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Derek Evans

Welcome to Evans Travel Health

Blog     posted on Wednesday 4th August 2021

       How to prepare for Travel Medicine post-Covid

"We are all aware of that the impact of Covid infections has had on travel and continues to do. With the advent of vaccination programs and sophisticated testing and recording systems in place travel is starting to increase.

However the types of travel such as short haul continues to expand according to the determination of national governments whilst long haul remains dormant. The traveller groups have changed and the emphasis on routine vaccinations being sought by first time travellers going to exotic destinations has shifted to business and essential workers.

With this in mind the marketing of any specific travel medicine services will need to understand these changes. Following lockdowns and extended restrictions many travellers are now attempting to visit families and friends (VFRs) who they have only seen through video links. These VFRs will be a key target group during the revival of travel medicine demands and services.

A key part of the practitioners will be the flexibility to react to short time departures and supply necessary vaccines and medication where required. This parallels with the quick turn around that Covid tests are required for entry into another country before departure from the UK. It seems that a mix of PCR and rapid antigen tests are required within a range of departure times from 24 to 96 hours before departure.

The underlying point here is that this increased cost needs to be allowed for during any travel consultation and also the returning costs of testing and/or isolation. It is unlikely that these costs will be removed in the short term and certainly Covid will become another disease to be routinely covered during a travel medicine risk assessment."


Sourcing non-microbiologically contaminated water when travelling.

Posted on January 31, 2018 at 9:15 AM

Some unpublished research following a survey of travellers indicated that their intention when travelling was to rely on the purchase of bottled water to rehydrate. The survey indicated that the largest group intending to rely on this were in the 20-29 age group, and travelling on holiday or for business for a period of less than 2 weeks. This defined a rough profile of a group wanting to use bottled water in place of that from the tap or local source. The destinations were not recorded beyond the regional level not the remoteness of the journey which may influence the choices of water sourcing.

The dependence on bottled water was considered mainly from the expectation that bottled water standards were the same across all countries and that water in a bottle was microbiologically safer than locally sourced or tap water. A meta-analysis survey of research reports have highlighted countries where unsafe microbiological water has been tested and includes areas of common destinations for travellers. The WHO standards identify unsafe water as only having E.coli coliforms present in a sample. Of the samples that tested positive to the standard, there were also a number that tested positive to other species such as Pseudomonas and Enterococci, but these are not included within the WHO.

A recent report from WHO (Progress on drinking water, sanitation and hygiene, 2017), shows in  annex 3 a guide to the purity of tap water found in each country by average, rural and urban sources. The target is to gain 0% of coliforms in the At least Basic Group with water being present on the premises and available when needed. By reviewing this list countries progress towards safer water can be established over a period of time.

As in all things within travel health this is a guide, and is sub-categorised according to location. When considering the reliance of the traveller on bottle water then the improving levels of local water with supplementary purification methods can provide a cost effective alternative to bottled water with unknown levels of contamination.

The role of the healthcare professional still remains to highlight the differences in water quality between home and destination and also to advise on maintaining the safety of supply. The question of whether they will conform to the advice given, has been studied and reported before. This is often the answer to the questions relating to water purification and travellers diarrhoea., All of the observed studies have reported travellers not following the advice and experiencing some form of gastro-intestinal upset that may be linked to prohibited food or water sources.

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