On 11 June 2019, the World Health Organization (WHO) confirmed a case of Ebola virus disease in a family group in Kasese, Uganda. The case concerns a five-year old boy, travelling with his family, who died shortly afterwards. A further two cases of Ebola were detected in that family group shortly afterwards, one of whom also subsequently died. The family were identified at the Democratic Republic of Congo (DRC)-Uganda border as they returned from caring for a relative in neighbouring North Kivu, DRC. The remaining case and family contacts are currently being cared for in the DRC.

There are no cases of Ebola currently in Uganda, although a number of contacts are being vaccinated.

At a meeting of the Emergency Committee, convened by WHO Director-General Dr. Tedros Adhanom Ghebreyesus on 14 June 2019, it was noted that the cluster of cases in Uganda was not unexpected, but that this incident was a reminder of the risk of spread to neighbouring countries. The committee concluded, however, that while the outbreak is a health emergency in DRC and the region, it does not meet the criteria for a Public Health Emergency of International Concern (PHEIC).

For further information on Ebola virus disease, consult TRAVAX (for health professionals) and fitfortravel (for the general public).

Sources: WHO Africa, 11 June 2019, WHO Emergency Committee, 14 June 2019, TRAVAX and fitfortravel (both 12 June 2019)

Seasonal outbreaks of Cyclospora infection in UK travellers returning from Mexico have been reported, with the majority of cases in travellers who have stayed in the Riviera Maya and Cancun regions of Mexico. The source of infection was likely to be contaminated food items supplied to hotels throughout the area.

Cyclospora cayetanensis is a protozoan parasite that can infect humans, causing frequent, watery diarrhoea, abdominal cramping, bloating, nausea, flatulence, low-grade fever and loss of both appetite and weight. HIV-positive individuals and those with other immune deficiencies can be at risk of more severe infection.

On return from Mexico, travellers with any symptoms such as those described should seek medical attention and inform their GP of their travel history.

Healthcare practitioners should raise awareness of Cyclospora infection with all travellers to Mexico, and should strongly advise that travellers maintain a high standard of food, water and personal hygiene, even if staying in high-end resorts.

For further information on protozoan parasitic infection, including Cyclospora, consult TRAVAX (for health professionals) and fitfortravel (for the general public).

Sources: TRAVAX and fitfortravel (both 10 June 2019)

The European Centre for Disease Prevention and Control (ECDC) has published 2017 annual epidemiological reports for:

• Giardiasis - there were 19,437 confirmed giardiasis cases in the EU/EEA in 2017.
• Hepatitis B - in 2017, 30 EU/EEA member states reported 26,907 cases of hepatitis B virus (HBV) infection.
• Lassa fever - no cases of Lassa fever, or other infections by arenaviruses responsible for viral haemorrhagic fevers, were reported in the EU/EEA in 2017.
• Q fever - 1,023 cases of Q fever were reported in the EU/EEA in 2017, 932 (91%) of which were confirmed.
• Smallpox - declared eradicated in 1980, there were no reports of confirmed or possible smallpox in the EU/EEA or other countries for 2017.
• West Nile virus infection - in 2017, eight EU/EEA member states reported 208 West Nile virus (WNV) infections, of which 201 (97%) were locally acquired. Infections were reported from Austria, Bulgaria, Croatia, France, Greece, Hungary, Italy and Romania.

Source: ECDC, 12 June 2019

The top nine retailers across the UK have published their latest testing results on Campylobacter contamination in UK-produced fresh whole chickens, covering samples tested from January to March 2019.

The latest figures show that across the major retailers, an average of 3.5% of chickens tested positive for the highest level of contamination. These are the chickens carrying more than 1,000 colony forming units per gram (cfu/g) of Campylobacter.

The results come from retailers Aldi, Asda, Co-op, Lidl, Marks and Spencer, Morrisons, Sainsbury’s, Tesco and Waitrose.

Source: FSA, 13 June 2019

Clean Air Day in Scotland webpage provides a range of resources and expert advice for organisations to run their Clean Air Day events. The webpage also provides links to the following supporting agencies:

• Cleaner Air for Scotland (CAFS) strategy 
• Cycling Scotland 
• Energy Saving Trust Scotland 
• Greener Scotland

Source: Clean Air Day, 20 June 2019

A new World Health Organization (WHO) report, launched on 12 June 2019 at the WHO High-level Conference on Health Equity in Ljubljana, Slovenia, shows that intra-country inequalities in environmental exposure persist, or in some cases, may have increased.

Environmental risk factors account for at least 15% of mortality in the region, equivalent to about 1.4 million avoidable deaths per year. Significant improvement in environmental conditions has been made in most countries, but disadvantaged population subgroups can have five times higher exposure levels to environmental risk factors than advantaged subgroups.

The reduction of many environmental health risks shows that environmental interventions are effective in preventing health impacts, but these interventions often fail to protect vulnerable populations. The report documents 19 inequality indicators on urban, housing and working conditions, basic services and injuries. This evidence confirms that socially disadvantaged population subgroups are the most affected by environmental hazards, causing avoidable health effects and contributing to health inequalities.

Source: WHO Europe, 12 June 2019

The Food Standards Agency (FSA) has published an updated version of the UK Multi-Annual National Control Plan (MANCP). 

The purpose of the plan is to ensure that effective control systems are in place for monitoring and enforcing feed and food law, animal health and welfare rules, and plant health law.

The MANCP includes an overview of how authorities and other bodies work together to:

• safeguard public, animal and plant health 
• protect consumers 
• promote animal welfare

Source: FSA, 13 June 2019

European Food Safety Authority (EFSA) scientists have re-evaluated the safety levels of phosphates in food and estimated that total dietary intake may exceed their own safe levels. EFSA also recommend the introduction of maximum permitted levels to reduce the content of phosphates when used as additives in food supplements, as those who take them regularly may be at risk.

While phosphates are essential nutrients which are present naturally in the human body, and are an essential part of our diet, a group of substances commonly referred to as ‘phosphates’ are authorised as food additives in the EU. They are added to a wide range of foods for technological functions, such as emulsifiers and antioxidants. Some of them can be used in foods for infants and young children.

Dietary exposure was calculated from the total amount of phosphorus from all dietary sources and not limited to the levels in food additives reported by manufacturers. The scientists estimated that food additives contribute from 6% to 30% of the total average intake of phosphorus.

Source: EFSA, 12 June 2019

The work carried out by French Agency for Food, Environmental and Occupational Health & Safety (ANSES) has demonstrated health risks for hairdressing professionals and consumers when persulphates are used as ingredients in hair products.

Persulphate substances are used in different forms in hair bleaching products, such as powders to be mixed in a liquid, granules, creams, and ready-to-use liquids. Occupational exposure occurs by the respiratory and dermal routes, mainly during the preparation, application and rinsing of these products. Consumers can also be exposed, either when using bleaching products designed for home use or as hair salon customers.

Source: ANSES, 12 June 2019

New figures, published on 13 June 2019, reveal that Scotland’s national tree planting has exceeded targets, making a critical contribution to fighting the global climate emergency.  11,200 hectares of new planting was undertaken in Scotland in 2018, exceeding the 10,000 hectare annual target and contributing to 84% of UK-wide new planting.

Source: Scottish Forestry, 13 June 2019