On 26 May 2020, Health Protection Scotland (HPS), part of Public Health Scotland (PHS), published two reports revealing the numbers of sexually transmitted infections (STIs) recorded in Scotland between 2018 and 2019, specifically genital chlamydia, gonorrhoea and infectious syphilis. A third report, published by the Scottish Bacterial Sexually Transmitted Infection Reference Laboratory (SBSTIRL), contains information on antibiotic resistance to gonorrhoea.

Genital chlamydia remains the most frequently diagnosed STI in Scotland, with 17,336 diagnoses reported in 2019, which represents a 6% increase compared to 2018 (16,338). While laboratory confirmed diagnoses predominate in women (57% of all diagnoses), the number of diagnoses among men was the highest recorded in over 10 years (7,489). For the past decade, young people are the group most affected, with 64% of all diagnoses made in those aged less than 25 years.

In 2019, gonorrhoea diagnoses also increased with 3,776 diagnoses reported, indicating a 17% increase compared to the previous year. Using data from clinical records, this is the largest annual total recorded since the mid-1980s. In contrast to genital chlamydia, more than two-thirds (68%, 2,581) of gonorrhoea diagnoses were among men and, principally, among men who have sex with men (MSM), however, there has also been a steady increase in female diagnoses over the last four years. In women, infection with gonorrhoea is associated predominantly with a younger age group, with three-quarters (77%, 923/1,193) of female episodes occurring in those aged under 25 years. In 2019, rectal gonorrhoea, a marker of condomless anal intercourse (CAI), also remained high with the largest number of episodes recorded over the past decade.

Global public health concern continues around the emergence of gonococcal antibiotic resistance. The surveillance programme is critical to inform treatment and management guidelines, prevent treatment failure and control the spread of infection. In the UK, given the observed increase in recent years of the proportion of gonococcal isolates demonstrating high-level resistance to azithromycin (4.5% of all isolates in 2019), guidelines for gonorrhoea treatment changed in 2019 from azithromycin plus ceftriaxone dual therapy to ceftriaxone monotherapy.  Importantly, in 2019, no gonococcal isolates were resistant to ceftriaxone and there were no documented treatment failures.

In contrast to the observed increase in gonorrhoea and genital chlamydia infection, the number of diagnoses of infectious syphilis decreased by 20% between 2018 and 2019 (from 455 to 369), the first time a decrease has been recorded since 2015. The burden of infectious syphilis infection remains with MSM (86% of all diagnoses), however, heterosexual transmissions are also occurring.

While the decrease in diagnoses, primarily among MSM, is encouraging news, there is evidence of recent transmission of syphilis which is concerning as are the observed increases in rectal chlamydia and rectal gonorrhoea recorded among MSM in 2019, reaching the highest levels recorded in more than a decade. The impact of increased STI testing, particularly among MSM, associated with the successful implementation of an NHS-funded HIV pre-exposure prophylaxis (PrEP) programme in Scotland in July 2017 must be considered when interpreting these data. To assess the impact of the programme, now in its third year, HIV and other STI incidence continues to be monitored.

The findings of these reports highlight the continuing rates of unprotected sexual intercourse and the risk of STI infection, particularly among MSM, in Scotland in 2019. Furthermore, they underline the importance of a coordinated public health response, involving safer sex education and condom provision, regular testing and rapid access to treatment, and effective partner management, to meet the challenges for the control and prevention of STIs in Scotland.

The coronavirus (COVID-19) pandemic continues to affect countries across the world. The World Health Organization (WHO) produces daily situation reports, listing all affected countries and the number of confirmed cases.

The pandemic has led to unprecedented international border closures, and all countries may impose travel restrictions without notice. Consequently, the associated Foreign and Commonwealth Office (FCO) Exceptional Travel Advisory Notices still stand. British nationals are advised against all non-essential travel worldwide, and those already abroad should return to the UK if commercial flights are still available.

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the general public) websites.

Information on COVID-19 for the general public is available on the NHS Inform (Scotland) and the NHS.UK (rest of the UK) websites.

Information and resources on COVID-19 for health professionals is available on the Health Protection Scotland (HPS) (Scotland) and Public Health England (PHE) (rest of the UK) websites.

Source: TRAVAX, 6 May 2020

The European Centre for Disease Prevention and Control (ECDC) has published a report providing the first collation of data relating to the monitoring of progress made towards the elimination of hepatitis B and C in EU/EEA countries. Data were collated from a range of existing sources pertaining to epidemiological context, prevention and control, and impact. Data were also collected directly from all member states on testing and treatment indicators for the continuum of care in relation to hepatitis B and C.

Despite the limitations of existing data sources and the difficulties arising from the diversity of data and gaps in completeness, this collated information may represent an important step towards understanding the priority areas for action and gaps in the national responses to hepatitis B and C epidemics. The data also provides a baseline to help map progress towards the World Health Organization (WHO) elimination targets, and the Sustainable Development Goal (SDG) to eliminate viral hepatitis by 2030. 

Source: ECDC, 19 May 2020

This year’s World No Tobacco Day focuses on preventing young people using tobacco and nicotine products, by aiming to: 

• Debunk myths and expose tactics employed by the tobacco and related industries, particularly marketing strategies targeted at young people, including the introduction of new and novel products and flavours. 
• Equip young people with knowledge about the intentions and tactics used by the tobacco and related industries to encourage current and future generations in the use of tobacco and nicotine products. 
• Empower influencers in pop culture, social media, the home and classroom to protect and defend young people and catalyse change by engaging them in the fight against tobacco and related industries. 

The World Health Organization (WHO) website provides more information and resources to support the campaign. 

Source: WHO, May 2020

The European Commission reports that emissions of greenhouse gases from all operators covered by the EU Emissions Trading System (EU ETS) reduced overall by 8.7% in 2019. Compared to 2018, there was an approximate 9% decrease in emissions from stationary installations, such as power plants and manufacturing installations, and a 1% increase of emissions from aviation, including all commercial aircraft operators and non-commercial aircraft operators with significant emissions.

Emissions from industry saw an overall decrease of 2%, with reductions in most sectors including the production of iron and steel, cement, chemicals and refineries. The biggest reduction was achieved in the power sector, with a decrease of 15% reflecting decarbonisation from coal being replaced by electricity from renewables and gas-fired power production.

Source: European Commission, May 2020

A European Environment Agency (EEA) report analyses the effects that a wide variety of rapid and long-term societal developments have on the environment in Europe, and provides insights on their impact on EU sustainability ambitions.

The report argues that varying global and European trends point not only to continuing sustainability challenges and new risks, but also towards opportunities for positive change. For example, new technology might save resources and alleviate environmental pressures but it can also lead to increasing demand for energy and natural resources. As such, achieving sustainability goals requires a transformation of Europe’s core systems of production and consumption through policies such as the European Green Deal (EGD), as well as wider changes in norms and priorities across all levels of society.

The report states that the complexity of known trends, together with the emergence of new developments in an increasingly interconnected world, point to the value of recognising the presence of deep uncertainties around future developments and the need to act differently. For Europe, responding to existing challenges and new risks calls for more anticipatory governance and engaging with actors across society, for example through strategic foresight processes.

The report points out those emerging developments with unknown implications can range from new security threats to changing values and more digital lifestyles. Another category of change drivers are ‘wild cards’, which, though seen as unlikely, could bring about highly disruptive changes, such as the dramatic decline in pollinators, potentially threatening the global food supply.

Source: EEA, 19 May 2020

The Scottish Government has opened a new consultation seeking views on the proposal to postpone the determination of the bathing season for 2020 and the designation of any bathing waters. This is in light of the on-going COVID-19 pandemic and the matter would be kept under review throughout the summer months.

The aim of the Bathing Waters (Scotland) Regulations 2008 is to protect public health by: 

• monitoring water quality at locations popular with large numbers of bathers 
• providing public information on that water quality 
• taking steps to improve water quality where the necessary standards are not met

The regulations require that Scottish ministers must consult with the public and relevant public bodies about any proposed change in the period of the bathing water season, and take due account of the results.

The consultation opened on 15 May 2020 and will remain open for comments until 29 May 2020. 

Source: Scottish Government, 15 May 2020