Implementation: To be determined by each Service. Change Notification UK National Blood Services No

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Issued by JPAC: 29 June 2017 Implementation: To be determined by each Service Change Notification UK National Blood Services No. 16-2017 Malaria This change applies to the Geographical Disease Risk Index (GDRI) Please amend the Malaria entry for countries below, including the country the map, as follows: Azerbaijan Risk occurs from June to October mostly between the Kura and Arax rivers but occasionally in other lowlying rural areas and cities Visitors to Baku, accept Cat C Belize All year in whole country Cat A Malaria risk is low in Stan Creek but negligible elsewhere - Cat C Previous Malaria Risk: All year in whole country Cat A until Dec 2016 Borneo Yes Borneo has three territorial areas. Malaria is present all year in the Malaysian and Indonesian territories which comprise the majority of the island. Malaria is not normally present in the small territory of Brunei unless the illness was contracted abroad. Cat B See Brunei Darussalam and/or Indonesia and/or Malaysia Cambodia All year, most of the country Cat B. Visitors to Phnom Penh, Siem Reap and Angkor Wat only, accept. Page 1 of 10

China There is an all year risk in Yunnan Province, Hainan Island, in Anhui, Ghuizhou, Henen, Hubei and Jiangsu Provinces. There is a very low to no risk of malaria on Yellow and Yangtze River cruises. There is no risk in urban areas: visitors to Beijing, Shanghai, The Great Wall and to the Terracotta Warriors in Xian can be accepted. Cat B C Previous Malaria Risk: Yes all year whole country until Feb 1996 Yes all year whole country below 1500m until Sept 2006 Yes all year in Hainan Island, Anhui, Guizhou, Henan, Hubei and Jiangsu provinces until Jan 2016 Page 2 of 10

Colombia All year in most of the country. Visitors to areas over 1600m and the cities of Bogota and Cartagena only, accept. Malaria is present throughout the year. High risk in Choco, Antioquia, Cordoba, Narino and the Amazon (Vichada, Guaviare, Vaupes, Guainia and Amazonas). Low to no risk in all other areas including the cities of Bogota and Cartagena Cat B Previous Malaria Risk Yes all year whole country until Feb 2015. Map downloaded from http://www.fitfortravel.nhs.uk on 26/01/17 Page 3 of 10

Eritrea It was agreed not to alter the GDRI wording but to update the map with the one showing mountainous regions. Correct the spelling of Asmara Page 4 of 10

Georgia July June - October in the south-east of the country Cat C Ko Samui Correction of spelling in Index to Ko Samui to be consistent to spelling in the text of the entry. Index is currently Koh Samui. Laos All year in most of country Cat B Visitors to Vientiane, Bokeo, Houaphanh only, accept Page 5 of 10

Malaysia All year in central Peninsular Malaysia and the Taman Negara National Park and all provinces of Sabah and Sarawak (on the island of Borneo) Cat B Page 6 of 10

Nepal All year in low lying areas in the South of the country. in districts of Bara Dhanukha Kapilvastu Mahotari Parsa Rautahat Rupendehi and Sarlahi May - October in Kavre district. Donors who have flown to Kathmandu and stayed within the Himalaya area, accept. Donors who have travelled overland from the Indian border and have travelled in the Southern lower plains along the Indian border, treat as malaria risk. Cat B Philippines It was agreed to include a map of the country and use the same wording as that for India. Risk present below 600m in rural areas, except in the island provinces of Aklan, Albay, Benguet, Bilaran, Bohol, Camiguin, Capiz,Catanduanes, Cavite,Cebu, Guimaras, Iloilo, Leyte, Masbate, North East and West Samar, Sequijor, Sorsogon, Surigao Del Norte and the metropolitan area of Manila. Risk is small in the plains to the north of Manila and in other major cities: Cat C All year in affected areas. Due to the complexity of the distribution the map below should be used. Visitors to Low to no risk areas (pale pink) only, accept. Cat B Page 7 of 10

Sri Lanka It has been highlighted that the current GDRI previous malaria risk entry for Sri Lanka is confusing as it states: Malaria No Previous Malaria Risk Yes all year whole country until Feb 1996 and Jan 1984 May 2005 Yes all year northern half of country Dec 2011 Feb 2015 After investigation it is thought that this is a typo and the correct entry for previous malaria risk should be: Previous Malaria Risk Yes all year whole country until Dec 2011 Yes all year northern half of country Dec 2011 Feb 2015 Page 8 of 10

Thailand All year in areas along the Cambodian, Laos and Myanmar borders Refer to map. There is also risk in inland areas of Surat Thani province. Visitors to all other areas including the cities of Bangkok, Chiang Mai, Chiang Rai, Pattaya, Phuket and the islands of Ko Samui and Ko Chang and the River Quai bridge area, accept. Cat B Page 9 of 10

Vietnam All year in whole country. Visitors to Ho Chi Min City, Hanoi, Da Nang and their 4 international airports, the Red River and Mekong deltas, Phu Quoc Island and coastal plains only, accept. Refer to map Cat B Dr Sheila MacLennan Professional Director - Joint UKBTS Professional Advisory Committee Direct Dial: (0113) 820 8638 sheila.maclennan@nhsbt.nhs.uk Page 10 of 10