Tuesday 4 July 2017

Travel Health Databases

There remains a lot of confusion over the different databases that we use for travel health advice following our travel risk assessments.  I hope this helps to explain what comes from where and some pointers about the services.

NaTHNaC is developed by the team in the National Travel Health Network and Centre and is designed both for healthcare professionals and the public to use.  It is a free of charge service.  The website is called TravelHealthPro and the service is commissioned by Public Health England.  To see more detail see here.  NaTHNaC run a telephone advice service for anyone to use.  For a list of the times of this and the TRAVAX line click here (see item no. 8 in Tools)

TRAVAX is maintained and continually updated by the Travel and International Health Team of  Health Protection Scotland. For more detail see here.  It is free to use in Scotland as an NHS service.  NHS users in Wales can access TRAVAX free of charge through their on-line NHS intranet services centrally funded by their Health Department.  My understand is that users who access it by this route cannot use the 'suitcase' feature.  In England and Northern Ireland a fee is charged for use. Some CCGs pay in England for all surgeries within the CCG to use it, however a surgery can individually subscribe and even an individual person can subscribe as well.  Costs are not that high so see 'About TRAVAX' for further informaiton and scroll to the bottom for prices.  Users of TRAVAX can use their telephone helpline as a support service.

Fitfortravel is the public site of TRAVAX, therefore the guidance is based on the advice given in Scotland.  Healthcare professionals NOT using TRAVAX should not use fitfortravel as a standalone website as this is developed intentionally for the public.  They should be using NaTHNaC as well to receive additional information appropriate to a healthcare professional.



Which database should you use for your day to day assessments and advice?

Yellow fever
NaTHNaC is responsible for a programme of designation, training, registration, standards and audit for Yellow Fever Vaccination Centres (YFVCs) in England, Wales and Northern Ireland (EWNI).  If you work in England, Wales or Northern Ireland you must therefore use TravelHealthPro for issues concerning yellow fever.  If you work in Scotland you must use TRAVAX.   The Scottish Government designated responsibility for the programme of registration and administration of Yellow Fever Vaccination Centres (YFVCs) in Scotland to HPS in December 2006.

Polio 
The guidance on who receives polio containing vaccine as an NHS provision as part of the PHEIC guidance currently for travel to Pakistan, Afghanistan and Nigeria is different between NaTHNaC and TRAVAX and you must follow the guidance in the country in which  you work - see my last blog about this.

Hepatitis A 
NaTHNaC has written on TravelHealthPro  Health professionals are advised to follow recommendations as per the jurisdiction in which they practice.  See the statement at the bottom of this page (just above resources)

Malaria
There are a number of differences in the advice between the two databases and at the current time you could use either, but again, document which one you have referenced.

NOTE UPDATE (WRITTEN 4th JANUARY 2018) 

In October 2017 Public Health England published the 2017 Guidelines for malaria prevention in travellers from the UK - within this document there is a statement on page 8, repeated on page 12 which says  "We recommend health professionals stick to using one resource for country specific malaria recommendations to optimise consistency of advice. Whilst we recognise that other sources of advice are available, healthcare professionals working in England, Wales or Northern Ireland are advised to use the ACMP guidelines as their preferred source of guidance for malaria prevention".

And a bit more information......

Other travel health advice 
At the current time you could use either database but please ensure you document which one you took your advice from.

Can I use a chart instead?
Pulse do publish a chart with vaccine and malaria recommendations but for years now we have advised to use an online database because this will provide you with the most up to date information.  It is far easier to update a website than something that is in print and less easy to monitor.

Why are there variations?
In fairness, different countries do provide varying advice and this is determined by their national bodies that decide on their guidance.  The important aspect is to work within the guidance of the country in which you work.  See CDC for an example of varying advice as an example.