Review of current typhoid fever vaccines, cross-protection against paratyphoid fever, and the European guidelines.

Typhoid and paratyphoid fever remain a global health problem, which - in non-endemic countries - are mainly seen in travelers, particularly in VFRs (visiting friends and relatives), with occasional local outbreaks occurring. A rise in anti-microbial resistance emphasizes the role of preventive measures, especially vaccinations against typhoid and paratyphoid fever for travelers visiting endemic countries. Areas covered: This state-of-the-art review recapitulates the epidemiology and mechanisms of disease of typhoid and paratyphoid fever, depicts the perspective of non-endemic countries and travelers (VFRs), and collectively presents current European recommendations for typhoid fever vaccination.

Awareness of meningococcal disease among travelers from the United Kingdom to the meningitis belt in Africa.

Meningococcal disease causes considerable morbidity and has a high case-fatality rate. In the United Kingdom, the meningococcal quadrivalent vaccine is recommended for travelers visiting the meningitis belt of Africa. We analyzed 302 responses to a cross-sectional study conducted in 2010 of travelers who had visited the meningitis belt recently or were shortly due to travel there.

Fever in the returning child traveller: approach to diagnosis and management.

During the last half century there has been an exponential increase in international travel including to more exotic and long-haul destinations. The assessment of febrile returning child travellers presents diagnostic challenges and is often performed poorly. A detailed travel and medical history, clinical examination and appropriate first-line investigations are essential.

Prevention of influenza among travellers attending at a UK travel clinic: beliefs and perceptions. A cross-sectional study.

Background: Travellers' compliance with measures to prevent influenza through the use of antivirals and influenza vaccine remains very poor despite influenza being one of the commonest travel and vaccine-preventable diseases. A study was undertaken to assess travellers' beliefs, perceptions and intentions to take antivirals for the treatment and prevention of influenza during the H1N1 pandemic.

Methods: A cross-sectional survey (n = 96) of travellers who attended the Royal Free Travel Health Centre, London, UK was undertaken in September 2009.

Review of oral cholera vaccines: efficacy in young children.

Background: Young children are one of the most vulnerable groups who may be infected with cholera. The following literature review of the efficacy of the currently available cholera vaccines provides a clear evidence base for the clinical administration of cholera vaccine, particularly in an epidemic situation.

Aim: To assess the efficacy of oral cholera vaccines in preventing cases of cholera in young children.

2010 FIFA world cup South Africa: travel health issues and new options for protection against meningococcal disease.

The public health implications of large crowds gathering at a range of key global events should never be underestimated. This is especially the case with the upcoming 2010 FIFA World Cup South Africa programme where thousands of local and travelling spectators, players and officials from all over the world will be present. Although meningococcal disease contracted whilst actually travelling is relatively rare, any travel health risk assessment should involve consideration of potential exposure to and transmission of this disease where crowding occurs.

Effectiveness of malaria chemoprophylaxis against Plasmodium falciparum infection in UK travellers: retrospective observational data.

What is already known on this topic. Malaria is a potentially life-threatening disease, and cases of imported Plasmodium falciparum malaria have increased among UK travellers over the past 20 years, although declining steadily in recent years. The HPA Advisory Committee on Malaria Prevention (ACMP) UK Traveller guidelines recommend doxycycline, mefloquine, or combination atovaquone plus proguanil for prophylaxis in travellers to P.

Hepatitis B immunisation in travellers: poor risk perception and inadequate protection.

Objectives: A survey of European travellers was conducted during 2006 to determine travellers' immunisation status and risk for exposure to hepatitis B while travelling.

Design: A first telephone (Omnibus) survey established the prevalence of travel in the previous five years as well as demographic profile of travellers amongst the general population. A second online survey targeted travellers to moderate or high hepatitis B endemicity countries, using data from the first survey to ensure a final sample representative of the travelling population in each country.

Imported malaria in the UK.

Is rising because of failure to comply with prophylaxis or to seek travel health advice

The true burden and risk of cholera: implications for prevention and control.

Cholera is a substantial health burden on the developing world and is endemic in Africa, Asia, South America, and Central America. The exact scale of the problem is uncertain because of limitations in existing surveillance systems, differences in reporting procedures, and failure to report cholera to WHO; official figures are likely to greatly underestimate the true prevalence of the disease. We have identified, through extensive literature searches, additional outbreaks of cholera to those reported to WHO, many of which originated from the Indian subcontinent and southeast Asia.

Should hepatitis B vaccination be introduced into childhood immunisation programmes in northern Europe?

Infection with hepatitis B causes between 500,000 and 1.2 million deaths per year worldwide, and is the leading cause of liver cancer. Over 12 years ago, WHO recommended that universal childhood hepatitis B vaccination be implemented globally.

The role of standby emergency medication for falciparum malaria: current opinion.

Travellers to malaria-endemic destinations are at risk of significant disease and, sometimes, death. Current malaria protection strategies, including chemoprophylaxis, can never be completely effective. In some cases, protective measures are discontinued or misapplied while the risk of infection still exists.

Meningococcal W135 carriage; enhanced surveillance amongst east London Muslim pilgrims and their household contacts before and after attending the 2002 Hajj.

Background: For two successive years, 2000 and 2001, there was a world-wide outbreak of W135 meningococcal disease amongst pilgrims who attended the Hajj and in their contacts after returning home.

Methods: Beginning January 2002, we offered meningococcal quadrivalent polysaccharide vaccine (against serogroups A, C, Y and W135) to pilgrims and collected a throat swab for meningococcal W135 carriage before and after their pilgrimage.

Results: The overall Neisseria meningitidis carriage pre-Hajj was 8.

Poliovirus immunisation for travellers.

Mass immunisation against poliomyelitis using principally oral live attenuated trivalent vaccine (OPV) has eradicated wild-type poliovirus transmission in the industrialised countries of the Western hemisphere and most other countries, and the global eradication of poliomyelitis is within reach. The risk of oral polio vaccine-associated poliomyelitis has been estimated by WHO at 0.5-3.