2021

The Nigeria Centre for Disease Control reports continued transmission of cholera in the country, with 14,343-suspected cases, including 325 deaths, reported by 16 Nigerian states from 1 January through to 27 June 2021.

Travellers to the region are advised to only consume safe food and water. Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables. Travellers are also advised that good personal hygiene is essential, particularly frequent hand washing.

A vaccine is available to protect against cholera, but as the risk to most travellers is very low, it is only recommended for: 

• volunteers, aid workers and medical personnel in disaster relief situations where cholera outbreaks are likely 
• those travelling to work in slums or refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible

Further information relating to cholera can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 12 July 2021

On 11 July 2021, the Health Minister of Kerala, India, reported 18 cases of Zika virus infection in the state. Media sources reported that the infection was first identified in a pregnant woman in Thiruvananthapuram, who was admitted to hospital on 28 June 2021 with symptoms of fever, rash and headache. These are the first reports of Zika virus infection in Kerala.

Zika virus infection is caused by the Zika virus (ZIKV), and is spread by mosquito bite,s which in pregnancy may result in congenital Zika syndrome, with severe consequences for the baby.

Further information can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 12 July 2021

Public health officials in Ireland have declared a national outbreak of syphilis. Most of the recorded cases are in men, but there is also an increase among women, and in heterosexual transmission.

The situation is ongoing and although the data for 2021 are incomplete, 242 cases were reported between 1 January and 30 April 2021. The majority of cases (79%) were recorded in Dublin, Kildare, and Wicklow, with smaller numbers recorded in Cork, Kerry, Limerick, Clare and Tipperary.

Syphilis is a bacterial sexually transmitted infection (STI) caused by Treponema pallidum, which can be treated with antibiotics, but if left untreated can cause serious health problems to the heart, brain, eyes and nervous system.

Source: TRAVAX, 13 July 2021

The European Centre for Disease Prevention and Control (ECDC) periodically publishes influenza characterisation reports, giving an overview of circulating influenza viruses. These reports provide details on the current vaccine strains, summarise the development of the viruses since the last report and closely follow the main developments for the ongoing influenza season.

On 14 July 2021, the ECDC published the eighth virus characterisation period report for the 2020 to 2021 influenza season. As of week 24 of 2021, 934 influenza detections across the World Health Organization (WHO) European Region had been reported, of which 51% were type A viruses, with A(H3N2) and A(H1N1)pdm09 being approximately equally represented, and 49% were type B viruses, with 16 having been ascribed to a lineage, 13 being B/Victoria and three B/Yamagata. These figures represent a 99.4% drop in detections compared with the same period in 2020.

Source: ECDC, 14 July 2021

In December 2018, the World Health Organization (WHO) established an expert advisory committee to examine the scientific, ethical, social and legal challenges associated with human genome editing.

On 12 July 2021, two new companion reports were published by the WHO, the first providing global recommendations to help establish human genome editing as a tool for public health, with an emphasis on safety, effectiveness and ethics. The second report presents a new governance framework, which identifies specific tools, institutions and scenarios to illustrate practical challenges in implementing, regulating and overseeing research into the human genome.

Source: WHO, 12 July 2021

The World Health Organization (WHO) has launched an updated version of its guidelines for recreational water quality. The guidelines, which should be applied alongside COVID-19 prevention measures, outline health-based water quality targets and best practice for monitoring and surveillance, pollution control, and communication approaches, such as predictive models to let users know in real time if the water is safe to enter.

Broadly, the three recommendations are to: 

• set national health-based targets for recreational water bodies, such as microbial levels from faecal contamination, and cyanotoxins from harmful algal blooms 
• develop and implement recreational water safety plans (RWSPs) for priority bathing sites 
• conduct ongoing surveillance and risk communication of recreational water-related illness, and give the public timely information about health risks

Source: WHO, 13 July 2021

The Scottish Government has published a new strategy, setting out Scotland’s air quality policy for the next five years. The strategy details a series of actions that aim to deliver further air quality improvements, building largely on the work of a previous review, published in 2019.

Source: Scottish Government, 15 July 2021