On 8 March 2022, Public Health Scotland (PHS) updated their immunisation and vaccine-preventable diseases web page to reflect the latest quarterly data on:

• Haemophilus influenzae
• human papillomavirus
• invasive pneumococcal disease 
• measles 
• meningococcal disease 
• mumps 
• pertussis 
• rotavirus 
• rubella 
• shingles

International travel continues to be impacted due to COVID-19, and the number of variant strains which have emerged globally. Guidance on international travel is available for people living in Scotland, England, Wales and Northern Ireland.

Since 11 February 2022, the rules for international travellers arriving in the UK have changed. In Scotland, travellers who are fully vaccinated no longer need to take a COVID-19 test within two days of arrival in the UK, but still must complete a Passenger Locator Form (PLF) in the 48 hours before travelling. Summaries are available detailing the changes for travellers arriving into Scotland, England, Wales and Northern Ireland.

Country specific COVID-19 risk

Country pages on the fitfortravel (for the general public) and TRAVAX (for health professionals) websites include a COVID-19 country specific risk-rating, which identifies the risk of exposure to COVID-19 for UK travellers. This information is listed in the Alerts section on each individual fitfortravel country page and the Emerging Health Risks section of each individual TRAVAX country page. This risk-rating identifies each country as having either:

• a high risk of exposure to COVID-19 for UK travellers, or   
• a risk of exposure to COVID-19 for UK travellers

For all countries, travellers should be aware that the risk of COVID-19 may change at short notice. Countries categorised as high-risk either have a greater risk of travellers being exposed to COVID-19, or an increased risk of emerging, or known variants, of coronavirus. Travellers should be advised to avoid non-essential travel to high-risk countries, even if fully vaccinated against COVID-19.

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, February 2022

Costa Rican public health authorities report continued transmission of malaria in the Zona Norte region of the country. Since September 2021, increased malaria case numbers have been reported from Medio Queso, San Gerardo, Cuatro Esquinas, Isla Chica, La Trocha, Las Delicias, Coquita, Santa Cecilia and San Francisco.

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, given the current increase in cases 
• practise strict mosquito bite avoidance 
• consider antimalarial chemoprophylaxis if 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 their potential exposure to malaria.

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

Source: TRAVAX, 25 February 2022

On 23 February 2022, the Global Polio Eradication Initiative reported a case of polio in Lilongwe, Malawi in 2021, which was thought to be imported from Pakistan.

Advice for travellers 

• Poliomyelitis is spread mainly through person-to-person contact via the faecal-oral route. 
• Travellers should be offered a booster dose of poliomyelitis vaccine if it has been more than ten years since their last dose.

The TRAVAX and fitfortravel websites have updated the recommendations for travel to Malawi to reflect this. 

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

Source: TRAVAX, 28 February 2022

Health authorities in Australia have issued a public health alert following a confirmed human case of Japanese encephalitis in Queensland. The virus has also been found recently in pigs on farms in New South Wales, with people in both states being advised to avoid mosquito bites.

Japanese encephalitis is a mosquito-borne virus which affects the central nervous system, most common around areas of rice and pig farming. It is transmitted from animals, mainly pigs and birds, to humans through the bite of an infected Culex mosquito which feeds in the hours around dusk. No human-to human transmission occurs.

Advice for travellers

All travellers to endemic countries or outbreak areas are potentially at risk of infection. This risk is greatest for those:

• travelling to rural areas during transmission seasons
• participating in outdoor activities during twilight hours
• travelling for a prolonged period of time

All travellers should be advised on:

• the risks and potentially severe consequences of Japanese encephalitis
• practicing strict mosquito bite avoidance measures, including correct use of insect repellents
• minimising outdoor activities during twilight hours when Culex mosquitoes bite

Travellers at increased risk of developing severe clinical disease are those:

• with pre-existing chronic medical conditions
• younger than ten years of age or older than 50

For most travellers the risk of acquiring infection is very small, but practitioners should consider vaccinating:

• those likely to be frequently exposed to mosquito bites in rural infected areas, such as backpackers, agricultural workers, volunteers
• long stays, of more than one month, in infected areas
• repeated visits to risk areas such as flood plains, rice paddies, and marshlands
• short stays during epidemics and outbreaks
• migrants going to live in an endemic area

Information and advice for travellers on Japanese encephalitis is available from the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 3 March 2022

The European Centre for Disease Prevention and Control (ECDC) has published its European external influenza virus quality assessment programme, using data from 2020.

Influenza epidemics occur every winter with high impact on disease burden, hospitalisations and excess mortality in countries in the World Health Organization (WHO) European Region. To understand the characteristics of circulating influenza viruses during seasonal epidemics, the ECDC performs virological influenza surveillance. Detected viruses are further characterised at national influenza centres (NICs) that are part of a wider network, the WHO Global Influenza Surveillance and Response System (GISRS).

External quality assessment (EQA) is an instrument in assessing the quality of the generated data that are reported nationally and internationally through The European Surveillance System (TESSy) and presented in Flu News Europe, the joint ECDC and WHO Regional Office for Europe weekly influenza update.

Source: ECDC, 25 February 2022

The World Health Organization (WHO) has announced recommendations for the viral composition of quadrivalent and trivalent influenza vaccines for the 2022 to 2023 influenza season in the northern hemisphere. The announcement was made at an information session at the end of a four-day information meeting on the composition of influenza virus vaccines, an event that is held twice annually.

The WHO organises these consultations with an advisory group of experts, gathered from WHO collaboration centres and WHO essential regulatory laboratories, to analyse influenza virus surveillance data generated by the WHO Global Influenza Surveillance and Response System (GISRS).  The recommendations issued are used by the national vaccine regulatory agencies and pharmaceutical companies to develop, produce, and license influenza vaccines for the following influenza season.

Source: WHO, 25 February 2022

The Food Standards Agency (FSA) has issued advice after infant formula producer Abbott took the precautionary step of recalling various batches of Elecare Similac and Alimentum Similac powdered formula, because of the possible presence of Salmonella and Cronobacter sakazakii.

Both formula products are for special medical purposes and are ordinarily used under medical supervision. Abbott has contacted all stores and pharmacies supplying these products to inform them of the recall. Anyone who has purchased or been prescribed any of the products included in the recall should not feed it to their baby and should return it to the place they got it from.

Source: FSA, 24 February 2022

The European Food Safety Authority (EFSA) has re-assessed the feed additive ethoxyquin, and has been unable to conclude on its safety for certain groups of animals, consumers and the environment.

Until 2017, ethoxyquin was authorised in the EU as a feed additive for all animal species and categories, because of its antioxidant properties and its use in preventing the spontaneous combustion of fish meal during transportation by sea.

The presence of p-phenetidine, an impurity that remains in the additive after the manufacturing process, is a possible mutagen, meaning the experts of EFSA’s Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) could not rule out risks to animals with a long-life expectancy and those reared for reproduction. By contrast, the additive is considered safe for animals that are reared for meat production, such as chicken, pigs, cattle, rabbits and fish.

Due to the lack of data on the presence of p-phenetidine in tissues and food products of animal origin, the experts could not draw a conclusion for consumers either. FEEDAP highlighted the need to minimise users’ exposure via inhalation due to the presence of this impurity in the additive.

When the additive is used in terrestrial animals, experts could not conclude on the safety of ethoxyquin for terrestrial and aquatic ecosystems. A risk for contamination via the aquatic food chain could not be excluded, as well as the risk for marine sediment-dwelling organisms exposed to ethoxyquin when used in sea-cages.

Source: EFSA, 3 March 2022

The United Nations (UN) Intergovernmental Panel on Climate Change (IPCC) has published the second part of its sixth assessment report (AR6), examining the causes, impacts and solutions to climate change.

In key findings from the report:

• Human-induced climate change, including more frequent and intense extreme events, has caused widespread adverse impacts and related losses and damages to nature and people, beyond natural climate variability.
• Approximately 3.3 to 3.6 billion people live in contexts that are highly vulnerable to climate change.
• Global warming reaching 1.5°C in the near-term would cause unavoidable increases in multiple climate hazards and present multiple risks to ecosystems and humans.
• Climate change impacts and risks are becoming increasingly complex and more difficult to manage. 
• Progress in adaptation planning and implementation has been observed across all sectors and regions, generating multiple benefits. However, adaptation progress is unevenly distributed with observed adaptation gaps.
• There are feasible and effective adaptation options which can reduce risks to people and nature. The feasibility of implementing adaptation options in the near-term differs across sectors and regions

Source: IPCC, 28 February 2022