Issue 9
06 March 2018
Volume: 52 Issue: 9
- Antimicrobial resistance in zoonotic bacteria - ECDC / EFSA report
- Lassa fever outbreak in Nigeria
- Meat processing plants - FSA/FSS review
- Hazardous substances at work - HSE review
- Health impacts of pollution
- Neonicotinoids: risks to bees confirmed
- Climate Change Plan - 2018-2032
- Impact of climate change on rivers
HPS Weekly Report
06 Mar 2018
Volume 52 No. 9
Antimicrobial resistance in zoonotic bacteria - ECDC / EFSA report
On 27 February 2048, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) published a report covering data on antimicrobial resistance in zoonotic and indicator bacteria in 2016, submitted by 28 EU member states. Resistance in bacterial isolates of zoonotic Salmonella and Campylobacter from humans, animals and food, and resistance in indicator Escherichia coli as well as in meticillin-resistant Staphylococcus aureus from animals and food were addressed and analysed jointly by the two agencies.
The main findings of the report have been identified as follows:
Humans
- One out of four Salmonella infections in humans are caused by Salmonella bacteria that show resistance to three or more antimicrobials commonly used in human and animal medicine. The proportion is significantly higher in S. Kentucky and S. Infantis (76.3 and 39.4% respectively).
- For the first time, ESBL-producing S. Kentucky with high resistance to ciprofloxacin was detected in four countries. This type of bacteria cannot be treated with critically important antibiotics.
- Campylobacter bacteria, which are the most common cause of food-borne disease in the EU, show high resistance to widely used antibiotics (ciprofloxacin resistance 54.6% in C. jejuni and 63.8% in C. coli; tetracyline resistance 42.8% in C. jejuni and 64.8% in C. coli). The levels of resistance increased in two of the three analysed antibiotics (ciprofloxacin and tetracycline), but combined resistance to the critically important antimicrobials is stable and overall low (0.6% in C. jejuni and 8.0% in C. coli). In some countries, however, at least one in three C. coli infections were multidrug-resistant to important antibiotics, leaving very few treatment options for severe infections.
Animals and foods
- Resistance to carbapenem antibiotics was detected at very low level in poultry and in chicken meat in two member states (15 E. coli bacterial isolates). Carbapenems are used to treat serious infections in humans and are not authorised for use in animals.
- Two livestock-associated methicillin-resistant Staphylococcus aureus bacterial isolates found in pigs were reported to be linezolid-resistant. Linezolid is one of the last-resort antimicrobials for the treatment of infections caused by highly resistant MRSA.
- Combined clinical resistance to critically important antimicrobials was observed at low to very low levels in Salmonella (0.2%), Campylobacter (1%) and E. coli (1%) in poultry.
- Resistance to colistin was observed at low levels (2%) in Salmonella and E. coli in poultry.
- Prevalence of ESBL-producing E. coli in poultry varies markedly between the member states, from low (less than 10%) to extremely high levels (more than 70%). Bacteria that produce ESBL enzymes show multi-drug resistance to β-lactam antibiotics – a class of broad spectrum antibiotics that includes penicillin derivatives, cephalosporins and carbapenems. This is the first time that the presence of extended-spectrum beta-lactamase (ESBL)-producing E. coli was monitored in poultry and poultry meat.
ECDC and EFSA have expressed concern that the continued detection of multidrug-resistant bacteria means that the situation is not improving. While there is a need to investigate the origins and prevent the spread of highly resistant strains, such as ESBL-producing Salmonella Kentucky, the detection of resistance to carbapenems in poultry and to linezolid in methicillin-resistant Staphylococcus aureus in pigs is alarming because these antibiotics are used in humans to treat serious infections.
Lassa fever outbreak in Nigeria
Nigeria’s Lassa fever outbreak has reached record highs with 317 laboratory confirmed cases, according to figures released by the Nigeria Centre for Disease Control (NCDC).
Although endemic to the West African nation, Lassa fever has never reached this case count in Nigeria before. The number of confirmed cases during the past two months exceeds the total number of confirmed cases reported in 2017. The outbreak has affected 18 states since the first case was detected on 1 January 2018, resulting in 72 deaths caused by the acute viral haemorrhagic fever. A total of 2,845 people who have come into contact with patients have been identified and are being monitored.
The World Health Organization (WHO) is supporting the NCDC-led response with a focus on strengthening coordination (including through the Global Outbreak Alert and Response Network), surveillance, contact tracing, laboratory testing, clinical management of patients, and community engagement. State health authorities are mobilising doctors and nurses to work in Lassa fever treatment centres.
Health facilities are particularly overstretched in the southern states of Edo, Ondo and Ebonyi. The WHO is working with health authorities, national reference hospitals and the Alliance for International Medical Action (ALIMA) to rapidly expand treatment centres and better equip them to provide patient care while reducing the risks to staff. Among those infected are 14 health workers, four of whom have died.
Health workers are being trained in infection, prevention and control measures, such as the importance of wearing personal protective equipment (PPE) and isolating patients during treatment. The WHO has provided an initial supply of PPE, other related materials and is assessing additional needs with a view to addressing them.
The WHO is also supporting national response efforts in neighbouring Benin, where more than 20 suspected cases have been reported.
Source: WHO Regional Office for Africa News Release, 28 February 2018
Meat processing plants - FSA/FSS review
On 2 March 2018, the Food Standards Agency (FSA) and Food Standards Scotland (FSS) published details of a major review into the sites where meat products are processed and stored in the UK.
The review comes in the wake of incidents involving major businesses in the meat industry over the last six months over adherence to hygiene rules designed to keep consumers safe and to sustain public trust in food.
The FSA also published its update to the Environment, Food and Rural Affairs Committee’s inquiry into standards in poultry processing and the findings of the FSA’s investigation into the 2 Sisters Food Group.
The scope of the review will incorporate:
- all types of cutting plants (red meat, white meat and game)
- how the current legislation works and the guidance supporting it
- how the ‘official controls’ are carried out which must be followed to ensure compliance with hygiene legislative requirements (this includes audits, inspections, sampling and surveillance)
- the roles and responsibilities of food businesses, regulators and assurance bodies
- how incidents are managed and responded to
- the end to end process of withdrawing and recalling products across the whole food chain
Sources: FSS News Release, 2 March 2018 and FSA News Release, 1 March 2018
Hazardous substances at work - HSE review
Three domestic regulations set out employers’ responsibilities in Great Britain to protect the health and safety of their workforce from exposure to hazardous substances. These are: The Control of Substances Hazardous to Health Regulations (COSHH); The Control of Lead at Work Regulations (CLAW); and The Dangerous Substances and Explosive Atmospheres Regulations (DSEAR).
The Health and Safety Executive (HSE) undertook an evidence gathering exercise to review these regulations to explore how risk management of hazardous substances at work could be simplified whilst maintaining standards of protection.
Following this, the HSE has published two reports:
- Research Report RR1124 analyses the responses to an on-line survey about dutyholders, employees’ and employers’ experiences of COSHH, CLAW and DSEAR. The research found that the regulations provide a useful framework for determining organisational policies and processes to manage the risks from hazardous substances but this could be simplified and supported by additional guidance.
- Research Report RR1125 details the findings from a series of focus groups which explored operational staff’s, dutyholders and consultants’ perceptions and experiences of COSHH, CLAW and DSEAR. Overall the regulations are seen as relevant, required, fit for purpose, and supportive of the occupational safety and health (OSH) of employees. Any changes to regulations should include guidance to ensure dutyholders understand how they should comply with the regulations.
Survey respondents suggested that to improve compliance dutyholders and managers responsible for health and safety needed to fully understand their responsibilities set out in the regulations, especially for DSEAR and CLAW. External consultants/advisers on health and safety matters considered that organisations need to be aware that DSEAR is not covered by COSHH. Focus groups indicated that experience and knowledge of the workplace environment and processes were crucial to managing risk well; conversely, the absence of this experience and knowledge were factors that contributed to poor risk management. Any changes to the regulations through simplification or merging would require having in place appropriate guidance to ensure that dutyholders understand what they are required to do to comply with the regulations.
Health impacts of pollution
On 2 March 2018, the Chief Medical Officer (CMO) for England published her annual report for 2017 which this year presents evidence and debate around:
- pollution caused by healthcare
- pollution and health inequalities
- new pollution issues
- measurement and communication of risks
The CMO’s report also makes recommendations to government, the NHS, Public Health England (PHE) and other agencies for action to improve the health system’s response to all types of pollution.
The report also considers:
- changes needed to better understand emerging threats
- the steps needed to bring together sources of information to give public health professionals a better idea of how to improve the health of people at a local level
Neonicotinoids: risks to bees confirmed
According to assessments published on 28 February 2018 by the European Food Safety Authority (EFSA), most uses of neonicotinoid pesticides represent a risk to wild bees and honeybees. The agency has updated its risk assessments of three neonicotinoids, clothianidin, imidacloprid and thiamethoxam, that are currently subject to restrictions in the EU because of the threat they pose to bees.
These new conclusions update those published in 2013, after which the European Commission imposed controls on use of the substances.
For the new assessments, which this time cover wild bees, bumblebees and solitary bees, as well as honeybees, EFSA’s Pesticides Unit carried out an extensive data collection exercise, including a systematic literature review, to gather all the scientific evidence published since the previous evaluations. The team also applied the guidance document developed by EFSA specifically for the risk assessment of pesticides and bees.
EFSA finalised its conclusions following two separate consultations with pesticide experts in the EU member states. The experts have supported the conclusions.
As with the previous assessments, exposure of bees to the substances was assessed via three routes: residues in bee pollen and nectar; dust drift during the sowing/application of the treated seeds; and water consumption.
EFSA’s conclusions will be shared with risk managers from the European Commission and member states, who will consider potential amendments to the current restrictions on the use of these pesticides.
Climate Change Plan - 2018-2032
On February 28 2018, the Scottish Government published its Third Report on Proposals and Policies, the Climate Change Plan for meeting greenhouse gas emission reduction targets 2018-2032. This plan sets out how Scottish Government will aim to drive down emissions over the period to 2032.
The Climate Change Plan, along with the Scottish Government’s Energy Strategy, provides the strategic framework for the transition to a low carbon Scotland. It includes proposals and polices aimed at reducing emissions from electricity generation, housing, transport, services, industry, forestry, peatlands, waste, and agriculture.
Building on previous reports on policies and proposals, the Plan sets out the intended path to a low carbon economy while helping to deliver sustainable economic growth and secure the wider benefits to a greener, fairer and healthier Scotland in 2032.
The document is accompanied a by a technical annex, which provides an overview of the analysis underpinning the Climate Change Plan and a written statement setting out the Scottish Government’s formal response to the reports prepared by the four Parliamentary Committees who scrutinised proposals and policies in the draft Climate Change Plan published in January 2017.
Impact of climate change on rivers
Scientists at Marine Scotland and the University of Birmingham have developed a river temperature model to predict the maximum daily river temperatures and sensitivity to climate change throughout Scotland, with interactive maps made available through the National Marine Plan interactive (NMPi) website.
Scotland’s rivers account for around 75% of the UK and 30% of European wild salmon production, with freshwater fisheries and associated expenditure contributing more than £79 million a year to the Scottish economy. However, with Atlantic salmon sensitive to changes in river temperature and temperatures expected to increase under climate change, there are concerns Scottish rivers could become less suitable for salmon.
Fisheries management organisations have also been involved with the new project, which identifies the rivers that are greatest risk of climate change impacts, making it easier for river managers to take forward mitigation measures. This work could include planting trees on river banks to increase shading or managing water demand and use.
The Scotland River Temperature Monitoring Network (SRTMN) was set up in 2013 to provide this information. It is a scientific collaboration between Marine Scotland Science Freshwater Fisheries Laboratory and the University of Birmingham delivered with support from local fisheries trusts and boards.
Resources include maps of maximum river temperature and climate sensitivity for Scotland to allow managers to plan where to plant trees and the Scotland River Temperature Monitoring website.