The report on quarterly epidemiological data on Clostridioides difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureus bacteraemia (SAB), and surgical site infection (SSI) in Scotland, April to June (Q2) 2020, was published by Health Protection Scotland (HPS) on 6 October 2020, under the mandatory programmes for surveillance of CDI, ECB, SAB, and SSI in Scotland. Please note that data for SSI are not included due to the pausing of surveillance to support the COVID-19 response.

This report provides data for the second quarter of 2020 in 14 NHS boards and one NHS special health board. In addition, an appendix can also be accessed which details all cases and denominator data for each NHS board and overall for Scotland.

As the coronavirus (COVID-19) outbreak continues to evolve, the Foreign, Commonwealth & Development Office (FCDO) advises British nationals against all but essential travel, exempting some countries that no longer pose an unacceptably high risk for British travellers. This advice is being kept under constant review and may change at short notice.

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.

This risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country and is regularly reviewed. So far, in September 2020, the risk rating has been increased in 22 countries, which are detailed on the individual country outbreak alerts on the TRAVAX and fitfortravel websites. In the past three months, the COVID-19 risk to UK travellers has been decreased in the following countries:

• Malaysia 
• St Vincent and the Grenadines 
• East Timor (Timor Leste) 
• Lao PDR 
• Brunei 
• Latvia 
• Cuba 
• Sweden

In the last week, the rating for the following countries has been raised to high risk: 

• Turkey 
• Poland 
• Saba 
• Bonaire 
• Sint Eustatius

The COVID-19 risk rating and travel advice from the FCDO is being kept under constant review and may change at short notice. All travellers are advised to continue following sensible precautions and consider the following sources of information below.

Advice for travellers

Before planning or booking international travel, please check: 

• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• the Foreign, Commonwealth & Development Office (FCDO) 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 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, 25 September 2020

The European Centre for Disease Prevention and Control (ECDC) has published its annual epidemiological report concerning pertussis. In 2018, there were 35,627 cases of pertussis reported by 30 EU and EEA countries. Five countries, Germany, the Netherlands, Norway, Spain and the UK, accounted for 72% of all notified cases.

The notification rate in 2018 was 8.2 cases per 100,000 of the population, which was similar to the previous four years but the lowest observed in this time period. Individuals over 15 years of age accounted for 62% of all cases reported. Infants below the age of one year were the most affected age group, with the highest rate of 44.4 per 100,000 of the population. Three deaths have also been reported in this age group.

The clinical presentation of pertussis in adolescents and adults may be mild and is often not recognised, which contributes to bacteria circulation in the population. This poses a transmission risk to infants who are too young to have completed the primary pertussis vaccination series. The objectives of pertussis prevention and control include prevention of severe disease and deaths among infants under six months, through well-adapted and implemented vaccination programmes. As of August 2020, eight countries have implemented maternal immunisation programmes and five countries’ vaccination programmes include at least one booster, including the pertussis component, in individuals over the age of 18 years.

Source: ECDC, 25 September 2020

EU states are being urged to step up surveillance and biosecurity measures to guard against possible new outbreaks of avian influenza this year. The warning follows outbreaks of highly pathogenic avian influenza (HPAI) among wild and domestic birds in western Russia and Kazakhstan over the past few months. This region is a known autumn migration route for wild water birds heading to Europe.

Northern and eastern Europe are likely to be the most vulnerable to new outbreaks given past experience. When HPAI was detected in the same area of Russia in the summers of 2005 and 2016, epidemics followed in northern and eastern Europe. If the pattern is repeated this year, HPAI is expected to arrive in the same areas of Europe in autumn or winter. Subsequent spread to countries in southern and western Europe is also possible.

The alert is included in the latest update on avian influenza in Europe and beyond. The new report, compiled by the European Food Safety Authority (EFSA), the European Centre for Disease Prevention and Control (ECDC) and the European Union Reference Laboratory for Avian Influenza, covers the period from May to August 2020.

The report recommends that EU countries should: 

• take measures to detect suspected cases of HPAI promptly and increase biosecurity measures at poultry farms 
• warn veterinary and wildlife health authorities of the likely risk of HPAI introduction, and urge them to carry out prompt testing of dead or sick wild birds

Spread of the virus is likely to be triggered by a sudden and persistent fall in temperatures in central Russia and Kazakhstan. Several studies demonstrate that cold weather conditions led to the rapid westward expansion of the HPAI virus by infected migratory birds during the 2005 to 2006 and 2016 to 2017 waves.

The risk of transmission of avian influenza viruses to the general public in Europe remains very low. However, to minimise the risk of transmission to humans, people are advised not to not touch dead birds without wearing appropriate personal protective equipment.

Source: ECDC, 30 September 2020

Food Standards Scotland’s (FSS) Scottish Food Crime and Incidents Unit (SFCIU) has published its food crime priorities for 2020 to 2021, alongside a joint UK Food Crime Strategic Assessment with the Food Standards Agency’s (FSA) National Food Crime Unit.

The SFCIU has taken an evidence and intelligence-based approach, working with partners and industry to identify key areas of concern which have previously and continue to be targeted by criminals, to the detriment of consumers and responsible businesses. The priorities are:

• red meat 
• fish 
• counterfeit or illicit alcohol 
• wild shellfish

These areas, assessed as high-risk and vulnerable to food crime in Scotland, are set out in the Control Strategy, which also looks to address issues across the entire supply chain with the aim to identify, understand and tackle food crime, which is hoped will protect consumers, as well as the reputation of the food and drink sector.

These commodities have been assessed as high risk not because they pose a direct safety risk to consumers, nor because those sectors are less vigilant, but because they are particularly attractive to those with criminal intent. Preventative activities, which focus on food and drink, are commonplace across these industries.

The UK-wide Food Crime Strategic Assessment examines areas of the food supply chain which may be vulnerable to food crime, as well as identifying emerging threats which need to be addressed. The assessment found that most food crime relates to two broad activities, these being selling something of little or no value to the food chain as edible and marketable, or selling passable food, drink or feed as a product with greater volume or more desirable attributes.

In practice, this could include replacing ingredients with cheaper and inferior materials, falsely extending use-by dates, or deliberately marketing unsafe products as being fit for human consumption. The SFCIU will continue its work with the FSA, Scottish local authorities, the food and drink industry, Police Scotland and other partners to investigate, detect, disrupt and prevent food crime.

Source: FSS, 29 September 2020

The Food Standards Agency (FSA) has launched a formal six-week consultation with key stakeholders to inform a review of the guidance on the safety and shelf-life of vacuum and modified atmosphere packed (VP/MAP) chilled beef, lamb and pork.

Currently, the FSA guidance advises that the maximum shelf-life of VP/MAP chilled beef, lamb and pork should be 10 days, unless suitable controls are in place to appropriately reduce associated risks.

This summer the FSA, industry and other partners signed up to a joint statement, committing to working together to review the existing guidance and consider possible changes.

For more information about the consultation, and to take part, visit the FSA consultation webpage. The consultation will close on 11 November 2020.

Source: FSA, 1 October 2020