The European Noise Directive (END) was adopted in 2004 and requires member states to bring about measures which are intended to avoid, prevent or reduce the harmful effects, including annoyance, due to exposure to environmental noise. The END was transposed through the Environmental Noise (Scotland) Regulations 2006

Every five years, the END requires the Scottish Government to produce strategic noise maps and thereafter prepare noise action plans based on the results of the noise mapping and then consult the public on these action plans. This consultation seeks the views of those individuals and / or organisations that hold an interest in noise pollution.

The consultation will run until 23 November 2018, after which responses will be evaluated and where appropriate the draft noise action plans amended. It is anticipated that the noise action plans will be formally approved early in 2019.

More information and the online consultation response form are available on the Scottish Government Consultation Hub

Glasgow launches new low emission buses 52/4211 Glasgow’s biggest bus operator, First Glasgow, has unveiled the first batch of 25 buses which have been fitted with cleaner engines ahead of the launch of Glasgow’s Low Emission Zone (LEZ) on 1 January 2019 (see current note 52/1305).

During phase one of the LEZ, 20% of a bus operator’s fleet is required to be compliant and a target of 100% has been set for the end of 2022. FirstGroup said it would cost nearly £100m to buy or convert buses so all those in the zone are at the Euro 6 engine standard. This will involve replacing or converting 450 of First Glasgow’s 850 vehicles. A further 50 compliant vehicles are also due to be delivered by November. In addition, ‘stop start’ technology means the bus engine will automatically switch off when the doors are open at bus stops, reducing exhaust fumes inhaled by pedestrians.

Source: REHIS, 15 October 2018

On 16 October 2018, the UK National Atmospheric Emissions Inventory (NAEI) published the ‘Air Pollutant Inventory Report for England, Scotland, Wales and Northern Ireland’. This report presents emission inventories for priority pollutants in the devolved administrations of the UK for the period 1990 to 2016.

In 2016, Scotland accounted for:

• 12% of UK ammonia (NH₃) emissions. Agricultural activity was responsible for 90% of this figure;
• 8% of UK PM₁₀ emissions. 32% of this figure came from combustion, 25% from industrial processes, 17% from transport sources and 15% from agriculture;
• 18% of UK non-methane volatile organic compounds (NMVOCs) emissions. Industrial processes (mainly breweries and distilleries) accounted for 48% of this figure, solvents and other product use 18% and fugitive emissions from fuels 14%;
• 8% of UK PM_2.5 emissions. 52% of this figure came from combustion and 21% from transport sources;
• 10% of UK nitrogen oxides (NO_X as NO₂) emissions. Transport sources accounted for 50% of this figure, combustion 31% and energy industries 16%;
• 7% of UK carbon monoxide (CO) emissions. Combustion accounted for 65% of this figure and transport sources 27%;
• 10% of UK sulphur dioxide (SO₂) emissions. 48% of this figure came from power generation, 29% from combustion and 18% from transport sources;
• 5% of UK lead (Pb) emissions. Combustion accounted for 42% of this figure, industrial processes 40% and energy industries 11%.

There are uncertainties associated with all estimates of pollutant emissions. The uncertainty ratings are ‘high’ for PM₁₀, PM_2.5 and lead, ‘moderate’ for ammonia and carbon monoxide and ‘low’ for nitrogen oxides, sulphur dioxide and NMVOCs. Low refers to the uncertainty of a particular pollutant being relatively low when comparing to the other pollutants and vice versa. However, although for any given year considerable uncertainties may surround the emission estimates, it should be noted that trends over time are likely to be more reliable.

Air pollutant emissions are reviewed every year, and the whole historical data series is revised to incorporate methodological improvements and new data.

The report is available on the NAEI website

Source: Scottish Government, 16 October 2018

Almost 10,000 sexually transmitted infection (STI) and HIV test kits, which could give unreliable and false results, have been seized by the Medicines and Healthcare products Regulatory Agency (MHRA) since 2015.

The MHRA are warning people to make sure that they are purchasing test kits from legitimate sources to avoid unreliable and false results. Fake test kits could potentially give false negatives and lead to an increase in diseases such as chlamydia, syphilis and gonorrhoea as well as HIV. A false negative test result occurs when the test shows negative and the person is instead positive.

Online marketplaces are a known avenue where potentially unsafe test kits are being sold. While MHRA works with companies to remove these types of products from sale, the next stage of the #FakeMeds campaign intends to educate people buying STI and HIV test kits online.

Approved self-testing kits carry a CE mark, illustrating that they have gone through the proper regulatory processes and, when used in accordance with their instructions, are safe to use. Approved kits should also clearly state they are intended for use as self-tests.

Separate MHRA research has revealed people are prepared to buy risky products over the internet. Approximately 25% of young people have bought medical products online in the past 12 months and around 9% admitted to buying products they knew, or strongly suspected, to be falsified. Around 63% of those surveyed bought STI test kits after reading articles about home testing kits on a website, forum or blog and 64% wanted to avoid the embarrassment of buying the kits in a shop or pharmacy.

Source: MHRA, 17 October 2018

A case of Bovine Spongiform Encephalopathy (BSE) has been confirmed on a farm in Aberdeenshire.

In-line with the disease prevention response plan, precautionary movement restrictions have been put in place at the farm, while further investigations to identify the origin of the disease occur.

All animals over four years of age that die on farms are routinely tested for BSE under Scotland’s comprehensive surveillance system. Whilst the disease is not directly transmitted from animal to animal, its cohorts, including offspring, have been traced and isolated and will be destroyed in line with EU requirements.

In addition to the measures for fallen stock and animal feed, there is a strict control regime to protect consumers. This includes the removal of specified risk material such as the spinal column, brain and skull from carcasses.

Food Standards Scotland (FSS) have confirmed there is no risk to human health as a result of this isolated case.

Source: Scottish Government, 18 October 2018

The European Centre for Disease Prevention and Control (ECDC) has published guidance on the management of latent tuberculosis infection (LTBI). The guidance is designed primarily for use in European Union/European Economic Area (EU/EEA) countries.

In October 2018, all United Nations (UN) member states pledged urgent action to end tuberculosis (TB) by 2030 (see current note 52/3904). Even in low-incidence TB regions such as Europe, this commitment will entail changes to improve TB management and prevention, especially concerning LTBI.

According to a recent study in PLOS Medicine, an estimated 1.7 billion people have LTBI, meaning that approximately a quarter of the world’s population have this ‘dormant’ form of tuberculosis. LTBI carriers are asymptomatic and not infectious, but the bacilli can spread at a later stage and result in TB. In low-incidence countries, a majority of TB cases occur due to the progression of LTBI to active TB disease. To fulfil the mandate of ending TB by 2030, thorough screening and treatment for LTBI needs to be implemented.

ECDC has created several guidance documents on screening strategies and management of LTBI. They are available on the ECDC website

Source: ECDC, 16 October 2018

The sixth annual World Polio Day takes places on 24 October 2018. Poliomyelitis is an acute enteroviral infection that mostly affects children under five years of age and in its most severe form the disease may result in permanent paralysis.

Since the Global Polio Eradication Initiative (GPEI) was launched 30 years ago, the incidence of polio has fallen by more than 99.9%, from about 350,000 cases a year to just 22 cases in 2017. World Polio day aims to celebrate this achievement and focus on the aim of eradicating polio.

More information is available on the End Polio website

A meeting of the International Health Regulations (IHR) Emergency Committee took place on 17 October 2018, in regard to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC), convened by World Health Organisation (WHO) Director-General, Dr. Tedros Adhanom Ghebreyesus. As of 16 October 2018, a total of 220 EVD cases (185 confirmed and 35 probable), including 142 deaths (107 confirmed and 35 probable) have been reported in seven health zones in North Kivu Province and three health zones in Ituri Province.

It was the view of the committee that a Public Health Emergency of International Concern (PHEIC) should not be declared at this time. However, the committee reports that it remains deeply concerned by the outbreak and emphasised that response activities need to be intensified and ongoing vigilance is critical. As a result of this discussion they issued additional public health advice including:

• prioritise the protection of health workers and facilities;
• special emphasis should be placed on the response in Beni and Butembo;
• efforts to link epidemiological data with real-time full genome sequencing should be supported to clarify chains of transmission;
• the granting of licences for vaccines should be urgently sought and efforts made to increase the limited global supply;
• neighbouring countries should accelerate preparedness and surveillance;
• exit screening, including at airports, ports, and land crossings, is of great importance. However, entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.

Source: WHO, 17 October 2018

The Food Standards Agency (FSA), Food Standards Scotland (FSS), Public Health England (PHE) and Health Protection Scotland (HPS) are reminding people to take care when handling raw meat and to cook it properly.

This comes at a time when investigations are ongoing into a rise in cases of a particular strain of Salmonella typhimurium which has been linked to lamb and mutton. The first increase in cases of this particular type was in July 2017. A number of control measures were put into place which led to a significant decline in cases at the end of that year. A total of 118 cases were reported up until May 2018.

Since June 2018, a further 165 cases have been reported (up to 19 October), which have led to control measures being put in place. However, this action has not led to the same decline in cases as in 2017. The likely cause of the increased numbers of this specific strain is considered to be meat or cross-contamination with meat from affected sheep.

People can be infected with Salmonella typhimurium in a number of ways such as not cooking meat properly, not washing hands thoroughly after handling raw meat or through cross-contamination with other food, surfaces and utensils in the kitchen.

Further advice for the public on the safe cooking of meat is available on the FSA website

Source: PHE, 19 October 2018

On 9 October 2018, French authorities reported that a case of locally-acquired dengue was identified in a patient living in St Laurent-du-Var, immediately to the west of Nice. The patient became unwell on 21 September and had not travelled outside the Provence-Alpes-Côte d’Azur in the previous 15 days.

Additionally, according to media quoting public health authorities, two residents of Alhama de Murcia in Spain have been diagnosed with locally acquired dengue. The two people became unwell in late August, having travelled within Murcia, as well as to Madrid and Cadiz. They had not travelled to any other country, leading public health authorities to conclude that the infection was acquired in Spain.

Aedes albopictus, the Asian tiger mosquito that transmits dengue virus, is common in both these European areas.

Information and advice for travellers on dengue is available from the TRAVAX (for health professionals) and fitfortravel (https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/dengue-fev... - for the general public) websites.

Source: TRAVAX, 10 October 2018 (Mainland France) and TRAVAX, 10 October 2018 (Spain)

Health Protection Scotland (HPS) have issued a reminder to travellers that an outbreak of extensively-drug resistant (XDR) typhoid continues in Pakistan. As reported by the Centers for Disease Control and Prevention (CDC), the XDR typhoid outbreak originated in Hyderabad in 2016, subsequently spreading to Karachi and multiple districts of Sindh Province. As a result, cases among travellers returning to the United Kingdom and the United States from Pakistan were reported in 2018.

Vaccination is recommended for travellers to high-risk areas where food and water may be contaminated. Vaccination in low-risk areas may be recommended only to those staying in conditions with poor sanitation and unable to maintain their own hygiene precautions e.g. hand hygiene and water purification.

Information and advice for travellers on typhoid is available from the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Health Protection Scotland (HPS) have today (23 October 2018) published a surveillance report on zoonotic disease in Scotland.

The report is available on our website