On 18 August 2020, Health Protection Scotland (HPS), part of Public Health Scotland (PHS), published provisional information on Shiga toxin-producing E. coli O157/STEC infection for Scotland for 2019. The information is compared to previous years’ data to show trends over time. 

In key points from the report: 

• During 2019, there were 150 cases of E. coli O157 and 108 cases of non-O157 STEC reported to HPS, which represents a slight decrease on the 156 cases of E. coli O157 and the 110 cases of non-O157 STEC reported in 2018. 
• Most isolates were reported in the summer months, a trend that is consistent with previous years. 
• E. coli O157/non-O157 STEC infection rates vary across the population, with overall higher rates observed in children under five years of age. 
• Enhanced surveillance information was available for 91% of cases.

On 4 July 2020, the Foreign & Commonwealth Office (FCO) updated its global advisory against all but essential travel, exempting some countries that no longer pose an unacceptably high risk for British travellers against coronavirus (COVID-19).

The fitfortravel (for the general public) and TRAVAX (for health professionals) country pages have been updated to include a COVID-19 country specific risk-rating, with every country being identified as high, moderate or low risk and each rating accompanied by appropriate travel advice. This information will be listed in the ‘Alerts’ section on each country page of fitfortravel and the 'Emerging Health Risks' section of every TRAVAX country page. The risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country, and will be regularly reviewed. However, as the global spread of COVID-19 can change at any time, travellers are advised to consider the advice below before planning international travel.

It should be noted that the risk ratings for Aruba, Austria, France, Hong Kong, Luxembourg, Spain, Belgium, Andorra, Malta, Monaco, the Netherlands, Iceland, Sint Maarten, Turks and Caicos islands, Cyprus, Denmark, Faroe islands, Germany, Japan and the Bahamas have recently been upgraded, reflecting an increase of cases in these countries.

Advice for travellers

Before planning and/or booking international travel, please check:

• the Foreign & Commonwealth Office (FCO) website, for country specific Travel Advisory Notices regarding travel and entry restrictions, and review the local medical care available at your destination 
• the COVID-19 risk-rating at your destination, which will be listed in the ‘Alerts’ section of all fitfortravel country pages and the ‘Emerging Health Risks’ section of all TRAVAX country pages
• the TRAVAX travel insurance page, as such insurance should be considered essential 
• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• the fitfortravel COVID-19 health considerations for travel page 
• physical distancing and hygiene measures in the country you are visiting

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, July 2020

The World Health Organization (WHO) annually consult with individual countries to confirm or update their country's yellow fever certificate requirements for international travellers. This is also known as the International Certificate of Vaccine or Prophylaxis (ICVP) requirement.

On 11 August 2020, the WHO published the annual update which details both countries and areas that have a risk of yellow fever transmission, and where there are ICVP certificate requirements for international travellers.  The country pages of the TRAVAX (for health professionals) and fitfortravel (for the general public) websites will be updated in the coming weeks to reflect any changes. In the interim, the WHO vaccination requirements and recommendations for international travellers 2020 edition can be used to access the latest requirements. 

Source: TRAVAX, 12 August 2020

On 6 August 2020, the European Centre for Disease Prevention and Control (ECDC) published its seasonal influenza annual epidemiological report for 2019-2020. Influenza activity started in week 45 of 2019, and returned to baseline levels in week 13 of 2020, earlier than previous seasons.

In key findings from the report: 

• Similar proportions of influenza A(H1)pdm09, A(H3) and B/Victoria were detected throughout the season. B/Victoria lineage viruses have greatly outnumbered those of the B/Yamagata lineage. 
• Different patterns of dominant type and A subtypes were observed among the countries. Early on, circulation of A(H3) was higher and later in the season increased proportions of A(H1)pdmp9 and B/Victoria viruses were observed. 
• The majority of severe cases reported this season were due to influenza virus type A infection and these mostly occurred in persons older than 40 years of age. 
• The majority of deceased hospitalised influenza patients were at least 65 years old and had influenza A virus infection. 
• During the period of high influenza virus circulation in early January and February, a slight excess mortality from all causes was observed, possibly related to influenza, while later in the season the excess mortality was driven by COVID-19. 
• The vast majority of influenza viruses tested were susceptible to neuraminidase inhibitors. 
• A moderately good vaccine effectiveness was observed, which was higher for type B and A(H1)pdm09 viruses.

Source: ECDC, 6 August 2020

The Scottish Government has announced that the flu vaccine programme will be expanded this year, in order to protect those most at risk during the COVID-19 pandemic. Social care workers, people over 55 years of age, and household members of those who are shielding, will all be eligible for the free seasonal flu vaccine.  The Scottish Government will look to extend the programme to those aged 50 to 54 years, if vaccine supplies allow.

NHSScotland health boards will be delivering the expansion of the vaccination programme in a phased approach, which allows vaccination for different groups to begin as soon as supplies of the vaccine becomes available, whilst prioritising those most at risk. The first phase will begin in October and will include those who are already eligible, household members of those shielding, and front-line social care workers.  The second phase is planned to begin in December, and will incorporate those aged from 55 to 64 years.

Source: Scottish Government, 7 August 2020

The Regional Verification Commission for Measles and Rubella Elimination (RVC) was established in the World Health Organization (WHO) European Region in 2011. The RVC is an independent group of experts that meets each year in June to review surveillance and immunization data submitted by the national verification committees, with the aim of assessing the status of measles and rubella elimination in each country and the region as a whole.

This year, the RVC meets virtually in a series of sessions, the first of which was held on 29 June 2020. The commission reviewed submitted annual status update reports from Armenia, Azerbaijan, Denmark, Estonia, Finland, Latvia, Netherlands, Norway, Sweden, Tajikistan and Turkmenistan. The RVC verified that all countries had maintained their measles elimination status, and all countries that had previously achieved rubella elimination also maintained this status. The commission based its conclusions on: 

• routine and supplemental immunization performance 
• measles and rubella surveillance with laboratorial and molecular epidemiology segments 
• outbreak response 
• activities focused on advocacy, communication and health literacy of the population and health-care workers 
• commitment of stakeholders to the elimination goal

Once the reports from all 53 countries have been reviewed, the full ninth RVC meeting report, with conclusions on elimination status in the region and country-specific recommendations, will be published.

Source: WHO European Region, 13 August 2020

The latest data from the World Health Organization (WHO) and UNICEF Joint Monitoring Programme (JMP) has shown 43% of schools around the world lacked access to basic handwashing with soap and water in 2019.

According to the report, around 818 million children lacked basic handwashing facilities at their schools, which puts them at increased risk of COVID-19 and other transmittable diseases. Over one-third of these children, approximately 295 million, are from sub-Saharan Africa. In the least developed countries, seven out of ten schools lacked basic handwashing facilities and half of schools lacked basic sanitation and water services.

In other key findings from the report: 

• Of the 818 million children who lacked a basic handwashing service at their school, 355 million went to schools which had facilities with water but no soap, and 462 million to schools which had no facilities or water available for handwashing. 
• In the 60 countries at highest risk of health and humanitarian crises due to COVID-19, three-in-four children lacked basic handwashing service at their school at the start of the outbreak, half of all children lacked basic water service and more than half lacked a basic sanitation service. 
• One-in-three schools worldwide had either a limited drinking water service or no drinking water service at all. 
• 698 million children lacked basic sanitation service at their school.

Source: WHO, 13 August 2020

The European Food Safety Authority (EFSA) has assessed the risks to human and animal health related to the presence of glycoalkaloids in food and feed, particularly in potatoes and products derived from potatoes. Glycoalkaloids are naturally occurring compounds found in the Solanaceae family of plants, which includes potatoes, tomatoes and aubergines.

The EFSA report identified a potential health concern for infants and toddlers, considering both mean and high consumers. Among adults, there is a potential health concern for high consumers only. Glycoalkaloids poisoning can cause acute gastrointestinal symptoms, such as nausea, vomiting and diarrhoea. Based on the latest available knowledge, the EFSA derived a lowest observed adverse effect level of one milligram per kilogram of body weight per day. This equates to the lowest dose at which undesired effects are observed.

Peeling, boiling and frying can reduce the content of glycoalkaloids in food. For example, peeling potatoes can reduce their content by between 25% and 75%, boiling in water between 5% and 65%, and frying in oil between 20% and 90%.

Source: EFSA, 11 August 2020

The Drinking Water Quality Regulator (DWQR) for Scotland has published its annual report, which shows that Scottish Water’s compliance with the standards for drinking water remains high, at 99.2%.

The report covers drinking water quality in Scotland during 2019, and states that a total of 310,605 regulatory tests were carried out on Scotland’s drinking water last year. Scottish Water take and analyse samples of drinking water from treatment works, storage points and customers taps throughout the year. Of those taken from samples at consumers’ taps, 99.92% met the required standards, a slight improvement on last year and consistent with previous years.

Source: Scottish Government, 10 August 2020

Food Standards Scotland (FSS) has published new Ipsos MORI-commissioned research, focussing on the public’s behaviour and attitudes towards food during the high-alert period of the COVID-19 pandemic. The online survey tracked food purchasing and consumption in Scotland for three months from May to July 2020, before the recent pub and restaurant easements introduced by the Scottish Government.

Results from the latest wave, covering the period 10 to 14 July 2020, found that in the last month, around a third (28%) of respondents said they had healthier meals more often. Additionally, 33% of people reported they purchased food from a takeaway less often compared to the period before lockdown, either directly because of cooking more at home, being concerned about COVID-19 or the fact they were looking to save money. In addition, 35% of people said they either bought less or no processed food, such as bacon and cured meats, but 37% said they snacked more on products high in sugar, salt and fat in the last month.

Source: FSS, 10 August 2020