HPS Weekly Report
15 Jan 2019
Volume 53 No. 02
Measles and rubella elimination strategy
A new measles and rubella elimination strategy maps out how the UK can achieve a future that is free of measles, rubella and congenital rubella syndrome (CRS). The strategy, developed by Public Health England (PHE) and partners including Health Protection Scotland (HPS), builds on the experience and success of 50 years of measles vaccination and 30 years of the measles, mumps and rubella (MMR) immunisation programme.
New analysis conducted by PHE shows that immunity levels within some age groups, especially young people aged 15 to 20 years, are well below the levels needed to prevent measles from spreading. Measles is one of the most infectious known diseases, so it can take only one infected person in an area with lower vaccination rates to cause an outbreak. Anyone who has not received two doses of MMR vaccine, which ensures full protection from measles, is at risk.
The World Health Organization (WHO) confirmed that the UK eliminated rubella in 2015 and measles in 2016. Whilst elimination means that measles and rubella are no longer native to the UK, it does not mean that these diseases have been completely eradicated. Measles and rubella remain endemic in many countries and with recent measles outbreaks across Europe, imported infections pose a very real threat to the UK’s achievements.
The strategy focuses on four core components required to maintain elimination of measles and rubella:
- achieve and sustain over 95% coverage with two doses of MMR vaccine in the routine childhood immunisation
- achieve over 95% coverage with two doses of MMR vaccine in older age groups
- strengthen measles and rubella monitoring
- ensure easy access to high-quality, evidence-based information for health professionals and the public
Green Book: yellow fever chapter updated
Public Health England (PHE) has updated the yellow fever chapter of the Green Book. The vaccine contraindications section has been revised to clarify the advice regarding thymectomy and incidental thymectomy.
The updated version of chapter 35 is available in the Green Book.
Thymectomy is addressed in the Travax yellow fever FAQ (for health professionals), which has been updated to reflect the changes to the Green Book.
Recent media reports have highlighted the case of a man aged over 60 years of age who has died, apparently after an adverse reaction to the yellow fever vaccine. The risk of adverse reactions to yellow fever vaccine, although very rare, is greater in those aged over 60 years. Risk assessments of travellers and discussion of vaccination risks are imperative, and must be undertaken prior to the administration of the vaccine.
WHO reports long-term progress on tuberculosis prevention and care in Russia
The World Health Organisation (WHO) and the Ministry of Health of the Russian Federation have worked closely over two decades to develop effective strategies for tuberculosis (TB) prevention and care.
Through the High-level Working Group (HLWG) on TB established in 1999, more than 30 Russian Federation and international non-governmental organizations have worked in partnership to make progress towards ending TB.
The HLWG has engaged in a range of TB control activities and projects, which have helped create a sharp decline in TB mortality and incidence in Russia, with an average annual decline of 16% in mortality and 6% in incidence in the last decade.
The HLWG’s activities have covered infection prevention in TB treatment centres, laboratory diagnostics, surveillance and monitoring of TB, professional training for specialists, awareness raising measures, provision of psychosocial support to enhance TB treatment and more.
WHO Europe continues to support the Russian Federation in fully implementing the Tuberculosis Action Plan for the WHO European Region 2016–2020. The action plan sets a regional goal of ending the spread of drug-susceptible and drug-resistant TB by achieving universal access to prevention, diagnosis and treatment in all countries of the region.
Source: WHO Europe, 9 January 2019
Guidance for Scottish local authority officers on the production of cheese from unpasteurised milk
The Scottish Food Enforcement Liaison Committee (SFELC) has endorsed guidance produced by their Joint Specialist Cheese and Risky Foods Short-Life Working Group on the production of cheese from unpasteurised milk.
The guidance aims to control the microbiological risks in the production of artisan cheeses made from unpasteurised milk, specifically Shiga toxin-producing Escherichia coli (STEC). The guidance applies to all establishments producing cheese made from unpasteurised milk from cows, goats, sheep and buffalo.
Cheese made from unpasteurised milk has been linked to outbreaks of human illness and in particular, illness caused by STEC organisms including E. coli O157. The guidance has been developed in relation to the control of STEC and is intended for use during the inspection and enforcement of food safety controls applied by cheesemakers producing cheese made from unpasteurised milk.
The guidance reflects current scientific knowledge and understanding in relation to STEC and the production of cheese from unpasteurised milk. As scientific information and evidence on STEC evolves, the guidance will be reviewed. In addition, the guidance will complete a pilot implementation phase before a scheduled review.
The guidance is available to view on the Food Standards Scotland website.
Details of a recent report on pathogen risks in unpasteurised cheese in Scotland can be viewed on the HPS weekly report, current note 52/5006.
Greenhouse gases from Scottish industry at a ten year low
The latest annual mass pollutant figures published by the Scottish Environment Protection Agency (SEPA) show that greenhouse gases emitted by Scottish industry are continuing to fall.
The figures are published online in the 2017 Scottish Pollutant Release Inventory (SPRI) and show how the pollutants emitted by Scottish regulated businesses are changing as the country continues to move to a more sustainable, resource efficient Scotland.
Greenhouse gas levels have reduced 57% since 2007 when 26 Megatonnes (Mt) of pollutants were released. The 2017 total was 11 Mt. The largest drop came in 2016, as Longannet powerstation was only operational for the first few months of the year. There was a further reduction of 6% (just under 1 Mt) in 2017 in the first full year with no emissions from the plant.
The data is available to view on the SPRI website.
Source: SEPA, 7 January 2018.