The report on quarterly epidemiological data on Clostridioides (formerly Clostridium) difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureus bacteraemia (SAB), and surgical site infection (SSI) in Scotland, October to December (Q4) 2018, has been published on 2 April 2019, under the mandatory programmes for surveillance of CDI, ECB, SAB, and SSI in Scotland. This report provides data for the fourth quarter of 2018 in 14 NHS boards and one NHS special health board.

The report, and an appendix detailing all cases and denominator data for each NHS board and overall for Scotland, can be found on the HPS website.

Salmonellosis is the second most commonly reported gastrointestinal infection and an important cause of foodborne outbreaks in the EU/EEA. This report, published by the European Centre for Disease Prevention and Control (ECDC), is based on data retrieved from the European Surveillance System (TESSy). In 2016, 95,326 confirmed cases were reported, of which 134 were fatal. 9,902 of these cases were reported in the UK.

Source: ECDC, 25 March 2019

The World Health Organization (WHO) has published updates on Lassa fever transmission in Liberia and Nigeria.

In Liberia, 14 cases were confirmed between 8 February and 3 March 2019. The cases were in Bong (six), Nimba (five), Grand Bassa (one), Grand Kru (one) and Montserrado (one) counties. The WHO reported a total of 36 cases including four deaths since the beginning of 2019.

In Nigeria, in the week ending 17 March 2019, 23 cases (including four deaths) were reported from nine states, with Edo (eight) and Ondo (four) states having reported 52% of the total cases. In 2019, 73 local government areas across 21 states have reported at least one confirmed case.

Lassa fever is low risk to most travellers to Liberia and Nigeria, unless living in poor sanitary conditions in rural overcrowded areas. Health care workers in these regions are at risk if appropriate infection control measures are not followed. Travellers, who develop symptoms after returning from affected areas, should seek immediate medical advice.

Further information and advice is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Sources: WHO, 24 March 2019 and fitfortravel, 27 March 2019

Tunisian media reports that there have been 700 cases of measles (including 14 deaths) in Kasserine Governorate, Tunisia. Kasserine is in the north-west of the country and is not usually visited by tourists.

Advice for healthcare professionals

Travel may increase an individual’s risk of exposure to measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. The travel consultation provides healthcare practitioners with a valuable opportunity to ensure individuals are protected against the measles virus. Health professionals should consider vaccinating:

• All travellers who have not previously had two doses of a measles containing vaccine or prior measles infection.
• In particular, children and those who will be living or working closely with the local population at their destination, in countries with high endemnicity or recent outbreaks.

Advice for travellers

It should be confirmed that children have received their recommended doses of MMR at 12-13 months of age and again around three years four months. Consider vaccinating all unimmunised adults who have not had the disease themselves, particularly if they are going to be at higher risk. Two doses of MMR vaccine, at least one month apart, are required to give adequate protection.

Further information and advice can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

The European Centre for Disease Prevention and Control (ECDC) has identified a microbiological link between an outbreak of nine Listeria monocytogenes ST1247 cases in Denmark and nine additional cases reported between 2014 and 2018 in Estonia (two) Finland (two), France (one) and Sweden (four).

Whole genome sequencing (WGS) analysis performed at the national level and by ECDC found all isolates from the 18 cases within two allelic differences from each other (core genome MLST using Moura scheme, 1540 of 1748 loci detected in all 18 isolates). The latest case was reported in Denmark in February 2019.

A large-scale study led by ECDC on WGS shows that most Listeria outbreaks remain undetected. The study, published in 2018, suggested that more than half of the severe listeriosis cases in the EU belong to clusters, many of which are not being picked up fast enough by the current surveillance system.

L. monocytogenes causes listeriosis, which primarily affects pregnant women, newborns, and adults with a weakened immune system. Listeriosis is a relatively rare but potentially severe food-borne disease that has been reported in increasing numbers in EU/EEA countries since 2008. In 2016, 2,536 cases were reported, including 247 deaths.

Source: ECDC, 27 March 2019

The Scottish Environment Protection Agency (SEPA) has published official statistics providing details of waste from households, construction and demolition, and commerce and industry. These statistics are based on 2016 and 2017 findings.

The total quantity of waste generated in 2017 increased by 5.5%, whilst 142,195 more tonnes of waste was recycled in 2017. The national recycling rate was 58.9%, a decrease of 0.2% from 2016.

In 2017, over 760,000 tonnes of waste was diverted from landfill through incineration with energy recovery or co-incineration. This is an increase of 14.7% from 2016 and follows the longer term trend with 182.6% more waste recovered since 2011. The quantity of Scotland’s waste being sent to landfill increased to 32.6% of all waste managed.

Data on waste are collected to monitor policy effectiveness, and to support policy development, particularly commitments in the Scottish Government's 'Making Things Last - A Circular Economy Strategy for Scotland'.

Source: SEPA, 26 March 2019

Renewable electricity generation in Scotland reached record levels in 2018. The latest figures from the Department for Business, Energy and Industrial Strategy (BEIS) show that the equivalent of 74.6% of gross electricity consumption was from renewable sources.

Renewable electricity generation in Scotland was 26,708 GWh, a 6.1% increase on the previous record in 2017.  This output of electricity is the equivalent of powering all households in Scotland for more than two-and-a-half years.

The latest statistics also show: 

• The growth of Scotland’s renewable electricity capacity has risen from 10.0 GW in 2017 to 10.9 GW in 2018.
• 2018 saw a big increase in electricity generated via offshore wind, with capacity and generation both more than doubling compared to 2017. Generation increased from 616 GWh in 2017 to 1,369 GWh in 2018, while capacity has increased from 246 MW to 623 MW. 
• It was a record year for electricity exports in Scotland, as net exports have almost doubled from 12,868 GWh in 2017 to 24,379 GWh in 2018.

Source: Scottish Government, 28 March 2019

A new consultation, launched on 26 March 2019, aims to determine a timetable for ambitious energy efficiency targets for Scotland. The consultation seeks to gather evidence which could support a change to the proposed timeframe to deliver standards for all properties across Scotland in an achievable and realistic way. The consultation closes on 17 June 2019.

As part of the Scottish Government’s wider efforts to meet their commitments under the Climate Change Plan, they also published another consultation on 26 March 2019, which is focused on decarbonising the heat supply to buildings that do not use gas. This will explore the barriers to the uptake of low carbon heat options, the opportunities and challenges for the supply chain, and how to avoid any potential adverse effects on fuel poverty.

Source: Scottish Government, 26 March 2019

A new Forestry Commission practice guide has been published which focuses on protecting the water environment during forest operations.

Providing advice to forest managers, planners, practitioners and supervisors on how forest operations should be planned and managed to protect the water environment, the guide helps to ensure that they comply with the UK Forestry Standard guidelines on forests and water, which is the primary source of information on the legal and good practice requirements.

The new guide is applicable both to large and small-scale forest operations and helps to ensure that land managers will be able to take the necessary steps to protect the water environment.

The guide emphasises the importance of planning, the use of buffer zones, and sets out good practice for eight key forest operations: cultivation, these being:

• cultivation 
• drainage 
• fertiliser application 
• use of pesticide 
• roads and quarries 
• harvesting 
• vehicle and machine maintenance 
• contingencies

The guide also describes monitoring activities.

World Health Day falls on 7 April 2019. This year, the World Health Organization (WHO) is focusing on universal health coverage, with the aim of helping people better understand what services and support should be available and where. The WHO is calling on people who have access to quality, affordable healthcare to advocate for equal access to care everywhere.

The World Health Day campaign also presents an opportunity for ministers of health, and other government decision-makers, to take action toward filling gaps in health coverage in their countries, as well as to highlight progress that has already been made.

Source: WHO Europe, April 2019