The Public Health etc. (Scotland) Act 2008

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Annual Data 2010

Information relating to notifications of infectious diseases for 2010 are summarised as key points with more detailed tables and charts below. These tables and charts contain 2010 and previous years data for notifications of infectious disease.

These analyses are for notifications to the year ended 31 December 2010.

Please note: From 2010 the following diseases are no longer notifiable - Bacillary dysentery, Chickenpox, Erysipelas, Food poisoning, Legionellosis, Leptospirosis, Lyme disease, Malaria, Puerperal fever, Scarlet fever, Toxoplasmosis, Typhus fever and Viral hepatitis. To access historical trends on these diseases please refer to the 2009 Notifiable disease data files.

Key Points

Anthrax

In December 2009 an outbreak of anthrax began in heroin users in Scotland. It is believed to have been due to the circulation of a batch of heroin contaminated with anthrax spores. Suspected cases continued to be identified into late 2010 and the outbreak was finally declared over in December and claimed a total of 14 lives among confirmed and probable cases.

Clinical syndrome due to E. coli O157 infection

On 1st January 2010, "Clinical syndrome due to E. coli O157 infection" became a notifiable disease under the Public Health etc. (Scotland) Act 2008.  Notifications do not require laboratory confirmation, and should be based on clinical suspicion, which should be aroused by (i) likely infectious bloody diarrhoea or (ii) acute onset non-bloody diarrhoea with a biologically plausible exposure and no alternative explanation [http://www.scotland.gov.uk/Topics/Health/Policy/Public-Health-Act]

Examples of biologically plausible exposures include: contact with farm animals, their faeces or environment; drinking privately supplied or raw water; eating foods such as undercooked burgers or unpasteurised dairy products or contact with a confirmed or suspected case of VTEC infection.  Where a case is notified as HUS (Haemolytic Uraemic Syndrome) it should not also be notified as "Clinical syndrome due to E. coli O157 infection". In 2010, there were 33 notifications of "Clinical syndrome due to E. coli O157 infection", of which 29 were confirmed microbiologically; as this is a new notification category comparisons with previous years are not yet available.

Haemolytic Uraemic Syndrome (HUS)

Haemolytic Uraemic Syndrome (HUS) is a rare disorder characterised by microangiopathic haemolytic anaemia, microthrombi, and multi-organ injury. HUS is one of the commonest causes of acute renal failure in childhood worldwide and is most frequently precipitated by infection with verotoxin-producing Escherichia coli (VTEC) such as E. coli O157. However, over the last decade, non-O157 VTEC serotypes have become increasingly important in the development of HUS. Although previous surveillance of childhood HUS in Scotland identified E. coli O157 in over 90% of cases, non-O157 serotypes have also been associated with HUS. All cases of HUS in Scotland have been reported to Health Protection Scotland (HPS) as part of an enhanced surveillance programme since 2003. In 2010, the number of cases of HUS reported to HPS via enhanced surveillance was 19, of which 15 were precipitated by VTEC infection. This compares with 5 clinical notifications for Scotland through the 'Notifiable disease' legislation.

Haemophilus influenzae type b (Hib)

Haemophilus influenzae type b (Hib) became notifiable as of January 2010 under the Public Health etc. (Scotland) Act 2008, and therefore there are no historical notifiable disease data with which to compare the three notifications received by HPS in 2010, although an enhanced surveillance scheme based on laboratory reports has been in place since the introduction of Hib vaccine in 1992. In 2010 there were 6 laboratory confirmed cases of Haemophilus influenzae type b, compared with 5 laboratory confirmed cases in 2009.

Measles

Notifications for measles are on the basis of clinical suspicion. As measles has become rare in Scotland, due to high uptake of vaccination, it is difficult to diagnose clinically without laboratory tests. There were 93 measles notifications in 2010, 11 were laboratory confirmed. This compares with 172 notifications and 17 laboratory confirmed cases in 2009. The majority of measles cases and suspected cases continue to occur in unimmunised or under-immunised individuals.

Meningococcal infection

There were 93 cases of meningococcal infection notified in 2010, compared to 122 in 2009. Meningococcal infection has steadily declined since the introduction of the Meningococcal C (MenC) vaccine in 1999, when 329 cases were notified. More than half the cases notified in 2010 (55%; 51 cases) were in children aged under 15 years.

Mumps

In 2010 there were 727 notifications of mumps compared with 1129 notifications in 2009. Cases continue to be mainly among the young adult age group, aged 15 to 24, who are often under immunised against mumps, not having been routinely offered two doses of MMR vaccine as children.

Paratyphoid / Typhoid

During 2010 there were 6 notifications of typhoid. This was an increase on the previous year's typhoid notifications (1 case in 2009). There were 2 notifications of paratyphoid in 2010 which was the same number as the previous year. Since numbers are small there can be no inference made around this. We have no detail on travel history for these cases, but HPS is confident that we would have been informed had infection been acquired indigenously. Infection abroad is usually the result of the ingestion of heavily contaminated food or water. Typhoid vaccine does not confer 100% protection and does not protect against paratyphoid infection therefore all travellers should be encouraged to exercise food and water precautions to prevent all types of enteric fever.

Pertussis (whooping cough)

There were 45 notifications for whooping cough in 2010 compared to 104 in 2009. There were 82 laboratory confirmed cases of Bordetella pertussis in 2010 compared with 119 in 2009. 11 of the laboratory confirmed cases were in children under the age of one year, for whom whooping cough is most serious.

Rubella

Notifications for rubella are on the basis of clinical suspicion. As rubella has become rare in Scotland, it is difficult to diagnose clinically without laboratory tests. There were 39 notifications of rubella in 2010, and 1 laboratory confirmed case. This compares with 93 notifications and no laboratory confirmed cases in 2009.

Tuberculosis

There were 525 notifications of tuberculosis during 2010. This was a slight increase from 2008 and 2009 when there 502 and 505 notifications respectively, representing the continued increase in notifications since 2005 when there were 389 notifications.

Of the notifications in 2010, 326 were respiratory cases, higher than the 310 cases in 2009 and 199 were of non-respiratory cases, compared with 195 non-respiratory cases in 2009.

The trend observed in notifications is also mirrored by the enhanced surveillance of Mycobacterial infections (ESMI). The ESMI scheme provisionally reported 506 cases in 2010, (compared to 485 in 2009) which is the highest ever number reported to the ESMI scheme since it began in 2000.

Tables and Charts for 2010