The report on quarterly epidemiological data on Clostridium difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureus bacteraemia (SAB), and surgical site infection (SSI) in Scotland, October to December (Q4) 2017, was published on 3 April 2018 under the mandatory programmes for surveillance of CDI, ECB, SAB, and SSI in Scotland. This report provides data for the fourth quarter of 2017 in 14 NHS boards and one NHS special health board.

Further to current note 52/0801, the European Medicines Agency (EMA) has issued the EU recommendations for the influenza virus strains that vaccine manufacturers should include in vaccines for the prevention of seasonal influenza from autumn 2018.

Trivalent vaccines for the 2018/2019 season should contain these three virus strains:

• an A/Michigan/45/2015 (H1N1)pdm09-like virus
• an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
• a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage)

For quadrivalent vaccines with two influenza B viruses, a B/Phuket/3073/2013-like virus in addition to the strains mentioned above is considered appropriate.

These recommendations also apply to the manufacture of live attenuated influenza vaccines.

Every year, EMA’s ad hoc Influenza Working Group issues EU recommendations for the composition of seasonal influenza vaccines on the basis of observations by the World Health Organization (WHO). The recommendations for the influenza season 2018/2019 were endorsed by the agency’s Committee for Medicinal Products for Human Use (CHMP) at their March meeting.

The agency recommends that marketing authorisation holders submit applications to change the composition of centrally authorised seasonal flu vaccines by 18 June 2018.

Source: EMA News Release, 26 March 2018

On 7 March 2018, Germany reported four human cases of acute encephalitis or encephalopathy caused by infection with Borna disease virus 1 (BoDV-1). Three of the cases belonged to a cluster of solid organ recipients from a single donor from southern Germany, two of whom died. One additional case of encephalitis due to BoDV-1, who also died, was also found in southern Germany.

This is the first time that a possible BoDV-1 transmission through organ transplantation has been reported. Infection with BoDV-1 is very rare in humans, but can cause severe disease (acute encephalitis).

In response the European Centre for Disease Prevention and Control (ECDC) has issued a rapid risk assessment. The assessment concludes that transplantation professionals and clinicians should be aware of possible BoDV-1 related encephalitis and the possibility of transmission through donated organs especially in areas where Borna disease is endemic.

Endemic areas so far have been identified in central Europe including eastern and southern Germany, the eastern part of Switzerland, Liechtenstein, the most western federal state of Austria and more recently in Upper Austria.

The bicoloured white-toothed shrew has been proposed as the animal reservoir of BoDV-1. The routes of transmission of BoDV-1 to humans from the animal reservoir, however, remain unknown and the assessment also argues that zoonotic transmission pathways should be further investigated.

Source: ECDC News Release, 26 March 2018

Volatile substance abuse (VSA) is defined by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) as ‘the deliberate inhalation of volatile compounds to produce psychoactive effects’. Terms such as ‘glue sniffing’ and ‘solvent abuse’ have been used previously to define VSA, but are now regarded as inadequate descriptions of the range of substances abused. Volatile substances include, but are not limited to: fuel gases, aerosol propellants, some types of industrial glues, nitrous oxide, alkyl nitrites (known as ‘poppers’) and some anaesthetics.

This report describes trends in deaths involving volatile substances registered between 2001 and 2016 in Great Britain. Although helium, an inert gas, is not a volatile substance, the latter sections of this report describe trends in helium-related deaths.

The report shows that:

• in 2016, there were 64 deaths related to volatile substances registered in Great Britain
• over 80% of these volatile substance abuse (VSA) deaths were males
• there were 834 deaths involving volatile substances registered between 2001 and 2016
• the mortality rate has remained similar throughout the time period, with one VSA-related death per million population in 2016
• residents of Scotland and North East England had an increased risk of death related to VSA, when compared with Great Britain overall
• there were 69 deaths involving helium in 2016 and 509 helium deaths in total between 2001 and 2016
• helium-related deaths have increased over time, with a mortality rate of one death per million population in 2016

Source: ONS Release, 26 March 2018

Further to current note 52/1105, Glasgow City Council has announced its plans to have Scotland’s first Low Emission Zone (LEZ) in place as 2018 draws to a close.

The new zone, covering the city centre, is due to come into effect at 23:59 on 31 December 2018. It will mark the start of a journey which will ultimately lead to all vehicles entering the zone being fully compliant by 31 December 2022.

Details were discussed in an update report to the Environment, Sustainability and Carbon Reduction City Policy Committee on 20 March 2018. The report outlines the work being undertaken by the council and partners including Transport Scotland, Strathclyde Partnership for Transport (SPT) and SEPA to address the various technical and legal matters associated with establishing a LEZ in Glasgow.

Source: Glasgow City Council News Release, 21 March 2018

In the coming three years, 20 EU member states are planning to evaluate 108 substances. The authorities have 12 months to evaluate the 21 substances specified for 2018. The aim is to clarify whether these substances pose a risk to people or the environment. If necessary, the registrants will be asked to provide further information on the substance so that authorities can assess the suspected concern.

The European Chemicals Agency (ECHA) is encouraging registrants of the listed substances to coordinate their actions and to contact the evaluating member state. Registrants are also urged to update their dossiers, especially for uses and exposure scenarios. They will have an opportunity to comment before any decision to request further information is taken. Such draft decisions will be reviewed by the other member states and ECHA before the final decision is issued.

The substances are selected for evaluation to clarify the concerns related to their exposure and suspected serious hazard properties: persistent, bioaccumulative and toxic (PBT), carcinogenic, mutagenic and reprotoxic (CMR), or endocrine disruptors in combination with wide dispersive consumer use. Other concerns on the substances may also be identified during evaluation.

Source: ECHA News Release, 20 March 2018

The International Organization for Standardization (ISO) published its standard for occupational health and safety (OH&S) on 12 March 2018.

‘ISO 45001:2018, Occupational health and safety management systems – Requirements with guidance for use’ is intended to provide a robust and effective set of processes for improving work safety in global supply chains. Designed to help organisations of all sizes and industries, the new international standard is expected to reduce workplace injuries and illnesses around the world.

According to 2017 calculations by the International Labour Organization (ILO), 2.78 million fatal accidents occur at work yearly. This means that, every day, almost 7,700 persons die of work-related diseases or injuries. Additionally, there are some 374 million non-fatal work-related injuries and illnesses each year, many of these resulting in extended absences from work. This paints a sobering picture of the modern workplace, one where workers can suffer serious consequences as a result of simply doing their jobs.

It is hoped that ISO 45001 will change that. It provides governmental agencies, industry and other affected stakeholders with effective, usable guidance for improving worker safety in countries around the world. By means of an easy-to-use framework, it can be applied to both captive and partner factories and production facilities, regardless of their location.

ISO 45001 will replace OHSAS 18001, the world’s former reference for workplace health and safety. Organisations already certified to OHSAS 18001 will have three years to comply with the new ISO 45001 standard, although certification of conformity to ISO 45001 is not a requirement of the standard.

Source: ISO News Release, 12 March 2018