2019 marks the fiftieth anniversary since the creation of a specialist unit in Scotland designated to conduct surveillance of communicable infections, the pro-genitor of HPS today.
The Communicable Diseases (Scotland) Unit (CD(S)U) was established in 1969 at Ruchill Hospital, Glasgow, and was one of the first specialist national units in the world set up to support the investigation, control and prevention of infectious outbreaks, following high profile incidents such as the 1964 Aberdeen typhoid outbreak, at the time the biggest outbreak in the UK since 1937, where more than 500 cases occurred. Many cases were quarantined in hospital and this outbreak had a major impact on the reputation of the city and Scotland at the time. This event not only demonstrated the need to improve the capacity across the country to manage serious outbreaks that could threaten public health and cause major community and economic disruption, but also highlighted the requirement to improve support for communicable disease control at a national level in Scotland.
CD(S)U was therefore set up in Glasgow as a national centre of expertise to carry out the surveillance of communicable disease across all of Scotland, co-ordinating the collection of information on new cases and outbreaks, as well as sharing intelligence on new sources and causes of infection. This was done to improve knowledge and understanding of how diseases spread and how they could be controlled. In addition, the unit also supported the work of local public health departments, such as that in Glasgow City, providing a resource to help investigate and manage outbreaks of infection in the community.
CD(S)U evolved over the next 50 years, firstly into CDEH(S)U when it absorbed its sister unit for Environmental Health (EH(S)U), also based in Glasgow, and expanded its role in helping protect the public from non-infectious environmental threats to health, e.g. chemical hazards and pollution in drinking water and outdoor air. In 1994, the unit was re-named the Scottish Centre for Infection and Environmental Health (SCIEH), and finally became Health Protection Scotland (HPS) in 2005. By then, the unit had a wider national remit supporting infection prevention and control in NHS health care services (Healthcare Acquired Infection (HAI)) and more broadly in community settings.
The unit has been involved in many of the major milestones of communicable disease surveillance and control, including identifying a mystery respiratory illness among Scottish holidaymakers returning from Spain in the late 1960’s, which went on the be identified as Legionnaires’ Disease after a large outbreak among veterans in the US. SCIEH, then HPS, was involved in supporting research into Cryptosporidium following one of the first ever recognised outbreaks of the infection associated with a contaminated water supply, identified in 1988 in Ayrshire, leading ultimately to investment which improved the quality of the public water supply throughout Scotland using improved filtration technology.
Staff in the unit have led many new developments, especially in the field of HIV and AIDS from its earliest days, and they are now heavily involved in efforts to eliminate hepatitis C infection in Scotland. HPV vaccination has been in the news recently in terms of the dramatic impact it has had on reducing cervical cancer, and this is another programme that HPS staff has been heavily involved with. There are many other developments over the years where the national unit has played a crucial role, the central Scotland E. coli 0157 outbreak investigation and the outbreak of anthrax among drug users due to contaminated heroin being just two examples.
After 50 years as a separate specialist unit, as of 1 April 2020, HPS will be merged into a new organisation, Public Health Scotland (PHS), dedicated to health protection and all other aspects of public health practice in Scotland and still with a base in Glasgow. PHS will continue the proud tradition, started in 1969 with the foundation of CD(S)U, of ensuring a high quality dedicated national level service to support health protection in Scotland.
Although CD(S)U was established in 1969, the weekly report preceded it by two years, and was originally collated and published on behalf of the Scottish Home and Health Department, part of the pre-devolution Scottish Office.