On 20 August 2019, Health Protection Scotland (HPS) published the surveillance report, ‘Shiga toxin-producing E. coli (STEC) in Scotland 2018: enhanced surveillance and reference laboratory data’. Overall, the number of cases of E. coli O157/STEC reported in Scotland increased slightly in 2018, cases of E. coli O157 decreased and cases of non-O157 STEC increased. The numbers are in keeping with normal variation expected from year-to-year.

A report from the surveillance of healthcare associated infection (HAI) in Scottish intensive care units programme was published by National Services Scotland (NSS) on 13 August 2019. Data relating to bloodstream infections (BSI), pneumonia and central venous catheter (CVC) related infections were reported within section five of the Scottish Intensive Care Society Audit Group (SICSAG) annual report.

Source: Health Protection Scotland (HPS), 13 August 2019

Guidance published by the Scottish Government Chief Medical Office Directorate in CMO(2019)08 on 14 August 2019 provides information on the extension of the human papillomavirus (HPV) vaccination programme. From the 2019-2020 academic year, the HPV vaccine will be offered to boys in S1, in addition to girls, as part of the routine school-based programme. The guidance provides the necessary information required to introduce the programme.

Source: Scottish Government, 14 August 2019

NHS Health Scotland has published the flu education pack, a set of resources aimed at school staff supporting the National Flu Immunisation Programme. The resources include: 

• The ‘Flu immunisation in primary schools in Scotland’ guide for head teachers, which contains background detail on the flu programme and may help plan immunisation schedules in schools. 
• Suggested classroom-based activities about flu and immunisation, with clear links to the Curriculum for Excellence. 
• Samples of the invitation letter and leaflet which will be sent to parents. 
• A sample of the post-immunisation advice leaflet, which is provided to parents following their child’s immunisation. 
• Guidance to help support parents in accurately completing the consent form. 
• The staffroom poster, a resource to raise awareness of the Flu Education Pack among teachers and school staff. 
• Copies of posters for display in schools to increase awareness among parents and children about the flu immunisation programme. 
• The ‘You and Flu’ film with short clips aimed at parents, carers, children and teachers, which can be shown in classrooms and assemblies. The film introduces flu and the concept of immunisation in what is hoped to be a fun and engaging way. It also shows the way the nasal spray vaccine is administered.

Source: NHS Health Scotland, 15 August 2019

The Health Protection Scotland (HPS) Travel and International Health Team have reviewed and updated the yellow fever resources and guidance on the fitfortravel website for both health care professionals working in yellow fever vaccination centres, and members of the public seeking information.

In addition to the yellow fever disease page on fitfortravel, a new yellow fever vaccine page has been added. Health professionals can add this page to the ‘suitcase’ when using TRAVAX to ensure travellers are aware of the relevant information.

This page gives the following information for travellers relating to the yellow fever vaccine: 

• why the vaccine will be recommended 
• contraindications 
• cautions 
• common side effects 
• rare side effects 
• vaccination in the over-60s 
• medical exemption certificates 
• avoiding travel to a risk area 
• where to seek help if unwell following vaccination 
• link to patient information leaflet 
• links to NHS Inform yellow fever pages

Source:  TRAVAX, 13 August 2019

On 14 August 2019, the Global Polio Eradication Initiative reported a case of polio in Benin in Kalale district, Borgou State, with onset of paralysis on 7 July 2019. The possibility of other cases remains high.

Advice from the World Health Organization (WHO) is that all travellers to polio-affected areas should be fully vaccinated against polio. The TRAVAX and fitfortravel websites have been updated to advise that all travellers to Benin should consider a booster of poliomyelitis vaccine if it has been more than 10 years since most recent vaccination.

The WHO also advises that residents from infected areas and visitors living in these areas for more than four weeks should receive an additional dose of oral poliovirus vaccine (OPV) or inactivated polio vaccine (IPV) within four weeks to 12 months of travel.

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

Source: Global Polio Eradication Initiative, 14 August 2019

The 2019 Rugby World Cup is scheduled to take place in Japan from 20 September - 2 November 2019, beginning in Tokyo. Matches will take place in twelve host cities.

The potential health risks will vary between individuals attending the World Cup depending on the amount of time spent in Japan, further travel around the country, onward travel to another destination and leisure pursuits.

Risk factors such as age, pre-existing health conditions and medications, pregnancy etc. should be taken into account during a travel consultation.

During the World Cup, many stadia and surrounding areas are likely to be crowded, which increases the risk of both respiratory and gastrointestinal illness. Food and water precautions and respiratory hygiene should be discussed with all travellers.

The pre-travel consultation provides a good opportunity to check a traveller’s history of National schedule vaccines.

All relevant risks and vaccination advice for health professionals can be viewed on the Japan country page of the TRAVAX website.

Source: TRAVAX, 12 August 2019

The Food Standards Agency (FSA) has published the Year 4 report for the UK retail chicken survey which took place between August 2017 and July 2018. Samples were collected every quarter, but after the first quarter only minor retailers were tested. The UK’s top nine retailers have carried out their own sampling since September 2017.

The report found that high level Campylobacter contamination in UK chickens has decreased considerably, but remains high in smaller retailers, independents and butchers.

Source: FSA, 13 August 2019

Following unplanned flaring at the Mossmorran Ethylene Plant, Fife which started on 12 August 2019, the Scottish Environment Protection Agency (SEPA) convened a multi-agency group with Fife Council, NHS Fife and Health Protection Scotland (HPS).

On 15 August 2019, ExxonMobil Chemical Ltd advised SEPA that the ExxonMobil Fife Ethylene Plant had successfully been fully shut down. The plant is expected to remain in shutdown for about four weeks whilst remedial maintenance is undertaken. SEPA has continued its deployment of air quality and noise monitoring at locations in Lochgelly, Auchtertool and Donibristle for public reassurance. Monitoring continues to demonstrate air quality in line with expectations of controlled flaring events.

On 16 August 2019, SEPA announced the outcome of its review into Best Available Techniques (BAT) assessments by ExxonMobil Chemical Limited and Shell UK Limited. SEPA’s review of the assessments has found that ExxonMobil Chemical Limited and Shell UK Limited are not currently using all Best Available Techniques for flaring. The agency acknowledged ExxonMobil’s recognition of the requirement to upgrade their plant but found that their proposed timescales to increase capacity and accessibility to ground flares were unacceptable. SEPA found that Shell UK Limited had not sufficiently demonstrated that the proposed principles, approach and level of upgrade to the plant would achieve Best Available Techniques and were also unacceptable. SEPA will now move within seven days to vary operating permits to include required timescales for the implementation of Best Available Techniques, and timescales for the provision of further details required.

SEPA’s response documents, the proposals from ExxonMobil Chemical Limited and Shell UK Limited and SEPA’s latest air quality monitoring summary report from the latest incident have been published on their website.

Source: SEPA, 16 August 2019