On 17 March 2020, Health Protection Scotland (HPS) updated their immunisation web pages to reflect the latest quarterly data on: 

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

On 11 March 2020, the World Health Organization (WHO) declared the outbreak of coronavirus disease COVID-19 a pandemic, reflecting the worldwide spread of this infection. The WHO produces daily situation reports, listing all affected countries and the number of confirmed cases.

Travellers to all destinations must be aware of how COVID-19 is transmitted, its symptoms, actions to take if symptoms develop and the risk factors for severe infection. Travellers can access information on COVID-19 on the fitfortravel and NHS Inform websites, while health professionals should access the TRAVAX website.

As of 12 March 2020, the Foreign and Commonwealth Office (FCO) advised against cruise ship travel for all British nationals aged 70 and over, and for those with pre-existing health conditions.

Recommendations for travellers

Prior to travel, the following should be checked: 

• The FCO website, for the latest country specific outbreak advice including: 
  • Any travel restrictions to a country. This advice is frequently updated, and must be checked regularly for the latest information. 
  • Entry requirements set by the destination country in response to COVID-19.  
  • Reports of COVID-19 at the destination and measures the country is taking in response to the outbreak. 
• Advice from healthcare practitioners, ensuring travellers receive any necessary health advice and vaccinations. This must happen at least four weeks in advance of travel, as courses of vaccines may take time. There is currently no vaccine available to protect against COVID-19.

In addition:

• Travellers should ensure they have travel health insurance and check the impact this outbreak may have on coverage. If the FCO advises against travel to a country and the trip still proceeds, travel insurance will be invalid.  
• Travellers should consider taking a  first aid kit, which should include some means of  checking body temperature. 
• If travelling with medication, ensure adequate supplies for the duration of the trip are taken and include extra for unforeseen delays, damage or loss.

The outbreak situation may change during travel, and local public health advice should be followed in this instance.

In attempting to prevent coronavirus infection during trips, travellers must: 

• wash their hands frequently and carefully, using soap, for at least 20 seconds. This must be done before eating, after visiting the toilet and before touching your face. If soap, clean water and towels are not available, alcohol hand rub (containing at least 60% alcohol) can be used 
• avoid touching eyes, nose or mouth unless your hands are clean 
• avoid close contact with people who appear unwell and their personal items

In addition, it should also be noted that there is currently insufficient evidence to support the use of facemasks as a way of preventing infection outside of hospitals.

If travellers become unwell during their trip, they should: 

• promptly seek out medical advice 
• call their travel health insurer for advice on health care cover 
• postpone any further travel until they are well again 
• follow good hygiene practices, such as covering their nose and mouth while coughing or sneezing, using tissues only once, disposing of them promptly and carefully, and washing hands frequently

Returning travellers who develop any symptoms of COVID-19 should follow advice on the NHS Inform website (Scotland) and the NHS.UK websites (rest of the UK).

Source: TRAVAX, 13 March 2020

The European Centre for Disease Prevention and Control (ECDC) has launched a toolkit to support the generation of robust prevalence estimates for hepatitis C virus (HCV) in EU/EEA member states.

Most European countries have a surveillance system for HCV in place that is based on routine notifications. EU/EEA countries are requested to upload surveillance data on HCV into the European Surveillance System (TESSy) on a yearly basis, using the EU case definitions. However, recent surveillance data reported to ECDC indicate that a few countries have experienced difficulties in providing any data on newly diagnosed HCV cases, and that for the majority of countries, completeness is an issue. Efforts to synchronise case definitions and differentiate between acute and chronic cases have been made, but so far have not been completely successful. Due to the differences in surveillance systems and the varying case definitions being used, the possibilities to interpret and compare HCV notification data across countries remain limited.

This toolkit has been developed with the aim of gaining a better understanding of the epidemiology of HCV in EU/EEA countries. A feature of the toolkit is a decision algorithm, which assists member states in selecting the type of survey that should be undertaken and provides modelled estimates of the national burden of HCV in individual countries.

Source: ECDC, 5 March 2020

Food Standards Scotland (FSS) has published new research on Campylobacter, the most common cause of bacterial food poisoning in Scotland, which provides evidence concerning those at greater risk of infection and severe illness, and the estimated healthcare cost of infection. Conducted between 2013 and 2019, this research was undertaken by Health Protection Scotland (HPS) and the University of Aberdeen, on behalf of FSS.

The research confirmed that, while a higher number of cases are reported in more affluent areas of Scotland, those living in the most deprived areas are at an increased risk of developing serious illness and being hospitalised.

The results showed that overall, around 14% of Campylobacter cases lead to hospitalisation, with hospital admissions more likely to have one or more of the following risk factors: 

• being 65 years or older 
• having an underlying medical condition 
• being prescribed with proton pump inhibitor to reduce stomach acid production in the 90 days prior to infection

The findings from this research have enabled public health authorities to estimate that, with approximately 6,000 cases reported per year, Scotland’s total annual healthcare cost for Campylobacter infections is approximately three million pounds.

The Food Standards Agency (FSA) has published a report presenting new estimates of the societal burden caused by foodborne illnesses in the UK.

The five-year study provides an in-depth understanding of the wider impacts of foodborne diseases such as norovirus, Campylobacter and Listeria. For the first time, the study also incorporates estimates based on the impacts of foodborne illness cases where a specific pathogen is not identified, often because people do not seek medical attention.

The new model, which produced the estimates, follow an established process used in the UK and internationally to assess the financial impacts and human costs, such as pain, grief, suffering and changes to quality and length of life. Estimates for these human costs were developed in part by surveying more than 4,000 people to produce monetised values to measure the impact of different foodborne pathogens. This process allows intangible human impacts to be considered alongside financial impacts, when decisions relating to foodborne illnesses are made.

Source: FSA, 12 March 2020

World Water Day, held annually on 22 March, is a United Nations Observance focusing on the importance of freshwater and raising awareness of the estimated 2.2 billion people living without access to safe water.

The theme for 2020 is water and climate change and how the two are inextricably linked. The campaign will show how changes to the way water is used could help reduce floods, droughts, scarcity and pollution. 

More information and resources are available on the World Water Day website.

A new European Environment Agency (EEA) report provides an overview of low-cost devices that citizens and non-governmental organisations (NGOs) can use to measure local air pollution levels.

The report addresses the following points:

• how such devices have been used by citizen science initiatives to answer questions about air quality 
• how low-cost passive air pollutant samplers and air quality sensors work 
• what the reliability of the different devices in measuring air quality is 
• how these devices can be used by individuals, within networks and on information service platforms 
• how such low-cost devices are stimulating new approaches to addressing air quality issues

The report demonstrates that citizen science initiatives can produce useful information about local air quality. This data may be used, for example, to improve official air quality models used to estimate pollution levels and identify suitable actions to improve air quality. The EEA do caution that the various types of measuring devices each have different advantages and disadvantages, and users should be aware of their limitations, such as low-cost sensors potentially lacking the capacity to measure very high or very low pollutant concentrations.

Source: EEA, 12 March 2020

The Scottish Environmental Incident Surveillance System (SEISS) recorded the following incident in the past week: 

• On 7 March 2020, BBC news reported the evacuation of a primary school in Milngavie, following a carbon monoxide leak. Pupils and staff temporarily left Craigdhu School after a newly fitted alarm picked up traces of the gas. The Scottish Fire and Rescue Service (SFRS) later confirmed that one of two gas boilers had developed a fault. This is the third primary school in East Dunbartonshire evacuated due to carbon monoxide leaks in recent weeks.

More detailed information can be found on the SEISS website.