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. 

There are currently no countries on the international travel red list, although the policy is continuing in Scotland with some managed quarantine capacity remaining 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.  

Currently, 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 arrive in and, if different, reside in.  

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 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 higher risk of exposure for travellers 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.  

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  
• 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 

Chinese New Year falls on 1 February 2022, with celebrations occurring between 31 January and 15 February 2022.

As a result of the increasing number of COVID-19 cases brought about by the Omicron variant, many countries around the world have implemented rules which include restricting mass-gathering events such as Chinese New Year celebrations.

The UK Foreign, Commonwealth and Development Office (FCDO) currently advise that all direct flights from the UK to mainland China have been suspended, and a future review date has not yet been given.

Source: TRAVAX, 24 January 2022

On 16 January 2022, the World Health Organization (WHO) issued an update on active cholera outbreaks in seven African countries. Outbreaks have been reported in Benin, Cameroon, the Democratic Republic of the Congo, Ethiopia, Niger, Nigeria and Togo, with a total of 126,050 cases and 3,996 deaths across these countries, the majority being in Nigeria.

Advice for travellers

Cholera is an acute diarrhoeal infection caused by ingestion of faecally contaminated food or water, and occasionally foodstuffs such as shellfish. Severe cholera is rare in travellers, and mild cases may present as travellers’ diarrhoea.

Travellers are advised to only consume safe food and water and practice effective hand hygiene.

A vaccine is available to protect against cholera, but as the risk to most travellers is very low, it is only recommended for:  

• volunteers, aid workers and medical personnel in disaster relief situations where cholera outbreaks are likely  
• those travelling to work in slums or refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible

Further information relating to cholera can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 24 January 2022

The Brazilian Ministry of Health has reported a continued transmission of dengue across the country, with 544,460 dengue cases, including 240 deaths, recorded between 3 January 2021 and 1 January 2022.

Advice for travellers  

• All travellers to endemic regions are potentially at risk of dengue fever, and should be aware of this infection. Prevention relies on avoiding mosquito bites at all times.  
• Travellers developing a fever during or on return from travel are advised to seek medical attention as soon as possible.

There is no vaccine against dengue fever licensed for use in the UK. 

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

Source: TRAVAX, 27 January 2022

The Ukranian Ministry of Health has reported a case of polio in a child from the Transcarpathia region in December 2021. Laboratory reports indicate the patient was infected with a polio virus similar to one identified in an outbreak in the Rivne region in October 2021.

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 10 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

Travellers who intend to visit Ukraine for more than four weeks can receive a booster dose of polio containing vaccine if it is more than 12 months since their last dose. In particular, this should include individuals with weakened immune systems, those who are pregnant, those travelling to areas with inadequate sanitation and water systems and aid workers or medical personnel likely to be in close proximity to polio cases. They may also wish to carry proof of polio vaccination.

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

Source: TRAVAX, 27 January 2022

The Brazilian Ministry of Health has reported continuing transmission of Zika virus across the country, with 6,483 cases recorded from 3 January 2021 to 1 January 2022.

Zika virus infection is caused by the Zika virus (ZIKV). It is spread by mosquito bites which in pregnancy may result in congenital Zika syndrome, with severe consequences for the baby.

Advice for travellers

Aedes mosquitoes, which transmit ZIKV and bite between dawn and dusk, are particularly persistent and aggressive. All travellers to countries that have reported ZIKV infection must consider: 

• strict mosquito bite avoidance measures, especially travellers who are pregnant or planning pregnancy 
• using condoms and contraception if sexually active, to avoid the sexual transmission of ZIKV and the risk of ZIKV in pregnancy, during travel and on return for two months if female, and three months if male 
• travel insurance, in particular pregnant women, who should check with their travel insurance company that they are covered under the policy before booking their trip, and be aware that the risk of ZIKV in any country may change during the time between planning the trip and travelling 
• if there are any additional travel recommendations for pregnant travellers, those planning pregnancy and for preventing onward sexual transmission, which can be found under the Emerging Health Risks tab of individual TRAVAX country pages and the Alerts section of individual fitfortravel country pages

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

Source: TRAVAX, 27 January 2022

The Brazilian Ministry of Health has reported continuing transmission of chikungunya across the country, with 96,288 cases, including 14 deaths, recorded from 3 January 2021 to 1 January 2022.

Advice for travellers

Chikungunya is a viral infection spread by mosquito bites which can cause acute fever and severe joint pain. All travellers to endemic regions are potentially at risk of chikungunya and should: 

• be aware of chikungunya and understand that no vaccine is available to fight this disease 
• avoid mosquito bites as Aedes mosquitoes are particularly persistent and aggressive, and they bite between dawn and dusk 
• seek medical attention as soon as possible if they develop a fever during, or on return, from travel and mention their travel history

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

Source: TRAVAX, 27 January 2022

Public health authorities in Nigeria have reported continuing widespread transmission of Lassa fever in the country. In the first two weeks of 2022, 96 cases, including 11 deaths, have been reported from Bauchi, Benue, Cross River, Ebonyi, Edo, Kaduna, Kogi, Ondo, Oyo, Plateau, and Taraba states, with three-quarters of these cases recorded in the Edo, Bauchi, and Ondo states.

Lassa fever is a type of viral haemorrhagic fever (VHF) endemic in parts of West Africa and is transmitted via the urine or droppings from infected rodents (Mastomys rats). Transmission can also occur via body fluids of infected people.

Advice for travellers

The risk to travellers becoming infected or developing Lassa fever is extremely low, unless living in conditions of poor sanitation and overcrowding in rural areas where these rodents are usually found. 

Travellers to known Lassa fever outbreak areas must be made aware of the risk of infection and transmission routes of Lassa virus, which is most commonly through: 

• ingesting or breathing in tiny particles in the air if it has been contaminated with infected rodent excretions, for example during cleaning activities such as sweeping
• touching objects soiled with infected rat excretions, and infecting open cuts or sores 
• eating food which has been contaminated with rat excretions

Medical personnel travelling to work in an outbreak region must follow strict infection prevention control guidance.

Travellers returning from a Lassa fever outbreak area should seek rapid medical attention by contacting NHS 24 (Scotland) or NHS 111 (rest of UK) for advice prior to attending UK medical facilities if they develop a fever and have: 

• returned to the UK within 21 days from a region or area with a known outbreak of Lassa fever 
• had contact with individuals infected with a VHF

Further information and advice on VHFs, including Lassa fever, is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 27 January 2022

The World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) have published the first antimicrobial resistance surveillance in Europe report, providing a pan-European overview of the antimicrobial resistance (AMR) situation in the European region. Featuring data from 2020, the report finds that more than 670,000 drug-resistant bacterial infections occurred in the EU and EEA alone, with approximately 33,000 people dying as a direct consequence of these infections. 

The report found high percentages of resistance to third-generation cephalosporins and carbapenems in K. pneumoniae, and high percentages of carbapenem-resistant Acinetobacter spp. in several countries, suggesting the dissemination of resistant clones in healthcare settings and indicating, in many countries or areas, the limitations in treatment options for patients with infections caused by these pathogens. Resistance to last-line antibiotics, such as vancomycin and those in the carbapenems group, is also raised as a concern.

The report concludes that robust investments in interventions to address AMR are urgently needed and would have a significant positive impact on population health and future healthcare expenditures in the region.

Sources: WHO, 26 January 2022 and ECDC, 26 January 2022

The European Centre for Disease Prevention and Control (ECDC) periodically publishes influenza characterisation reports, giving an overview of circulating influenza viruses. These reports provide details on current vaccine strains, summarise the development of viruses since the last report and closely follow the main developments for the ongoing influenza season.

On 25 January 2022, the ECDC published the third virus characterisation period report for the 2021 to 2022 influenza season. As of week 52 of 2021, 23,246 influenza detections across the World Health Organization (WHO) European Region had been reported. Of these, 96% were type A viruses, with A(H3N2) dominating over A(H1N1)pdm09, and 4% were type B viruses, with 13 having been ascribed to a lineage, one of which was B/Yamagata. This represents an increase of 5,601% in detections compared to the 2020-2021 season, on the back of an increase in the number of samples tested, and is closer to the more usual number of detections seen at this time in earlier seasons.

Source: ECDC, 25 January 2022

The World Health Organization’s (WHO) human health risk assessment on chemical hazards toolkit aims to provide users with guidance to identify, acquire, and use the information needed to assess chemical hazards, exposures, and the corresponding health risks in their given risk assessment contexts at local and national levels.

Since the publication of the first toolkit in 2010, there have been new developments in chemical risk assessment methodologies, new tools, and new WHO publications. This revised edition is intended to incorporate information about these changes and keep references and links to the information sources up-to-date. The toolkit has been developed for public health and environmental professionals, regulators, industrial managers and other decision-makers.

Source: WHO, 25 January 2022