The European Centre for Disease Control and Prevention (ECDC) and World Health Organization (WHO) Regional Office for Europe have jointly published a situation update for seasonal influenza, which uses epidemiological and virological data to assess the seasonal increase of influenza cases in relation to disease severity and impact on healthcare systems. The report is designed to assist forward planning in EU member states.

In summary: 

• First detections for the 2019–2020 season indicate co-circulation of influenza types A (71%) and B (29%) viruses in the WHO European Region. All of the four influenza subtypes and lineages are circulating. Of the types A and B viruses detected, the A(H3) subtype and B/Victoria lineage have been dominant in north-western Europe and Central Asia, respectively. 
• Genetically and antigenically diverse influenza A(H3N2) and B/Victoria virus strains are co-circulating in the region. 
• The season has started slightly earlier than usual but it is too soon to predict how the season will develop in terms of peak week, severity and duration. 
• A(H3N2) is typically associated with serious health impact in older age groups. Some countries, such as the UK, are already seeing increased rates of influenza hospitalisation. There is no evidence of significant excess mortality at this early stage, however experience during past seasons suggests a significant mortality impact on the elderly during A(H3N2) dominated seasons. 
• B virus circulation might be associated with a higher burden on younger age groups, as already observed in Portugal. 
• Continued emphasis on vaccination programmes targeting the elderly and other eligible populations, such as individuals with pre-existing cardio-respiratory medical conditions, is strongly encouraged. 
• Surge capacity of healthcare facilities should be reviewed in anticipation of probable increased patient flows in emergency care during the peak influenza weeks. 
• The timely administration of neuraminidase inhibitor antivirals following national guidance is recommended to mitigate severe disease outcomes. 
• Measures to communicate practices, such as self-isolation when ill, respiratory etiquette and hand hygiene, should be encouraged.

Source: ECDC, 18 December 2019

The European Centre for Disease Prevention and Control (ECDC) has published 2018 annual epidemiological reports for: 

• Tick-borne encephalitis - 3,212 cases of tick-borne encephalitis (TBE) were reported in EU/EEA countries, 3,092 of which were confirmed. 
• Crimean-Congo haemorrhagic fever (CCHF) - eight cases of CCHF were reported in EU/EEA countries. Bulgaria reported six locally-acquired confirmed cases, Greece one travel-related confirmed case and Spain one locally acquired probable case. 
• Plague - no cases of plague were reported by EU/EEA countries. 
• Rift Valley fever - no cases of Rift Valley fever were reported by EU/EEA countries. 
• Zika virus disease - 51 cases of Zika virus (ZIKV) infection were reported in EU/EEA countries, though no autochthonous vector-borne cases of ZIKV infection were reported and there were no reports of cases involving sexual or vertical transmission of ZIKV.
• Cholera - 26 confirmed cases of cholera were reported across five EU/EEA countries, with 20 of these being reported in the UK. 
• Q fever - 922 cases of Q fever were reported in EU/EEA countries, 794 of which were confirmed. 
• Dengue - 27 EU/EEA countries reported 2,191 cases of dengue, of which 2,033 were confirmed. 
• Ebola and Marburg fevers - no cases of Ebola virus disease and Marburg haemorrhagic fever were reported in EU/EEA countries. 
• Chikungunya virus disease - 14 EU/EEA countries reported 160 cases of chikungunya virus disease, of which 113 were confirmed. 
• West Nile virus infection - eleven EU/EEA member states reported 1,605 West Nile virus (WNV) infections, of which 1,548 were locally acquired. The majority of locally acquired cases were reported by Italy, Greece and Romania.

Source: ECDC, 18 December 2019

According to a report published by the World Health Organization (WHO) on 19 December 2019, the number of cholera cases decreased globally by 60% in 2018. The report points to an encouraging trend in cholera prevention and control in the world’s major hotspots, including Haiti, Somalia and the Democratic Republic of the Congo.

There were 499,447 cases of cholera and 2,990 deaths in 2018, according to reports from 34 countries. While outbreaks are still ongoing in various countries, the case load represents a significant downward trend in cholera transmission that has continued into 2019. 

According to Dr Dominique Legros, head of WHO’s cholera programme, the global decrease in case numbers appears to be linked to large-scale vaccination campaigns and countries beginning to adopt the Global Roadmap to 2030 strategy in their national cholera action plans.

Source: WHO, 19 December 2019

The World Health Organization (WHO) has reported continued widespread occurrence of yellow fever across Nigeria, with nearly a three-fold increase in number of confirmed cases in 2019 compared to 2018, suggesting intensification of yellow fever virus transmission.

From 1 January to 10 December 2019, there have been 4,189 suspected yellow fever cases, including about 210 deaths, in 604 out of 774 Local Government Areas across all the 36 states and the Federal Capital Territory. Sixty-eight per cent (134) of laboratory-confirmed cases (total 197) were reported from Bauchi, Katsina, Edo and Ebonyi states.

Advice to travellers 

• Yellow fever is transmitted by Aedes mosquitoes that bite most often in daylight. Rigorous mosquito bite avoidance is advised at all times. 
• Yellow fever vaccination is advised for travellers to Nigeria, unless contraindicated.
• Country requirement at entry (WHO): yellow fever vaccination certificate required for all travellers aged nine months or over.

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

Source: WHO, 17 December 2019

On 17 December 2019, Scotland’s chief statistician published ‘Scotland’s Carbon Footprint: 1998-2016’. The report provides estimates of Scotland’s greenhouse gas emissions on a consumption basis, emissions that are associated with the spending of Scottish residents on goods and services, wherever in the world these emissions arise, together with emissions directly generated by Scottish households.

The key points highlighted are that: 

• Between 2015 and 2016, the carbon footprint, which is the emissions from all greenhouse gases, decreased by 6.9% to a record low of 73.8 million tonnes of carbon dioxide equivalent (MtCO2e). This is the largest year-on-year decrease since the recession in 2008. 
• Between 1998 and 2016, the carbon footprint fell by 12.3%, from 84.1 MtCO2e in 1998 to 73.8 MtCO2e in 2016. 
• Scotland's carbon footprint rose steadily from 1999 to a peak of 100.9 MtCO2e in 2007 before falling sharply in the following years, coinciding with the recession. 
• Scotland's carbon footprint has generally fallen gradually in more recent years, with the overall reduction of 26.9% being recorded between the 2007 peak and 2016.

Source: Scottish Government, 17 December 2019

On 17 December 2019, the Scottish Government published its second annual report monitoring progress against the 85 policy output and implementation indicators established in the Climate Change Plan: third report on proposals and policies 2018-2032.

This report is made up of a series of sectoral chapters, containing information on the policy output and implementation indicators set out in the corresponding chapter of the Climate Change Plan.

When the first monitoring report was published in 2018 it was too early to make an assessment of the majority of the indicators, and a comprehensive assessment of whether the plan was fully on track was not possible. The number of indicators in this position has reduced, but it remains the case that it is too early to make an assessment for the majority of the indicators as data is not yet available for the period covered.

Of the indicators where on-track assessments have been possible, seven are assessed as being on-track (across the electricity, transport and forestry sectors) and three are assessed as being off-track (across waste and peat). Further information on these indicators, and the actions being taken where indicators are off-track, are set out in the body of the report.

Source: Scottish Government, 17 December 2019

An exhibition about five tropical diseases and the parasites that cause them is currently taking place in the National Museum of Scotland in Edinburgh. 'Parasites: Battle for Survival' focuses on malaria, schistosomiasis, leishmaniasis, sleeping sickness and guinea worm disease. This interactive exhibition continues until 19 April 2020, and more information can be found on the National Museums Scotland website.

The Scottish Fire and Rescue Service (SFRS) has launched its festive safety campaign. Topics covered are:

• alcohol and cooking 
• candle safety 
• trees and decorations 
• older people 
• electrical safety 
• wood burning

Health Protection Scotland (HPS) would like to wish all readers a merry Christmas and a happy and healthy New Year. The next HPS Weekly Report will be published on 7 January 2020.

We hope you will find these links helpful during the festive season: 

• NHS Inform ‘Be Health-Wise This Winter' 
• NHS Inform ‘Self-help guide: flu-like illness’ 
• NHS Inform Flu Vaccine 
• NHS Inform Services Directory 
• Scottish Government Ready Scotland 
• Food Standards Scotland Christmas Food Safety Checklist 
• Food Standards Scotland Turkey Cooking Guide