On 19 February 2019, Health Protection Scotland (HPS) issued the annual report on shingles vaccine for the 2017 to 2018 season, the fifth year of this programme. The coverage of the  vaccine, in both the routine and catch-up cohorts, is compared with previous years of the programme. The impact of deprivation on uptake of the vaccine is also discussed.

Shingles, also known as herpes zoster, is a painful infection which causes a blistering rash and is caused by reactivation of varicella zoster virus (VZV), the primary infection of which usually occurs in childhood. Shingles, although painful, tends to be self-limiting and lasts from between two to four weeks. However, some people go on to develop a long-lasting neuropathic pain complication, post-herpetic neuralgia (PHN). The risk and severity of shingles and related complications increases markedly with age. The vaccine is aimed at reducing the burden of disease associated with shingles and long-term pain complications.

In the 2017 to 2018 programme, the vaccine was offered to those aged 70 years old and to a catch-up cohort of those aged 76 years. Shingles vaccine coverage in those aged 70 years was 44.7%, representing a decrease of 1.8% from the 2016-2017 season. For the catch-up cohort, aged 76 years in 2017-2018, there was a slight increase in coverage compared to the previous catch up cohort in 2016-2017, of 0.6% to 40.4%. Similarly to previous seasons, vaccine coverage in the routine cohort (aged 70) was significantly higher than that of the catch-up cohort (aged 76), with a difference of 4.3%. In addition, there was also an increase in coverage in those who were aged 70 years in the first year of the programme, demonstrating that vaccination of those who remained eligible was taking place opportunistically.

French health authorities have reported a rise in measles cases at the Val-Thorens ski resort, one of the highest in the Alps, and a popular destination for both French and foreign tourists. The Auvergne-Rhone-Alpes (ARS) regional health agency for the district have recorded 18 cases. The ARS recorded just eight cases in the Auvergne-Rhone-Alpes region in 2016, 45 cases in 2017 and 84 cases during 2018.

Travel may increase an individual’s risk of exposure to the measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. Travax encourages all travellers, particularly children, to ensure that they are up to date pre-travel with UK national schedule vaccines, which includes having received two doses of a measles containing vaccine, unless they have had a prior measles infection.

Further information and advice on travel to France and on the MMR vaccine is available to view on the Travax (for health professionals) and fitfortravel (for the general public) websites.

Sources: Travax, 13 February 2019 and fitfortravel, 13 February 2019

The World Health Organization (WHO) has scaled up its efforts to support West Africa’s response to Lassa fever, with five countries reporting cases. The largest outbreak has affected 16 states in Nigeria, where 213 confirmed cases, including 42 deaths, have been reported. A total of 12 cases have been confirmed in Benin, Guinea, Liberia and Togo, including two deaths.

The WHO is assisting health authorities in these countries with contact tracing and providing medical and non-medical supplies, as well as technical and financial resources, where needed for case management, risk communication and logistics.

Lassa fever is an acute viral haemorrhagic illness that occurs predominantly in West Africa, after human exposure to the urine or faeces of infected Mastomys rats. More than 80% of Lassa fever cases are via rodent-to-human transmission. Person-to-person transmission occurs in both community and health-care settings.

Further information and advice on viral haemorrhagic fever (VHF), and on travel to Nigeria and the other four countries is available to view on the Travax (for health professionals) and fitfortravel (for the general public) websites.

Source: WHO Africa, 08 February 2019

The World Health Organisation (WHO) Regional Office for Europe is supporting its member states in scaling up their health emergency preparedness and response capacities through a series of capacity building initiatives.

Outbreaks and health emergencies continue to reveal that they can happen in any country, at any time. This requires all countries to prioritize and prepare for different types of health threats, such as infectious diseases, natural disasters, conflicts or environmental risks. A critical part of this preparation is capacity building through training and simulation exercises, which are essential for enhancing International Health Regulations (IHR) core capacities throughout the region.

An Action Plan, tailored to meet the needs of the European Region, has been developed. The Action Plan has been devised as a call for all countries to strengthen or maintain emergency response capacities through, for example, training and opportunities to practice and review new and existing capacities, with a needs-based approach to capacity building being an important component of the plan.

Source: WHO Europe, 11 February 2019

As part of the French Government’s action plan on plant protection products, aimed at reducing dependence on pesticides in agriculture, the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) has publishing the results of its expert appraisal and its recommendations to strengthen the regulatory framework for the protection of bees and other pollinating insects. The aim of these recommendations is to reduce bee exposure to plant protection products.

Bees and other pollinating insects play a crucial role in biodiversity and agriculture. Bee health is affected by many factors, including plant protection products, and protecting them from exposure to these products is therefore seen as a priority. ANSES received a formal request from the French Ministry of Agriculture and Food and the Ministry of Ecological and Inclusive Transition to make recommendations to achieve this aim. In response to this request, the agency will therefore be issuing a series of recommendations and guidelines for strengthening the assessment of plant protection products with regard to the risks to bees and other pollinators.

Source: ANSES, 8 February 2019

The Scottish Government has made a commitment to develop a new five-year Climate Change Adaptation Programme for Scotland. The new adaptation programme will build on progress made under the 2009 Adaptation Framework, and the first statutory adaptation programme in 2014. The new programme will take into account the latest Climate Change Risk Assessment, published in 2017, and assessments of the current programme by the independent advisers, the Adaptation Sub-Committee of the Committee on Climate Change.

The Scottish Government is requesting the public submit their views on the draft programme: its vision, outcomes, sub-outcomes, and the policies in place to deliver these, as well as how progress should be monitored. The feedback will be used to develop the programme for launch in autumn 2019.

Source: Scottish Government, 12 February 2019

Scottish Water have announced investment of £2.2 million, with the aim of helping protect and enhance the environment of the Firth of Clyde and the coastal waters of Largs. The project involves the renewal and upgrade of sections of the existing sewer infrastructure in the area, where improvements are being made to help reduce the frequency and volume of combined storm water and waste water spillages into the bay in storm conditions. It is hoped the Firth of Clyde will significantly benefit in terms of improved water quality and a cleaner environment.

Source: Scottish Water, 12 February 2019

The Scottish Government and the Medicines and Healthcare Products Regulatory Agency (MHRA) have published a drug alert and medicine recall of contaminated Irbesartan, a class of medicine prescribed to treat blood pressure, heart attacks and heart failure.

The recall is taking place as part of the continued investigation into potential N-nitrosodiethylamine (NDEA) contamination of sartan containing medicines. The investigation into possible contamination began in 2018, after another impurity, N-nitrosodimethylamine (NDMA), was identified as part of the manufacturing process in a valsartan active substance manufactured at one facility based in China. NDEA was discovered after further testing.

The MHRA continues to monitor the situation in the UK and are investigating the issue alongside the European Medicines Agency (EMA) and the European Directorate for the Quality of Medicines (EDQM).

Sources: Scottish Government, 13 February 2019 and UK Government, 13 February 2019

A body modification artist who carried out a number of extreme procedures at his tattoo parlour in Wolverhampton, including ear and nipple removal and tongue-splitting, pleaded guilty to three counts of grievous bodily harm (GBH).

Public protection officers at the City of Wolverhampton Council served a notice on a tattoo parlour owner preventing him from carrying out body modification under the Health and Safety at Work Act 1974. The tattoo parlour had been carrying out what were considered to be significant cosmetic procedures which should be carried out in a suitable medical facility. 

An ear, nose and throat specialist, engaged by the City of Wolverhampton Council, advised that lack of medical training, an unsuitable operating environment, lack of specialist equipment, and working with untrained personnel at the tattoo parlour, meant that clients were at risk of severe bleeding, infection and life-changing complications.

A cabinet member for City of Wolverhampton Council called for the introduction of national legislation to protect members of the public against the risks of extreme body modification.

Source: City of Wolverhampton Council, 12 February 2019

A number of national and international conferences have been identified from a variety of sources. This note is to keep readers informed of the range of meetings being held around the world and is not necessarily a comprehensive list. These conferences all take place in London, England with the exception of the conference marked *, which takes place in Vienna, Austria.

• 20 February 2019
  The Unusual Suspects: Rare Diseases in Everyday Medical Care
• 28 February to 1 March 2019
  Fourth Annual Infection Control, Sterilization and Decontamination in Healthcare Congress
• 28 February to 1 March 2019
  Second Annual Infectious Diseases Diagnostics Conference
• 4 to 5 March 2019
  Second International Congress on Advanced Treatments in Rare Diseases*
• 4 to 6 March 2019
  Second World Congress on Infectious Diseases
• 4 to 6 March 2019
  Ninth Orphan Drugs and Rare Diseases Global Congress
• 11 to 12 March 2019
  Eighth World Congress on Immunology