On 10 December 2019, Health Protection Scotland (HPS) updated their immunisation web pages to reflect the latest quarterly data on: 

• Haemophilus influenzae 
• invasive pneumococcal disease
• measles
• meningococcal disease
• mumps 
• rotavirus
• rubella
• shingles
• whooping cough

Norovirus is a common cause of infectious gastroenteritis that results in diarrhoea and vomiting. As it’s most common during the winter months, norovirus is sometimes known as the winter vomiting bug, but infections can occur at any time of year.

Norovirus is very easily spread from one person to another. Outbreaks of norovirus where more than two people are infected can commonly occur in places where people are in close contact with one another for long periods of time, such as hospitals, care hones, schools and cruise ships.

The best way to stop norovirus spreading is to ensure people: 

• stay at home for at least 48 hours after symptoms have stopped to avoid further spread 
• use soap and water for hand-washing as alcohol based hand rub may be ineffective against norovirus 
• wash their hands, particularly after contact with someone who is ill, after using the toilet and before preparing food

To find out more about norovirus and how to stop it spreading, visit the NHS Inform website.

In addition, norovirus campaign materials are now available with posters and leaflets being issued to boards. These materials and social media messages can also be viewed on the NHS Inform website.

The World Health Organization’s (WHO) World Malaria Report 2019 shows that in 2018, an estimated 11 million pregnant women were infected with malaria in areas of moderate and high disease transmission in sub-Saharan Africa. As a result, nearly 900,000 children were born with a low birthweight. However, an estimated 61% of pregnant women and children in sub-Saharan Africa were sleeping under insecticide-treated bed nets, compared with 216% in 2010, while access to preventive medicine for malaria has increased significantly in recent years.

Pregnancy reduces a woman’s immunity to malaria, making her more susceptible to infection and at greater risk of illness, severe anaemia and death. Maternal malaria also interferes with the growth of the fetus, increasing the risk of premature delivery and low birth weight, which are leading causes of child mortality.

Despite the encouraging signs seen in the use of preventive tools in pregnant women and children, there was no improvement in the global rate of malaria infections in the period 2014 to 2018.

Further details and guidance can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: WHO, 4 December 2019

Malaria is due to infection of with a Plasmodium parasite. Five species of Plasmodium regularly infect humans, Plasmodium falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi.

Of the five species, P. falciparum is the most severe and is responsible for most deaths. However, in recent years, P. knowlesi is increasingly giving cause for concern because it too can cause severe illness.

P. knowlesi is a natural parasite of macaque monkeys found in Southeast Asia and is classed as a zoonotic infection. So far there have been no recorded cases of P. knowlesi anywhere that macaques are not found.

Since 2004, there have been increasing reports of P. knowlesi in Malaysia, Thailand, Philippines, Vietnam, Indonesia and Myanmar and it is now the most common type of malaria found in Malaysia and Western Indonesia, countries that are nearing the elimination of malaria due to decrease in P. falciparum and P. vivax.

The mainstay of prevention of P. knowlesi is the same as for all other forms of malaria and is based around the A, B, C, D of malaria prevention advice. For travellers going to countries classed as ‘malaria free’ but where P. knowlesi is reported (Brunei and Singapore), antimalarials are not currently advised, but awareness of risk, bite avoidance and prompt investigation of fever are important.

Further information can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites. 

According to new estimates jointly published by the World Health Organization (WHO) and the Centers for Diseases Control and Prevention (CDC), more than 140,000 people died from measles in 2018 worldwide. These deaths occurred as measles cases surged globally, amidst devastating outbreaks in all regions.

The report finds that the countries with the highest incidence rate of the disease were the Democratic Republic of the Congo (DRC), Liberia, Madagascar, Somalia and Ukraine, and these five countries accounted for almost half of all measles cases worldwide.

Most deaths were among children under five years of age. Babies and very young children are at greatest risk from measles infections, with potential complications including pneumonia and encephalitis (a swelling of the brain), as well as the risk of lifelong disabilities such as permanent brain damage, blindness or hearing loss.

This year, the US reported its highest number of cases in 25 years, while four countries in Europe, Albania, Czechia, Greece and the UK, lost their measles elimination status in 2018 following protracted outbreaks of the disease. This happens if measles re-enters a country after it has been declared eliminated, and if transmission is sustained continuously in the country for more than a year.

More information on measles is available on the HPS website.

Source: WHO, 5 December 2019

Public Health England (PHE) has confirmed that an individual has been diagnosed with monkeypox in England. The patient is believed to have contracted the infection while visiting Nigeria and is receiving treatment in London. 

Monkeypox is a rare viral infection and has been reported mainly in central and west African countries. It does not spread easily between people and the risk to the general public is considered very low. While usually a self-limiting illness with most people recovering within a few weeks, severe illness can occasionally occur in some individuals.

Further information on monkeypox and related guidance is available on the PHE website.

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

Source: PHE, 4 December 2019

The European Food Safety Authority (EFSA) has launched an open consultation on its scientific opinion regarding public health risks related to the presence of Ochratoxin A (OTA) in food. OTA is a mycotoxin naturally produced by fungi such as the Penicillium and Aspergillus species.

OTA is found in a variety of foods including grains and grain products, preserved meats, fresh and dried fruits. It is also found in breast milk.

EFSA previously assessed public health risks related to OTA in food in 2006. Experts concluded that OTA accumulates in the kidney and is particularly toxic to this organ. At high doses, OTA also causes kidney tumours in rats. EFSA set a tolerable weekly intake (TWI) of 120 nanograms per kilogram of body weight. More information has since become available suggesting that OTA may be genotoxic and carcinogenic. In such cases, EFSA experts calculate a margin of exposure (MOE) for consumers. In general, the higher the MOE, the lower the level of concern for consumers. The estimated MOE for OTA is below 10,000 across most consumer groups, suggesting a possible health concern.

Interested parties are invited to submit written comments to EFSA's Panel on Contaminants in the Food Chain (CONTAM) by 24 January 2020.

Source: EFSA, 4 December 2019

Residents in high-rise properties are being given leaflets outlining how to prevent fires in the home and what to do if one starts in their building.

The advice, which is produced by the Scottish Government and the Scottish Fire and Rescue Service (SFRS) , is being delivered to high-rise homes from December and will also be available in libraries and community centres in all 15 local authorities with these property types.

Guidance has also been published for those responsible for fire safety in high-rise buildings, including councils, housing associations, owners and private landlords. Publishing such guidance was one of the recommendations of the Ministerial Working Group on Building and Fire Safety.

Source: Scottish Government, 4 December 2019

On 4 December 2019, the European Environment Agency (EEA) published its latest ‘State of the Environment’ (SOER 2020) report, which finds that Europe faces environmental challenges of unprecedented scale and urgency. SOER 2020 is the most comprehensive environmental assessment ever undertaken on Europe, providing a snapshot of where Europe stands in meeting 2020 and 2030 policy targets as well as longer term 2050 goals and ambitions to shift to a sustainable, low carbon future.

The report notes that Europe has already made significant progress over the past two decades in terms of climate change mitigation and reducing greenhouse gas emissions. Signs of progress are also evident in other areas, such as tackling air and water pollution and the introduction of new policies to tackle plastic waste and bolster climate change adaptation and the circular and bio-economy.

However, the report further argues that a change of direction is urgently needed to face climate change challenges, reverse degradation and ensure future prosperity. Nonetheless, the report states that there is reason for hope, amid increased public awareness of the need to shift to a sustainable future, technological innovations, growing community initiatives and stepped up EU action like the European Green Deal.

Source: EEA, 4 December 2019