On 4 July 2020, the Foreign & Commonwealth Office (FCO) updated its global advisory against all but essential travel, exempting some countries that no longer pose an unacceptably high risk for British travellers against coronavirus (COVID-19).

The fitfortravel (for the general public) and TRAVAX (for health professionals) country pages have been updated to include a COVID-19 country specific risk-rating, with every country being identified as high, moderate or low risk and each rating accompanied by appropriate travel advice. This information will be listed in the ‘Alerts’ section on each country page of fitfortravel and the 'Emerging Health Risks' section of every TRAVAX country page. The risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country, and will be regularly reviewed. However, as the global spread of COVID-19 can change at any time, travellers are advised to consider the advice below before planning international travel.

Advice for travellers

Before planning and/or booking international travel, please check: 

• the Foreign & Commonwealth Office (FCO) website, for country specific Travel Advisory Notices regarding travel and entry restrictions, and review the local medical care available at your destination 
• the COVID-19 risk-rating at your destination, which will be listed in the ‘Alerts’ section of all fitfortravel country pages and the ‘Emerging Health Risks’ section of all TRAVAX country pages 
• the TRAVAX travel insurance page, as such insurance should be considered essential 
• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• physical distancing and hygiene measures in the country you are visiting 
• the fitfortravel COVID-19 health considerations for travel page

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the general public) websites.

Information on COVID-19 for the general public is available on the NHS Inform (Scotland) and the NHS.UK (rest of the UK) websites.

Information and resources on COVID-19 for health professionals is available on the Health Protection Scotland (HPS) (Scotland) and Public Health England (PHE) (rest of the UK) websites.

Source: TRAVAX, 7 July 2020

World Hepatitis Day, which falls on 28 July 2020, is an annual event organised by the World Hepatitis Alliance (WHA) in collaboration with the World Health Organization (WHO), which raises awareness of the global burden of hepatitis.

There are five main strains of the hepatitis virus, A, B, C, D and E. Together, hepatitis B and C are the most common cause of deaths, with 1.3 million lives lost each year. Amid the COVID-19 pandemic, viral hepatitis continues to claim thousands of lives every day.

‘Find the missing millions’ is a three-year global awareness-raising and advocacy campaign, aimed at tackling the main barriers to diagnosis. For 2020, the WHO is focusing on a ‘hepatitis-free future’, with a strong emphasis on preventing hepatitis B among mothers and newborns. To coincide with World Hepatitis Day, the WHO will publish new recommendations on the prevention of mother-to-child transmission of the virus.

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

On 22 July 2020, the European Centre for Disease Prevention and Control (ECDC) published  2018 epidemiological reports for hepatitis B and hepatitis C.

In key findings from the hepatitis B report: 

• In 2018, 30 EU/EEA member states reported 24,588 cases of hepatitis B virus (HBV) infection. When the five countries that only reported acute cases are excluded, the number is 24,034, which corresponds to a crude rate of 6.0 cases per 100,000 of the population. 
• Of all cases, 10% were reported as acute, 51% as chronic, 30% as unknown and 9% could not be classified. The highest rate of acute infections was observed among 35–44-year-olds, with the highest rate of chronic infections was among 25–34-year-olds. 
• The rate of acute cases has continued to decline over the last few years, which is in accordance with global trends and most likely reflects the impact of national vaccination programmes. 
• Among acute cases with complete information, heterosexual transmission was most commonly reported (26%), followed by nosocomial transmission (19%) and transmission due to sex between men (14%). 
• Among chronic cases, mother-to-child transmission and nosocomial transmission were the most common routes of transmission reported, recorded at 37% and 26% respectively.

In key findings from the hepatitis C report: 

• In 2018, 37,527 cases of hepatitis C were reported in 29 EU/EEA member states. When the countries which only reported acute cases are excluded, the number is 37,427, which corresponds to a crude rate of 8.8 cases per 100,000 of the population. 
• Of the cases reported, 4% were classified as acute, 26% as chronic and 67% as unknown. 
• Hepatitis C was more commonly reported among men than women, with a male-to-female ratio of 2.1:1. 
• The most affected age group among males was between 35–44 years, and for females it was between 25–34 years. 
• The mode of transmission was reported for just 21% of cases. The most commonly reported mode was injecting drug use, which accounted for 46% of cases with complete information on transmission status.

The ECDC report finds interpretation of hepatitis C notification data across countries remains problematic, with ongoing differences in surveillance systems and difficulties in defining reported cases as acute or chronic. With hepatitis C, a largely asymptomatic disease until its late stages, surveillance based on notification data is challenging, with data reflecting testing practices rather than true occurrence of disease.

Sources: ECDC, 22 July 2020 and ECDC, 22 July 2020

The European Centre for Disease Prevention and Control (ECDC) has published its annual Legionnaires’ disease epidemiological report for 2018.

Legionnaires’ disease remains an uncommon and mainly sporadic respiratory infection, with an overall notification rate of 2.2 per 100,000 of the population for the EU/EEA in 2018. There is heterogeneity in notification rates between EU/EEA countries, with the highest rate reported by Slovenia (7.7 per 100,000). The annual notification rate increased continuously over the period 2014–2018, from 1.3 per 100,000 of the population in 2014, to 2.2 in 2018. There was a 23% increase in the number of cases in 2018 compared with 2017. Four countries, France, Germany, Italy and Spain, accounted for 71% of all notified cases in 2018. Males aged 65 years and above were most affected (8.5 per 100,000).

Source: ECDC, 23 July 2020

The European Centre for Disease Prevention and Control (ECDC) has published its annual chlamydia epidemiological report for 2018.

For 2018, 26 EU/EEA member states reported 406,406 confirmed cases of chlamydia infection. The crude notification rate was 146 cases per 100,000 of the population. Notification rates of chlamydia infection varied considerably across Europe, with the highest country-specific rates over 1,000 times greater than the lowest rates, which probably reflects the differences in chlamydia testing, case finding and reporting, rather than being indicative of actual differences in chlamydia prevalence. Notification rates continue to be highest among young adult women and heterosexuals. The overall trend appears to have remained stable in recent years, but there are variations at country level.

Source: ECDC, 24 July 2020

On 23 July 2020, the European Environment Agency (EEA) published its EU emission inventory report for the period 1990–2018. The report confirms the overall trend of steady but slow progress by EU member states, including the UK for the period it was a member, in reducing emissions of the main air pollutants present in Europe since 1990.

In all, 26 pollutants are monitored in the report, which is sent by the EU to the United Nations Economic Commission for Europe (UNECE). Between 2017 and 2018, emissions of nitrogen oxides (NOx), non-methane volatile organic compounds (NMVOCs), sulphur oxides (SOX), fine particulate matter (PM2.5), carbon monoxide (CO) and ammonia (NH3) dropped by 4.1%, 2.0%, 6.7%, 3.8%, 4.3%, and 1.6%, respectively, for the EU as a whole. Wider differences were reported by member states, with increased emissions of certain pollutants occurring in a number of individual countries.

The EEA report finds that, in 2018, the residential and household sector, which is one of the main emitting sectors for several pollutants, emitted 61% of all polycyclic aromatic hydrocarbons (PAHs), 51% of all primary PM2.5 and 41% of all dioxins and furans to the air in the EU. As in past years, around 93% of all NH3 emissions came from agriculture. Road transport was responsible for 39% of all NOx emissions, followed by the energy production and distribution (16%) and the commercial, institutional and household (14%) sectors. Energy production and distribution, which includes emissions from power plants, was also responsible for 41% of all mercury and 48% of all SOX emissions. These figures reflect emissions data for 1990-2018 and do not take the effects of the COVID-19 lockdown into account.

Source: EEA, 23 July 2020