On 21 August 2018, Health Protection Scotland (HPS) published the surveillance report ‘Shiga toxin-producing E. coli (STEC) in Scotland 2017: enhanced surveillance and reference laboratory data’.

Figures released by the European Centre for Disease Prevention and Control (ECDC) show that in June 2018, a total of 1,054 cases of measles were reported across 17 countries in the EU/EEA, a decrease from the 1,467 cases reported during the month of May. Five countries continued to report generally high case counts, but with a decreasing trend from the previous month: Italy (260), France (181), Greece (155), Germany (90) and the UK (89), none of which were in Scotland. Slovakia reported a marked increase with 72 cases, compared to 18 cases in May. Romania reported 111 cases, an increase from the 100 cases reported in May.

Looking at the situation over the past year (1 July 2017 to 30 June 2018), 13,234 cases of measles were reported across 29 EU/EEA member states. The highest number of cases were reported by Italy (3,341), Greece (3,193), France (2,740) and Romania (1,354), accounting respectively for 25%, 24%, 21% and 10% of all cases reported by EU/EEA countries.

Of 13,233 cases with known age, 3,924 (30%) were children less than five years of age, while 6,796 (51%) were aged 15 years or older.

Measles continues to spread across Europe because vaccination coverage in many countries is suboptimal. Only four EU/EEA countries reported figures of at least 95% vaccination coverage for both doses of measles-containing vaccine for 2017. If the goal of eliminating measles is to be reached, vaccination coverage for children and adults needs to increase in a number of countries.

The report, which also looks at levels of rubella for the same period, can be viewed on the ECDC website.

Source: ECDC, 13 August 2018

An unusual early start and high number of locally acquired West Nile virus infections have been observed this year. The European Centre for Disease Prevention and Control (ECDC) assessed the epidemiological situation and the risk to public health in the EU in a rapid risk assessment published on 13 August 2018.

In 2018, as of 9 August, EU member states had reported 231 human cases and EU neighbouring countries had reported 104 cases. The surveillance data gathered through seasonal monitoring indicates a higher number of West Nile virus infections compared to the same period in previous years. Additionally, these cases were reported earlier in the season.

Options for response include: 

• all persons in affected areas should take personal protective measures against mosquito bites 
• clinicians and public health professionals in both affected areas and as yet unaffected areas with suitable environmental conditions should be aware of the epidemiological situation to ensure early detection 
• clinicians are advised to include West Nile fever in the differential diagnosis for persons who have returned from affected areas 
• EU member states must implement 28-day donor deferral or test blood donors, after leaving an affected area, to prevent infection through blood transfusion

Advice and information is also available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: ECDC, 13 August 2018

The UK is currently working closely with the government of the Democratic Republic of the Congo (DRC), the World Health Organisation (WHO) and other partners to help tackle the latest outbreak of Ebola virus in the country.

The UK is providing expertise and support to help the government of the DRC and WHO respond effectively to this outbreak, which is occurring in a very insecure region. This response is enabling faster diagnosis and monitoring of the spread of the disease and is improving medical facilities and their capacity to treat patients. It will also protect health workers and raise awareness of the disease within local communities.

In addition, the UK is supporting the WHO to strengthen surveillance at borders and help neighbouring areas to prepare to tackle the disease should it spread.

Source: Department for International Development, 16 August 2018

Public Health England (PHE), Public Health Wales (PHW), Health Protection Scotland (HPS) and the Health Protection Service Northern Ireland (HPSNI) are investigating an increase in cases of Cyclospora cayetanensis infection in travellers who have recently returned from Mexico. This is the fourth successive year since 2015 that cases of the infection have been reported in travellers returning from Mexico.

As of 3 August 2018, 63 laboratory-confirmed cases of Cyclospora cayetanensis have been reported in England, Scotland and Wales. Where information is available, 55 (87%) report travel outside the UK, of which 49 (89%) report recent travel to Mexico. Where information is available, cases have stayed at several different hotels in the Cancun and Riviera Maya region suggesting the source is likely to be a foodstuff that has been distributed to hotels throughout the region.

Cyclospora cayetanensis is a protozoan parasite that infects humans and other primates. Infection can cause diarrhoea, abdominal cramping, nausea, flatulence, loss of appetite, fatigue, low-grade fever and weight loss. Infection without symptoms is also reported. Infections in HIV positive people and those with other immune deficiencies can be more severe.

Infection is commonly derived from food or water contaminated by human faeces. The foods commonly involved are soft fruits such as raspberries and salad products such as coriander, basil and lettuce. The risk of infection presented by imported foods is considered to be low.

Advice for travellers on the prevention of Cyclospora can be viewed on the fitfortravel website.

Source: UK Government, 13 August 2018

Proposals to promote cleaner domestic burning and cut pollution by prohibiting the sale of the most polluting fuels in England have been laid out in a consultation published on 17 August 2018.

The burning of wood and coal in the home is the largest single contributor to particulate matter pollution, identified by the World Health Organisation (WHO) as the most damaging air pollutant. Particulate matter is formed of tiny particles that can get into the body and lodge in major organs, causing short- and long-term health problems. Domestic burning contributes 38% of particulate matter pollution, compared with 16% from industrial combustion and 12% from road transport.

The UK government aims to ensure that only the cleanest fuels will be available for sale in the future. Delivering on a commitment in the government’s Clean Air Strategy, the consultation proposes preventing 8,000 tonnes of harmful particulate matter from entering the atmosphere each year by: 

• restricting the sale of wet wood for domestic burning 
• applying sulphur standards and smoke emission limits to all solid fuels 
• phasing out the sale of traditional house coal

The government also seeks to make sure that only the cleanest stoves are available for sale by 2022. This will bring benefits for consumers and householders as burning cleaner fuels and using these devices produces less smoke, soot and more heat.

Source: UK Government, 17 August 2018