On 30 April 2018, Health Protection Scotland (HPS) published the latest HIV surveillance report, which provides a summary of HIV diagnoses data in Scotland to the end of December 2018.

This newly formatted report replaces the quarterly report and provides data on:

• first ever diagnoses in Scotland
• recent infections by transmission risk category
• individuals previously diagnosed elsewhere but now reported in Scotland
• the cohort of individuals diagnosed and living with HIV in Scotland at the end of December 2018

At the end of December 2018, HIV-antibody positive test results for 318 individuals not previously recorded as HIV-positive were received from NHS Scotland laboratories. Of these, 194 were first ever HIV diagnoses and 124 had been previously diagnosed out-with Scotland, but were newly reported in Scotland during 2018. It is estimated that there are 5,375 individuals living with HIV in Scotland, of whom 3,935 are male and 1,440 are female.

A further report later in the year will present data on access to specialist HIV care and treatment, and outcomes of infection.

The World Health Organization (WHO) is calling on everyone to be inspired by the global movement to achieve universal health coverage (UHC), i.e. achieving better health and well-being for all people at all ages including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

The theme for Global Hand Hygiene Day this year is ‘Clean care for all – it’s in your hands’, promoting hand hygiene being practiced in all care settings, including care homes and primary care, as well as hospitals. Calls to actions have been provided to encourage all levels of staff to take part and these are: 

• Health workers: ‘champion clean care – it’s in your hands.’
• Infection prevention and control leaders: ‘monitor infection prevention and control standards – take action and improve practices.’
• Health facility leaders: ‘is your facility up to WHO infection control and hand hygiene standards? Take part in the WHO survey 2019 and take action!’
• Ministries of health: ‘does your country meet infection prevention and control standards? Monitor and act to achieve quality universal health coverage.’
• Patient advocacy groups: ‘ask for clean care – it’s your right.’

Health Protection Scotland (HPS) supports the WHO Global Hand Hygiene Day each year and has undertaken several activities to promote the 2019 day including: 

• Providing an HPS hand hygiene day webpage with campaign details and resources showing correct hand hygiene technique. 
• Promoting the day to NHS boards and stakeholders in the HPS HAI Digest. 
• Issuing tweets on the run up to the day and using #handhygiene, #healthforall and #infectionprevention hashtags.
• Launching the four moments for hand hygiene poster for residential homes in the National Infection Prevention and Control Manual website. 
• Co-ordinating the WHO Global survey on infection prevention and control for Scotland. Boards are encouraged to take part by registering. The closing date for the survey is 16 July 2019. 
• Creating a solidarity chain to show support for the day.

More information on Global Hand Hygiene Day can be accessed on the WHO website.

Source: WHO, April 2019

The European Centre for Disease Prevention and Control (ECDC) reports that following a decline in notification rates in 2016, the number of gonorrhoea cases has gone up by 17% across the reporting EU/EEA countries, with more than 89,000 confirmed diagnoses in 2017, which is more than 240 cases a day.

The 2017 increase follows the overall trend over the last decade, during which 20 of the 28 EU/EEA countries consistently reporting an increase in the number of notified gonorrhoea cases.

Since 2008, France and Portugal experienced a six-fold increase, while Denmark and Ireland now record more than three times as many confirmed cases. It is believed some of the reported increases are the result of improved national surveillance systems and use of more sensitive tests.

After a small drop in 2016, gonorrhoea notifications rose again in the majority of the 27 reporting countries in 2017. Some countries noted striking year-on-year increases of more than 40%, such as Finland and Sweden.

Earlier this year, results from ECDC’s sentinel European Gonococcal Antimicrobial Surveillance Programme showed a persistent level of resistance of Neisseria gonorrhoeae to azithromycin, which compromises the recommended dual therapy with ceftriaxone.

Men who have sex with men (MSM) accounted for almost half of gonorrhoea cases (47%) in 2017. The rise in notified cases among women between 2016 and 2017 (from 9.5 to 11 per 100,000 population) is concerning, as untreated gonorrhoea can lead to pelvic inflammatory disease or cause infertility.

Rates of reported gonorrhoea infection vary considerably across Europe, from below one to 75 cases per 100,000 of the population, with higher rates reported in northern Europe. While this variation could be linked to real differences in incidence of gonococcal infection, they are likely influenced by different testing policies and methods, healthcare systems and access to services, as well as reporting and surveillance system structures.

With 558,155 confirmed cases between 2008 and 2017, gonorrhoea is the second most notified sexually transmitted infection in the EU/EEA after Chlamydia, of which 3,826,299 cases were reported during the same time period.

Source: ECDC, 25 April 2019

The European Centre for Disease Prevention and Control (ECDC) has recently published four annual epidemiological reports.

The epidemiological reports available to view, using 2017 data, are: 

• gonorrhoea 
• Haemophilus influenza 
• invasive meningococcal disease
• pertussis

Source: ECDC, April 2019

The government of Malawi launched the world’s first malaria vaccine on 23 April 2019 in a landmark pilot programme. The vaccine, known as RTS,S, will be made available to children up to two years of age. Ghana and Kenya will also introduce the vaccine in the coming weeks.

Malaria remains one of the world’s leading killers, claiming the life of one child every two minutes. Most of these deaths are in Africa, where more than 250,000 children die from the disease every year. Children under five years of age are at greatest risk of its life-threatening complications. Worldwide, malaria kills 435,000 people a year, most of them children.

RTS,S has taken 30 years to develop and is the first and only vaccine that has demonstrated it can significantly reduce malaria in children. In clinical trials, the vaccine was found to prevent approximately four-in-ten malaria cases, including three-in-ten cases of life-threatening severe malaria.

Financing for the pilot programme was raised through collaboration between three key global health funding bodies: Gavi the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria and Unitaid. Additionally, the World Health Organization (WHO), PATH and GlaxoSmitKline (GSK) are providing in-kind contributions.

Source: WHO, 23 April 2019

After two reports of fatal adverse reactions to the yellow fever vaccine (Stamaril), the Medicines and Healthcare products Regulatory Agency (MHRA) has issued a warning to healthcare professionals who administer the drug.

Due to an increased risk of life-threatening reactions, the vaccine must not be given to anyone with a medical history of thymus dysfunction or who is immunosuppressed.  In addition, extreme caution must be used and a careful risk assessment conducted before vaccination of people aged 60 years and older, due to a substantially increased risk of such adverse reactions in this age group.

Source: MHRA, 16 April 2019

On 21 April 2019, the Scottish Environmental Protection Agency (SEPA) responded to complaints of unplanned flaring at ExxonMobil Chemical Limited’s Ethylene plant at Mossmorran, Fife. 

Whilst flaring is an important safety mechanism and is permitted through permit conditions, SEPA deployed a full regulatory, air quality and noise monitoring response which will inform their understanding of the nature of the event.

Regulatory and noise monitoring and air quality monitoring was carried out on 22 April 2019, which showed no cause for concern.

As ExxonMobil Chemical Limited advised that flaring is likely to continue over coming days, SEPA reinforced to the site operators the importance of restarting the plant as quickly as possible with the minimal amount of elevated flaring.

Over 600 complaints have been received by the SEPA 24 hour pollution hotline, one of the highest numbers for any single event.

Source: SEPA, 25 April 2019

The Food Standards Agency (FSA) has published the findings for wave five of their ‘Food and You’ survey.

The bi-annual survey, which includes data from England, Wales and Northern Ireland, is used to collect information about the public’s self-reported behaviours and attitudes to buying, cooking and eating food.

The key findings cover areas including: shopping habits, food hygiene ratings for food businesses, hygiene habits in the home and food poisoning.

Source: FSA, 24 April 2019

The theme of Allergy UK’s Allergy Awareness Week this spring is 'Air Quality: the allergens around us', and will run between 29 April and 3 May 2019.

Allergy UK aims to raise awareness of the impact of poor air quality and the link between poor air quality and allergy. Allergy Awareness Week aims to encourage the public to get involved in activities such as travelling by public transport to reduce pollution, meal planning an allergen free menu and buying local so as to reduce air miles.

It also aims to increase the knowledge and understanding among healthcare professionals, as well as promoting better management of allergic conditions.

Interested parties can sign up to receive news, information and resources on Allergy Awareness Week 2019.

Source: Allergy UK, April 2019

The Scottish Environmental Incident Surveillance System (SEISS) recorded the following incidents in the past week: 

• Firefighters worked through the night of 22 April 2019 to tackle a large wildfire near a wind farm in Moray. The alarm was raised just before 3pm, when flames were spotted near Paul's Hill wind farm at Knockando, south west of Elgin. About 30 firefighters attended the scene of the blaze and at its height more than 50 people were involved. The blaze covered an area of six miles by two miles. There were no reports of any casualties. The Paul's Hill wind farm, consisting of 28 turbines, is run by Fred Olsen Renewables. There was a large grass fire in the same area the previous weekend. 
• Firefighters tackled a wildfire affecting about 75 acres of land in Lochaber. It broke out south of Kinlochleven on 21 April 2019 and was still burning the following evening. The flames were being fanned by windy conditions, and four pumps were sent to the scene. Both of these fires were reported by BBC News. 
• Emergency services were called at 8.39pm on 22 April 2019 to reports of a grassfire on the Muirhead heathland in North Lanarkshire. One fire appliance was sent to the scene but subsequently another three were sent to tackle the blaze. The Scottish Fire and Rescue Service (SFRS) said the last appliance left at 10.09pm when the fire had been fully extinguished. The cause of the fire remains unknown. This fire was reported by the Evening Times.

More detailed information can be found on the SEISS website or contact either Ian Henton or Colin Ramsay at HPS on 0141 300 1100.