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Derek Evans

Welcome to Evans Travel Health

Blog     posted on Wednesday 4th August 2021


       How to prepare for Travel Medicine post-Covid

"We are all aware of that the impact of Covid infections has had on travel and continues to do. With the advent of vaccination programs and sophisticated testing and recording systems in place travel is starting to increase.

However the types of travel such as short haul continues to expand according to the determination of national governments whilst long haul remains dormant. The traveller groups have changed and the emphasis on routine vaccinations being sought by first time travellers going to exotic destinations has shifted to business and essential workers.

With this in mind the marketing of any specific travel medicine services will need to understand these changes. Following lockdowns and extended restrictions many travellers are now attempting to visit families and friends (VFRs) who they have only seen through video links. These VFRs will be a key target group during the revival of travel medicine demands and services.

A key part of the practitioners will be the flexibility to react to short time departures and supply necessary vaccines and medication where required. This parallels with the quick turn around that Covid tests are required for entry into another country before departure from the UK. It seems that a mix of PCR and rapid antigen tests are required within a range of departure times from 24 to 96 hours before departure.

The underlying point here is that this increased cost needs to be allowed for during any travel consultation and also the returning costs of testing and/or isolation. It is unlikely that these costs will be removed in the short term and certainly Covid will become another disease to be routinely covered during a travel medicine risk assessment."


Blog

Should Dengue vaccine be licensed for travellers from the UK?

Posted on October 11, 2019 at 12:55 AM



The spread of the dengue virus is highly reported as rapidly increasing in many Asian countries in particular. Last week Bangladesh and Pakistan reported high levels of outbreaks exceeding the number of beds and medical facilities available to treat these patients. These countries are in addition to those reporting earlier in the year such as Philippines, Indonesia, Taiwan and India.


In  an article published last week there are references from France and Spain of patients returning home after contracting dengue abroad and a call for a rapid risk assessment process in case autochthonous cases develop.


Although currently the levels of the transmitting mosquito, Aedes albopictus, are low in Southern Europe, the impact of global warming and the climate is indicating a potential of this mosquito moving further north in the forthcoming years. In the USA for example the last 2 years have had reports of dengue in Florida and this year is the same with CDC recording watch levels on the infection.


So what about the vaccine. We know about the suspended vaccinations in the Philippines where it was concluded that the vaccine could only be given to patients with a laboratory confirmed result of previous infection. With the disease having 4 serotypes and no cross protection (ie contraction of type does not give protection against types 2,3 and 4) then for full protection a patient would need to contract dengue up to 4 times. With the disease showing that it can also produce 2 further conditions of dengue haemorrhaging fever and severe dengue. This is unlike other viruses of the same family such as zika and chikungunya.


With increasingly low air fare costs to infected countries and the only protective advice is the daytime use of insect repellents, is there the risk of a UK traveller returning with dengue increasing?


With the EU licensing the use of dengue vaccine for clinically assessed patients, should the MHRA now be considering the introduction of the vaccine for use in travellers resident in the UK and travelling to endemic areas, such that we have an established set of trial data that will be available should the infection ever mutate and survive in the UK weather conditions.

 

References

1. https//www.ecdc.europa.eu/sites/default/files/documents/RRA-dengue-in-Spain-France_1Oct2019.pdf

2. https//economictimes.indiatimes.com/news/science/dengue-virus-is-becoming-resistant-to-vaccines-and-treatment-study/articleshow/71253957.cms

3. https//wwwnc.cdc.gov/travel/notices/watch/dengue-americas




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