Species of Palythoa and Zoanthus soft corals, collectively called zoantharians, can produce a toxin called palytoxin. Zoantharians are popular with marine reef aquarists as they are very colourful, commercially available, and often seen as a good ‘starter’ coral.

Exposure to palytoxin may occur via the skin, eyes or by inhalation. Symptoms of palytoxin poisoning may include fever, cough, headache, difficulty breathing, rapid heart rate, skin redness/rash, muscle pain, irritation of the eye, sensitivity to  light and conjunctivitis.

A number of incidents involving palytoxin from corals in home aquaria have been reported internationally. Generally, there is a lack of understanding of how palytoxin survives in the environment, however no reports have been found of individuals being reexposed or ill again on re-entry to homes or premises where exposure has previously occurred. The risk of palytoxin exposure is likely to be greatest at the time of the production of the toxin and is expected to be lower in the following hours or days.

In 2018, Health Protection Scotland (HPS) worked with the Ornamental Aquatic Trade Association (OATA) to produce detailed guidance for marine reef aquarists on how to prevent palytoxin poisoning. We have now produced recommended cleanup procedures following a suspected palytoxin incident.

‘Recommended clean-up procedures following Palytoxin incidents’ can be accessed on our website.

The OATA provide advice on preventing palytoxin poisoning, which can be accessed on their website.

Source: HPS, 17 January 2019

Cervical Cancer Prevention Week runs from 21 - 27 January 2019.
The human papillomavirus (HPV) vaccine helps protect against the main cause of cervical cancer.Evidence shows the high uptake of the HPV vaccine has helped to reduce levels of cancer causing HPV in young women in Scotland by 90%.

The combination of HPV immunisation and cervical screening from the age of 25 offers the bestpossible protection against cervical cancer. The award winning cervical screening social media campaign, The Flower, will be running during January in cinemas and on social media.

NHS Health Scotland has also produced a toolkit for primary care to address falling attendance rates and women’s poor understanding of the benefits of cervical screening. The information will help GPs, practice nurses and other practice staff to better understand what stops women attending (especially with vulnerable groups). It will also help staff to use tried and tested methods to increase attendance.

The toolkit can be viewed on the Health Scotland website.

The Flower social media campaign can be found online.

More information on the HPV vaccine can be viewed on the NHS Inform website.

World Leprosy Day takes place on 27 January 2019. This year, governments and authorities are being called upon to dedicate more resources to leprosy research.

Across the globe, leprosy charities and partners will join together to raise awareness of this disease that many people believe to be extinct, when in fact around 210,000 new cases are diagnosed each year. It is believed that millions more people are living undiagnosed, leaving them at risk of disabilities.

Source: Lepra, 4 January 2019

The evidence base regarding potential health hazards associated with animal bites has recently been reviewed and updated guidance for medical professionals and the general public has been produced.

Animal bites are not uncommon during travel and alongside the morbidity associated with injury, represent a risk of rabies, tetanus and bacterial wound infections.

The greatest number of injuries are due to bites and scratches from dogs, cats, monkeys and snakes.  Although there are no formal estimates, dog bites alone are thought to cause tens of millions of injuries annually worldwide. In the US, 4.5 million dog bites are recorded every year with 20% requiring medical care and 18% becoming infected.

Travellers should maintain a sensible distance from animals during travel, especially dogs, monkeys and cats, to avoid bites and scratches. This is particularly important with young children. Animals are most likely to bite when they feel threatened or are disturbed eating, sleeping or caring for young.

Further information and advice on yellow fever is available to view on the Travax (for health professionals) and fitfortravel (for the general public) websites.

Source: Travax, 14 January 2019

A recently published report from the European Centre for Disease Prevention and  Control (ECDC) discussed an assessment mission in 2018 on antimicrobial resistance (AMR) issues in Norway.

The overall objective of the mission was to provide an observation-based assessment of the situation in Norway regarding prevention and control of AMR through prudent use of antibiotics and infection control.

Data showed that the proportion of AMR in bacteria from bloodstream infections in Norwegian patients is consistently below the EU/EEA average and often among the lowest in Europe. Nevertheless, resistance to broad-spectrum antibiotics such as third-generation cephalosporins has been increasing over the past ten years. This is the result of  emergence of strains that produce an extended-spectrum beta-lactamase (ESBL), combined with increasing consumption of broad-spectrum antibiotics in healthcare.

The report can be viewed on the ECDC website.

Source: ECDC, 16 January 2019

The European Centre for Disease Prevention and Control (ECDC) has released two expert consensus protocols addressing carbapenem and colistin resistance detection and characterisation.

The primary objective of the carbapenem and/or colistin-resistant enterobacteriaceae (CCRE) survey is to determine the occurrence, geographic distribution and population dynamics within the healthcare setting of high-risk CCRE clones and/or transmissible resistance/genetic elements of critical public health importance in Europe in order to enable informed risk assessment and control policies.

The ECDC website provides the protocols covering carbapenem resistance and colistin resistance.

Source: ECDC, 14 January 2019

The Scottish Environmental Protection Agency (SEPA) is changing the way it regulates the dry cleaning sector in Scotland and new legal powers have allowed the agency to issue fines for non-compliance.

The fines have proven effective in changing behaviour and deterring those who damage the environment and undermine legitimate businesses.

Each operator is required to submit a data return each year to ensure that they complied with the limit of solvent that is set by EU guidelines.  Historically, many operators did not submit the data with fewer than 80% doing so in 2012.

In response, SEPA adopted a sector-based approach for the regulation of dry cleaners, moving to a national team with one dedicated staff member. This meant more time and effort could be spent supporting the dry cleaning sector. As a result, the number of operators submitting the required data rose to around 90% over the next few years.

Source: SEPA, 16 January 2019

A report recently released by the European Environment Agency (EEA) recommends more attention to the danger posed by the ‘cocktail effect’, whereby mixtures of chemical substances that individually may be present at harmless concentrations can combine and pose a risk to health,  in European lakes, rivers and other surface water bodies.

The report concludes that Europe-wide action to prevent and reduce hazardous chemicals from making their way into Europe’s fresh water bodies has been successful over past decades. However, challenges remain in effectively dealing with mercury and brominated flame retardants, and with many harmful chemicals which have not been prioritised for monitoring under the EU Water Framework Directive.

The aim of the report is to improve understanding of which chemicals continue to pose significant risks to the environment, especially when they are present in water. It also looks at how better knowledge and understanding can help to improve controls in order to minimise harm.

The report gives an overview of information about pollutants used in the assessment of water quality under the Water Framework Directive and describes some of the newer techniques available for assessing of water quality.

The report ‘Chemicals in European Waters’ can be viewed on the EEA website, while the EU Water Framework Directive can be viewed on the European Commission (EC) website.

Source: EEA, 16 January 2019

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

• Hundreds of pupils were sent home for the day from a school in Aberdeenshire after a suspicious chemical smell was reported on Friday 18 January. Firefighters were called to Aboyne Academy at about 10:40am. The Fire Service said it responded to reports that there was an odour similar to sulphur coming from a cleaning cupboard. The school was evacuated and pupils were allowed to leave early. No one was injured. The source of the smell is still being investigated. Source: BBC News, 18 January 2019

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