Infectious diseases in air travellers arriving in the UK

The ease of access to air travel and its increased popularity over the last 30 years have led to a significant incidence of imported infectious diseases and potential infectious hazards. The commonest type of illness found is acute gastroenteritis. Tuberculosis and malaria are not currently common conditions encountered in the UK, but medical vigilance is increasingly necessary as a result of these and other infectious diseases being carried by arriving air travellers. Risks of transmission to other passengers have been considered, and tuberculosis has been shown to have relatively low infectivity on commercial flights. Incidence of serious communicable disease occurring in arriving passengers is low, and should be referred to communicable disease specialists for advice on management. High standards of precautionary hygiene measures are mandatory to commercial aircraft to prevent spread of infectious agents. Disease vectors and products of animal origin pose additional potential threats to public health. Vigilance by environmental health specialists helps maintain national defences against this group of threats. Alertness to recent travel history and awareness of international public health concerns is essential for clinicians likely to encounter sick members of the travelling public. The largest commercial airports have health surveillance units, tasked with acting as a first line of defence against infectious disease. The majority of cases do not present in flight or at the airport, so they can present to any primary care clinician or emergency department. An integrated strategy for health protection will be developed in the UK with the setting up of a Health Protection Agency.