The 11th BTHA Conference – 28th November 2009 at the Charing Cross Hotel London

The annual conference in 2009 was for the first time themed to address a particular area of Travel Medicine – ‘Arthropod borne diseases’. Also new to the programme were smaller workshop sessions designed to allow greater interaction between delegates.

Dr Eric Walker opened the day with his farewell address as outgoing President of the BTHA. His talk was wide ranging, covering areas as diverse as steam engines and his own personal travel experiences, reflecting the uniquely diverse and open nature of the BTHA.

The first presentation covering the conference theme was given by Hilary Simons from NaTHNac covering yellow fever. The major part of the presentation raised awareness concerning the spread of yellow fever in parts of South America and how recent data had been utilised to redraw the Maps identifying endemic areas.

Dr Dom Colbert representing the Irish Society of Travel Medicine presented the current position regarding important diseases spread by the Aedes spp of mosquito; Dengue and Chikungunya as well as the recent reports of Zikka virus. He considered the spread of Aedes albopticus into more temperate climates. He clarified the quite complex immunology of dengue infection and how this manifested in the various presentations Of Dengue Fever and Dengue Haemorrhagic Fever. He discussed that a new genotype of DEN3 could be responsible for the emergence of more severe disease and of importance to travellers. He also hypothesised that the recent massive outbreaks of chikungunya may be related to an increased severity of the disease due to genetic mutations of the virus.

Prof. Sarah Randolph from the Dept of Zoology University of Oxford examined the science behind the current epidemiology of Tick Borne Encephalitis (TBE) and its relationship to the zoonoses of the tick vector. She pointed out that the incidence of TBE was dependent not only on the biological factors increasing the tick population but changes in human behaviour that could cause greater exposure to ticks. Amongst factors increasing tick bulk are the changes in deer distribution, a sudden increase in spring temperatures, decline of agriculture and reduced use of pesticides. Human behaviour changes may be related to greater activity in forests by those taking leisure trips or visiting for other purposes such as reliance on forest food harvests. The reduction of TBE incidence achieved by more widespread uptake of vaccination was also described. Overall it was suggested that the various factors affecting human behaviour rather than ‘climate change’ per se best explain TBE epidemiology.

One workshop examined a variety of products used to protect against mosquito bites. Participants worked in groups and were asked to rate the products in terms of their ability to protect travellers from bites and acceptability/ease of use. The other workshop employed a wide range of case studies to discuss issues related to malaria and Japanese encephalitis in travellers. The conference concluded with a lively debate concerning whether greater regulation was required in travel medicine.

A full conference report will appear in the next edition of the BTHA journal