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 international 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 on 26 July 2021, changes to the rules in Northern Ireland came into effect. 

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.

Since 15 July 2021, the COVID-19 risk to UK travellers has been increased in: 

• British Virgin Islands 
• Cuba 
• Fiji 
• Portugal (Madeira) 
• Spain (Canary Islands)

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

WorldPride is a global lesbian, gay, bisexual, transgender and intersex (LGBTI+) festival to celebrate and advocate for LGBTI+ equality worldwide, while the EuroGames provide a safe space for LGBTI+ athletes to compete without discrimination. This year, Copenhagen2021 will host both events between the 12 and 22 August 2021, at venues in both Copenhagen and Malmö, Sweden.

On 20 July 2021, Denmark and Sweden restricted travel from the UK, full details of entry requirements being available to view on the Foreign, Commonwealth and Development Office (FCDO) website. Travellers should follow the latest coronavirus (COVID-19) international travel guidance for either Scotland, England, Northern Ireland or Wales, depending on where they live.

The following TRAVAX pages provide useful advice:

• accident prevention and personal safety 
• country pages: Denmark and Sweden
• food and water precautions 
• sexual health risks
• travel insurance

Further information and advice on WorldPride can be viewed on the fitfortravel website.

Source: TRAVAX, 21 July 2021

On 14 July 2021, the State Public Ministry of Bahia reported an outbreak of malaria in the municipality of Itabela, in the state of Bahia. There have been 53 cases since 27 April 2021, with no deaths reported, mostly in the Margarida Alves area of the municipality.

Malaria is not usually present in this part of Brazil, and the infection in believed to have been introduced by a traveller from the city of Manaus.

Advice for travellers

While higher than expected cases of malaria continue to be reported, travellers to this area should: 

• be made aware of the risk of malaria 
• practise strict mosquito bite avoidance 
• consider antimalarial chemoprophylaxis if they are in a group at higher risk from malaria

Travellers returning from malarious areas should seek prompt medical advice if they develop a fever during travel or on their return, ensuring they highlight potential exposure to malaria.

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

Source: TRAVAX, 19 July 2021

The European Centre for Disease Prevention and Control (ECDC) has reported that, between 15 March and 6 July 2021, 348 confirmed cases of Salmonella braenderup (S. braenderup) sequence type 22 (ST22) were recorded in 12 EU or EEA countries, and the UK. Of these cases, 68 were hospitalised, with no deaths recorded. 

Based on epidemiological, microbiological and traceability investigations, the vehicles of infection are presumed to be melons imported from outside the EU, EEA and UK. A batch of galia melons from a Honduran producer are reported to be a probable source of infection, however the first cases were detected in March 2021, before this batch had been harvested. This indicates that contaminated food vehicles had been circulating in these countries earlier, seemingly confirmed by the April 2021 detection, in Austria, of the outbreak strain in melons.

Further investigations are required to identify the point of contamination along the production chain. The Honduran producer finished harvesting melons in April 2021, and their produce is no longer on the market, with no additional exports from Honduras foreseen until the new season starts in December 2021. Given delays in reporting and the possibility of secondary cases, further infections may still be reported, but with decreasing frequency.

Source: ECDC, 20 July 2021

The European Centre for Disease Prevention and Control (ECDC) has published an update to an existing risk assessment, first produced in response to evidence of healthcare associated transmission of OXA-244 producing Escherichia coli (E. coli) in the EU and EEA. A doubling of cases in the main cluster, and three new countries detecting cases, confirm the high risk for further spread of OXA-244 producing E. coli.

An urgent enquiry was made to ECDC’s Epidemic Intelligence Information System (EPIS), regarding a healthcare-associated outbreak involving 12 cases of OXA-244 producing E. coli in Norway. Subsequently, national public health reference laboratories in EU and EEA countries were invited to submit to ECDC whole genome sequencing (WGS) data, collected since the previous rapid risk assessment was published on 18 February 2020.

The analysis included WGS data submitted to ECDC from 13 countries, completed with data from the public domain. Among 458 isolates of E. coli ST38, 370 carried the blaOXA-244 gene encoding for the OXA-244 carbapenemase. Several clusters were identified, including one large cluster with 225 closely-related OXA-244-producing E. coli ST38 isolates. Of these, 210 isolates were detected in 11 EU and EEA countries and the UK, and 15 isolates were from other countries.

The source and route of transmission for OXA-244-producing E. coli in the EU, EEA and UK is currently unclear, and there is a need for further investigation to determine this so that control measures can be put in place. The wide geographical dispersion of cases within countries, without cases being linked in place and time, indicates transmission in the community as the main mode of spread.

Source: ECDC, 20 July 2021

The World Health Organization (WHO) has published a position statement on innovative clinical trial designs for development of new tuberculous (TB) treatments. The statement summarises key innovations in TB clinical trial designs, ranging from pharmacokinetic/pharmacodynamic (PK-PD) modelling and new advances in biomarker development, to the value of novel clinical trial design methodologies and post-licensure observational studies. For various stages along the development pathway, remaining challenges are described alongside possible solutions to help overcome these issues.

Source: WHO, 19 July 2021

World Hepatitis Day, which falls on 28 July 2021, is an annual event organised by the World Hepatitis Alliance (WHA) in collaboration with the World Health Organization (WHO), helping to raise awareness of the global burden of hepatitis.

The theme this year is ‘Hepatitis can’t wait’, conveying the urgency of efforts needed to eliminate hepatitis as a public health threat by 2030. The campaign highlights that a person dies every 30 seconds from a hepatitis related illness, and that, despite the current COVID-19 pandemic, viral hepatitis must be acted upon.

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

According to official data published by the World Health Organization (WHO) and UNICEF, 23 million children did not receive basic vaccines through routine immunisation services in 2020, 3.7 million more than in 2019. This latest set of official worldwide childhood immunisation figures, the first to reflect global service disruptions due to COVID-19, show the majority of countries last year experienced drops in childhood vaccination rates.

The WHO and UNICEF data highlights disruptions to immunisation services were widespread in 2020, with the WHO Southeast Asian and Eastern Mediterranean regions most affected.  As access to health services and immunisation outreach were curtailed, the number of children not receiving their first vaccinations increased in all regions. When compared with 2019, 3.5 million more children missed their first dose of diphtheria, tetanus and pertussis vaccine (DTP-1), while three million more children did not receive their first measles dose.

Source: WHO, 15 July 2021

The EU Bee Partnership (EUBP) has launched a new online data platform, which aims to play a role in efforts to protect bee and pollinator health. Stakeholders from various sectors, including beekeeping and farming associations, European agencies, scientists and academia, have collaborated to develop the prototype platform.

The hub will host a collection of harmonised data on bees and pollinators from across Europe, and will play an important role in the success of the new framework developed by the European Food Safety Authority (EFSA), for an environmental risk assessment of multiple stressors in bees, known as MUST-B. Available datasets on the platform include automatic monitoring, demography and biology, pollinator health, and socio-economic data.

Source: EFSA, 15 July 2021

The Health and Safety Executive (HSE) has published its report on fatal injuries in agriculture, forestry and fishing in Great Britain (GB) for 2020 to 2021.

In key findings from the report: 

• 41 people were killed as a result of farming and other agriculture-related activities, 18 more than the previous year, and eight more than the five-year average 
• more than half of the workers killed were 60-years-old plus 
• the five most common causes of death were: 
  • being struck by moving vehicles 
  • being killed by animals 
  • contact with machinery 
  • being struck by an object 
  • falling from height

Source: HSE, July 2021

The Scottish Government has launched a consultation seeking the views and opinions of stakeholders on a review of building standards relating to the fire safety of cladding.

The consultation covers five main areas: 

• The wording of mandatory standard 2.7 relating to fire spread on external walls. 
• Consideration of a definition and ban on the highest risk metal composite material (MCM) cladding panels. 
• Options to improving standards and guidance on cladding systems, including the continued role of the large-scale fire test, BS 8414. 
• Consequential matters, combustible exemptions. 
• Impact assessments.

The proposed changes outlined in the consultation aim to improve fire safety for the design and construction of all buildings, in relation to external wall cladding systems, making them safer for those in and around buildings in the event of an outbreak of fire. The consultation is open until 8 October 2021 and responses can be completed online.

Source: Scottish Government, 16 July 2021