Stuart White 16-11-2018 10:02 AM
Categories: HRMC Articles written by Managing Director, Stuart White
A 58-year old man called Omar Zouhri died in Britain this week. So what, you might think – lots of men must have died there this week, death being part of life and of course you would be quite correct. What makes his death different is the cause of his somewhat premature demise which was that he died from rabies. He contracted the disease from a bite from a cat he whilst holidaying in Morocco. It is understood that he was bitten a few weeks ago and was not given immediate, potentially life-saving, treatment. Public Health England (PHE) issued a warning to travellers after the UK resident contracted the disease stating the somewhat obvious ‘Prompt care, including wound cleaning and a course of the rabies vaccine, is very effective and can save an infected person's life’.
Professor Jimmy Whitworth, professor of international public health at the London School of Hygiene and Tropical Medicine, said: "My understanding is that this is somebody who had contact with a cat that was behaving abnormally and sought care, I believe in Morocco and in the UK, but unfortunately didn't receive vaccination until it was too late. I believe that the cat bit this person a few weeks ago. The typical time interval (for symptoms to appear) is two to three months, so you do have enough time (to seek care). But it can be as short as a week and that's why seeking prompt care and getting vaccination is so important. In this tragic case the person didn't get the vaccine in time. It is hard to know from the information provided, the delay could have been Morocco, the delay could have been in the UK.
I bring this to your attention because the extended holiday season is nearly upon us, the time when many of you will be travelling locally and abroad and without wishing to sound like a harbinger of doom, to quote the folksinger Cat Steven’s ‘It’s a wild world’ out there full of mean streets where danger lurks round every corner. This is most clearly delineated on the new 2019 Interactive Travel Risk Map. The map divides up the world into colour-coded zones showing high, medium and low risk areas in the fields of health, security and travel safety, making it easy to assess the potential risk levels wherever you plan on travelling.
Some, of course, are obvious. Libya, Afghanistan, Somalia and Syria rank as the most dangerous which is scarcely surprising since they are all war zones where no-one in their right mind would venture unless it were absolutely necessary. Afghanistan, Yemen, Libya, South Sudan and Mali also test low on personal safety, again not most people’s cup of vacation tea but, popular holiday destinations including Mexico, parts of the Caribbean and parts of India were labelled as being of high risk.
At the other end of the scale, Norway, Finland and Iceland all were deemed to have a low risk of medical problems, security and road safety issues, meaning they are the safest. This again is no surprise. These cold, northern countries scarcely feature in the international news since nothing much every happens there and the worst a traveller might expect might possibly be a touch of frostbite if they forget to pack their thermal underwear and heavy overcoat! Denmark, Switzerland, Slovenia, Greenland & Finland also carry minimal safety risks.
When looking at health, countries with a highest risk of contracting medical issues or disease included the African countries South Sudan, Niger, Ivory Coast and Sierra Leone. Iraq was also labelled a high risk country when it came to health along with Lebanon, Venezuela and North Korea. Yes, I know hardly anyone chooses to travel to North Korea on their hols but there’s one more reason if you needed it! Brazil, China and Russia are all deemed to have 'rapidly developing variable risk' when it comes to health.
In contrast, places with a low risk of disease were deemed to be most of Europe as well as Canada, the US, New Zealand and Japan.
When it comes to road safety, the countries beside those in Africa that pose the greatest risk include Brazil, Bolivia, Saudi Arabia, Iran and Kazakhstan. In this category the U.S scores a 'moderate' ranking.
But let’s face it, most of your travel is likelt to be local, either within or just outside of our borders so how does our area fare? Well, health-wise, South Africa ranks as low risk, whilst Botswana and Namibia are medium . Travel to Zimbabwe, however, and the risk rises to ‘high’.
Security-wise Botswana and Namibia are low, South Africa and Zimbabwe are medium but of course with the benefit of local knowledge and footprint we can break that down further – we know where the danger hotspots are down south and most of us are savvy enough to take suitable precautions when travelling round that country.
As to road safety, Botswana and Namibia are marked as ‘high’ with South Africa coming out as ‘very high’ so that’s a sobering warning to us all, both figuratively and literally. Drink driving is still a big issue in the region, particularly over holiday periods and driving standards not as high as we’d want so please take extra care if you’re planning any road trips next month.
Back to the unfortunate man with the cat bite. Happily, though not totally rabies-free, I can say that the risk from being bitten by a rabid animal locally is fairly low. However, if you are worried I can reveal that there is one country in the world where such risk is not just low but non-existent and that is Iceland. Animal movement in that country is so severely restricted even healthy stock is not allowed in and if it ever goes back there is zero chance of it every being allowed back in. So if that’s your secret fear, try a trip to Reykjavik on your next holiday but be warned – you’re still at risk of dying……of boredom!


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