The UK Health Security Agency (UKHSA) is not changing its travel advice to Europe, it has told The Pharmacist, following the publication of a report that identified an increasing risk of mosquito-borne diseases in Europe.

Meanwhile, the National Travel Health Network and Centre (NaTHNaC) said the new report ‘raises awareness of the importance of seeking up-to-date, reliable pre-travel health advice’, and suggested that community pharmacists may want to provide guidance and products to help travellers avoid insect bites.

The report, published on Friday by the European Centre for Disease Prevention and Control (ECDC), said that there is an increasing risk of mosquito-borne diseases in Europe following the spread of the Aedes species of mosquito.

A warming trend, with more frequent heat waves and flooding, has created more favourable conditions for invasive mosquito species such as Aedes albopictus and Aedes aegypti, the ECDC said.

The mosquito species Aedes albopictus, which can carry chikungunya and dengue viruses, is becoming established further northwards and westwards in Europe, with mapping from the ECDC showing established populations in Mediterranean countries including France, Spain and Italy.

A mosquito population is considered to be established in an area when it breeds and spends the winter there.

In the last 10 years, the mosquito has become established in 223 new administrative areas of five more EU/EAA countries, in addition to the 114 regions of eight EU/EAA countries with an established population a decade ago.

The ECDC also said that another species of mosquito, Aedes aegypti, which is known to transmit dengue, yellow fever, chikungunya, zika and West Nile viruses, has been established in Cyprus since 2022 and may continue to spread to other European countries.

Andrea Ammon, ECDC director, said: ‘In recent years, we have seen a geographical spread of invasive mosquito species to previously unaffected areas in the EU/EEA.

‘If this continues, we can expect to see more cases and possibly deaths from diseases such as dengue, chikungunya and West Nile fever.

‘Efforts need to focus on ways to control mosquito populations, enhancing surveillance and enforcing personal protective measures.’

The ECDC said that people can protect themselves against mosquito-borne diseases by using mosquito repellent, wearing clothes that cover most of the body, using mosquito bed nets (preferably insecticide-treated), or sleeping or resting in screened or air-conditioned rooms, and using window screens.

And they said that mosquito populations can be controlled sustainably by eliminating standing water sources where mosquitoes breed, using eco-friendly larvicides, and promoting community awareness about mosquito control.

The UKHSA said there was no change to its advice for travel in Europe following the ECDC report, and pointed to the National Travel Health Network and Centre (NaTHNaC) website for resources for health professionals and the public.

A spokesperson for NaTHNac said that the ECDC’s report ‘raises awareness of the importance of seeking up-to-date, reliable pre-travel health advice’. They pointed community pharmacists to its website for travellers and health professionals, Travel Health Pro, which has up-to-date recommendations for each destination.

They said: ‘The risk of insect borne diseases while travelling is carefully monitored by NaTHNaC and our colleagues at UKHSA.

‘Should there be changes of any significance in terms of disease risk, our website will be updated, and information disseminated to travel clinics,’ they added.

And they highlighted that many of the diseases transmitted by Aedes mosquitoes are not currently vaccine preventable.

‘For these diseases, prevention relies on good insect bite avoidance both day and night. Community pharmacists will want to be up to date with current recommendations to guide customers on effective repellents and other products,’ they said, highlighting their resources on insect and tick bite avoidance.

And they added that vaccine preventable diseases and recommendations on the indications for vaccination will be listed on the relevant Country Information pages on the Travel Health Pro website.

What are Dengue and West Nile fever?

Dengue is a viral infection caused by the dengue virus, which is carried by infected mosquitos and transmitted to humans through a mosquito bite.

West Nile virus is transmitted when infected Culex mosquitoes bite birds, and can also infect humans and other mammals.

Around 80% of West Nile Virus infections in humans are asymptomatic, but some people may present with West Nile fever, characterised by a sudden onset of symptoms that may include headache, malaise, fever, myalgia, vomiting, rash, fatigue and eye pain.

Elderly and immunocompromised people have a higher risk of developing West Nile neuroinvasive disease which can be fatal and does not have any specific prophylaxis or treatment in humans.