The World Health Organization (WHO) has published the 2018 update of its treatment guidelines for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB), which provides information on how to improve MDR/RR-TB care. TB strains with MDR/RR are more difficult to treat than drug-susceptible TB and threaten progress towards eradicating the disease globally.

The new recommendations, based on the most recent available evidence, suggest new approaches on how to treat MDR/RR-TB. Injectable agents kanamycin and capreomycin are no longer recommended for longer MDR-TB regimens. Fully oral regimens are the preferred option for most patients, while fluoroquinolones (levofloxacin or moxifloxacin), bedaquiline and linezolid are recommended in longer regimens. 

Most regimens would include at least four agents likely to be effective in the first six months, then three thereafter. The proposed total duration of longer MDR-TB regimens is about 18-20 months.

Monitoring MDR-TB regimens with monthly culture offers the best option to detect a failing regimen in time for corrective action.

Detailed evidence summaries are available from the WHO.

Source: Eurosurveillance, 7 March 2019

Tuberculosis (TB) remains the world’s deadliest infectious killer. Each day, nearly 4,500 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease. Global efforts to combat TB have saved an estimated 54 million lives since the year 2000 and reduced the TB mortality rate by 42%.

To accelerate the TB response in countries to reach targets, heads of state came together and made strong commitments to end TB at the first-ever UN high level meeting in September 2018.

The theme of World TB Day 2019 is ‘It’s time’, which focuses on the urgency to act on the commitments made by global leaders. 

Further information about World TB Day can be found on TRAVAX.

Source: WHO, 24 March 2019

Scarlet fever is usually a mild illness but it is highly infectious. Public Health England (PHE) is advising parents to be on the lookout for symptoms, which include a sore throat, headache and fever with a characteristic fine, pinkish or red body rash with a sandpapery feel. 

The latest report by PHE shows that 6,316 cases of scarlet fever have been reported since mid-September 2018, compared to an average of 6,680 for the same period over the last five years. There were 409 cases reported for the period 18-24 February 2019.

Early treatment with antibiotics is important as it helps reduce the risk of complications such as pneumonia and the spread of the infection to others. Children or adults diagnosed with scarlet fever are advised to stay at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others. 

Source: UK Government, 28 February 2019

The Institute of Epidemiology, Disease Control and Research (IEDCR) reports Nipah virus has caused five deaths in the northwestern Thakurgoan district of Rangpur Division, Bangladesh. People have been warned to avoid drinking raw palm sap, which may be contaminated by Nipah virus.

Further information and advice on Nipah virus and travel to Bangladesh is available to view on the Travax (for health professionals) and fitfortravel (for the general public) websites.

Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) and Global Action Plan have launched a Clean Air Hospital Framework (CAHF), a strategy aimed at improving air quality in and around hospitals, in order to create a healthier environment for patients, visitors, staff and the local community.

The CAHF aims to reduce the amount of air pollution the hospital community is exposed to. As part of this aim, seven key areas are examined including travel, procurement and supply chain, local air quality, and communication and training. The framework group hopes the wider NHS community will champion the framework, so patients and communities across the UK can benefit.

Source: UK Health Alliance on Climate Change, 6 March 2019

In the World Health Organisation (WHO) European region, women make up the majority of the health workforce, surpassing the 50–50 gender breakdown for physicians and other segments of the health workforce. Health systems in the region rely on the contribution of millions of female health workers, and informal or unpaid health care is generally carried out by women in the region, with women performing three times more unpaid healthcare than men.

In some areas, female employees face barriers to achieving leadership positions, accessing income equality and overcoming gender stereotypes about the kind of health-care roles they are expected to fill.

The theme for International Women’s Day 2019, ‘Think equal, build smart, innovate for change’, hopes to underscore the importance of females in building inclusive systems, efficient services and sustainable infrastructure in health care.

Source: WHO Europe, 7 March 2019

A number of national and international conferences have been identified from a variety of sources. This note is to keep readers informed of the range of meetings being held around the world and is not necessarily a comprehensive list. 

• 13-14 March 2019 12th World congress on Virology & Infections Diseases (Singapore, Singapore)
• 18-19 March 2019 Seventh International conference on HIV/AIDS, STDs, & STIs (New York, USA)
• 26-28 March 2019 Foodborne pathogens & whole genome sequencing: impact on public health protection (Paris, France)
• 9-10 April 2019 WHO European High-level Conference on Non-communicable Diseases: Time to deliver (Ashgabat, Turkmenistan)
• 10-12 April 2019 Third International Conference on Influenza and Emerging Infectious Diseases (Toronto, Canada)
• 11-12 April 2019 Wellcome Meeting on Genomics of Rare Disease (Hinxton, Cambridgeshire)
• 12-14 April 2019 Environmental Health Symposium (Scottsdale, Arizona, USA)