International travel continues to be severely restricted due to the coronavirus (COVID-19) pandemic, with a cautious approach to resumption underway for people living in Scotland, England, Wales and Northern Ireland since late spring 2021. Travelling abroad carries a risk of bringing new cases and variants of COVID-19 back into the UK, therefore travellers are still advised to consider whether their trip abroad is necessary before booking travel. The Foreign, Commonwealth & Development Office (FCDO) continues to advise against travel to red list countries.

A traffic light system which categorises countries on to a red, amber or green list, based on their COVID-19 risk, is in place for travellers arriving into the UK. It should be noted that the traffic light system does not indicate which countries are currently allowing UK travellers to enter their country.

Currently, anyone entering Scotland from countries on the international travel green list will not be required to quarantine on arrival, but will have to take a PCR test for COVID-19 and complete a passenger locator form. On 8 August 2021, Scotland, England, Wales and Northern Ireland updated their rules for returning to the UK from some red, amber and green list countries.

On return to the UK, travellers should be aware that testing and quarantine rules differ for Scotland, England, Wales and Northern Ireland. Prior to their journey, travellers must ensure they are able to comply with the rules appropriate to the UK nation they will be arriving in and reside in, if different.

Country specific COVID-19 risk

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.

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.  

• Each country or territory on the FCDO foreign travel advice page provides up-to-date information on their 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 website.

Sources: TRAVAX, 29 July 2021

During the current coronavirus pandemic, the TRAVAX team have focused on the importance of health professionals informing travellers of the dangers posed by other illnesses and health risks, as well as COVID-19.

Not all UK health professionals ask for a travel history during assessment of an unwell patient, and therefore may not consider travel-related or tropical diseases, such as malaria, as a diagnosis, unless they are aware that the traveller has recently been to a country where such diseases exist.

During a pre-travel consultation, travellers should always be advised to seek medical advice as soon as possible, and mention their travel history if they become unwell or develop a fever either during their trip or once they return home, for up to one-month after travel.

A reminder of some of the different health risks that may need to be discussed with travellers before travel, and thus should be considered if they present unwell on return: 

• The risk of malaria infection, transmitted to humans by mosquito bites. 
• Other diseases transmitted by mosquito and insect bites, including yellow fever, dengue fever and Zika virus infection. 
• Illnesses which can be transmitted by eating or drinking food and water contaminated by viruses, bacteria or harmful chemicals, such as travellers' diarrhoea, hepatitis A, typhoid and cyclosporiasis. Travellers should be advised to practise safe food and water precautions and hand hygiene measures to minimise risk. 
• Airborne diseases, such as common colds, chest infections and flu (influenza), which can be transmitted by inhaling infected droplets in the air released by people with the infection, or by touching surfaces which have been contaminated with these infected droplets and then touching their eyes, nose or mouth. 
• Travellers may become infected with blood borne virus infections (including HIV) and sexually transmitted infections (STIs) if they come into close contact with blood or body fluids of an infected person without taking safe precautions. 
• Risks from the environment, including accidents, sunburn and heat stroke, altitude sickness or animal bites.

Advice for travellers

Before booking any travel, all travellers should be advised to review the fitfortravel country page relevant to their destination to find: 

• up-to-date travel health recommendations for that country 
• advice on health risks to be aware of at their destination 
• if they need to receive any vaccinations, boosters or purchase antimalarial tablets before travel

Travellers should be reminded to always seek medical advice if they develop a fever either during travel or after they return home, and to always inform a health professional about their recent travel history, particularly if they have been in a malaria-endemic country. 

Source: TRAVAX, 3 August 2021

The European Centre for Disease Prevention and Control (ECDC) has reported that, as of 29 July 2021, one confirmed case of dengue fever has been reported. The case was detected in the Var department in south-eastern France.

Advice for travellers

Dengue is an infection spread by mosquito bites that can cause a severe flu-like illness. All travellers to endemic regions are potentially at risk of dengue fever and should: 

• be aware of dengue fever 
• avoid mosquito bites 
• seek medical attention as soon as possible if they develop a fever during or on return from travel

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

Source: TRAVAX, 5 August 2021

The European Centre for Disease Prevention and Control (ECDC) has reported that, as of 19 June 2021, 68,330 cases of chikungunya disease have been reported in Brazil in 2021, including 27,353 confirmed cases and five deaths, an increase of 20,286 cases and two deaths since 22 May 2021.

Compared with the same period in the previous year, there has been a significant rise in cases. As at 28 June 2020, 48,316 probable cases (no confirmed data) and 11 deaths were recorded.

Advice for travellers

Chikungunya is a viral infection spread by mosquito bites that 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 
• 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, 5 August 2021

The European Centre for Disease Prevention and Control (ECDC) has published a risk assessment on the risk of variant Creutzfeldt-Jakob disease (vCJD) transmission via blood and plasma-derived medicinal products (PDMPs), manufactured from donations obtained in the UK.

In February 2021, the UK lifted its ban on the use of UK-sourced plasma to produce immunoglobulin products. Taking into consideration a risk-benefit analysis, the UK assessed the vCJD risk for immunoglobulin products manufactured from UK plasma as very low, and acceptable in the context of overall vCJD risk in the general population. The presence of transmissible proteinaceous infectious particles, called prions (PrPSc), have been linked to vCJD among asymptomatic blood and plasma donors.

The ECDC report that the prevalence of vCJD-related PrPSc in the UK blood donor population is likely to broadly mirror the prevalence in the UK population as a whole. Evidence from retrospective cohort studies, using peripheral lymphoid tissue, suggests that the underlying prevalence of people that may be in the vCJD carrier state is around 0.05%, although there remains uncertainty around this estimate. The contrast between the estimated prevalence of vCJD-related PrPSc and the reported number of clinical vCJD cases seen to date, suggests that those in whom PrPSc is detected through an antemortem lymphoid tissue survey may never develop any symptoms of prion disease. Further uncertainty exists regarding the extent to which individuals who may be carrying PrPSc as latent or subclinical vCJD infection are capable of transmitting the infection to others, including through donation of blood and blood products.

The vCJD infection risk from the donations and final products is decreased by the safety measures implemented to reduce the risk of donation by exposed donors, and during whole blood processing or plasma fractionation. However, the ECDC find that absence of a reliable diagnostic blood test makes it difficult to assess the residual risk for transmission of vCJD infection through blood components and PDMPs obtained from UK-sourced blood and plasma donations with any degree of confidence.

Source: ECDC, 3 August 2021

From 1 October 2021, the legal requirements for labelling food sold pre-packed for direct sale (PPDS) will change in Scotland. Examples of PPDS foods include sandwiches placed into packaging by the food business and sold from the same premises, wrapped deli counter goods, such as cheese and meats, and boxed salads. The new labelling aims to help inform and protect consumers by providing ingredient and allergen information on the packaging.

Food Standards Scotland (FSS) has produced guidance intended to help food business operators check whether they will be affected by the changes to the labelling rules, and what they need to do to meet new requirements if they are. The new legislation will require PPDS food to be labelled with: 

• the name of the food 
• a full ingredients list 
• allergen information, emphasised within the list

Source: FSS, 2 August 2021

On 30 July 2021, the National Records of Scotland (NRS) published the latest data on drug-related fatalities, reporting 1,339 deaths in 2020, an increase of 5% on the previous year, and the highest figure on record. The Scottish Government has announced that from September 2021, there will be quarterly reporting of suspected drug deaths, with the aim of enabling better surveillance and response from all those involved in tackling this issue.

A national mission aiming to reduce drug-related deaths and harm was announced in January 2021, with measures introduced so far this year including: 

• funds to improve outreach services and support for families, and increasing residential rehabilitation provision 
• expansion of the provision of long-lasting buprenorphine (Buvidal) into the wider community, following a pilot in prisons 
• expansion of the existing heroin-assisted treatment facility in Glasgow, exploring its use in other parts of Scotland 
• £3 million to services to expand near-fatal overdose pathways 
• £3 million to expand the range of outreach services  
• £13.5 million for alcohol and drugs partnerships to support local and national initiatives 
• guidance on the consistent prescribing of benzodiazepine 
• consultations with stakeholders on the formation of a National Collaborative (Forum) to focus on the voices of people with lived or living experience and families

Source: Scottish Government, 30 July 2021

The Scottish Government has launched a support scheme offering free bottled water to people with reduced private water supplies, following recent warm weather. Some springs, streams and rivers used for private supplies, particularly in the north and west of Scotland, are now running dry and, despite the forecasts of heavy rain for parts of Scotland, many will remain vulnerable.

Around 3% of Scotland’s population is on a private water supply, equating to just over 150,000 people. Any affected households should contact their local authority in the first instance.

It should be noted that public water supplies, which the vast majority of households in Scotland use, are not affected by these issues.

Source: Scottish Government, 30 July 2021

The Scottish Environment Protection Agency (SEPA), together with local authorities, have launched a joint consultation to help shape the direction and delivery of flood risk management across Scotland. Actions to help tackle flooding in areas identified as being at the greatest risk are detailed in the consultation, alongside information on where the most benefits can be gained from taking action.

Following feedback from this consultation, SEPA will publish a flood risk management plan for each of the 14 local plan districts Scotland has been divided into for flood risk management purposes. Each plan will confirm the immediate priorities for flood risk management, as well as set out the future direction to be taken by all responsible authorities.

The consultation launched on 30 July 2021, and members of the public and businesses have until 31 October 2021 to comment on it. 

Source: SEPA, 30 July 2021