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.

On 15 December 2021, all countries were removed from the international travel red list, meaning travellers to the UK from countries previously on the list will no longer have to stay in hotel quarantine for ten days on arrival. Despite no countries remaining on the red list, the policy is continuing in Scotland and some managed quarantine capacity will stay in place in order to react to any change in assessment that would see a country added to the list.

It should be noted that the travel lists may be amended at short notice, and do not indicate which destinations are currently allowing UK travellers to enter their country, nor if the Foreign, Commonwealth and Development Office (FCDO) advises against travel to these countries. Information relating to this can be checked on the relevant FCDO foreign travel advice country pages.

From 7 January 2022, people travelling to Scotland from abroad who are fully vaccinated, or under the age of 18, will no longer need to take pre-departure COVID-19 tests, and will also no longer be required to self-isolate on arrival until they have received a negative result. Travellers in this group will still need to complete a Passenger Locator Form (PLF) and take a lateral flow test within two days of arrival in the UK. Anyone who tests positive on their lateral flow test will need to isolate and take a free confirmatory PCR test.

Testing and quarantine rules may differ in Scotland, England, Wales and Northern Ireland, therefore travellers must ensure they 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 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 country page of fitfortravel and the Emerging Health Risks section of every 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 having a high risk of exposure to COVID-19 either have a high risk of exposure for travellers to COVID-19, or a high 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.

As of 7 January 2022, the following countries and territories continue to have a FCDO advisory warning against travel and have therefore been classified as having a high risk of exposure to COVID-19: 

• Afghanistan 
• Burundi 
• Democratic People's Republic of Korea (North Korea) 
• East Timor (Timor Leste) 
• Guinea-Bissau 
• Haiti 
• Nicaragua 
• Papua New Guinea 
• Turkmenistan 
• Venezuela 
• Yemen

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, 10 January 2022

The European Centre for Disease Prevention and Control (ECDC) has published an overview of avian influenza for the period from September to December 2021. Between 16 September and 8 December 2021, 867 highly pathogenic avian influenza (HPAI) virus detections were reported in 27 EU and EEA countries, and the UK. This included 316 cases in poultry, 523 in wild birds and 28 in captive birds. The majority of the detections in wild birds were reported by Germany with 280 cases, Netherlands with 65 cases and the UK with 53 cases.

Since the last ECDC avian influenza summary report in September 2021, 13 human infections due to HPAI A(H5N6) and two human cases due to A(H9N2) low pathogenic avian influenza (LPAI) virus have been reported from China. 

The risk of infection to the general population in EU and EEA countries is assessed as low, and for occupationally exposed people, low to medium, with large uncertainty due to the high diversity of circulating viruses in the bird populations.

Source: ECDC, 22 December 2021

Public health authorities in South Africa have updated the total number of rabies cases in the country in 2021, with 19 confirmed cases as of 14 December 2021, nine in Eastern Cape, six in KwaZuluNatal and four in Limpopo provinces. In addition, four probable rabies cases were reported, three from KwaZulu-Natal and one in Eastern Cape provinces. Some of these cases have been linked to outbreaks of dog rabies in the affected provinces.

Rabies is a fatal but preventable disease of the central nervous system caused by the rabies virus. People are infected when saliva from an infected mammal comes into direct contact with broken skin or mucous membranes (eyes, nose or mouth), usually from a bite, scratch or lick. Rabies is invariably fatal once symptoms develop. Only a small number of people with the disease are known to have survived.

Advice for travellers

All travellers to rabies endemic areas should be aware of the risk of rabies and advised to avoid contact with wild and domestic animals, particularly dogs and cats.

Children are more vulnerable to rabies than adults, as they are less likely to understand the risk of interacting with animals, less able to defend themselves from an animal attack and may not report a potential exposure.

All travellers to endemic areas should be aware of immediate wound care and advised to seek medical attention immediately following potential exposure. Effective rabies vaccines, which can be used pre- and post-exposure, are available and prevent clinical rabies from developing. 

Further information is available from the TRAVAX rabies and rabies post-exposure guidance pages.

Source: TRAVAX, 6 January 2022

The Global Polio Eradication Initiative reported 64 cases of polio in Nigeria in the week ending 28 December 2021. Cases were recorded in nine states, with 35 in Kebbi, eight in Sokoto, six in Kaduna, four in Nasarawa, four in Kwara, two in FCT, and one case each in Niger, Ekiti and Lagos. This brings the total number of polio cases in Nigeria in 2021 to 385.

Advice for travellers

Poliomyelitis is spread mainly through person to person contact via the faecal-oral route. 

The polio vaccination recommendations for Nigeria remain unchanged. However, due to the recent increase in cases, travel health professionals are reminded that travellers should: 

• be offered a booster dose of poliomyelitis vaccine if it has been more than ten years since their last dose 
• practice safe hand hygiene and food and water precautions during travel to reduce their risk of exposure to polio virus

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

Source: TRAVAX, 6 January 2022

The World Health Organization European Region (WHO Europe) has stated that, in the week commencing 13 December 2021, the number of flu cases (caused by the influenza virus) detected in the region was above what would normally be expected in the population for the second week in a row, which indicates the flu season epidemic has started. In any given year 5-15% of the population is affected by influenza, leading to between three and five million cases of severe flu and around 650,000 deaths globally.

The main circulating influenza virus in the region has been A(H3N2). In most cases, this will cause mild illness, but in older adults can occasionally lead to severe disease and death. Fewer influenza A(H1N1)pdm09 or influenza B viruses have been detected to date, although the distribution of viruses usually changes over the course of the winter, so this situation may change.

WHO Europe recommends that countries:

• monitor the situation 
• vaccinate those at increased risk 
• use antivirals on at-risk infected individuals

Source: WHO Europe, 25 December 2021

The year 2021 has seen a wide range of work and achievements for the World Health Organization European Region (WHO Europe) with COVID-19 affecting nearly all of the WHO’s work. Through the European Programme of Work, the Regional Office has begun to make progress on other areas of health, most notably launching the Pan-European Mental Health Coalition and the Immunization Agenda 2030.

The WHO has published a timeline infographic, which looks back at some key moments of the last year, highlighting achievements across the region as well as some specific country initiatives.

The Scottish Government has launched a consultation on the update of the Marine Litter Strategy for Scotland. This consultation proposes new priority actions to tackle marine litter in Scotland, building on the work already conducted through the original strategy.

The main purpose of the strategy is to develop current and future measure to prevent litter from entering the maritime and coastal environment and to support litter removal, in order to bring ecological, economic and social benefits.

The consultation paper is available on the Scottish Government website, and participants can fill in the online form to give their views. The consultation closes on 22 March 2022.

Source: Scottish Government, 29 December 2021