Long-haul travel is expected to pick-up this year with the outlook improving as countries have lifted pandemic restrictions.

As people in the UK book their holiday abroad for 2023, here is a roundup of the latest travel advice for pharmacies providing vaccinations for travellers.

Cholera in Africa  

In January, the World Health Organisation (WHO) has reported outbreaks of cholera are continuing in Africa. The disease is rare in travellers and the risk very low. A vaccine is only usually recommended to those volunteering or humanitarian workers travelling to work in disaster relief situations.

Contaminated medicines 

In January, medical alerts were issued by the WHO for contaminated products and medication in Uzbekistan, Yemen and Lebanon.

Two products were identified in Uzbekistan - Ambronol syrup and DOK-1 Max syrup - which failed to meet either their quality standards or specifications and were identified as containing a substance toxic to humans, which could prove fatal.

The affected mediation in Yemen and Lebanon was Methotrex 50mg, used to treat some cancers and autoimmune diseases.

Substandard and falsified (counterfeit) medical products are a growing problem across the world, with a range of counterfeit medicines available, including painkillers, antimalarials, antibiotics, blood pressure medicines and vaccines.

Travellers who take regular or intermittent medications are advised to obtain these in the UK before travel, especially if there is any cause for concern about the legitimacy of medications at their destination. This includes those recommended to take antimalarial medicines. Travellers are advised to take sufficient supplies to cover the duration of a trip.

Those travelling abroad may seek advice about the active ingredient in a medicine, so if they need to purchase it abroad, they can check it is the same.

Ebola 

An Ebola outbreak in Uganda was declared over on 11 January – 42 days since the last patient was discharged from hospital.

Currently, there is no licensed vaccine available for UK travellers to prevent Ebola.

Risks of infection to travellers is extremely low.

Cholera in Haiti 

From 2 October 2022 to 2 January 2023, the Haitian Ministry of Health reported a total of 22,469 suspected cases in the country. The county is experiencing civil unrest, which exacerbates its public health challenges. Cholera is rare in travellers and the risk very low. A vaccine is only usually recommended to those volunteering or humanitarian workers travelling to work in disaster relief situations.

Cholera in the Dominican Republic  

The Dominican Republic has reported cases of cholera in recent weeks, with 10 cases confirmed at the end of December. Cholera is rare in travellers and the risk very low. A vaccine is only usually recommended to those volunteering or humanitarian workers travelling to work in disaster relief situations.

Polio

The WHO has issued a reports on polio eradication, as it is currently discussing the topic at a meeting of the WHO Executive Board (to 7 February). The goal of the Polio Eradication Strategy 2022-2026 is to permanently interrupt all poliovirus transmission in endemic countries.

Travellers are advised to consider having a booster dose of polio vaccine if it has been more than 10 years since their last booster and they are travelling to a country where polio remains a problem.

Yellow fever in Africa  

The WHO has reported continued transmission of yellow fever in Africa, with 455 cases and 40 deaths reported from 13 countries between 1 January 2021 and 7 December 2022.

The affected countries are:

Cameroon: 54 cases

Central African Republic: 29 cases (4 deaths)

Chad: 61 cases (7 deaths)

Cote d'Ivoire: 33 cases

Republic of the Congo: 71 cases

Democratic Republic of the Congo: 16 (1 death)

Gabon: 1 case

Ghana: 137 cases (21 deaths)

Kenya: 13 cases (5 deaths)

Niger: 6 cases (2 deaths)

Nigeria: 31 cases

Sierra Leone: 1 case

Uganda: 2 cases

Travellers are advised to have a yellow fever vaccine if they are visiting areas where there is a risk of transmission.

Rabies  

Transmission of rabies continues in Vietnam. According to Vietnamese media, a woman died of rabies in Binh Thuan in late December 2022, which was the third death from rabies in the province last year.

Rabies has also been reported in Mexico.

Travellers are advised to consider having rabies vaccines before travel, at least four to six weeks before travelling, if there is a rabies risk at their destination.