Understanding Coronavirus COVID-19 and It’s Impact

What is Coronavirus, COVID-19?

COVID-19, first identified in China in December 2019, is a highly contagious virus belonging to a larger family of viruses capable of causing illnesses ranging from the common cold to more severe diseases such as SARS. Recognised as a significant global health crisis, the COVID pandemic prompted widespread travel restrictions and heightened public health measures across the world.

According to the World Health Organisation, the majority of those infected with COVID will experience mild to moderate respiratory symptoms and recover without the need for special treatment. However, the virus can cause severe illness and require intensive medical care, particularly in older adults and individuals with underlying health conditions such as cardiovascular disease, diabetes, chronic respiratory disease, or cancer. It is important to understand that COVID can affect anyone, with the potential for serious health consequences at any age. More information is available on WHO’s official website.

COVID-19 Vaccination in the UK

In the UK, the COVID vaccine is provided free to all adults and high-risk groups through the NHS. To increase accessibility and protection against the virus, you can book your vaccination appointment directly via the (National Health Service) NHS website.

The UK offers several COVID vaccines, including Pfizer/BioNTech and Moderna, with each vaccine suitable for different groups. 

It is scientifically confirmed that you cannot contract COVID from the vaccines, nor can you transmit it to your baby through breast milk. If you have any concerns about vaccination during pregnancy or while breastfeeding, consulting with your GP or maternity team is strongly recommended.

Travel Advice for COVID-19

For those planning to travel, it’s essential to stay informed about the latest travel advisories and entry requirements, as these can change frequently due to the evolving nature of the pandemic. Travellers should check the UK government’s travel advice page for up-to-date information regarding their destination.

Before travelling, ensure you comply with any testing requirements and are aware of quarantine protocols for your destination and upon return. Travellers are also advised to be fully vaccinated, if possible, as many countries require proof of vaccination for entry. Additionally, maintaining good hygiene practices such as hand washing and wearing masks in crowded or indoor settings can help reduce the risk of infection.

Travel Restrictions

Coronavirus COVID-19

Within the UK, there is general freedom to travel.   Government restrictions related to Covid that were previously in place have been lifted.   As cases of Covid continue, good personal hygiene is an essential step to reducing risk of infection.

If you are travelling internationally, please be mindful that local rules at your destination may be different from those at your home location.  You must comply with local rules at all times.  Read the guidance on international travel.

COVID-19 Travel Certificates: Navigating International Travel Requirements

United Kingdom

As of 21 June 2021, the UK has implemented the NHS COVID Pass to serve as proof of COVID vaccination status for international travellers. The NHS COVID Pass is accessible at no cost through the NHS App—which is distinct from the NHS COVID App—and is available to anyone registered with an NHS GP in the UK.

Within the NHS App, the NHS COVID Pass generates a daily refreshed QR code that verifies your vaccination status. It’s important to note that possessing an NHS COVID Pass does not exempt travellers from the requirements for a PCR test or isolation periods mandated by certain international destinations. For the most current travel advice and entry requirements, UK residents should consult the UK government’s travel advice page.

European Union

Starting from 1 July 2021, the EU introduced the Digital COVID Certificate. This certificate is proof that a person has either been vaccinated against COVID, received a negative test result, or recovered from COVID. Available in both digital and paper formats, the certificate is recognised in all EU member states and can be obtained free of charge through national health authorities.

As the UK is no longer a member of the EU, UK residents are not eligible for the EU Digital COVID Certificate scheme. However, individual EU countries may have specific rules and requirements for travellers from the UK, particularly because the UK has been designated as a “variant zone” by some EU countries, leading to stricter entry restrictions. Travellers should verify the latest rules and restrictions by visiting the UK government’s travel advice page.

Transmission and Prevention of COVID-19

Travellers should be aware that COVID-19 is primarily transmitted through respiratory droplets, such as those expelled when an infected person coughs, sneezes, or talks. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

While less common, there are also indications that the virus might spread through contact with infected faeces, blood, or urine. It’s important to maintain good personal hygiene, including frequent handwashing and avoiding touching your face, to reduce the risk of such transmissions.

Current Treatments and Vaccinations

As of now, multiple COVID vaccines have been developed and are available globally, providing effective protection against the virus. These vaccines have undergone rigorous testing to ensure they are both safe and effective in preventing severe illness, hospitalisation, and death caused by the virus. In the UK, vaccines are available free of charge to those considered in high risk categories and can be accessed through the NHS. For those requiring the vaccine privately there are now numerous pharmacy outlets providing the vaccine from April 2024. 

While there is no specific antiviral treatment for COVID, there are various medications and therapies available to help manage and relieve symptoms. Patients are advised to follow healthcare providers’ recommendations, including taking prescribed medications for symptom relief and supportive care.

What are the most common symptoms of COVID?

While we now mainly observe mild illness from COVID the most common symptoms of COVID include:

  • A persistent cough that is new or worsening
  • A high temperature (fever)
  • A loss of, or change in, your normal sense of taste or smell (anosmia)

For the majority of individuals, COVID will present as a mild illness. However, it’s important to note that some people may be asymptomatic, meaning they do not exhibit any symptoms despite being infected with the virus. This can lead to unwitting transmission to others, particularly among those who are unvaccinated or have not previously contracted the virus.

Who is at Risk of Contracting COVID-19?

COVID-19 is primarily transmitted between people through respiratory droplets and particles released when an infected person coughs, sneezes, talks, or breathes. Individuals are at higher risk of catching the virus if they are in close contact (less than 1-2 meters) with someone who is infected. This proximity allows them to inhale droplets or have these droplets land on surfaces they may touch and then subsequently touch their face, introducing the virus to their respiratory system through the nose or mouth.

In addition to these transmission methods, COVID can also spread in crowded indoor environments, particularly where there is limited ventilation and people are in close proximity for extended periods. This underscores the importance of maintaining physical distancing, wearing masks in crowded settings, and ensuring good ventilation in indoor spaces to reduce the risk of airborne transmission of the virus.

How can I prevent Coronavirus, COVID?

To lower the risk of Coronavirus, COVID the following precautions can be taken:

  • Wash your hands regularly with soap and  water for at least 20 seconds, especially after being in public places, before eating, and after blowing your nose, coughing, or sneezing.
  • Use antibacterial wipes in situations where you cannot wash your hands, especially after touching surfaces in public areas such as bathrooms and on public transport.
  • Try to avoid touching your face including your mouth, nose and eyes
  • Do not share personal items such as toothbrushes, towels etc.
  • Maintain social distancing.  Keep a distance of at least 2m (6ft) between yourself and other people, especially if they are coughing or sneezing.
  • Avoid contact with others showing symptoms of flu-like symptoms or who appear unwell
  • Keep up to date with travel advisories and information from your government when moving around your own country or travelling overseas
  • Check advice when you return to your own country regarding precautions you should take if you have been to an area where cases of COVID are considered high 
  • If at any time you feel unwell with mild flu-like symptoms it is important to stay at home.  For more severe symptoms a person in the UK should call NHS 111 for advice
  • Vulnerable people should follow advice to prevent COVID and ensure they have received the COVID vaccination where suitable. 
  • You should also be remember that if you try to take a flight and are suffering from a respiratory problem you could be refused access to the flight – if you have an existing condition make sure you have a letter from your doctor!
  • Before travelling overseas to certain countries during the “flu” season it is advisable to discuss flu vaccination with your health advisor.
  • Finally the only precaution to prevent serious consequences of COVID is vaccination – consider a vaccination or regular COVID boosters especially when travelling.  

Those travelling should:

  • Check Travel Advisories: Before planning any trip, check the latest travel advisories from your government and the health advisories for the destination. This includes understanding any restrictions, quarantine requirements, or entry bans.

  • Vaccination: Ensure you are fully vaccinated against COVID before travel. Many countries require proof of vaccination for entry, and being vaccinated reduces the risk of severe illness.

  • Testing: Depending on the destination, you may need to show a negative COVID test result before departure or on arrival. Make sure to check the type of test required (e.g., PCR, antigen) and the time frame within which it must be taken.

  • Masks and Hygiene: Wear masks in crowded and enclosed spaces such as airports, planes, and public transport. Carry hand sanitizer and wash your hands frequently.

  • Steer clear of markets where live birds and animals are sold for food: These settings can increase the risk of exposure to zoonotic diseases, including potential new strains of viruses. If you must visit such areas, ensure you follow strict hygiene practices, avoid touching surfaces, and wash your hands thoroughly after your visit.

  • Social Distancing: Maintain a safe distance from others where possible, especially in crowded areas.

  • Health Insurance: Ensure you have travel health insurance that covers COVID related issues, including treatment and potential hospitalisation.

  • Stay Informed: Keep up-to-date with the COVID-19 situation in your destination as conditions can change rapidly. Download and use any required health apps or tracking systems mandated by the country you are visiting.

  • Prepare for Quarantine: Some destinations might require you to quarantine upon arrival. Prepare for this possibility by understanding the requirements and duration.

  • Respect Local Guidelines: Follow all local COVID-19 safety guidelines and regulations. Different destinations may have varying rules about mask-wearing, social gatherings, and curfews.

  • Symptoms Monitoring: Monitor your health throughout your trip. If you develop symptoms, follow the local public health advice regarding testing and self-isolation.

  • Flexible Planning: Have flexible travel plans as restrictions and policies may change quickly depending on the outbreak situation. Be prepared to alter your plans accordingly.

  • Emergency Contacts: Keep a list of local emergency contacts, including healthcare providers and the nearest embassy or consulate


Tularaemia Disease (Tularemia)

What is Tularaemia Disease?

Tularaemia (Tularemia) is an infectious disease.  Humans can become infected following a bite from an infected tick or animal contact.  The bacteria enters the body through an area of broken skin however, it can also be breathed  in through the nose or mouth.

The symptoms include a high fever, generalised aching and swollen glands.  The symptoms of Tularaemia can last over a period of a few weeks although it is not possible to catch the disease from other infected humans.

Who is at risk of the disease?

When visiting areas where the disease is endemic (that is: the infection is present in low levels) there is a risk. There have been recent outbreaks in all states in the USA, with the exception of Hawaii, and Netherlands.  Hunters and those trecking through land where infection exists in animals and ticks are also at risk.

How  Tularaemia be Prevented – also know as Tularemia?

Currently there is no vaccine available in the UK to prevent tularaemia.  Travellers should be careful to ensure their surroundings are kept clean, so as not to encourage rats and other potential carriers. Any water should be boiled if used for personal consumption or food preparation. Any food should be protected from animals and cooked thoroughly. Dead animals should not be handled.

A good insect repellent to prevent tick bites should be used.  Ticks should be carefully removed using tweezers.

Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional. Please discuss your travel health requirements with your regular family doctor or practice nurse.

Travel Advice on Zika Virus Disease

What is Zika Virus?

Zika Virus has been declared a “Public Health Emergency of International concern” (WHO).  It is a disease spread by mosquitos. This is not a new disease. The first human case was recognised in 1952. It is usually a mild illness which can occur up to seven days after a bite from an infected mosquito.  The illness usually lasts up to a week.  Symptoms include fever, rash, conjunctivitis, joint pain, headache.

Cases of Zika virus have recently been reported in Africa, Pacific Islands, Caribbean, Brazil and Southeast Asia.  In recent years there has been a rapid increase in cases of the disease. Due to the nature of the disease it continues to spread globally – therefore it is best to check with your doctor or travel clinic for latest updates especially if you are a pregnant traveller.

Who is at risk of Zika Virus?

Any traveller to areas of the world where the disease exists is at risk. Due to the mild nature of the illness a traveller might not even realise they have had the disease.

Experts believe that the biggest risk of this disease is for the unborn child.  There is growing evidence that Zika virus can cause birth defects.

Pregnancy and Zika Virus

Women travelling to areas where they will be at risk of Zika virus are advised:

  • In Pregnancy – postpone non-essential travel until after the pregnancy
  • If travel cannot be avoided bite prevention is essential
  • Avoid getting pregnant while away and for 28 days on return

How can I prevent Zika Virus?

There is currently no vaccine to prevent Zika virus, although trials are underway. The best method of prevention is bite prevention.  It is important to remember that the Ades mosquito bites during the day.

Evidence also suggests the disease can be passed sexually. In order to prevent transmission:

  • When a partner is pregnant a condom should be used during travel and for 28 days on return
  • If a partner is planning or could become pregnant condom use is recommended
  • A male partner with symptoms of the disease following travel is recommended to use a condom for 6 months

Countries where the virus is endemic will be the same countries that other mosquito borne disease can be spread such as Dengue and Chikungunya.

References and Further Information

Malaria Lifecycle and How Malaria Spreads

The following pictorial diagram shows the lifecycle of the mosquito responsible for the spread of malaria. This diagram has been provided and reproduced with permission from GlaxoSmithKline.

malaria life cycle
Pictorial Diagram showing how Malaria spreads

Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

West Nile Virus

In most cases the virus causes mild flu like symptoms 3-14 days after the bite from an infected mosquito. Other symptoms might include eye pain, vomiting and a rash on the skin. These symptoms usually last 3-6 days.

Only 1 in 150 infected persons can go on to develop a more severe form of the disease, with increased age (over 50) being an indicator for higher risk. Severe symptoms include fever, weakness, vomiting and a change in mental behaviour. These symptoms can eventually lead to death.

Who is at risk of West Nile Virus?

Up until 1999 this disease was mainly found in Africa, Egypt, South-east Asia and the Southern parts of France. The first recorded cases in the Western Hemisphere were reported in New York in 1999 and since 2000 many cases have been reported throughout the United States and Canada. Any person travelling to these areas is at risk of the disease.

Risk is seasonal in most places and will therefore vary at different times of the year – however those travelling to the Southern States of the United States should be aware that the risk remains all year. The CDC website can provide up to date information on currently infected areas.

What can I do to prevent West Nile Virus?

There is no vaccine to prevent WNV in those travelling to high-risk areas — prevention of bites from mosquitoes is the best line of protection. Most of the mosquitoes bite from dusk to dawn and a good repellent should be used during this time, however in some areas day biters have been found so use repellent accordingly.


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Yellow Fever Virus

What is Yellow Fever?

Yellow Fever is a virus, which is spread via the bite of an infected mosquito. The disease exisits  in tropical areas of Africa and South America. While the disease is not found in Asia – the potential is there for spread due to the presence of the Ades mosquito, which is responsible for its spread.

Yellow Fever is recognised in two different forms – urban and jungle. Urban Yellow Fever occurs in the cities and is spread from mosquito to human to mosquito. In the jungle form Yellow Fever is spread from mosquitoes to monkeys and also to humans.

The disease presents itself after an incubation period of about 3-6 days with flu like symptoms, with death occurring in around 5% of those who become infected. There is no treatment for Yellow Fever, and so relief of symptoms is the primary course of action.

Who is at risk of Yellow Fever?

Any traveller to areas where Yellow Fever is endemic (that is: the infection is present in low levels) is at risk. This includes areas of Africa and South America.

How can I prevent Yellow Fever?

Travellers should obtain the necessary vaccination and a certificate of vaccination when travelling to endemic areas of the world.  This certificate is the ONLY internationally regulated certificate. The WHO recommends it for all travellers to endemic areas, as well as for those coming from an endemic area to an area of potential transmission. The purpose of the certificate is not only to protect the traveller but to also protect those in areas of the world where infection is possible due to the presence of the Ades mosquito. It is essential to ensure that the traveller plans ahead due to the shortages of vaccine at this present time.

Also see Preventing Bites.

  News and References 

  • May 2016 – Independent reports that “Yellow Fever – World on brink of global emergency over deadly outbreak, academics warn”
  • JAMA Article May 2016 – A Yellow Fever Epidemic
  • Find a Registered Yellow Fever Clinic near you

Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Typhoid and Can you Prevent it?

Typhoid is a Bacterial Infection

Typhoid is an infection caused by bacteria.  The bacteria is similar to the one that causes salmonella food poisoning.  You can become infected with Typhoid after eating or drinking infected food and water. The time between becoming infected and the first symptoms is around 1-3 weeks.  The disease can occur in any age group.  The disease is rare in children under 2 years of age.

Symptoms usually appear over the course of a month.  Once infected you might experience headaches and tiredness. This can progresses to aching muscles and stomach pains. Some people have a ‘rose spot’ rash after the first week of infection. Constipation can occur followed by bloody diarrhoea and a high temperature. If the disease is not treated quickly it can lead to death.  After contracting the disease you can pass the infection to others for 6 weeks to 3 months.

Typhoid is Present around the World

Typhoid is mainly present in South America, Africa and areas of Asia.  Therefore there is a higher risk if you travel to undeveloped areas of the world.

It is also important to understand that Typhoid can potentially occur anywhere in the world.  This is due to the way the disease spreads and the speed of travel. Natural disasters and imported cases can allow for outbreaks in parts of the world that would normally be considered low risk areas.

Typhoid can be Treated with Antibiotics 

Antibiotics can be used to treat mild cases, if the disease is diagnosed early. However, late diagnosis usually requires hospitalisation and  carries the risk of serious complications or death.

Vaccination can help Prevent Disease

Getting vaccinated (injection or oral) is a good idea when you are traveling to risk areas, and for occupational risks. Also vaccination against both Hepatitis A and Typhoid as a two-in-one injection is also available.

As vaccination does not provide 100% protection, it is also important to avoid food and drink which could be infected. You should also wash your hands properly before eating or using the bathroom.

References and Resources

Note: This information is intended to complement and not replace the relationship you have with your existing family doctor or travel health advisor.  Please discuss your travel health requirements with your regular family doctor, pharmacist or practice nurse.

BCG Vaccination

Empowering Immunity with a Milder Form of Tuberculosis BCG Vaccination 

The BCG (Bacillus Calmette-Guérin) vaccine protects individuals against tuberculosis (TB), a serious bacterial infection that primarily affects the lungs but can also impact other parts of the body. Introduced as part of the UK’s public health strategy in 1953, the use of the vaccine has evolved over the years. Routine vaccination for teenagers in schools was discontinued in 2005, shifting to a targeted, risk-based vaccination programme.

Currently, in the UK, the BCG vaccine is administered by the National Health Service (NHS) to babies, children, and adults under the age of 35 residing in high-risk areas, including London. Key characteristics of the vaccine include:

  • It contains a weakened form of the tuberculosis bacterium.
  • It is a live vaccine.
  • It is free from Thiomersal and other preservatives.

Tuberculosis is marked by symptoms such as a persistent cough, often accompanied by blood, night sweats, fever, and unexplained weight loss. These symptoms may develop slowly, making early detection and prevention critical.

For those travelling overseas, TB transmission can occur in crowded or enclosed environments, particularly in areas with poor ventilation where the bacteria can remain airborne for several hours. High-risk areas often include parts of Africa, Asia, and Eastern Europe where TB prevalence is higher.

The BCG vaccine is administered only if deemed necessary following a comprehensive risk assessment and tuberculin skin test. Travellers under the age of 16, planning to live or work in a high-risk area for more than three months, are particularly encouraged to get vaccinated.

If you are planning to travel abroad, undergoing a full risk assessment is crucial to determine if the BCG vaccine is necessary. Private travel clinics are equipped to assess your risk and provide essential advice, ensuring you are protected against TB during your travels.

Resources and information for Tuberculosis and BCG Vaccination


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.


Tuberculosis is spread from person to person via droplets in the air from coughing or sneezing. On rare occasions, it is spread via contaminated milk in the tropics.

Once an individual is infected they can remain without symptoms or go on to experience weight loss and general ill health. Tuberculosis most commonly affects the lungs and is accompanied by persistent coughing, blood stained sputum (phlegm), chest pain and fever.

Who is at risk of Tuberculosis?

Tuberculosis is found all over the world with China and India having the highest number of cases and Africa having the most deaths. In the UK, there has been a 25% increase in cases in the last ten years mainly among those from Asian backgrounds.

TB can only be caught from someone who already has the disease.

In the UK, routine vaccination of all school children is no longer practiced (DOH July 2005). A new vaccination programme now targets those children and adults at highest risk to the disease.

For those travelling to high-risk areas, such as Africa, Southeast Asia and parts of South America, proof of immunity is recommended.

How can I prevent Tuberculosis?

Partial protection is gained through BCG vaccination. The vaccination is only given at the presentation of a negative mantoux or heaf test. Only newborn babies are vaccinated without the test.

It is essential for all travellers going overseas to have a test and the subsequent vaccination if required. It is possible that immunity after vaccination is not lifelong and therefore all persons moving abroad to work in risk areas should consider testing, especially if the vaccination scar is not present. For advice regarding BCG, you should make an appointment with your family doctor or Travel clinic nurse.

For those with TB, treatment involves a variety of antibiotics taken over a period of months. The treatment will cure the disease ONLY if the treatment is continued until the end of the course. Because many people feel better, they stop taking the medication and this results in a recurrence of the disease.


Please note that the recommendations in other countries may differ from those in the UK and local advice should be sought.

European BCG Recommendations

Australian BCG Recommendations

American BCG Recommendations

Resources for TB

The DOH has provided answers to many common concerns about the jab

NHS Immunisation Information Service has produced multi-lingual fact sheets about TB and other vaccine preventable diseases

Amazon has a collection of books covering history and medical treatment of TB including Timebomb: The Global Epidemic of Multi-drug-resistant Tuberculosis (Paperback) £6.95

Health Protection Agency provides excellent information and reports on Tuberculosis with latest health reports and epidemiological data from the UK and abroad.


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Tick Borne Encephalitis

What is Tick Borne Encephalitis?

Tick Borne Encephalitis is a viral disease spread via the bite of an infected Ixodes tick. It can also be transmitted via unpasturised milk from infected goats or cows. Ticks bite humans when they walk through undergrowth or grasses where contact is made. Peak biting times are during the warmer months of August, or following a warm humid summer in September and October. After an incubation period of 2-28 days, symptoms begin with a fever and can progress at varying degrees. Death rates are highest in the elderly.

Who is at risk of Tick Borne Encephalitis?

Tick Borne Encephalitis is a risk for travellers going to endemic areas; that is: areas where infection exists at low rates. It is most prevalent in Europe and Asia in long grass and undergrowth, at a tick infection rate of 5%. A variation of Tick Borne Encephalitis occurs in Russia and China.

How can I prevent Tick Borne Encephalitis?

While a vaccination is available for those at high risk, travellers should try to avoid areas where the disease is prevalent. If it is essential to go walking in long grass or undergrowth, suitable clothing should cover arms and legs, with trousers tucked into socks for protection. DEET can also be used as a repellent. Those trekking can impregnate cloth with permethrin to use as a ground sheet to sit on in infected areas.

If a tick gets onto the skin, it should be removed using the correct technique of pulling it straight from the skin using tweezers or a similar instrument, not twisting.


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.