Guidelines for malaria prevention in travellers from the United ...

1. General Issues
G UIDANCE G UIDELINES FROM THE FOR HPA M ALARIA ADVISORY P REVENTION C OMMITTEE IN
ON MT ALARIA RAVELLERS P REVENTION FROM THE IN U NITED UK TRAVELLERS K INGDOM
extend to risks from infectious agents • establish procedures to use if an
arising from work activities, ie risks to employee is presented with serious
non-employees. The ACMP prophylaxis The MHSWR guidelines provide aare
intended and imminent for UK-based danger, visitors and to
broad malaria framework endemic for areas controlling and may health not be •appropriate co-operate and for use co-ordinate by those health
and
residing
safety
in
at
endemic
work. COSHH
areas.
provides a and safety if there is more than one
framework Whilst these aimed guidelines at controlling deal the with risks malaria, employer malaria in prevention a workplace. is only one
from aspect hazardous of pre-travel substances advice. including An overall risk assessment-based package of
infectious travel health agents. advice should be provided. Control of Substances Hazardous
In these guidelines, which have been specifically
to Health
developed
Regulations
for travellers
2002
from the
Duties UK, there under are a Section small number 3 of the of instances HSWA where (as amended) the advice given differs from that
in guidelines from other countries or the World Health Organisation. This is because
6. travellers If people from working the UK under do not the usually control visit all possible 8. Under localities COSHH the of malaria-endemic
manager is required
and
countries
direction
and
of
may
others
not visit
are treated
the same
as
localities
to
as travellers from other countries.
Many travellers from the UK who enter malaria-endemic countries are visiting friends
self-employed and relatives in for localities tax and from national which people tend • assess to migrate the risks to of the exposure UK. They todo
not
insurance therefore suffer purposes, exactly they the are same nevertheless patterns of malaria hazardous exposure substances as permanent in their residents
treated or visitors as from employees other cultures. for health and workplace,
safety
1.1 How
purposes.
to give
It may,
the advice
therefore, be •
1.2
prevent
Medical
exposure
history
or
of
substitute
the traveller
with a
necessary to take appropriate action to less hazardous substance or
protect Emphasise them. to the If any traveller doubt the exists ABCD about of It is process/method essential that a full if possible, clinical history is
malaria prevention:
obtained, to include current medication,
who
Awareness
is responsible
of risk
for the health and
significant
• control exposure
health problems
if prevention
and any
or
safety Bite of prevention a worker, this could be clarified known substitution drug allergies. are not reasonably
and Chemoprophylaxis
included in the terms of a contract. practicable,
prompt Diagnosis and treatment Safe and effective malaria prevention
However, a legal duty under Section 3 of • maintain, examine and test the control
requires a sound knowledge of the
HSWA • Emphasise cannot that be passed whilst no on regimen by means is of medical measures, history eg of automatic the traveller. dosing When their
a contract 100% effective, and there the will combination still be duties of patients systems, seek pre-travel advice in primary
towards
preventive
others
measures
under Section
advised
3
will
of HSWA.
give care,
• provide
this information
information,
will
instruction
be available
and
significant protection against malaria. from their own practice records but in the
If such workers are employed on the training for their employees, and
• Make use of visual aids, especially case of specialist travel clinics malaria
basis malaria that they distribution are responsible maps and for their prevention • provide health advice surveillance may be sought of at the
own show health examples and safety, of the legal preventive advice first employees attendance. if appropriate. The General Medical
should measures be sought advised, before such doing as aids to Council (2001)
bite prevention.
9. More information on COSHH in general
• Discuss the choices of
Management
chemoprophylaxis
of Health
regimens
and
and
Safety
their
at can be found in the COSHH Approved
Work individual Regulations advantages 1999and
Code of Practice (ACoP)4 and on
disadvantages, including cost.
Legionella in Legionnaires’ disease: The
7. • Under Provide these the traveller Regulations with the written manager
control of legionella bacteria in water
of a information spa pool is on required malaria toand
its
systems ACoP5 (L8).
prevention. The Department of Health
• assess the risks in their workplace,
has an information leaflet available in
• use 11 different competent languages help to (see apply chapter health 9).
and safety legislation,
1 states “If you provide
treatment or advice for a patient, but are
not the patient's general practitioner, you
should tell the general practitioner the
results of the investigations, the treatment
provided and any other information
necessary for the continuing care of the
patient, unless the patient objects.”
ACMP suggests that a hand-held record of
the malaria prevention measures advised
is given to the traveller so that they may
pass it on to their GP.
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