Monday, 29 May 2017

Malaria Matters E learning course

Many of you may have already taken this course but some new software means I've now been able to update it and it works smoothly now on a tablet and mobile phone as well as your personal computer! This is a huge relief because although the course has been very well evaluated, worked efficiently for some, has driven others a little bit crazy!  Despite this I know that hundreds of people have also done it and gained great benefit, so I hope it will be plain sailing in the future ..... I'm a 'one man band' and sometimes sorting out IT issues is a real challenge!

Click on the image to see more detail.  


When you enter the e learning platform called 'LearnUpon' to undertake the free of charge course it will tell you you have two weeks to complete it. The platform costs to host the course, but I feel so keen that people learn more about malaria that I make it free to the end user at the current time. I limit the time access to manage this.  If you're mid-way and just haven't had time to finish but really want to do so, please e mail me as instructed on the course and I'll extend your time.  If you looked and decided not to complete then I'll remove your registration to make way for someone else to use it.  

LearnUpon now have an app to manage the course through on a mobile device - for the IoS version on the Apple store click here   I haven't been able to find an Android app for it yet but am still making enquiries.  

Thursday, 25 May 2017

Update on ACWY conjugate vaccine booster

Please note this information was up to date at the time of writing this piece and is updated information to my posting on the subject on 31st August 2016.  It has subsequently been updated again on 22nd June 2017. 

The vaccines we use in the UK and the reason for giving for travel purposes

In the UK we use two quadravalent meningococcal vaccines against the strains A, C, W135 and Y. These two CONJUGATE vaccines are Menveo (supplied by GSK) and Nimenrix (supplied by Pfizer - please note Nimenrix is no longer a black triangle drug). These vaccines are given to travellers going to endemic areas in the meningitis belt of Africa and for travellers undertaking pilgrimage - Hajj and Umrah for which a certificate of proof of vaccination is required, enabling the traveller to obtain a visa for entry to Saudi Arabia.

The Ministry of Health for the Kingdom of Saudi Arabia (KSA) publishes annually its requirements and recommendations for Hajj and Umrah. The new guidance was published in June for 2017 - see here and of significant importance it says 'the conjugate meningococcal vaccine certificate is valid for 5 years.  However, the certificate must state clearly that the Hajji actually received the conjugate meningococcal vaccine. If the vaccine type it not indicated in the certificate, then it will be assumed that it is not the conjugate vaccine and it the validity of the certificate will to be for 3 years.

Whereas in 2016 the KSA announced new information for the length of time to write on the certificate stating 8 years for a conjugate vaccine.  This information should NOW NOT be followed. The should not be administered less than ten days before arrival in the KSA.

For more details about Hajj and Umrah see this NaTHNaC Factsheet

In the UK because we now only use the conjugate vaccines, it is very important to write the name of the vaccine given on the certificate.


UPDATE ON BOOSTING OF THESE VACCINES
On my vaccine chart found at item no. 3 in the TOOLS section of my website, I have put 'when or if a booster should be given is not clear at the current time'  because there is nothing out there giving clear guidance as far as I can see!

  • KSA are saying 8 years for a conjugate vaccine on the certificate (as above). 
  • The Green Book chapter 22 on Meningococcal was updated September  2016 and says:
    • Children and young adults aged 10 years to less than 25 years (including students up to 25 years attending university for the first time) may also be eligible, or will shortly become eligible, for the teenage MenACWY conjugate vaccine. Those in this group who have never received a MenC-containing vaccine should be offered a single dose of the MenACWY conjugate vaccine. No further vaccination is then required.  (page 12)
    • In the section for children and adults with asplenia, splenic dysfunction or complement disorders it says booster doses of MenACWY conjugate vaccine in at-risk individuals are currently not recommended because the need for, and the timing of, boosters has not yet been determined. (page 13)
    • In the section for travellers, the previous information for boosting has just been removed. (page 14)

  • NaTHNaC has no information about boosting. 
  • TRAVAX says 'The need for and timing of a booster dose in those over 1 year of age has not yet been determine'. 
  • The Pharma companies GSK and Pfizer both have data for 5 years. 

Out of interest, looking up information for the CDC Yellow Book online in relation to conjugate vaccines (2016 version still online but also in the 2018 book just published) it says for those over 7 years at continued risk boost at 5 years and every 5 years thereafter for people who are at continued risk.

However here in the UK as nurses we must follow UK guidance.  If and when I learn of any new information then I will post here but at the current time I don't think things are very clear and perhaps you need to phone one of the travel helplines to make a final decision for your traveller after performing a travel risk assessment.  See item no 8 here for these details.









Wednesday, 10 May 2017

Nuggets of Knowledge - Hepatitis A vaccine

Hepatitis A vaccine has caused many a query for a very long time.  I've created a short e learning piece on this in the attempt it will help consolidate the theory about the rules, because once understood, hepatitis A vaccine is actually quite easy.

In the learning I explain these rules and explain the evidence behind them, take you through some of the historical issues of hepatitis A protection and provide some questions to test your knowledge.

The programme has been built in software that should work on desktop computers, tablets and mobile phones.  If the speed of your wifi is slow, some the pages may take a while to load.  On some iPads, it may ask you to watch it through an app called 'articulate' which is free to download.  Click on the image below to access the short learning or here.  At the end you'll be directed to a survey monkey to evaluate your experience.  Please complete this if you can.  Thank you!



Thursday, 4 May 2017

CDC Yellow Book 2018

Every two years the Centers for Disease Control and Prevention (known as CDC) publishes a great text book on travel health.  The 2018 edition will be published on 15th May.  They then sell it on their stand at the International Society of Travel Medicine conference which is also held every two years - this year in Barcelona from 14th - 18th May 2017.

The book is published by Oxford University Press and they sell copies, but you can also buy it on Amazon .  Once published and paper copies are available to buy it will also be available online - see here.  And as in previous years I'm sure there will be an app too!

Or as I suggested on a Facebook posting you could consider coming to the ISTM conference in Barcelona and get a copy there - its a great meeting.  This time I will be presenting a workshop on Risk Communication, but more about that in a later blog!



Sunday, 30 April 2017

Travel health in the future NHS

In March, NHS England announced a review after local health bosses identified £400m of spending they believe has little or no clinical value.  Travel vaccines were one of the ten 'low value' medicines mentioned on the list - see here to view a BBC news report.   This spurred me to write a personal reflection on the topic for the Practice Nurse Update in April. Also included is the Editorial which covers the subject written by Mandy Galloway.  As the General Election was subsequently called we are now in a period of purdah and no further government information will be released until after June 8th, but please read my article (click on the image below) and ensure for now you are still seeing travellers in a GP setting - you will be receiving funding for this at the present time.  


Factsheets in April

The National Travel Health Network and Centre have some excellent well referenced fact sheets that are either new or updated, posted on their website TravelHealthPro on a regular basis.  

These are also then put into their TravelHealthPro EBook.   Have you tried using this?  It works well on tablets for example and you can subscribe to updates to the E book as well and updates to the website in general.  

So the new factsheets on the website in April were as follows 





Tuesday, 28 March 2017

Travel Medicine - the Big Picture

Excellence in Healthcare 2017 is a large conference from the Royal College of Physicians and Surgeons of Glasgow.  This particular event is held every 3 years and this is the 4th such occasion.  The travel medicine strand is to be held on Thursday 8th June at 200 St Vincent Street, Glasgow which is a short walk up the hill from the Central Station.  This time we have a number of high profile speakers covering topics such as Zika virus, malaria prospects for the future, humanitarian aid work post Ebola, hepatitis C, the threat of anti-microbial resistance in the tropics and its impact on travel medicine, and the latest on anti-venom research.  Added to this we also have plenary sessions which are related to travel medicine  including entomologist Dr James Logan speaking at the end of the day asking are we ‘Bug Body Ready’?  The event costs £90 to attend for a full day of high quality education, refreshments, exhibition, poster section plus excellent networking.   To look at the website and also to book a place look here or click on the image below.