As a travel nurse based in London, I was concerned to hear the recent warning from health officials about the spread of tick-borne encephalitis (TBE) virus in several parts of the country. The UK Health Security Agency (UKHSA) has confirmed three cases of TBE virus in patients in Yorkshire, Norfolk, and on the border of Hampshire and Dorset. Further tests on ticks across the country have found that the disease, which was commonly found in parts of Europe and Asia until now, is now present in the UK. The experts have warned that it is unlikely that TBE virus will disappear, so it’s essential to establish a surveillance program. 

Public health officials say the risk is low, but it’s essential for walkers to take precautions and seek medical help if they fall ill after being bitten, especially if by a tick.  

As a clinic that specialises in travel, we are used to urging everyone to take precautions to protect themselves from tick bites anyway, but this news reinforces the importance of doing this at home as well as when travelling abroad. It is essential to cover your ankles and legs, apply insect repellent, and check clothes and your body for ticks, particularly when visiting areas with long grass such as woods, moorlands, and parks. 

In most cases the TBE virus typically causes mild flu-like symptoms, but it can also lead to severe infection in the central nervous system resulting in meningitis or encephalitis a high fever with headache, neck stiffness, confusion, or reduced consciousness, and long-term impairment.  

As a travel nurse, I think it is really important to educate people about the symptoms of TBE to encourage them to seek medical help immediately if they experience any of these symptoms, but also to emphasise the fact that infections are preventable. 

Ticks are becoming more common in parts of the UK, mainly due to increasing deer numbers. They live in undergrowth and latch on to humans when they walk through long grass. It is thought infected ticks may have arrived in the UK via migrating birds. Scientists had suspected the virus had arrived in the UK in 2019, following a couple of cases, but complexities involved in testing meant these could not be confirmed. 

It’s crucial to emphasise the significance of vaccination for individuals who are considered of a higher risk. You are much more likely to catch TBE if you work outdoors or if you enjoy outdoor activities such as camping, hiking, dog-walking, countryside rambling and even jogging. Children playing outside may be especially vulnerable. 

Vaccines can provide protection, and as there is currently no known cure for tick-borne encephalitis virus, those individuals who would be considered at higher risk are advised to be vaccinated as a precaution.  

It’s worth noting that a vaccine is used routinely in areas of high incidence in Europe, and its advisable to consider vaccination for individuals with outdoor occupations in regions where the virus is prevalent.  

For the general public the risk of contracting TBE is relatively low. Therefore, it’s essential to educate people about TBE and encourage them to take precautions to protect themselves from tick bites, particularly when travelling to areas where the virus is found. 

Related services available at Fleet Street Clinic 

Tick Borne Encephalitis Vaccination 

GP Services 

Travel Clinic 

For further reading, more news coverage can be found here: 

Gov.uk – Tick Borne Encephalitis detection in England 

The Times – Tick-borne encephalitis warning to walkers

The Telegraph – First cases of rare tick disease found in England 

Dengue Fever has been in the news following two cases linked to travel to the Spanish island of Ibiza. This has sparked concerns about the spread of mosquito-borne illnesses in Europe, which is especially unusual for this time of year.

Dengue fever is a viral infection transmitted by the Aedes mosquito, which is found in tropical and subtropical regions worldwide. With rising temperatures and changing climates, there is a risk of mosquitoes and other disease vectors spreading to new areas, potentially causing outbreaks of diseases such as dengue fever.

The two cases of dengue fever in Ibiza were reported by the Spanish Ministry of Health and were both in residents of Germany who had visited the island before becoming ill. Each case was accompanied by two family members who were also suspected to have had dengue fever.

The risk of dengue fever in Spain is highest between the months of May and November, when mosquitoes are most active so to have cases at this time of year is uncommon.

So, why are we seeing cases outside of the usual infection months?
The reason is multi-facetted.

Our medical director and travel health specialist, Dr Richard Dawood explains:

“Firstly, there is the introduction or spread of mosquitoes to “pastures new” – places that might have been previously inhospitable, perhaps through temperature; or alternatively, that offer an environment with plenty of suitable breeding sites that they are suddenly able to take advantage of. These mosquitoes can bring disease with them, or can spread it around if there is a reservoir in the local population.

Secondly, there is the possibility of introducing disease to a vector population that is already established, ready and waiting. This is exactly the (long-standing) concern with yellow fever. There are mosquito species in Asia, for example, that are easily capable of spreading yellow fever were it to be introduced by an infected traveller – which is why Asian countries are so careful to insist on proof of yellow fever vaccination from travellers arriving from the endemic zones of Africa and South America. Asia is yellow fever-free, and wants to remain so. However, this type of introduction has already recently happened in Australia, where Japanese encephalitis (a virus infection that can cause rare but serious complications in humans) has recently established a reservoir of infection in farm animals, that may be impossible to reverse. It is also happening with Lyme disease spreading gradually into parts of Europe (and the UK) with a susceptible tick population.

Similar concerns apply to Zika – there is very large potentially susceptible mosquito population that could spread the virus in many tropical countries, if introduced; dengue fever; and also potentially malaria, in parts of the world that have been the target of successful elimination campaigns, but where mosquito populations could still spread it, were it to be reintroduced, if control measures are neglected or ceased.

With changing climates, a valid concern about global warming is that it could create conditions in which populations of mosquitoes and other vectors thrive and spread – hence the crucial importance of vigilance, surveillance, and early action if needed.”

How can you protect yourself from Dengue Fever?

There is no vaccine against dengue licensed in the UK, though several candidate vaccines are in development.

The best way to protect yourself against dengue fever is to take measures to avoid mosquito bites. This includes wearing protective clothing, using mosquito repellent, and staying in places with air conditioning or screens on windows and doors.

If you develop a high fever during or after travelling to an affected area, seek medical advice as soon as possible and provide details of your recent travel history. Dengue is often also accompanied by a rash and joint or muscle pain.

In conclusion, rising temperatures and changing climates have the potential to create conditions in which populations of mosquitoes and other disease vectors thrive and spread. It is crucial for public health authorities to remain vigilant and take early action if needed to prevent the spread of diseases such as dengue fever. By taking appropriate measures to protect against mosquito bites, travellers can reduce their own individual risk of contracting dengue as well as other insect-borne infections.

Suitable Medical Kits available to buy online

Buy: Ultimate Bug Kit

Buy: Essential First Aid Kit

Related services available at Fleet Street Clinic

Travel Vaccinations

Travellers’ Diarrhoea Online Consultation

Antimalarials

Travelling can have a significant positive impact on one’s physical and mental health, according to a study published in the Journal of Travel & Health. The study surveyed over 1,000 adults who had recently returned from a trip and found that the majority of them reported improvements in overall well-being, including increased energy and reduced stress levels. 

One of the key reasons for these self-rated health benefits is that travelling allows individuals to step out of their daily routine and experience new environments and cultures. This can lead to increased physical activity, as travellers may be more likely to walk or bike instead of drive which may also expose them to different types of food, leading to a healthier diet. 

Additionally, travelling can have a positive impact on mental health as well. The study found that the majority of participants reported feeling more relaxed and less stressed after their trip. This is likely because travelling can provide a sense of excitement and adventure, as well as a break from the demands and responsibilities of everyday life. 

Another benefit of travelling is that it allows individuals to build new social connections, which can be important for mental health. Meeting new people and forming new friendships can provide a sense of belonging and can also help to reduce feelings of loneliness and isolation. 

In conclusion, the study suggests that travelling can be good for one’s physical and mental health. It can help to increase energy levels, reduce stress and improve overall well-being. So, next time you are planning a trip, remember it’s not only good for your soul but also for your body. 

To read the full study, continue reading here: https://www.sciencedirect.com/science/article/pii/S2214140522002079?via%3Dihub 

Related services available at Fleet Street Clinic: 

• Travel Vaccinations
• Jet Lag Calculator
• Travellers’ Diarrhoea Online Consultation
• Antimalarials
• DVT Rick Calculator