The Independent and Health-Informed Tourist?

Mers-virus-3D-imageFULLBy Scinceside – Own work, CC BY-SA 3.0

An innocuous visit to Dubai
A young friend of my extended family was recently taken seriously ill and ended up in a London hospital following a short trip to Dubai to visit a partner working abroad for a few months. The symptoms of the infection, taken together with the location, and the fact that the trip involved taking a camel ride, led the hospital to suspect deadly MERS (Middle Eastern Respiratory Syndrome). Acting on that basis, the partner was tested in a local hospital in Dubai and sent home to wait-out the 14 day transmission window for this disease.

About MERS
Its caused by a coronavirus (MERS-CoV), and infection is linked to travel in the Middle East and close contact with camels, camel secretions and uncooked camel products. The fatality rate is 40%, but deaths are usually linked to underlying medical conditions which weaken the immune response. There is no vaccine: disease transmission is controlled by hygiene, by contact tracing of confirmed cases and the wearing of personal protective equipment by hospital staff (1). Since 2012, 27 countries (including UK) have reported 2266 cases, the majority in Saudi Arabia, with a serious imported outbreak in 2015 in South Korea.

Fortunately the friend turned out not to have MERS but it was a very difficult and traumatic 24 hours finding information to reassure relatives (40% fatality is a scary statistic) … and it set me thinking:

How much can you be expected to know as an independent traveller and what is the responsibility of your tour organiser to inform you? Continue reading

Migrants fleeing conflict: a trial run for mass-migration due to climate change

Refugees_Budapest_Keleti_railway_station_2015-09-04
Refugees, Budapest station, Hungary. Credit: Rebecca Harms
(http://creativecommons.org/licenses/by-sa/2.0)
via Wikimedia Commons

 AS I write this I have a sense of déjà vu.
Public health professionals as far back as the 6th ECTMIH conference [2009], which I attended, recognised that very little was being done in Europe to address mass migration (at that time from Sub-Saharan Africa). Travel medicine specialists were refocusing their research onto migration and asking why this was not being reflected in travel medicine text books and journals.

“Does anyone ever ask if migrants suffer from diarrhoea?” asked Manuel Corachan [CRESIB, Spain], one of the plenary lecturers at the conference.  

At that time, Italy (conference host) was bearing the brunt of illegal migration. The conference debated the needs of illegal migrants to Italy, the importance to public health in the host country of giving them access to health services and of having an awareness of disease prevalence & cultural attitudes in the migrant’s home country.  In 2011, the  organisers of ECTMIH , the Federation of European Societies for Tropical Medicine and International Health (FESTMIH) devoted the entire conference to “global change, migration & health”. 

But this foresight was not just ethically driven, it was in expectation of mass migration into Europe due to climate change.

What we are now seeing, less than 6 years later, headlining our daily news and social media is a trial run for what is to come. What was previously perceived as a problem arising out of climate change has hit the EU earlier than might have been anticipated because of people fleeing conflict and dictatorship.

Continue reading