New WHO report warns against ‘conflicting’ travel guidelines

Written by By Rosanna Elia

Rosanna Elia is a journalist at CNN and the author of Where to Go When You’re Sick

If you’re still trying to figure out what to do with all your extra travel money in the wake of the H1N1 epidemic, you might be in for more confusion after a new UN report finds that while some member countries have gone easier on travelers, others are more restrictive.

Scientists behind the World Health Organization’s (WHO) high-level review of H1N1 (also known as swine flu) coronavirus safety and public health policies reported that travel warnings still need to be issued about the illness.

“Countries still need to be alert when using warnings to discourage travel, as recommending travel is still an important aspect of early infection control,” said Dr. Jonas Brandt, a senior WHO health security expert who co-chaired the report.

“UN agencies might issue alerts about the spread of respiratory infections, and travel advice could be developed,” he said.

The WHO report emerged from a series of events held in Geneva in March and April to review recommendations and recommendations made in the months after the pandemic began, which included a review of advice by the U.S. Centers for Disease Control and Prevention (CDC) and recommendations from airlines and travel agencies.

Tainted travel advice

After the outbreak in Mexico in April 2009, the WHO issued statements warning people that it may be risky to travel there — by May, the CDC’s advice had been withdrawn and travel warnings modified.

By that time, there were 5,608 laboratory-confirmed cases in the United States, 64 countries and territories had reported high-risk cases and 1,207 deaths.

The WHO review found that the lack of progress in telling travelers and sending out travel alerts reflected the “still very contradictory messages.”

For example, although travel advice has not been changed in any of the 14 countries where H1N1 has reemerged, other countries issued travel advisories to their neighbors when outbreaks were detected elsewhere. This could be done much more quickly if there was a coordinated push from WHO, it added.

Recommendations still not being enforced

WHO said that travel guidance is important because it reflects the “ongoing risk.”

The travel advisories can help countries to spread information about the risks of illness and to provide information on help, they said.

“Those considerations need to be taken into account when weighing the impact of travel on pandemic and non-pandemic illness,” they said.

“[But] the actions taken by countries to address issues such as travel advisories are insufficient, vague and tend to be inconsistent,” they said.

Current WHO guidance on travel and health includes the following:

Don’t get the flu

If you do get sick, avoid traveling or to places where people have caught the virus. Don’t get a flu shot unless advised to do so by your health care provider.

When not to travel

When you’re pregnant or older than 65 years;

Any person you know is pregnant or planning to become pregnant;

If you have a chronic disease or other conditions such as tuberculosis or diabetes.

If your place of residence is outside the United States.

Not if you’ve recently traveled to Mexico, Central America, the Caribbean, South America, or New Zealand.

If you’ve recently had a travel-related problem while abroad.

If you are sick, stay home. Symptoms typically develop 3-8 days after you return from abroad.

Doesn’t travel bring on illness?

While WHO said travelers should not be worried about being infected while traveling, “when there is a travel warning, patients can be at high risk of complications. Some of those complications include bacterial and viral meningitis, pneumonia, meningeal infections and a form of sepsis known as secondary infection syndrome.”

Although the WHO is no longer providing travel advisories, its advice has generally been straightforward:

When in doubt, avoid unnecessary travel. When you do travel, you should wash your hands regularly and avoid contact with sick people.

Keep your immune system strong and take antiviral drugs if you think you might catch the virus.

If you are hospitalized, contact your doctor and follow his recommendations.

The newest World Health Organization travel guidelines are available online here: http://www.who.int/Health/TRS/GEN/docs/Memo_United_States.pdf

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