We have been featuring H1N1 influenza heavily here on 'Hand picked' lately, in line with the worldwide headlines the virus has been making since the emergence of an outbreak in Mexico. From the daily travel news alerts which hit my inbox, the virus has not only hit tourism in Mexico severely, but has also raised worldwide fears for possible effects on travel and tourism should the outbreak worsen. But how real is the threat to travellers?
Thankfully, although the World Health Organisation (WHO) pandemic alert remains at Level Five, the number of new cases in Mexico is decreasing, and most cases elsewhere in the world remain mild. Nevertheless, the number of countries officially reporting cases has now risen to 22 according to the WHO, with a current total of 1516 cases.
Whatever the current status of the disease, with public concern and high media attention, and with the possiblity that the virus could at any time change its character to become more deadly, governments have to plan for the worst. This creates problems for industries such as travel and tourism, particularly when countries start issuing travel advisories even though the WHO says that travel restrictions are futile. So the travel industry has to, as the European Tour Operators Association (ETOA) puts it, reassure people that everything is being done to "minimise a minimal risk".
According to the ETOA, "the risk currently posed to potential travellers within Europe is nil", and responding to the 'threat' can be viewed as "pandering to stupidity". In a strongly worded press release, the ETOA says that "even were the disease to become far more deadly and virulent than currently proved, death from H1N1 Swine 'flu is less likely than death by falling trees, bee stings, snake bites, lightening strikes or a wide variety of bizarre modes of fatality. Even if it is not contained, it seems to be respond to treatment and is not as deadly as first suggested. It is far less of a threat to life than existing endemic 'flu strains."
However, Tom Jenkins, Executive Director of ETOA, says "Yet the threat to the travel industry is real. Comparatively spurious threats to individuals can trigger a mass response. In 2001 the foot and mouth crisis posed no threat to anyone travelling in the UK. Yet demand for holidays in the UK dropped sharply. After September 11th it was ludicrously safe to fly, but planes flew empty. SARS was largely restricted to an affected 0.0002% of the population of Asia, yet travel in that region dropped by 40%. There is a pattern of disproportionate damage."
"So we have to declare the industries comparative safety and our determination to ensure that our clients remain safe from this virus."
ETOA's assertion is that the use of face masks should be avoided. If someone is ill, then a mask may help prevent them spreading disease. If used incorrectly (such as removed when sneezing) they are worse than useless [see also Isobel's blog on the use of masks].
What ETOA does recommend for tour operators is:
– When coaches are used, they should be vacuumed and cleaned with anti-bacterial agent daily
– Ensure air conditioning filtration systems are cleaned regularly
– On request from clients, supply antiseptic gels or wipes
– Remind clients of good hygiene procedures
– Where necessary, supply a bin for disposal of tissues
– Ensure that the usual procedures on isolating sick clients are followed
– Ensure clients have adequate medical insurance
While the ETOA may be correct regarding the current health risk of H1N1 influenza for travellers, when it comes to travel it is not just the actual risk to health that is important, but other factors that can impact on the travel or holiday experience. Thus while the 2001 foot and mouth crisis indeed posed no threat to anyone travelling in the UK, then for those for whom part of their holiday would have been walking in the countryside, the fact that footpaths in many parts of Britain were off-limits would have spoilt any holiday spent here. And while the incidence of SARS in Asia was low, then the travel experience would nevertheless be affected by (for example) the common practice in China during the epidemic of taking tourists temperatures when they arrived at a hotel, with the threat of being barred entry and placed in quarantine if they showed signs of a fever.
Thus while I would personally have few health worries about travelling to Mexico, especially away from Mexico City, I would be unlikely to go there while restaurants, clubs, museums and archaeological sites remain closed: as a tourist interested in all these things, there would be little point. But in other parts of the world these impacts on the holiday experience are not yet present, so the message probably can safely be: keep travelling.
To keep up to date with all the latest news on influenza A(H1N1), visit this CABI website, which combines news with free access to the Global Health database, where many pre-prepared database searches provide information on various public health aspects of influenza and other pandemics.