Rabies advice (bats)

There are no reports of indigenous bats in this country; however, bats may be imported in which may carry rabies-like viruses. Prevention Contact with bats should be avoided – any bites should be thoroughly cleansed and urgent medical advice sought Pre-exposure vaccination is not recommended Post-exposure advice and treatment should be in accordance with Public Health England guidance…

Tick-borne encephalitis advice

Cases in humans is unknown; however, there is evidence of some risk. Prevention Using insect bite avoidance measures can reduce the risk of transmission of tick-borne encephalitis: Keep limbs covered – wear long-sleeved tops and trousers that can be tucked into socks for added protection. Clothing can be sprayed with a suitable insecticide such as permethrin. Insect repellents should be applied to exposed skin. After walking in risk areas the body should be checked visibly for ticks. If a tick is found, it should be removed as soon as possible by gripping it as close to the skin as possible, preferably using a pair of tweezers, and pulling away slowly. Take care not to squeeze the tick. Travellers should avoid drinking or eating unpasteurised dairy products in risk areas.…

Zika virus

Zika virus disease is an emerging mosquito-borne viral infection. In the majority of cases, the virus is transmitted to people through the bite of an infected female Aedes mosquito which also transmits other diseases such as chikungunya, dengue and yellow fever. However, in a small number of cases, the Zika virus has occurred through sexual transmission or via the placenta from mother to foetus. Signs and symptoms Following a bite from an infected mosquito, the first symptoms can develop in 3-12 days; however, the incubation period can be shorter or longer in some people. In the majority of cases, infected individuals do not experience any symptoms – in travellers who do, the symptoms are usually mild, self-limiting and last for around 2-7 days. Treatment Currently, there is no specific, antiviral treatment or vaccine available. Prevention The best form of prevention is protection against mosquito bites. The Aedes mosquito bites predominantly during the day, especially mid-morning and late afternoon to dusk. This is different to malaria-transmitting mosquitoes which bite between dusk and dawn. It is, therefore, advisable to practice bite avoidance measures. All travellers should also exercise precaution to avoid sexual transmission. Further information Refer to the NPA Zika virus resources The latest A-Z list of countries/areas/territories with active Zika virus transmission according to risk catergorisation can be accessed from the Public Health England website Country-specific information can be found on TravelHealthPro website  …

Biting insects or ticks

Diseases spread via biting insects or ticks Insect/tick bites can irritate the skin and cause infections and some of the diseases which are spread via the bite include: Chikungunya Crimean-Congo haemorrhagic fever Leishmaniasis West Nile virus Country-specific details can be found on TravelHealthPro website Prevention There is no vaccine to prevent these diseases. Travellers to areas of risk must use bite avoidance measures day and night.…

MERS-CoV

Although the risk of Middle East respiratory syndrome coronavirus (MERS-CoV) is very low, Public Health England are advising travellers to: Avoid unnecessary contact with camels and avoid consumption of raw camel milk and camel products Avoid consuming any type of raw milk/milk products and any food that could be contaiminated with animal secretions unless it is cleaned/peeled/thoroughly cooked Follow good general hygiene and regularly wash hands, especially after visiting barns, farms or market areas Avoid close contact with sick animals or people Be aware of the symptoms which include cough, fever or shortness of breath; if the traveller becomes unwell within 14 days of being in the Middle East, medical attention should be sought…

Altitude

Risk Risk of altitude sickness occurs when travelling  to destinations of 2,500-3,500m (8,200-11,500 feet), although cases have been reported at lower altitudes 1,500-2,500m (5,000-8,200 feet). Risk factors for altitude sickness include the altitude itself, the rate of ascent and sleeping altitude. Travellers are at a higher risk if they have rapid ascent without a period of acclimatisation. Risk management Travellers should avoid travelling directly into areas above 3,500m A few days at an altitude below 3,000m prior to ascending should help travellers to acclimatise When ascending above 3,000m, this should take place gradually with no more than a 300-500m increase in sleeping altitude per day, and a rest day every three days Acetazolamide may be used off-label for altitude sickness prevention, although pharmacological prophylaxis is not encouraged Symptoms of altitude sickness include headache, fatigue, loss of appetite, nausea and sleep disturbance; if symptoms develop travellers should avoid further ascent and descend if there is no improvement Symptoms of severe forms of altitude sickness must be treated as a medical emergency and immediate descent is required; such symptoms include high-altitude cerebral oedema (confusion, difficulty with balance and coordination) or high-altitude pulmonary oedema (shortness of breath at rest, cough and chest tightness) …

Dengue fever

Transmission Dengue fever is transmitted through the bite of an infected mosquito. The mosquito that carries this disease is active during daylight hours, with most activity being first thing in the morning and during the early evening. Vaccination There is no vaccine to prevent dengue fever. Travellers to areas of risk must use bite avoidance measures especially during daylight hours with extra vigilance around dusk and dawn.…

Schistosomiasis

Schistosomiasis, or bilharzia, is a parasitic infection transmitted by freshwater snails releasing schistosoma larvae in freshwater streams, rivers or lakes. The larvae can penetrate intact skin and cause infecton. There is no risk in sea water or chlorinated swimming pools. Most cases of schistosomiasis originate from Africa, although it is prevalent in many tropical areas. Vaccination There is no vaccine to prevent schistosomiasis. Travellers should avoid wading, swimming or bathing in fresh waters in areas at risk. Symptoms Initial symptoms are an itchy papular rash, with other symptoms developing within two-to-three weeks. These include fever, urticaria, malaise, diarrhoea, cough, headaches, myalgia and weight loss, although some individuals remain symptomless. Suspected cases should be referred to a specialist in tropical medicines for treatment.…