International travel continues to be impacted due to COVID-19, and a number of variant strains have emerged globally, with information on such travel available for people living in Scotland, England, Wales and Northern Ireland. To help prevent new COVID-19 variants being exported and imported, the Foreign, Commonwealth & Development Office (FCDO) currently advise against travelling to red list countries.

On 4 October 2021, the traffic light system for travel to the UK was simplified, with the green and amber lists merging, and a red list remaining for countries with high case numbers and variants of concern. The rules travellers need to follow depend on whether they have been fully vaccinated against COVID-19 using a UK government approved vaccine, and whether they are arriving from, or in the previous ten days have travelled through, a red list country or territory, or from the rest of the world on the non-red list. It should be noted that the lists do not indicate which destinations allow UK travellers to enter their country.

Currently, anyone aged over 18 years who is fully vaccinated and entering Scotland from a non-red list country or area will be required to complete a passenger locator form and take a COVID-19 PCR test within two days of arrival. Isolation is only required if the COVID-19 test result is positive, or NHS Scotland Test and Protect makes contact to inform of the need to isolate due to travelling with someone who has tested positive for COVID-19.

Travellers should be aware that testing and quarantine rules may differ in Scotland, England, Wales and Northern Ireland and 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.

In September 2021, the COVID-19 risk for UK travellers decreased in Kuwait.

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. 

• The FCDO foreign travel advice country pages have up-to-date information on 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 COVID-19 health considerations for travel page.

Source: TRAVAX, 5 October 2021

The Hong Kong Department of Health has reported 21 cases of H5N6 bird flu in China this year, with the two most recent instances reported in Guangxi and Chongqing on 30 September 2021. Guangdong Province, Hunan Province, Sichuan Province, Anhui Province and Guizhou Province have also reported cases this year. 

Advice for travellers

Travellers to countries where avian influenza has caused human disease should be aware of the potential risk of infection, particularly those visiting friends and relatives. These travellers should be advised to avoid contact with: 

• live poultry, including chickens, ducks, geese, pigeons and quail, or any wild birds 
• surfaces that may be contaminated with poultry or bird droppings 
• commercial poultry farms, backyard poultry farms, and live poultry markets 
• sick or dead poultry and birds

Information and advice for travellers on avian influenza is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 5 October 2021

The World Health Organization (WHO) has recommended widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa, and other regions with moderate to high Plasmodium falciparum (P. falciparum) malaria transmission. The recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800,000 children since 2019.

The WHO have reported a number of key findings, listed below, from their pilot project. 

• The vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS,S seen through routine immunisation systems. This has occurred even in the context of the COVID-19 pandemic. 
• RTS,S has increased equity in access to malaria prevention, with data from the pilot programme showing that more than two-thirds of children in the three pilot programme countries, who do not sleep under a bednet, have benefitted from the RTS,S vaccine. 
• To date, more than 2.3 million doses of the vaccine have been administered in three African countries, with a favourable safety profile. 
• In areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations, or health seeking behaviour for febrile illness. 
• A reduction of 30% in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment. 
• Modelling estimates that the vaccine is cost-effective in areas of moderate to high malaria transmission.

The WHO report that next steps will include funding decisions from the global health community for broader rollout, and country decision-making on whether to adopt the vaccine as part of national malaria control strategies.

Source: WHO, 6 October 2021

The European Centre for Disease Prevention and Control (ECDC) has published its annual cryptosporidiosis epidemiological report for 2018.

In 2018, 14,299 cryptosporidiosis cases, of which 14,252 were confirmed, were reported to ECDC by 20 EU and EEA countries, with an overall notification rate of 4.4 confirmed cases per 100,000 of the population. Children aged zero-to-four years had the highest notification rate, at 15.8 cases per 100,000 of the population. Four countries accounted for 76% of all confirmed cases, with the UK accounting for 41% of this number.

Source: ECDC, 5 October 2021

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

In EU and EEA countries, cholera is a rare disease that is primarily associated with travel to endemic countries outside of the EU and EEA. In 2019, seven EU countries reported 26 confirmed cases of cholera, which was similar to previous years, with 16 of these cases being reported by the UK.

Source: ECDC, 7 October 2021

Global Handwashing Day, on 15 October 2020, aims to increase awareness and understanding regarding the importance of handwashing with soap, as an effective and affordable way to prevent diseases and save lives.

The coronavirus (COVID-19) pandemic has acted as a reminder that one of the most effective ways to stop the spread of viruses is simple hand hygiene, especially handwashing with soap. The learnings from the past year have emphasised the need for collective action to address the historic neglect of hand hygiene investments, policies, and programmes. 

The theme for Global Handwashing Day 2021 is ‘Our future is at hand – let’s move forward together’, and calls for coordinated action to actively work toward universal hand hygiene.

International Infection Prevention Week (IIPW), organised by the Association for Professionals in Infection Control and Epidemiology (APIC), takes place from 17 to 23 October 2021. The theme this year is ‘Make your intention infection prevention’, which aims to highlight the science behind infection prevention.

The IIPW website contains a numbers of materials to promote IIPW 2021, including a toolkit, videos and social media resources.

The Scottish Government has published its Heat in Buildings Strategy, setting out a pathway aiming to cut greenhouse gas emissions from homes and buildings, which currently account for about one-fifth of Scotland’s emissions, by more than two-thirds by 2030. This will require over one million homes and the equivalent of 50,000 non-domestic buildings to convert to zero emission heat by 2030. 

The four strategic priorities contained in the strategy are: 

• supporting those least able to pay  
• investing in strategic technologies in low or no regrets areas 
• showcasing net-zero leadership and to share learning through early adoption in key areas of focus 
• investing in innovation and demonstration to drive forward competitive advantage

Source: Scottish Government, 7 October 2021

Scottish Water and the Scottish Environmental Protection Agency (SEPA) are calling on householders and businesses to help protect water supplies throughout autumn and into winter. This comes after Met Office data shows that the north and west of Scotland experienced its driest April-to-September in 160 years, while for the whole country it was the second driest on record for the same period.

Officials at SEPA say the significant rainfall deficit over recent months means that, in some areas, double the normal amount of autumn rain is needed to return water levels to normal for this time of year.

Sources: Scottish Water, 5 October 2021 and SEPA, 5 October 2021