On 21 March 2019, the immunisation web pages on the Health Protection Scotland (HPS) website will be updated to reflect the most recent quarterly surveillance data on:

• Haemophilus influenzae
• human papillomavirus
• invasive pneumococcal disease
• measles
• meningococcal disease
• mumps
• rotavirus
• rubella
• shingles
• whooping cough

On 11 March 2019, the World Health Organization (WHO) released its Global Influenza Strategy for 2019-2030, aimed at protecting people in all countries from the threat of influenza. 

The goal of the strategy is to prevent seasonal influenza, control its spread from animals to humans, and prepare for the next pandemic.

Influenza remains one of the world’s greatest public health challenges. Every year, there are an estimated one billion cases globally, of which between three and five million are severe cases, resulting in 290,000 to 650,000 influenza-related respiratory deaths.

The WHO recommends annual vaccination as the most effective way to prevent influenza. Vaccination is especially important for people at higher risk of serious influenza complications and for health care workers.

The new strategy is the most comprehensive and far-reaching developed for influenza. It outlines a path to protect populations and helps prepare for a pandemic through strengthening routine programmes. The strategy has two overarching goals:

• To build stronger country capacities for disease surveillance and response, prevention and control, and preparedness. To achieve this, it calls for every country to have a tailored influenza programme that contributes to national and global preparedness and health security.
• Develop better tools to prevent, detect, control and treat influenza, such as more effective vaccines, antivirals and treatments, with the goal of making these accessible for all countries.

Source: WHO, 11 March 2019

The European Centre for Disease Prevention and Control (ECDC) has published a risk assessment of the cross-border public health risk related to the multi-country outbreak of Salmonella poona infections in infants and young children linked to consumption of infant formula in Europe.

The outbreak of Salmonella poona cases affecting France (30 cases), Belgium (one case) and Luxembourg (one case) is linked to infant formula products based on rice proteins. All 32 patients were infants and young children infected with the same bacterial strain with onset of symptoms between August 2018 and February 2019.

The suspected infant formula products were made by a factory in Spain between August and October 2018 and marketed by a French company. The products were distributed to EU/EFTA and four non-European countries through wholesalers, online shops or e-commerce.

So far, all tests performed at the Spanish factory and on samples of the implicated batches have been negative for Salmonella poona. This may be due to the fact that Salmonella is typically difficult to detect in dried products and requires sampling and testing methods with a high degree of sensitivity.

A recall and a withdrawal of infant formula products and baby food of the same brand were initiated on 24 January 2019 by the manufacturers in France, followed by a recall in Luxembourg. Public warnings released in France, Belgium and Spain should decrease the risk of new infections. However, additional outbreak cases may be reported, among those who bought and consumed the products before the recall.

In order to prevent infections when using infant formula, member states should consider providing advice to the public on basic hygiene rules when preparing food for infants, including information on the safe preparation, handling and storage of powdered infant formula products. Caregivers of children who have consumed infant formula and develop diarrhoea should be advised to contact their healthcare provider.

Cases of salmonellosis in infants should be notified to the national health authorities for serotyping. S. poona isolates should be sequenced to identify whether they are associated with this outbreak.

Source: ECDC, 12 March 2019

Public Health England (PHE) has recently published a report which gives a comprehensive overview of actions that national and local government can take to improve air quality and health.

PHE was commissioned by the Department for Health and Social Care (DHSC) to review the evidence for practical interventions to reduce harm from outdoor air pollution, stratified by their health and economic impact.

The focus of the review was on those actions available to local authorities and, where appropriate, the national actions needed to support them.

PHE commissioned five rapid evidence assessments that focused on vehicles and fuels, spatial planning, industry, agriculture, and people’s behaviour and sought evaluations that made direct links between actions and consequent health and health economic outcomes.

The report provides local practitioners and policy-makers with an indication of the range of interventions that can be used to address different problems, and which of those interventions may be worth considering further due to their potential health benefits. The report outlines principles for strategies and the future design and evaluation of interventions.

Source: PHE, 11 March 2019

The theme for World Water Day 2019 is ‘Leaving no-one behind’. This is an adaptation of the central promise of the United Nations’ 2030 Agenda for Sustainable Development, which states that as sustainable development progresses, everyone must benefit. Sustainable development goal six aims to ensure availability and sustainable management of water for all by 2030. 

Billions of people in the world still live without safe water – their households, schools, workplaces, farms and factories struggle to survive. Marginalized groups – women, children, refugees, indigenous peoples, disabled people and many others – are often overlooked, and sometimes face discrimination, as they try to access and manage the safe water they need.

Safe water is shorthand for a ‘safely managed drinking water service’, water that is accessible on the premises, available when needed, and free from contamination.

Source: World Water Day, March 2019

The Scottish Environment Protection Agency (SEPA) has urged farmers and land managers to discuss any plans to undertake river engineering works in Scotland with SEPA’s local representatives before commencing work.

On 11 January 2019, SEPA served a fixed monetary penalty to the firm of Nisbet Mill after the Jedburgh-based operator breached regulations on sediment removal, while on 10 January 2019, Townfield Construction Limited were fined after engineering work took place in the Avon Water without the necessary authorisation in place.

Engineering works can damage habitat in rivers, lochs and wetlands and affect populations of invertebrates, plants, birds and mammals. Engineering works can also block the passage of migrating fish and damage spawning habitats during sensitive times. Some affected fish, such as salmon, are an important economic resource in many areas of Scotland. Engineering can also result in erosion of valuable adjacent land resources.

More information and advice is available from the SEPA website, including a range of guides on water and engineering. Advice for farmers can be found at Farming & Water Scotland’s website, while advice for land managers can be found at NetRegs.

Source: SEPA, 15 March 2019

The Scottish Government has provided funding of £175,000 to support emergency flood relief in Malawi.

Severe flooding in the south of Malawi over recent days has affected nearly one million people, resulting in loss of life and many tens of thousands of people being displaced.

The money will be used to deliver critical work to secure water supplies and treat contamination in the immediate aftermath of the disaster.

Source: Scottish Government, 14 March 2019

The Chief Medical Officer (CMO) has issued an alert to NHS colleagues regarding recent hospitalisations and deaths reported across the UK relating to the consumption of 2,4- Dinitrophenol (DNP).

DNP is an industrial chemical that is unfit for human consumption and illegal for use in foodstuffs. Despite best efforts to remove products from sale, this product is still available and may be used by people trying to alter their appearance, such as body builders and those attempting to achieve rapid or extreme weight loss, including some who may be vulnerable. DNP is usually sold as a yellow powder, sometimes in capsule form, and is marketed as a ‘fat burner’ or weight loss supplement.

The letter states that prior to 2012, enquiries to the National Poisons Information Service (NPIS) regarding cases of DNP toxicity were rare, but the number of cases referred, and documented fatalities, have increased sharply since then. The majority of cases have involved younger adults, with more males affected than females. During 2018, the NPIS recorded the highest number of DNP exposed cases (20) and DNP related deaths (six) since 2015.

The Scottish Government is working with Food Standards Scotland (FSS), Health Protection Scotland (HPS), NHS boards and local authorities to raise awareness of the dangers of this chemical and to remove products containing DNP from sale.

Further information for health professionals and the public is available from the FSS website.

Source: Scottish Government, 12 March 2019

March is endometriosis awareness month. To coincide with this, the Royal College of General Practitioners (RCGP) has released a new education e-module which is free to RCGP members and other healthcare professionals in the UK. The course aims to promote awareness of the symptoms, signs and management of endometriosis, in order to help GPs support earlier diagnosis of the disease. 

The new education e-module is part of the RCGP’s spotlight project on menstrual wellbeing, developed in partnership with the charity Endometriosis UK.

In September 2017, the National Institute for Health and Care Excellence (NICE) published guidance on diagnosing and managing endometriosis. The guideline aims to raise awareness of the symptoms of endometriosis and to provide clear advice on what action to take when women with signs and symptoms of endometriosis first present to their GP or healthcare professional. It also provides advice on the range of treatments available.

Source: Endometriosis UK, 5 March 2019

World Oral Health Day (WOHD) is celebrated globally every year on 20 March. It is organised by FDI World Dental Federation and is the largest global awareness campaign on oral health.

WOHD spreads messages about good oral hygiene practices to adults and children alike and demonstrates the importance of optimal oral health in maintaining general health and well-being.

Source: World Oral Health Day, March 2019