As the coronavirus (COVID-19) outbreak continues to evolve, the Foreign, Commonwealth & Development Office (FCDO) advises British nationals against all but essential travel, exempting some countries that no longer pose an unacceptably high risk for British travellers. This advice is being kept under constant review and may change at short notice.

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. This risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country and is regularly reviewed.

Since October 2020, the COVID-19 risk to UK travellers has decreased for the following countries:

• Australia (Victoria state) 
• Canary Islands (Spain) 
• Cayman Islands
• Greek islands of Crete, Lesvos, Milos (Serifos), Tinos, Santorini, Zakynthos and Mykonos 
• Maldives

The COVID-19 risk rating and travel advice from the FCDO is being kept under constant review and may change at short notice. All travellers are advised to continue following sensible precautions and consider the following sources of information listed below.

Advice for travellers

Before planning or booking international travel, please check: 

• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• the Foreign, Commonwealth & Development Office (FCDO) 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 fitfortravel COVID-19 health considerations for travel page 
• physical distancing and hygiene measures in the country you are visiting

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

On 14 October 2020, the 26th meeting of the Emergency Committee under the International Health Regulations (IHR) (2005) regarding the international spread of wild poliovirus, was convened by the World Health Organization (WHO). The committee agreed that the situation still constitutes a Public Health Emergency of International Concern (PHEIC) and recommended the extension of the temporary recommendations. 

The committee provided the director-general with updated risk categories as below:  

• A certificate for polio vaccination under IHR (2005) is required for travellers from countries listed below, which are infected with WPV1, cVDPV1 or cVDPV3, with the potential risk of international spread: 
  
  
  • Afghanistan (WPV1)  
  • Malaysia (cVDPV1) 
  • Myanmar (cVDPV1) 
  • Pakistan (WPV1) 
  • Yemen (cVDPV1) 
    
    
• While travellers are encouraged to carry proof of polio vaccination, there is no certificate requirement under IHR (2005) for countries listed below, which are infected with cVDPV2, with potential or demonstrated risk of international spread, with the exception of Afghanistan, Malaysia, Pakistan and the Philippines, which are also infected with WPV1 or cVDPV1: 
  
  
  • Afghanistan 
  • Angola 
  • Benin 
  • Burkina Faso 
  • Cameroon 
  • Central African Republic 
  • Chad 
  • Cote d’Ivoire 
  • Democratic Republic of Congo 
  • Ethiopia 
  • Ghana 
  • Guinea 
  • Malaysia 
  • Mali 
  • Niger 
  • Nigeria 
  • Pakistan 
  • Philippines 
  • Somalia 
  • South Sudan 
  • Sudan 
  • Togo 
  • Zambia 
    
    
• States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV: 
  
  
  • China
  • Indonesia
  • Mozambique 
  • Myanmar
  • Papua New Guinea 

Advice for travellers and further information can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 30 October 2020

On 3 November 2020, Public Health England (PHE) published its annual report reviewing data on new HIV diagnoses, people accessing care in the UK, and HIV testing in England in 2019.

The report finds the total number of people newly diagnosed with HIV has continued to decrease, from 4,580 in 2018 to 4,139 in 2019, which represents a fall of 34% from a peak of 6,312 new diagnoses reported in 2014. In 2019, a total of 98,552 people (30,388 females and 68,088 males) were seen for HIV care in the UK. The number of deaths among people with HIV has remained stable, with 622 deaths (498 males and 124 females) in 2019, representing a crude mortality rate of 631 per 100,000 of the population living with diagnosed HIV infection.

PHE report that the number of gay and bisexual men (GBM) with newly diagnosed HIV fell to the lowest point in 20 years, with 1,700 new HIV diagnoses in GBM in 2019. New HIV diagnoses among people who probably acquired HIV through heterosexual contact also declined to 1,559 in 2019, a fall of 6% since 2018 and a fall of 33% since 2014. Among people who probably acquired HIV through injecting drug use, new HIV diagnoses remain stable at around 100 cases per year. Other transmission routes remain rare in the UK.

The current quarterly HIV infection in Scotland surveillance report, which includes data on new reports, to 31 December 2019, can be viewed on the Health Protection Scotland (HPS) website.

Source: PHE, 3 November 2020

The United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) have issued an urgent call to action to avert major measles and polio epidemics as COVID-19 continues to disrupt immunization services worldwide, leaving millions of vulnerable children at heightened risk of preventable childhood diseases.

In recent years, there has been a global resurgence of measles with ongoing outbreaks in all parts of the world, with vaccination coverage gaps further exacerbated in 2020 by COVID-19. In 2019, measles climbed to the highest number of new infections in more than two decades. Annual measles mortality data for 2019 to be released next week will show the continued negative toll that sustained outbreaks are having in many countries around the world.

At the same time, poliovirus transmission is expected to increase in Pakistan, Afghanistan and in many under-immunised areas of Africa. Failure to eradicate polio now may lead to global resurgence of the disease, with estimates suggesting there may be as many as 200,000 new cases annually, within 10 years. 

New tools, including a next-generation novel oral polio vaccine and the forthcoming Measles Outbreak Strategic Response Plan are expected to be deployed over the coming months to help tackle these growing threats in a more effective and sustainable manner, and, it is hoped, ultimately save lives. The plan is a worldwide strategy to quickly and effectively prevent, detect and respond to measles outbreaks.

Source: WHO, 6 November 2020

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

During 2018, 30 countries in the EU/EEA reported 52,862 TB cases. The number of notifications per 100,000 of the population was 10.2. The overall notification rate continued to fall, as did most country-specific rates. However, the report reveals that the EU/EEA is not currently on-track to reach the goal of ending the TB epidemic by 2030.

Source: ECDC, 3 November 2020

The European Centre for Disease Prevention and Control (ECDC) has published its ninth external quality assessment (EQA-9) scheme for typing of Shiga toxin-producing Escherichia coli (STEC).

Human STEC infection is a zoonotic disease. In 2018, it had an EU notification rate of 2.3 cases per 100,000 of the population, which represented an increase after a stable period from 2014 to 2017. The most commonly reported STEC O group was O157, compromising 34.5% of cases with known serogroup. The EQA-9 contains serotyping, detection of virulence genes and molecular typing-based cluster analysis.

Source: ECDC, 5 November 2020

Food Standards Scotland (FSS) has published a report to address knowledge gaps and better understand the risk of Shiga toxin-producing Escherichia coli (STEC) contamination of wild venison.

The report aims to: 

• map the venison industry in Scotland 
• assess STEC prevalence in wild deer faeces in Scotland 
• review cross-contamination risks in the slaughter and processing stages of wild deer from field to larder

FSS report that although the prevalence of STEC O157 in wild deer is low, it is the strain associated with the most severe forms of human disease. Therefore, adherence to strict hygiene practices from cull to final product are strongly recommended within the report.

Source: FSS, 5 November 2020

Established in 2009, World Pneumonia Day is marked every year on 12 November. It aims to:

• raise awareness about pneumonia 
• promote interventions to protect against, prevent and treat pneumonia 
• highlight proven approaches and solutions in need of additional resources and attention 
• generate action, including continued donor investment, to combat pneumonia and other common, sometimes deadly, childhood diseases

On this World Pneumonia Day, organisers are calling on governments and other stakeholders to ensure that the massive effort to control the COVID-19 pandemic contributes to reducing ‘all-cause’ respiratory infections and deaths, among both children and adults.

Further information and resources on World Pneumonia Day are available on the Stop Pneumonia website.

The European Food Safety Authority (EFSA) has completed its series of assessments on Rift Valley Fever (RVF). On 4 November 2020, the EFSA published its scientific opinion examining the effectiveness of surveillance and control measures in the EU.

RVF is a viral zoonosis that primarily affects animals, but also has the capacity to infect humans if they come into contact with the blood, body fluids or tissues of infected animals, or through bites from infected mosquitoes. 

The disease is endemic in sub-Saharan Africa and in the Arabian Peninsula, but has never been reported in continental Europe, although its range is expanding. In 2018 to 2019, it reappeared after ten years in Mayotte, where there have been outbreaks involving multiple human cases.

Source: EFSA, 4 November 2020

The Scottish Government is consulting on a new draft air quality strategy for Scotland. The draft five-year strategy includes proposals to: 

• take forward potential measures to control the supply of the most polluting domestic fuels, including wet wood and house coal 
• work with the agriculture sector to develop a voluntary code of good practice to help reduce emission of air pollutants 
• adopt a new approach to public engagement and behaviour change in relation to air quality
• continue the shift to more sustainable transport modes, as set out in the National Transport Strategy

The consultation is open until 22 January 2021, and a number of stakeholder events to engage directly with the relevant sectors are planned.

Source: Scottish Government, 30 October 2020

The Health and Safety Executive (HSE) has published its annual report concerning statistics for work-related ill health, workplace injuries, working days lost, enforcement action taken, and the associated costs in Great Britain.

Key figures from the report include: 

• 1.6 million people experienced a work-related illness 
• 111 people killed at their place of work 
• 693,000 injuries occurred at work, according to the Labour Force Survey 
• 65,427 injuries to employees reported under RIDDOR 
• 38.8 million working days lost due to work-related illness and workplace injury 
• £16.2 billion is the estimated cost of injuries and ill-health from current working condition

Source: HSE, November 2020

The Scottish Fire and Rescue Service (SFRS) has published fire and rescue incident statistics for the period 2019 to 2020.

In key findings from the report: 

• The SFRS attended 91,971 incidents, of which 57.8% were false alarms, 26.6% were fires and 15.6% were non-fire related. 
• There were 27 fatal fire casualties, down 18 from 45 in 2018, and 1,024 non-fatal fire casualties, down 14.5% since 2018. 
• There were 438 non-fire fatal causalities, up from 391 in 2018, and 3,208 non-fatal causalities, down 7.9%.

Source: SFRS, 30 October 2020